Sept. 13, 2018
Family Research Council has submitted public comments urging the Department of Veterans Affairs to retain a regulation that prohibits “gender alterations” (hormone therapy and gender reassignment surgery) from being funded by taxpayers as part of the VA’s medical benefits package.
The VA had received a “Petition for Rulemaking” from transgender activists urging that it lift the restriction, which is found in 38 CFR 17.38(c)(4).
The comment, written by FRC Senior Fellow for Policy Studies Peter Sprigg, said that the cost of these procedures would be exorbitant, and there is no convincing scientific evidence that they are effective in improving mental health or reducing suicide rates among those who undergo them.
A synopsis of the comments stated:
VA benefits should be aimed at the direst, most life-threatening needs first. They should not go to surgery on physically healthy individuals who elect to alter their physically healthy bodies.
In 2016, the Centers for Medicare & Medicaid Services (CMS) issued a memo declining to issue a National Coverage Determination (NCD) mandating coverage for gender reassignment surgery. They declared that “there is not enough high quality evidence to determine whether gender reassignment surgery improves health outcomes.” What CMS was unwilling to do for Medicare recipients, the VA should not be doing for recipients of VA medical benefits.
Advocates for taxpayer funding of medical gender transition claim that it will reduce the mental health problems and risk of suicide that are known to exist at higher levels among those who identify as transgender. However, one of the strongest studies ever done on the subject, a 2011 study out of Sweden (Dhejne et al., PLoS ONE) did not support such a conclusion. The CMS memo stated:
The study identified increased mortality and psychiatric hospitalization compared to the matched controls. The mortality was primarily due to completed suicides (19.1-fold greater than in control Swedes), but death due to neoplasm and cardiovascular disease was increased 2 to 2.5 times as well. . . . The risk for psychiatric hospitalization was 2.8 times greater than in controls even after adjustment for prior psychiatric disease (18%).
Finally, the exorbitant cost of these procedures can hardly be justified for so little benefit. Data from the Philadelphia Center for Transgender Surgery suggests that a comprehensive package of male-to-female surgical procedures would cost $110,450, and female-to-male procedures would cost $89,050. That’s not to mention hormone treatment, which is required indefinitely and can cost as much as $200 a month.