The toxic atmosphere within the VA is shattering trust and jeopardizing the mission of caring for those who have served our country — and it needs to stop. As health care providers within the Veterans Health Administration, we find ourselves alarmed by the current climate within our agency. Mass terminations have created an environment of fear. Executive orders have sown confusion and threaten the well-being of both VA staff and the Veterans we serve. We have been urged to report on our colleagues for even daring to use the word “transgender” in official communication.
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This is not only unprofessional—it’s unethical. Our Veterans deserve better than a workforce divided by fear and suspicion. Most disturbing, the latest government directives have turned dystopian for transgender Veterans, who are being denied the care they need.
Related: Veterans Affairs clinicians sign letter against Trump's ban on trans vets' care: ‘There is resistance’
It happened in small steps, as oppression often does. Staff pronouns were eliminated from bios. Education resources were axed. We were instructed to remove Pride flags from our hospitals and clinics, and to find and report use of the acronym “LGBTQ+.” The words trans and gender were removed from all external publications. Afraid for their jobs, some staff members began to alter their behavior beyond this required censorship, too frightened to stand by the fundamental values of compassion and inclusivity that the VA once stood for.
On March 17th, VA Secretary Doug Collins announced that the VA will phase out gender-affirming care for Veterans. Directives quickly followed requiring us to stop new hormone therapy prescriptions and referrals for gender-affirming care. As health care providers, we are furious. We know that gender-affirming care saves lives. With starting hormone therapy, we have seen Veterans pulled back from the brink of suicide and witnessed decades of suffering lift.
Veterans have made sacrifices in body and soul for our country. In return, our government promises to care for those who have borne the battle. The VA’s mission is to honor their service, to treat them with dignity, and to provide comprehensive and compassionate medical and mental health care. This includes gender-affirming care, which is evidence-based and life-saving. These new directives break this promise. We are failing our Veterans.
To our government: we call on you to get out of our lane and leave the medical decision-making where it belongs—between clinicians and patients. Over the years, Veterans have fought hard for the medical care they need, from care for Agent Orange to military sexual trauma. Thanks to their efforts, the VA has made strides on treating post-traumatic stress disorder, reducing Veteran suicide, managing toxic exposures, and providing reproductive and gender-affirming care. We must uphold these advancements for all Veterans.
Veterans—especially those who are transgender—now live in fear. Despite their sacrifices, they are losing access to crucial medical care. Many are afraid to seek care at all, terrified they’ll be targets of humiliation or violence. They fear further cuts—to their disability benefits, their pensions, their housing support. These individuals served our country with honor, only to be abandoned by the system that is supposed to care for them.
To our Veterans: please know that we vehemently oppose these orders, and that even in this darkness there is resistance. As your health care providers, we will not stand by while policies erode the respect that you so richly deserve. We will not forsake the oath we took to provide care regardless of religion, nationality, race, age, gender, sexual orientation, disabilities, party politics, or social standing. Know that we are working to ensure that gender-affirming care remains available, along with every other component of comprehensive care, and we will find ways to get you the care you need. Know that we are fighting back.
In the meantime, please take care of yourselves and each other. It seems that our leadership has forgotten its responsibility to honor all who served, but your VA providers have not. We will continue to treat you with the respect and dignity you were promised when you sacrificed in service of our country. Here, in our clinics and hospitals, you are welcome, and you are not alone.
Signed by 116 VA clinicians across 21 states and the District of Columbia, including chaplains, pharmacists, psychologists, program coordinators, physicians, dieticians, researchers, social workers, nurses, nurse practitioners, peer support specialists, physical therapists, and post-doctoral fellows. Their identities remain anonymous to avoid retaliation.
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