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Am J Public Health. 2014 Sep;104 Suppl 4:S532-4. doi: 10.2105/AJPH.2014.302086.

Access to care for transgender veterans in the Veterans Health Administration: 2006-2013.

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Michael R. Kauth and Jan Lindsay are with VA South Central Mental Illness Research, Education, and Clinical Center, Michael E. DeBakey VA Medical Center, Houston, TX. Jillian C. Shipherd is with VA Boston Healthcare System, Boston, MA. John R. Blosnich is with the VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion, Pittsburgh, PA. George R. Brown and Kenneth T. Jones are with the Office of Health Equity, Department of Veterans Affairs, Washington, DC.


A 2011 Veterans Health Administration directive mandated medically necessary care for transgender veterans. Internal education efforts informed staff of the directive and promoted greater access to care. For fiscal years 2006 through 2013, we identified 2662 unique individuals with International Classification of Diseases, Ninth Revision diagnoses related to transgender status in Veterans Health Administration medical records, with 40% of new cases in the 2 years following the directive. A bottom-up push for services by veterans and top-down education likely worked synergistically to speed implementation of the new policy and increase access to care.

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