Major Evan Young, a retired U.S. Army officer, joined the military in 1989 during an era which barred him from disclosing his sexual orientation.
“I was a lesbian at that time so I was used to being in the closet,” Young says.
Just as the gay rights movement was taking root, then-President Ronald Reagan in 1982 issued a stern directive to the U.S. Department of Defense stating that anyone serving in the military who engaged in homosexual acts or professed to be lesbian, gay or bisexual would be immediately discharged.
A decade later President Bill Clinton issued a new directive, one that became a metaphor for a generation that found persecution based on sexual orientation to be increasingly unacceptable, even as violence and legal segregation persisted. The directive barred military applicants from being asked about their sexual orientation: If superiors don’t ask, and subordinates don’t tell, everyone may move forward without conflict.
The effect was to force lesbian, gay, bisexual and transgender (LGBT) people serving in the military to keep a large part of themselves concealed, and under President Barak Obama “Don’t Ask, Don’t Tell” was finally rescinded. Gay service members may now marry, live with, and share benefits with their same-sex spouses.
But it wasn’t until this summer, on June 30, that the U.S. Department of Defense announced that transgender Americans could also sign up and serve. Arkansan Evan Young was ecstatic.
He transitioned to male beginning five years ago, and today he serves as national president of the Transgender American Veterans Association (TAVA).
“We don’t have to hide who we are or worry about losing our careers, or our lives,” he says.
As a woman in the military, Evan Young was a successful soldier, finally achieving the rank of U.S. Army Major. Before he retired in 2013, he was based in Colorado specializing in public affairs for the North American Aerospace Defense Command and the U.S. Northern Command.
Today, Young raises his twin daughters, whom he carried prior to his medical transition.
Young and two other transgender veterans petitioned the U.S. Department of Veterans Affairs last spring to change the rule that categorically excludes sexual reassignment surgery for transgender veterans. Lambda Legal, based in Washington, and the Transgender Law Center along with co-counsel WilmerHale law firm filed the petition.
Evan Young admits that both the Central Arkansas Veterans Health Care System in Little Rock and the Veterans Health Care System of the Ozarks in Fayetteville are generally supportive of LGBT veterans—but problems persist.
“Specifically, the administration is transphobic and homophobic,” he says, referring specifically to an administrator within the Central Arkansas Veterans Health Care System whom he says refused to accommodate treatment for complications due to one of his final gender confirming surgical procedures: his penile implant, performed at the University of Chicago Medical Center, broke in late March.
“I have a rod that is essentially poking me everywhere and could be causing infection,” and the state’s veterans’ care providers aren’t giving him the help he’s entitled to, he says.
The V.A. doesn’t pay for sex reassignment surgery, but under its plans, transgender veterans have the right to receive V.A. coverage for pre-and-post op gender confirming surgical care. Evan Young says his failed phalloplasty, which he paid for with private insurance, occurred within the 10-week window for post-operative care.
And Young insists he’s followed post-surgical protocols. “I’ve not engaged in any sexual intercourse,” he says.
But rather than pay out of pocket to have the broken prosthetic repaired, Young bit the bullet, pushing the Central Arkansas V.A. to refer his case, so that he would be covered by the USDVA health care system.
We contacted the Central Arkansas Veterans Health Care System press office for comment. Within hours of that query, Evan Young says he was contacted by staff stating his case would be resubmitted for approval.
Four days later, he got another call. “The National Office (USDVA) has reconsidered my case,” he says, “and I’m now approved for surgery to repair or replace my broken prosthetic.”
Matt Boone, acting Chief of Ambulatory Mental Health at the Central Arkansas Veterans Health System, where he’s a member of the transgender clinical team, says it takes time to build staff tolerance when it comes to LGBT health care.
“We consider ourselves a culturally competent health care provider,” he says. “That being said, there’s going to be variation amongst all the thousands of staff we have here, in understanding best evidenced-based care and how to provide respectful care.”
Central Arkansas Veterans Health Care System Psychologist Renee Gibbs serves as transgender clinical coordinator at the Little Rock V.A. She says all veterans who come to the facility receive treatment for transition care (where applicable). That includes a mental evaluation, hormone therapy, even legal counseling.
“They also meet with an endocrinologist, a specialized primary care provider and a speech pathologist. So we provide a a full menu of care for transgender veterans. We also offer support groups—and educate staff on how transgender veterans should be treated.”
Margaret Moore, LGBT Veteran Care coordinator at the Little Rock V.A., says her medical system has gotten high marks from the nation’s top LGBT civil rights advocacy group, the Human Rights Campaign.
“Under HRC’s Health Care Equality Index, we became a leader in 2013 and have maintained that status each year,” she says. “And we continue to make improvements.”
The Veterans Health Care System of the Ozarks in Fayetteville has also been listed on the Human Rights Campaign health care equality index.
“We serve all that have served and we are inclusive,” says Amy Tucker, LGBT Veteran Care Coordinator.
The Fayetteville V.A. prides itself on providing culturally and clinically competent care for all LGBT vets. It’s hosted annual forums, and reportedly, staff have marched in local gay pride parades.
“Being seen in public,” Tucker says, “will make vets feel more comfortable, knowing we are here for them.”
Seventy-year old retired Sgt. First Class Denny Meyer refers to himself as a “gay patriot,” having served two tours of duty during the Vietnam conflict. Based in New York City, Meyer works as public affairs officer for American Veterans for Equal Rights, the oldest LGBT veterans civil rights group in America. Meyer says V.A. hospitals vary in providing equal medical treatment to LGBT vets, but “they are trying thru national directives to provide good care.”
Unfortunately, “individual providers and doctors … have their own rules — [some] in violation of federal regulations.”
Denny Meyer also serves as a consultant to the U.S. Department of Veterans Affairs’ LGBT healthcare program, begun four years ago. The initiative urges veterans to “come out” to their provider, disclose their identity and secure appropriate, comprehensive medical care. But many still remain in the closet, he says.
“LGBT veterans, particularly older ones, are afraid of being discriminated against.”
But Arkansas transgender veteran Evan Young, the president of the Transgender American Veterans Association, says he will remain on the front line, along with two other transgender vets, petitioning the U.S. Department of Veteran Affairs to repeal a rule that excludes sex reassignment surgery for transgender veterans.
“Gender confirming surgery by American medical standards,” he says, “is medically necessary.”
That is, a necessary treatment for many with gender dysphoria, a chronic discomfort with one’s sex, assigned at birth.
The American Psychological Association also recognizes the “efficacy, benefit and medical necessity of gender transition treatments for appropriately evaluated individuals and calls upon public and private insurers to cover these medically necessary treatments.”
Evan Young is among an estimated 134,000 transgender veterans nationwide, along with 1.4 million lesbian, gay and bisexual veterans who rely on their local VA hospitals for comprehensive health care.
