The U.S. Department of Veterans Affairs (VA) has changed its policy to prohibit VA doctors from completing forms and letters of support for gender-affirming surgeries for transgender veterans, even when they are seeking care privately at their own expense. The new directive, VHA Notice 2025-01(1), “providers are not permitted to complete non-VA documentation for the purpose of gender alteration surgery.” According to clinicians speaking anonymously, the policy shift effectively cuts off access to surgical care outside the VA system, since many external providers and insurers require supporting documentation from a patient’s existing physician. Previously, VA doctors could provide that support. One doctor described the change as both harmful and inconsistent with VA’s publicly stated commitment to serve the veterans who rely on them. Because the VA does not perform gender-affirming surgeries itself, many transgender veterans rely on private providers. The amendment was inserted quie...