The Transgender American Veterans Association (TAVA) filed a federal lawsuit on Thursday against the US Department of Veterans Affairs (VA), in which they are asking the VA to provide gender-affirming medical care to transgender veterans. Filed in the US Court of Appeals for the Federal Circuit, the lawsuit comes months after a demand letter was sent to the VA on Transgender Day of Remembrance in November 2023. In the letter, TAVA demanded that the VA grant or deny the order within 30 days to avoid suit.

“Three years ago today, President Biden repealed the military’s ban on transgender service members. Yes, when we return from service, we do not receive the same level of healthcare from the VA that other veterans do,” said President of TAVA Rebekka Eshler in a press release. “The natural step toward transgender people’s true inclusion in the military is for the VA to remedy this gap. Transgender veterans have waited far too long for the VA to provide the gender-affirming surgery so many of us need to survive.”

In TAVA’s lawsuit, they note that gender-affirming surgery is a necessary step in living a desired gender role. TAVA cites to several sources that allege that the association of gender-affirming surgery on reducing depression, psychological distress and suicidal ideation.

“[The] VA’s failure to provide gender-affirming surgey has been dangerous for me more than my time in the service. Without VA coverage for this surgery, I was finanicially out of options. I tried to perform my own gender-affirming surgery at home, without any medical training,” said Natalie Kastner, a TAVA member. “Were it not for the emergency room care, I would have lost my life. I was told that the VA would take care of me because I was willing to risk my life for this country. Instead, I was safer in the service than I am now.”

TAVA’s lawsuit argues that the nearly eight-year delay in responding to their rulemaking petition is a violation of the Administrative Procedure Act, which requires that agencies respond in a reasonable time to any matters presented to them. In filing the petition, TAVA asks the court to compel a formal repsonse from the VA on its 2016 petition and to require the VA to provide an answer on this matter within a reasonable time.