Every morning at the Veterans Affairs hospital in Tucson staff and patients stop in their tracks, stand at attention and salute while the national anthem plays on loudspeakers overhead.
Thousands of veterans come to the palm tree-adorned, Spanish-style campus seeking medical care each year. And now, the Tucson VA is one of the first hospitals in the country to open a clinic devoted specifically to the needs of Veterans like Sue McConnell.
“In 1994 I was diagnosed with PTSD," McConnell said, speaking at the Tucson VA. "I was also dealing with the fact that I was a woman."
McConnell came out as transgender while serving with the Navy in Vietnam, which meant leaving the military. Coming out took a personal toll as well, and her family has shunned her. But, she says she simply had no choice.
“I had to be who I am, no matter the cost,” she said.
Treating Dysphoria, Not A Disorder
McConnell is one of more than 130 transgender veterans receiving treatment at the Tucson VA. Because of the high demand for these services, the women’s clinic at the hospital is now devoting one day a month to the expansion of care for transgender veterans.
Dr. Sonia Perez-Padilla is the director of the women’s clinic at the Tucson VA. She’s now also in charge of the transgender clinic, which includes a psychologist, social workers, clinical pharmacists and a therapist.
“We have been flooded with phone calls since we’ve announced that the clinic will be opening," Perez-Padilla said. "Patients from all over wanting to know about it – to be able to take advantage of this opportunity.”
In 2011 the VA central office issued a directivethat all Veterans Affairs hospitals begin to provide care for transgender veterans. That’s when Perez-Padilla’s women’s clinic began offering treatment for Gender Dysphoria, which replaced the previous diagnosis of Gender Identity Disorder.
“There’s nothing wrong with these Veterans," Perez-Padilla said. "They’re unhappy because there’s a mismatch between who they are and their biological organs, but it’s not a disorder at all.”
Aside from hormone treatment and psychiatric care, the clinic offers a peer support group – something Veteran Sue McConnell found helpful as she attempted to embrace her true identity.
“The transgender support group gives us an outlet where we can talk about things that we need to talk about," McConnell said. "Clothing, make-up. You know, how to dress, how to act.”
But, she says the best therapy is knowing she’s not alone.
“It’s kinda like ‘Oh, wow, there is somebody else like me,'” McConnell said.
Despite Progress, Discrimination Persists
Evan Young is a retired Army major and president of the Transgender American Veterans Association. He says with so much recent attention paid to gays and lesbians in the military, he feels transgender service members and veterans have been overlooked.
“When 'don’t ask don’t tell' was repealed we kinda got left back in the closet,” Young said. “I get calls, daily, from veterans that have experienced discrimination.”
While gays and lesbians can now serve openly in the military, transgender people still can’t. However, Secretary of Defense Ash Carter created a working group in 2015 that is charged with ending the ban. And the VA issued another directivein 2013 clarifying and extending the range of procedures their hospitals are to provide to trans vets.
But Young says despite the progress, transgender veterans are still turned away at some VA hospitals.
“For a lot of people, it’s your last hope, and when you get that crushed, there’s nowhere else to go,” Young said.
Many veterans’ hospitals around the country offer a range of services for trans vets, but the Tucson VA, as well as the VA in Cleveland, Ohio, are among the few that offer a standalone clinic.
'We Serve All Who Have Served'
While the VA offers pre- and post-operative treatment for trans vets, they do not cover the cost of, or perform, gender reassignment surgery. Perez-Padilla says covering the surgery would be the next logical step as the VA moves to providing equal care to everyone.
“If a veteran has an onset of cancer or a heart condition and needs a transplant – anything that might arise after they’ve served – we take care of it," Perez-Padilla said. "We serve all who have served.”
Because, Perez-Padilla says, regardless of gender identity, all of her patients identify as veterans.