The Directive was very clear that medical records will now reflect an individual’s self-identified gender. However, the policy also indicated that the individual must provide official documentation as per Veterans Health Administration policies in order to change the gender marker. This was initially interpreted incorrectly by some staff and facilities to require proof of sex reassignment surgery.
The VA has now clarified that this policy is intended to mirror the State Department passport policy. Effective immediately, to change the gender on VHA medical records, a vet must simply provide a letter from a physician certifying that the vet has changed genders and has had appropriate clinical treatment for gender transition. To be clear, the physician’s letter does not need to certify that some specific surgery or any particular medical procedure has been completed—only appropriate clinical care for the individual veteran as determined by the physician.