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Additions to VA Care

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I was at my local VA hospital this morning, and I met my VA LGBTQ VCC. She let me know the VA is now offering orchietomies. They need a letter from the mental health provider, legal name change, and one year on HRT. To get this procedure approved they basically said that MTF HRT can create a high risk of blood clots, and that since an Orchiectomy will reduce required dosages they should be performing them as part of MTF transition. Interestingly, she said the Seattle VA has been doing this for about 15 years, but they kept it quiet. 

She also said the VA is offering electrolysis and laser hair removal, but to prep for GCS. 


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7 hours ago, Janeshannon said:

She also said the VA is offering electrolysis and laser hair removal, but to prep for GCS. 

OMG I was getting so excited when I started to read this last sentence.  But then saw it was for GCS surgery prep.  Darn it, I was hoping the VA would cover facial electrolysis.

Its the one thing that is my MOST dysphoric issue is my facial hair and its the one things I need done that is not covered under insurance for me.  (sigh)

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The hair removal from the VA is not only for GCS prep, at least not at the VA hospital I go to.  I am having laser hair removal done on my face by the dermatology department at the VA hospital.  As far as orchiectomy goes, the way I read the Trans care guidelines say that it can be done if traditional HRT methods are ineffective, or in the case where it would cause serious complications with another medical condition.


c. In cases when anti-androgens and/or doses of estrogens cannot be tolerated by the patient, are ineffective, or if the Veteran would be at increased risk for adverse effects, such as cardiovascular or other thrombotic events, and when an appropriate medical provider has determined that there are no other standard medical options for hormone management, surgical orchiectomy is an acceptable treatment recommendation. In these select Veterans, orchiectomy can be considered medically necessary as part of their hormone management, and not gender confirming/affirming surgery. Decisions about the appropriate use of orchiectomy should be made on a case-by-case basis as determined by the treatment team, and should include a medical provider who has expertise in the management of hormone therapy. NOTE: Transgender E-consultations and/or ethics consultations are available for case-specific consultation.



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Orchidectomy as a VA option  would be great. I will check on that with my therapist, as we move along to HRT.

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Just had my 1st appointment at the Los Angeles Trans clinic (run through Women's Health by docs who are doing it voluntarily on their own time turns out) and yeah laser treatment has always been turned down here and the head gal is still trying to find loopholes to get it covered but not yet successful.

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8 hours ago, Janeshannon said:

Does anyone know how much it would cost to have a VA orchi?

It would all depend upon your VA classification. Those categories determine not only costs to you but also treatment priority (barring bleeding out in the ER of course).


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On 2/11/2020 at 8:26 AM, MiraM said:

The hair removal from the VA is not only for GCS prep, at least not at the VA hospital I go to.  I am having laser hair removal done on my face by the dermatology department at the VA hospital. 

I am not a great candidate for laser treatments as my facial hair is mostly grey at this point   Laser only really works on dark hairs follicle.  Si I have been told.  I need electrolysis to do any good and I would rather go that route as electrolysis is a permanent treatment were as laser can grow back in over time.  

If I'm going to let someone torture my face with pain it better be permanent.  LOL

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  • 2 months later...
On 2/12/2020 at 9:28 AM, ShawnaLeigh said:

I am not a great candidate for laser treatments as my facial hair is mostly grey at this point   Laser only really works on dark hairs follicle.  Si I have been told.  I need electrolysis to do any good and I would rather go that route as electrolysis is a permanent treatment were as laser can grow back in over time.  

If I'm going to let someone torture my face with pain it better be permanent.  LOL


Ditto! I had two rounds of laser 15 years ago before I chickened out of my process. After even those two rounds, though, not only did the dormant folicles activate, but shaving those was even harder. I just couldn't seem to get everything short of taking off a layer of skin.

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  • 9 months later...

Jane, Yes the VA Does perform early pre-GCS orchiectomies but, from my reading of the manual, this would be available in the case of two or three HRT chemical fails. Contact your Endocrinologist or PCP for more detailed intel. I will try to find the manual for citation. Hope all goes well for you.   Kjiersten,   <Kj>

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