The journey of transgender veterans seeking inclusive healthcare has been marked by both triumph and adversity. Giovonni Santiago, a veteran who transitioned through the Department of Veterans Affairs (VA), has witnessed firsthand the establishment and subsequent erosion of vital services for transgender veterans.
In 2013, Santiago began his transition journey at the Cleveland VA Medical Center under the care of Dr. Megan McNamara. Their collaboration led to the creation of the Gender Identity Veterans Experience (G.I.V.E.) Clinic in November 2015, a pioneering initiative within the VA system. However, recent policy changes threaten to undo years of progress.
The Birth and Promise of the G.I.V.E. Clinic
The G.I.V.E. Clinic at the Louis Stokes Cleveland VA Medical Center was a beacon of hope for transgender veterans. It provided a comprehensive range of services, including primary care, hormone therapy, mental health treatment, and social services. Santiago, who served as an Air Force police officer from 2006 to 2010, was instrumental in advocating for this dedicated space.
Santiago’s efforts extended beyond the clinic. He founded META Center Inc, an Ohio nonprofit supporting transgender youth and adults, furthering his commitment to the community. The clinic’s success was evident in the lives it touched and the support it provided to approximately 100 doctors and countless patients.
The Erosion of Transgender Veterans’ Healthcare
The rollback of transgender healthcare services began in with the rescission of a VA directive that established standards for the respectful treatment of transgender and intersex veterans. This was followed by a halt on new hormone prescriptions for most transgender veterans and the elimination of services such as voice training and prosthetics.
In June 2026, a memorandum ordered facilities to eliminate gender identity-based initiatives and remove “LGBTQ+” from the Veteran Care Coordinator program. A subsequent email in July ended specialized meetings, training, communications, and shared resources, converting LGBTQ+ coordinators into general care coordinators. These changes have had a profound impact on the lives of transgender veterans like Santiago.
The Human Impact of Policy Changes
For Santiago, who has a 100 percent VA disability rating, the loss of access to transgender-specific healthcare would significantly alter his life. Private insurance would mean smaller paychecks and increased out-of-pocket expenses for essential services. The financial burden would extend to hormones, primary care, glasses, and other services earned through his military service.
Beyond the financial implications, Santiago fears for the clinicians who have dedicated themselves to providing care for transgender veterans. Dr. McNamara, his primary care physician of 13 years, faces the dilemma of balancing patient care with professional risks. Santiago expresses his concern, stating, “I would never want my health care to cause her to lose her job.” This sentiment resonates with nurses, social workers, and schedulers who care deeply about their patients but now face the risk of losing their livelihoods.
The rollback of transgender healthcare services is not just a setback for transgender veterans but also a warning for lesbian, gay, and bisexual veterans. Santiago emphasizes the interconnectedness of these issues, urging the broader LGBTQ+ community to stand together against these policy changes. “What we need is for those who, again, are the L and the G to stand up, because their healthcare is being put under scrutiny at the VA also,” he says.
