[Congressional Record Volume 167, Number 112 (Monday, June 28, 2021)]
[House]
[Pages H3161-H3162]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   TAXPAYERS SHOULD NOT BE RESPONSIBLE FOR SEX REASSIGNMENT SURGERIES

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
North Carolina (Mr. Murphy) for 5 minutes.
  Mr. MURPHY of North Carolina. Madam Speaker, today I rise to speak on 
the recent ruling by the Secretary of Veterans' Affairs to allow 
taxpayer dollars to be spent to provide sex reassignment surgeries. I 
have been a board certified urologist for 30 years, so I am quite 
knowledgeable about patients who suffer from gender dysphoria. Those 
who experience this mental and physical ambiguity may seek care that 
involves years of psychological and psychiatric evaluation counseling, 
years of hormonal manipulation, and then multiple cosmetic surgeries. 
The cost of these interventions may easily run into the hundreds and 
thousands of dollars.
  Recent numbers cited by the National Center for Transgender Equality 
stated there were an estimated 134,000 transgender veterans in our 
Nation. However, using the American Psychiatric Association's 
Diagnostic and Statistical Manual of Mental Disorders data from 2019, 
that calculated number appears to be far less. Regardless, the new 
Secretary has mandated that sex reassignment surgery be covered by the 
VA.
  Again, I am very empathetic to the challenges that these patients 
face, but as a surgeon and a Member of Congress, I must question the 
surgical priorities here. The VA is already understaffed and 
overburdened, and now requiring a competing array of treatments may 
lead to a delay in diagnosis for serious life-threatening disorders. It 
is an issue of resources and priorities.
  There is actually a much heated debate on whether this sex 
reassignment surgery is truly appropriate or beneficial. In fact, in 
2016 the Obama administration came to the conclusion that it was not. 
In 2016, the Centers for Medicare and Medicaid Services revisited the 
question of whether sex reassignment surgery would be covered by 
Medicare plans. Despite receiving a request that its coverage be 
mandated, it refused. It refused to cover it on the grounds that we 
lack evidence that it truly benefits patients.
  It is well documented that up to 40 percent of the transgender 
population will attempt suicide at some point. There is no clear 
evidence that this tragic statistic changes anything after having sex 
reassignment surgery. In fact, as recent as August of 2020 in the 
American Journal of Psychiatry, it states that comparing those with 
gender dysphoria who had sex change surgery with those who did not, 
that the results demonstrated no advantage of surgery in relation to 
subsequent mood or anxiety disorder-related healthcare visits or 
prescriptions or hospitalizations following suicide attempts in that 
comparison. I could go on with the medical statistics, but suffice it 
to say, there is no clear consensus regarding surgical intervention in 
this population.
  Madam Speaker, I represent the sixth largest number of veterans in 
any congressional district in the country. These surgeries that are 
required require complex surgical intervention by highly trained 
surgical specialists that the VA does not have, nor has any prospect of 
employing in the future.
  The Nation is already suffering a severe shortage of surgeons. The 
American College of Surgeons cites severe shortages of general 
surgeons, urologists, and plastic surgeons. Those that we have are 
needed to take care of cancer, bowel obstructions, and limb 
reconstructions following battlefield injuries, real life and death 
issues. They are not going to jump ship to be paid less in a 
bureaucratic Government-run healthcare system.
  We already know the VA is short-staffed. They need mental health 
treatment individuals for PTSD and traumatic brain injury from injuries 
sustained by veterans in battle. We already have 17 veterans dying a 
day from service-connected psychiatric issues. They do not need to 
compete for resources with those who are suffering from issues that 
have nothing to do with being a member of the military.
  We do not have enough psychiatrists or psychologists to deal with the 
trauma that our veterans have faced in their fight to keep this Nation 
free. Is it right to divert resources away from those who require years 
of therapy for nonservice-connected issues? The answer, I submit, is 
no.
  Further, gender dysphoria requires years of hormonal transitioning, 
needless to say requiring medications for anxiety and depression. This 
increase of pharmaceutical needs will further strain the VA pharmacy 
system that is already overtaxed.
  But now the Secretary in an effort to appease the far left wants to 
stress the

[[Page H3162]]

system more. What are his priorities? Secretary Denis McDonough was 
supposed to fix the VA. So what is his first major action? Spending 
millions in diverting resources from our service-connected veterans for 
nonservice-connected issues. We are bankrupting this Nation chasing the 
far left progressive wish list.
  Again, I will say, as a physician, I am very sympathetic to those 
that deal with gender dysphoria. I truly do. They face many challenges 
in life, but cosmetic surgical interventions on the backs of taxpayers 
is not the answer. Congressional duties are about setting priorities. I 
ask the Biden administration to reassess their priorities.

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