The US Department of Veterans Affairs (VA) has issued an internal directive instructing health facilities to remove gender identity-based initiatives and eliminate LGBTQ+ specific designations within its care system.
The June 12 memorandum, obtained by The Advocate, signed by Veterans Health Administration Under Secretary for Health John J. Bartrum, orders nationwide compliance with federal executive directives that restrict diversity, equity and inclusion (DEI) programs and limit references to gender identity in government operations.
What is changing under the new directive?
The memo requires VA facilities to:
-Eliminate all DEI and DEIA programmes
-End gender identity-based and “gender ideology” initiatives
-Remove references to LGBTQ+ identity in programmes and communications
-Restrict use of federal funds, facilities and staff time for such initiatives
-Review websites, training materials, policies and internal systems for compliance
-Redesignate LGBTQ+ Veteran Care Coordinators as general “Care Coordinators”
In effect, specialised identity-linked programming and labels are being replaced with broader, non-categorised service structures.
Why is this being implemented?
The directive references executive orders issued under the Trump administration that:
-End federal DEI programmes and related funding priorities
-Require federal agencies to recognise only binary sex categories (male and female)
The memo frames the changes as a compliance requirement, directing VA facilities to align all operations, communications and training with these orders.
What programs are affected?
The policy raises concerns about the future of several specialised initiatives designed for LGBTQ+ veterans, including:
PRIDE in All Who Served — a 10-week support and health education programme aimed at improving mental health outcomes
CBT-PRISM — a cognitive behavioural therapy programme addressing PTSD, chronic pain and minority stress among LGBTQ+ veterans
Both programmes were developed in response to documented disparities in healthcare outcomes affecting LGBTQ+ veterans and have been associated with improved mental health indicators such as reduced depression, anxiety and suicide risk.
Why are these programmes significant?
These initiatives were created after VA research identified that LGBTQ+ veterans often face:
-Higher rates of mental health challenges
-Increased stigma and discrimination in healthcare settings
-Barriers to accessing inclusive care
Programs like PRIDE and CBT-PRISM were designed to provide targeted support, build social connection and reduce minority stress.
What concerns have been raised?
Healthcare providers within VA facilities have reportedly expressed immediate concern that the directive could lead to the loss or scaling back of specialised services.
One VA medical professional told The Advocate that staff fear “loss of programming and services that are uniquely designed for LGBTQ+ veterans.”
Advocates argue the policy could weaken targeted mental health support and remove structures that were built to address long-standing disparities.
The memo requires VA leadership and facilities to confirm compliance within a short timeframe, including reviewing all materials and implementing structural changes.
However, questions remain about whether existing programmes will be fully discontinued, restructured, or absorbed into broader care frameworks without identity-specific designation.
For now, the directive marks a significant policy shift in how the US federal veterans’ healthcare system approaches LGBTQ+ specific services.
