According to the web page of the Tennessee Valley Healthcare System of the Department of Veterans Affairs (VA), “America is home to an estimated one million LGBT service members and Veterans who have served in the US military with honor and distinction.” For many years they served in secret, and if they were honorably discharged with benefits, they would seek their medical care at the VA without bringing special attention to their specifically LGBT needs.

In recent years, however, things have changed at the VA. As Don’t Ask Don’t Tell (DADT) was repealed and gradually more and more federal benefits were opened to LGBT people and their families, the VA has done its best to keep up with the changes.

“Changes really started picking up three or four years ago after 'Don't Ask Don't Tell' (DODT) was repealed,” said Deanne Novak, the LGBT awareness coordinator in the local VA system, who also happens to be a transgender veteran.

When the Human Rights Campaign (HRC) introduced its Healthcare Equality Index, the VA hospital at Vanderbilt developed a program to seek that accreditation. “When it first started,” Novak mused, “I think we were one of four hospitals, and now I think almost all of the VA hospitals have it.”

As far as programming went, staff training was the primary early priority, and Novak has been involved in that from its inception. “What I do is train the staff to make sure that they understand the cultural diversity and things like that,” she said.

While LGBT programming coordinates with a number of other departments, another key figure in assuring that the needs of LGBT people are served is Helen Jarboe, the office’s veterans care coordinator (VCC). Jarboe helps LGBT veterans navigate the system. This is especially important now that rules and regulations have changed, allowing transgender people to serve openly in the military.

The VCC can assist those seeking to transition determine what care they can receive from the VA. While the process follows the same course as it would for those receiving civilian care, Jarboe “is the one that deals with all of the veterans that call in, to help them navigate through the system, getting them to a primary care provider, who will refer them to mental health, where they can work toward a referral to endocrinology, for services like hormone therapy.”

Novak says she is amazed by how far LGBT programs have come at the VA. “We started just by putting out information of interest to LGBT veterans, including copies of O&AN. Then we got mental health involved, and they’ve helped train the primary health providers. Any person who represents as female can be seen at the female clinic now, and of course people use the bathroom of their choice. The policies are there, the Equality Board is there, the support from the director is there, support from all of the clinics is there. It's taken baby steps, but it's a process.”

Getting the word out about programs, like the monthly support groups, is the biggest challenge, but it’s necessary to make sure veterans get the care they need, and to develop the best programs for the community. “We're hoping that, by being more public about our offerings,” Novak said of her program, “people will realize that the VA does offer these programs, they do offer hormone replacement therapy, they do offer pre- and post-operative care. This is important information for someone trying to navigate the VA system and trying to figure out just what is available.”

“We want to get this message out in a positive way, to say 'Hey, yes, the VA does have this, and we do welcome you,'” she added. “That's what we're ready for and that's what all this training has been leading up to. That's why we have these positions dedicated to this and why the director's office is as involved as it is. I'm hoping that the more it gets out that the VA has these programs for the LGBT community, the more that come in and the more desire they have for programming, then we'll look at that!”

For Novak, it’s a personal quest, not just because she’s been involved with the process from the beginning. As a transgender veteran herself, she says, “Every veteran who walks through those doors needs to know that they deserve to, and will treated fairly… Our group is directed at LGBT equality, but this affects all veterans, because if we can’t represent all veterans equally, then something is wrong…”

For more information about LGBT Programs at the VA in Middle Tennessee, visit TennesseeValley.va.gov, or email Deanne Novak (Deanne.Novak@va.gov) or Helen Jarboe (Helen.Jarboe@va.gov). Photo, from left to right: Dr. William Irwin, Amy Willis, Deanne Novak.