Be it noted: This is an unusual story. It contains an unusually high number of positive moments and anecdotes, especially considering the general coverage of its topics. They include:
1. Transgender women.
2. Veterans.
3. Medical treatment from the Department of Veterans Affairs.
You can imagine the potential for disaster in a story that combines 4. All of the above.
And there is some of that — disaster — in the accounts of the attendees of the New Orleans VA Transgender Support Group, which meets at the VA mental health clinic on Canal Street Friday mornings. Some of these veterans have been treated less than perfectly in their history of health care (and the VA itself has certainly been beleaguered and at times disastrous in recent years). And after all, transgender people are not allowed to serve in the military, of which these veterans were obviously all a part, some with more devastating results than others. But mostly, where the elements of transgender, veterans, and VA treatment intersect in this group, there is — surprisingly, counterintuitively, upliftingly — not that.
Photographed on May 8, 2015, in New Orleans
Edmund D. Fountain for BuzzFeed News
Our guide to the group will be one Ms. Donna Jean Loy. She is the one who corrals everyone to Mandina’s Restaurant, an old-school Creole joint in a big pink house on Canal down the street from the clinic, after a meeting on a recent Friday.
Donna Jean is a 65-year-old who served in the Air Force in Vietnam from 1969 to 1970, on a flight crew for C-130s and C-141s. At Mandina's, she sits in the middle of a long table, a bunch of wooden tables pushed together, as the other ladies start to trickle in across the wood floor. The table is at the back of the back room, which is roomy, but not enough to entirely diffuse the smell of foods frying.
Donna Jean is a buoyant strawberry blonde. (It’s a dye job, to cover gray.) Her hair is long but actually shorter than how she wore it in her early veteran days, when she presented as a man with long locks, so long, down to her ass, but hippies did that too in her time so it was still stealth. During her tours of duty, Donna Jean kept ladies' undergarments on beneath her men's uniform, and when her fellow soldiers expressed hope that they wouldn’t be shot down, she agreed heartily, though for the different reason that she didn’t want capturing enemy forces ripping open her flight suit and discovering her identity.
She didn’t — get shot down. Or discovered. Today she says her transition work is complete. Her Louisiana driver’s license and federal Social Security card are gender-correct, as is her VA ID card, and she can explain the processes to others for how to get those things done. She started coming to the group at the request of her treating VA doctor — who is also a trans woman, but we’ll get to her in a bit — more to offer support than to receive it. She feels a bit like a mother to some of the younger, or less further along, gals.
A woman named Dee Fulcher sits down next to Donna Jean, dropping her keys on the table. Dee was in the Marine Corps for 13 years — Desert Storm, Beirut, Grenada, Honduras — the baby of the group not quite in age (52) but in transition (she started just last year, and still shows up presenting as male to coach her kid’s soccer team and to work, on an offshore oil platform).
After everyone else arrives and is settled, there are a total of eight women here to eat onion rings or pasta or po’boys. There are a couple of trans men in the group, but they almost never come. “The trans men are so stealth,” Donna Jean says. “They start taking testosterone and after they transition they just slip right into society.” They have different kinds of — and, in the opinion of many in this group, fewer — problems, even though these also happen to be the only people of color in the group. (Overall, trans people of color are statistically more likely to experience transgender-related job loss, denial to homes or apartments, harassment or assault by police, and physical and sexual assault at work.)
So there’s Donna Jean, or DJ, as her friends often call her, and then Dee to her left, and to Dee’s left, at one head of the table, is Stephanie Lee Grathouse, 59, also Marine Corps, who served in Vietnam and Guam and Sydney and who says she had her share of rendezvous with other soldiers when nights got lonely and dark or drunk. To Stephanie’s left, on the other side of the table from Donna Jean, is Deanne Cooley, 55, one and a half years in the Marine Corps Reserve and four years in the Air Force, noncombat, whose ex-wife talked her into therapy in hopes that she’d get “fixed” but which ultimately led to her decision to transition; she’s been Stephanie’s partner since 2008. Next to Deanne is Bobbi Perry, a biker gal in a Harley shirt, leather vest, and skirt who was in the Air Force briefly in the ’70s, also noncombat, formerly homeless, and sassy with the busboy (“I’m eatin’, baby”). The next veteran to her left is Caroline L’huillier, 51, blonde-haired with blue eyes and matching nail polish, Navy brat cum Louisiana National Guard/Iraq veteran, clearly close friends with Bobbi W., 72, the Vietnam vet next to her, at the other head of the table. Both of them served, in different decades and wars, in or attached to the 173rd Airborne. They join hands on top of the table in a mother-daughter way from time to time. Finally there’s Pamela Raintree, 62, finishing the tour around the table right back at Donna Jean’s right. She is famous here and on Google for getting a Bible-quoting council member in Shreveport, Louisiana, to stop trying to repeal an antidiscrimination ordinance by bringing a rock to a city council meeting and inviting him to stone her.
Donna Jean wasn’t always living her best life, surrounded by sympathetic company like this. When she got out of the military in 1971, the then-raven-haired, then-legally male Donna Jean worked at a municipal airport in Willoughby, Ohio, for 14 years, then at an HVAC and electrical contractor, where she paid her premiums for the company health insurance though she’d been honorably discharged and was eligible for VA care. When those premiums were suddenly doubled, then doubled over again within a year, she had no choice but to collect on her service benefits. Which is how in 2006 or 2007, around the age of 57, she came to walk into a VA clinic in Cambridge, Ohio, a town two hours east of Columbus and an hour west of Wheeling, West Virginia, so inconsequential that even Ohioans have never heard of it. And in a state, one of only a few in the union, that still won’t change the sex on a birth certificate even after a person has had sex reassignment surgery (SRS).
At that time, Donna Jean needed help. After decades of underdressing (that’s wearing ladies' undergarments beneath one's clothes), and hiding, as much from herself as anyone, she had become suicidal. She had a second wife, and a lot of anger issues. When she went to therapy, everything just came out, all that bottled-up gender dysphoria.
“I was the first trans patient they’d ever seen in this little bitty VA clinic,” she says. But: “They bent over backwards to take care of me.”
Donna Jean’s doctor in Cambridge asked her for help helping her. Did Donna Jean have any resources, research, or websites she could recommend? The doctor read everything diligently. She did research of her own, too, so she could prescribe hormones correctly. The rest of the staff seemed to be equally keen on educating themselves. “I assume if you’re here, there’ll be more people behind ya,” DJ says they told her. DJ says, “We learned together. It’s been outstanding for me.”
She moved to New Orleans in 2010, for a relationship. The VA has been equally amazing here. At least.
Pamela, to Donna Jean’s right, is a transplant too. She moved to outside New Orleans from Shreveport, some five hours toward the northwest corner of the state, just last fall, specifically to get treated at this VA clinic. She sees the same doctor Donna Jean and everyone else at this table sees: Dr. Jamie Buth. Bobbi W. comes here for that, as well, all the way from Alabama, 190 miles each way, every Friday.
“You can’t buy better health care anywhere,” Bobbi W. says. She’s got curly dirty-blonde hair and a skirt-and-blouse set. “I’ve been treated with respect.”
“The VA took an interest in me and cared for me,” Caroline says. “They supported me in my transition 100%.” She says many times, with a voice that’s been feminized with the help of a vocal therapist that the VA has provided for her, “I feel like the VA saved my life.”
Deanne (left) and Bobbi P. (right)
Edmund D. Fountain for BuzzFeed News
Of course, it wasn’t always this way.
The reason Bobbi W. started coming here all the way from Alabama 10 years ago is because her experience as a transgender veteran was more the unfortunate type you might fear.
Where Bobbi lives, the closest VA is in Pensacola, Florida. When Bobbi started going there as trans in the ’90s, the doctors she was assigned to, they would not touch her. They literally would not put their hands on her. “The Gulf Coast VA in Pensacola, anything that deviates from normal is not accepted there,” she says. She says at one point she saw a urologist who told her that she needed a psychiatrist, not a urologist — or to be committed to a mental hospital. She says she waited all day another time with a urinary tract infection, and when she filled out a comment card to complain, the director of that VA called her after to say she couldn’t blame his system for something that was seriously, drastically wrong with her. (In response to a request for comment on these specific allegations as well as the current state of trans care at Pensacola, Public Affairs Officer of the Gulf Coast Veterans Health Care System Mary Kay Gominger wrote, “Gulf Coast Veterans Health Care System is committed to caring for all Veterans regardless of their self-identified sexual orientation. In 2014, GCVHCS met all of the Core Four criteria for LGBT Healthcare Equality Leader status from the Human Rights Campaign.” Comment from the director himself was requested but not provided.)
In 2003, two transgender veterans named Angela Brightfeather and Monica Helms founded the Transgender American Veteran’s Association (TAVA). They’d been hearing that trans care at the VA was unreliable, and TAVA’s goal was to hold the Veterans Health Administration to treating all transgender veterans “with courtesy and dignity ... as the first-class citizen that you are,” per the organization’s pledge. Back then, with no policy directive in place, it was up to individual clinicians to choose how to act; trans vets never knew if the doctor to whom they happened to be assigned at the clinic coincidentally closest to their house was going to treat them kindly, or treat them at all. There was no formal prohibition against treating trans people, but there was one against SRS — not to mention against transgender people serving in the military — so different VAs were interpreting differently what that meant for their responsibility as health care providers.
“We found out through other trans veterans that there was inconsistency between VAs and how they treated trans people,” says Helms, co-founder of TAVA and its president for 10 years. Donna Jean, after all, received her excellent care in rural Ohio; Bobbi W.’s in Pensacola was a constant source of insult and distress. As soon as TAVA was formed, “we began the process of letting the VA know what the problem was,” Helms says. But these were Bush years. “At the time, there was an administration that didn’t want to listen to anything we said. It was very hard to approach the VA about anything.” TAVA got no response. Helms surmised the VA’s strategy was that “they figured if they ignored us, we’d go away.”
In 2007, TAVA launched a large online survey of trans veterans about the care they were getting. The National Center for Transgender Equality (NCTE) helped publicize it. The results were compiled into a white paper by the Palm Center, a public policy outfit that specializes in gender, sex, and the military. The report showed that of the 827 participants, only 29% used a VA hospital for health care; 10% of those reported being turned away because they were transgender. More reported being disrespected and discriminated against, with providers cussing them out or lecturing them on “brave real men,” et cetera.
After the paper, and an incessant calling campaign orchestrated by a trans civilian mariner in the Navy named Nicole Shounder, and a coalition between TAVA, NCTE, and trans lawyers — and an administration change with the election of President Obama — a policy was finally drafted.
In 2011, the Veterans Health Administration issued to all of its facilities nationwide a transgender health care directive, “establishing a policy of respectful delivery of healthcare to transgender and intersex veterans who are enrolled in the Department of Veterans Affairs (VA) healthcare system or are otherwise eligible for VA care,” by NCTE’s own description. Reissued in 2013, it forbids discrimination. It mandates confidentiality and the provision of all transition-related medical needs excluding SRS, but including hormones, health screenings, and therapy. It helpfully defines words like “sex,” “gender,” and “transgender,” and an addendum in the 2013 edition answers such frequently asked questions as “Is transgender the same as being ‘gay’ or ‘lesbian’?” (“No.”)
“It was not exactly what we wanted, but it was far better than anything so far,” Helms says. “It went out to all VA facilities. Two days later, we started getting emails from trans veterans all around the country saying, ‘It works.’ It was helping them.”
Edmund D. Fountain for BuzzFeed News