Abstract:Inclusion and eliminating health disparities are guiding principles for health care systems, including the Veterans Health Administration (VHA). Compared to cisgender veterans, transgender and gender diverse (TGD) veterans have elevated prevalences of mental health conditions and suicidality. Though numerous medical societies have attested to the medical necessity of gender-affirming care, this care is not uniformly covered by private insurance and Medicaid coverage varies by state. Since 2011, the Veterans Health Administration (VHA) has covered most gender-affirming healthcare services but explicitly excludes gender-affirming surgeries (GAS). Though not all TGD people need or desire GAS, many do,5,6 and there are no studies of TGD veterans’ interest in GAS.