Veterans Affairs Secretary Denis McDonough has ordered a top-down review of department policies to ensure they comply with a presidential executive order designed to combat discrimination on the basis of gender identity and sexual orientation.
In his first news conference since taking office, McDonough said Tuesday that he has directed a department-wide policy review to ensure the VA is a "welcoming and inclusive environment for LGBT vets and employees."
On Inauguration Day, President Joe Biden signed an order directing every federal agency to review all regulations, guidance documents, policies and programs to ensure that they prohibit discrimination on the basis of sex, gender identity and sexual orientation.
McDonough said the review, expected to be completed by March 30, follows the order and seeks to "increase alignment between VA and the Department of Defense," particularly in the areas of medical services and treatment for veterans.
"While I obviously can't get ahead of the review -- that's why we are doing the review -- and what it will find, my goal as secretary is to ensure VA is welcoming to all our vets, including transgender vets," he said.
In October, the Government Accountability Office released a report saying VA physicians risked missing medical diagnoses among lesbian, gay, bisexual and transgender veterans because information on sexual orientation is not recorded consistently in medical records.
The VA maintains an Office of Health Equity and launched the LGBT Health Program in 2012 to establish policies and procedures to identify and resolve gaps in medical services.
The GAO report noted, however, that the VA fails to have a full understanding of its LGBT veteran population because it does not track sexual orientation and gender identity data in medical records.
Following the report's release, VA officials said they understood the importance of collecting such data, pledging to develop a working group to study the issue and make recommendations to senior leadership to ensure that such data would be captured in existing VA medical records, as well as the new electronic health records system expected to be adopted across the Veterans Health Administration by 2028.
According to the GAO, more than 6 million veterans used VA health care in fiscal 2018, but the number of patients identifying themselves as members of the LGBT community was unknown.
Data dating back a decade indicate there may be roughly 1 million LGBT veterans, with an estimated quarter of those utilizing VA health care.
McDonough said the policy review will focus mainly on medical services and care for these veterans. But he also promised that the department will focus on diversity in its employee population, including leadership and in efforts to fill more than 80,000 vacancies.
"This will be a very important piece of demonstrating seriousness about diversity and inclusion," he said.
One question raised in the past few years has been over the inclusivity of the VA's motto, a quote from Abraham Lincoln's second inaugural address: "To care for him who shall have borne the battle and for his widow, and his orphan." Some Democratic lawmakers, advocates and veterans say that it excludes female veterans and makes them feel unwelcome at the VA.
They have called for the motto to be changed to a more gender-neutral version: "To care for those who have borne the battle and for their families and survivors," or similar wording.
Former VA Secretary Robert Wilkie told Military.com last fall that the "only time I hear anything about this motto is from activists in this town."
"If we don't have a place in our collective memory for Abraham Lincoln, we're in a hell of a fix," he said.
McDonough said the motto is one of the many items being looked at by his team.
"Obviously, this is something that came up in the context of confirmation hearings and my conversations with the veterans service organizations. I'm not in a position to announce anything on that," he said.
In addition to discussions on diversity and inclusion, McDonough said the VA is highly focused on vaccinating its veteran population, particularly hard-to-reach vets who live in rural and remote areas, and minority veterans who may be at risk for severe cases of COVID-19.
According to McDonough, 1.4 million veterans have received the COVID-19 vaccine, including 400,000 who have had their second dose. More than 259,000 VA employees have received a vaccine, and 220,000 have been fully vaccinated, he added.
The department has inoculated 29% of all White veterans over age 75 with access to VA health care, as well as 31% of all Hispanic vets and 34% of Black veterans in that group.
McDonough said the department "has work to do."
"But I'm happy to report those numbers because there is a lot of demand for the vaccine," he said.