A group of House lawmakers is calling on the Department of Veterans to incorporate gender reassignment surgery as part of its coverage for U.S. veterans, calling denial of the procedure for transgender people “unconscionable.”In the Sept. 7 letter, the lawmakers respond to a request for comment on coverage for gender reassignment surgery.

“Simply put, the VA has an obligation to provide the necessary care that is prescribed to enrolled veterans by their health care practitioners,” the letter says. “It is unconscionable to deny veterans the same access to health care services that civilians receive in the private sector, and that is available to Medicare beneficiaries and federal workers, simply because of outdated and unscientific prejudice against their gender identity.”

The VA has request comment on gender reassignment surgery as a consequence of ongoing litigation against the department seeking coverage for the procedure. The case is currently pending before the U.S. Circuit Court of Appeals for the Federal Circuit.

Given the anti-LGBT policies of the Trump administration, including the attempt to ban transgender people from the U.S. military, it’s hard to see how the solicitation for comment could result in a proposed rule change. In fact, the administration could use comments against coverage as justification for current policy.

Brownley, top Democrat on the House Veterans’ Affairs Health Subcommittee, said in a statement the estimated 160,000 transgender veterans in the United States are deserving of coverage and “have put their lives on the line in order to protect our constitutionally protected freedoms.”

“It is simply unacceptable that we would ask our veterans to risk their lives to protect our rights but we would refuse to defend theirs in return,” Brownley said. “The VA must put an end to this discriminatory and outdated ban on treatments for gender dysphoria and ensure that all our nation’s veterans have access to the healthcare they have earned.”

The lawmakers’ letter to the VA has a blemish of bipartisanship. Among the 83 House members who signed the missive was Rep. Ileana Ros-Lehtinen (R-Fla.), who has a transgender son and is slated to retire from Congress at the end of this year.

Charlotte Clymer, a transgender veteran and spokesperson for the Human Rights Campaign, said in a statement the exclusion of gender reassignment surgery from VA coverage is harmful.

“The Department of Veterans Affairs’ exclusion of many forms of transition-related health care flies in the face of every major medical authority and undermines the health and wellbeing of transgender patriots who have laid their lives on the line for this country and their families,” Clymer said.

Indeed, the letter says studies have shown transition-related care, including gender reassignment surgery, can reduce the rate of suicide among transgender people as well as mental health problems, such as anxiety and depression.

“This broad medical consensus on the treatment of gender dysphoria is based on decades of peer-reviewed studies and clinical observation — including studies of veterans — that demonstrate its efficacy and substantial health benefits,” the letter says.

The Department of Veterans Affairs during the Obama administration had floated the idea of covering gender reassignment surgery, but the planned was scrapped after the election of President Trump — but before his inauguration — under the pretext of concerns about cost.

A VA spokesperson said in response to the letter the department “appreciates the lawmakers’ views and will respond to them directly.”

“VA will consider the comments received and determine the appropriate response,” the spokesperson added. “Although there is no specific timeframe required for this type of consideration, VA will announce any action it takes in the Federal Register.”