The Southern Arizona VA Health Care System transgender clinic opens its doors today. That VA hospital will become the fourth in the nation to offer special clinic hours for transgender patients.

The Tucson treatment team will be headed by Dr. Sonia Perez-Padilla, who says the Tucson hospital is now recognized by the VA as a "national center of excellence for transgender care."

Local VA officials say the population of transgender veterans in Tucson has grown from 50 to 130 in the past five years.

The Department of Veterans Affairs ordered all its medical facility to take better care of transgender veterans beginning in 2011.

Before that, discrimination was not uncommon.

--Dr. Perez-Padilla

Treatment has improved, says Dr. Perez-Padilla.

Most VA employees had no training in the needs of transgender patients, and some felt uncomfortable being around them.

Today, many training sessions later, the situation is much better, but there still may be some employees who don’t understand that being transgender “is not a choice. It’s something innate.”

The VA now routinely provide treatments such as hormone therapy, mental-health care and pre- and post-operative care for sex-change surgery. The surgery itself still isn’t covered, though Perez-Padilla thinks it will be eventually.

A growing body of research shows the military is a magnet for biological males with gender issues who often try to quell their inner conflict through “hypermasculine” pursuits, said Nadine Cole, a clinical psychologist on the local VA treatment team.

The suicide rate for such veterans is “20 times higher” than their peers, Cole said.

Many are combat veterans who suffer not just from war trauma but from the added angst of gender transition after they leave the military, she said.

Erin Russ of Tucson, a former Army captain who transitioned from male to female in 2001, said the changes in transgender acceptance are welcome, though long overdue.

Russ said she was kicked out of the service in 1990 following an after-hours traffic stop in which she was dressed as a woman but had a man’s military ID. She now lectures on transgender awareness to train VA personnel.