In an unannounced policy change, the Department of Veterans Affairs is making it harder for male veterans with breast cancer to get care and disability benefits.
Critics are calling it a misguided attempt to bend science to the Trump Administration's war on gender ideology.
Breast cancer - regardless of gender - is among several illnesses Congress declared "presumptive" in the PACT Act of 2022. That meant veterans who got sick after exposure to burn pit smoke or other toxins had an easier time getting their VA claims approved.
But the VA is now saying it will no longer consider the illness as presumptive among male veterans, though it will remain so for women.
"The PACT Act allows VA to presume service connection for 'reproductive cancer,' and under this provision, the Biden Administration falsely classified male breasts as reproductive organs," said VA Press Secretary Pete Kasperowicz in a written statement responding to questions about the policy. "VA has eliminated the Biden Administration's false classification, and as of Sept. 30, the department no longer presumes service connection for male breast cancer."
The policy change, which was first reported by ProPublica, means men with breast cancer not only have to document that they were exposed to toxins, but also have to prove that those toxins caused the disease.
"That's a real head scratcher," said Terry Ballinger, a veteran of the first Gulf War, who was diagnosed with breast cancer last year. "Everybody in oncology is highly confident that male breast cancer and female breast cancer are virtually identical — they're identical in the way that they're diagnosed and the way that they're treated."
Ballinger filed his disability claim when male breast cancer was still considered presumptive. Even so, the VA initially said no, and his attorneys had to step in to help.
Ballinger said he was exposed to a wide range of toxins in the Army, including asbestos, depleted uranium, burn pit smoke, and the choking clouds from burning oil wells during the war.
With no family history or known genetic predisposition to breast cancer, he said his service-related exposures are the most obvious culprit.
"I don't want to say it has to be, but if you start eliminating possibilities, you end up coming back to that," he said.
Critics - including several Democratic members of Congress - said the change was made in a politically motivated attempt to conform to an executive order signed by President Trump titled: "Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government." That order said federal government policies must treat men and women as biologically different.
Twenty-five members of Congress signed a letter demanding the agency reverse course.
"This change will deny many veterans timely access to care and benefits, despite strong evidence that exposure to burn pits and other toxins increases cancer risk in both men and women," the letter said.
"Cancer does not care about ideology, and neither should the agency charged with caring for those who served," the letter said. "The PACT Act is the law — not a suggestion — and it requires VA to follow the evidence, not executive orders that distort science for politics. No one who risked their life for this country should have to wonder if their diagnosis fits an administration's political comfort zone."
Some scientists and doctors say they're puzzled by the policy change.
"The vast majority of male breast cancer biologically is in fact reflective of the most common type of breast cancer in women," said Dr. Ben Park, a leading breast cancer researcher who has studied the disease in men and women.
He said it's irrational to use semantics about gender to treat male and female breast cancer patients differently.
"To me, that doesn't make sense," Park said. "That would be like, 'let's not treat colon cancer in men, but we'll treat it in women.'"
Some studies suggest male breast cancer is more common among veterans than in those who haven't served. The VA says it diagnoses about 100 cases a year.
Mike Partain is an activist who lobbied to make sure the PACT Act included people exposed to toxic water at Camp Lejeune, N.C. He was born on the base while his father was a Marine. Later, as an adult, Partain developed breast cancer.
He called the policy change disturbing.
"Science is science, and to interject politics and especially what I call the gender wars that go on between the left and the right... . It's an absurdity, and it's a slap in the face to our veteran community."
Partain said it adds to what he regards as a serious flaw in the law.
"The PACT Act covers the veterans who were exposed to toxic chemicals overseas," he said. "It does not apply to the Camp Lejeune veterans or military veterans exposed to toxins here in the U.S., which is a major pitfall of the PACT Act."
For years, Partain said, he kept a list of men who developed breast cancer after exposure to the Camp Lejeune water, and said when he eventually stopped, the number was about 125.
"If science says that the tissues of the breast, male and female … can be affected by chemicals and link cancer to an exposure to those things, there shouldn't be any argument," Partain said.
He said if the illness isn't considered presumptive for military-related exposures, the VA will approve perhaps five percent of claims.
The VA spokesman said in his statement that the policy change doesn't mean abandoning male veterans with breast cancer.
"Any male veteran currently receiving VA care or benefits for breast cancer will continue to receive that care, and the department will continue to provide care and benefits to veterans who show a service connection to male breast cancer," Kasperowicz wrote. "The department grants disability benefits compensation claims for male veterans with breast cancer on an individual basis and will continue to do so."
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans.
