Veterans Affairs doctors could begin providing sex reassignment surgery in coming years to patients with gender identity issues, under a new rule proposed by the department.

The move would remove a long-held ban on the surgery and likely provide another cultural point of controversy in the wake of federal rules, issued last month, that mandate public schools allow transgender students to use the bathroom of the gender they choose.

The proposal In the proposed rule, made public this week by transgender advocates and Time magazine, states that past surgical procedures were too poorly understood. Officials therefore could not justify providing them to veterans with suffering from gender dysphoria, a condition experienced by where individuals who don’t identify with their biological gender for a variety of mental and physiological reasons.

"However, increased understanding of both gender dysphoria and surgical techniques in this area have improved significantly, and surgical procedures are now widely accepted in the medical community as medically necessary treatment for gender dysphoria," the proposed rule says.

"Additionally, recent medical research shows that gender dysphoria is a serious condition that has had severe medical consequences for certain patients if transition-related surgeries and procedures are not provided."

Advocates hailed the move as both an important step forward for equality and a signal that the department is committed to offering the best available health care to all veterans.

"So many veterans rely on the VA for important medical care that they have earned serving our nation, including transgender veterans," said Ashley Broadway-Mack, president of the American Military Partner Association. "Gender confirmation surgery is often a critically important and medically necessary treatment, and lifting this ban is long overdue."

Decisions on whether veterans should undergo the surgery would be made on a case-by-case basis, after consultation with VA medical experts.

No timetable has been specified for when the department might start offering the surgery, but such similar changes can take several years to work through federal bureaucracy.

VA officials told Time magazine that the proposed change has already been in the works since 2014, the same year Medicare officials lifted a their ban on the surgery.

The National Center for Transgender Equality estimates that more than 134,000 veterans are transgender, and more than 15,000 transgender individuals are serving in military today despite rules forbidding them from serving openly.

Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at lshane@militarytimes.com.