Publication year
2014
Citation Title
Communication between VA providers and sexual and gender minority veterans: A pilot study.
Journal Name
Psychological Services
Journal Volume
11
Issue Number
2
Page Numbers
235-242
DOI
10.1037/a0035840
Summary
Lesbian, gay, bisexual or transgender (LGBT) Veterans participated in a focus group or individual interview and completed self-report measures about their experiences, beliefs and preferences in communicating with VA healthcare providers. Results indicate that participants reported experiencing the VA as welcoming to sexual minority Veterans, although the majority of providers did not assessed their sexual orientation. Veterans reported a variety of fears related to disclosing their sexual orientation.
Key Findings
Twenty-four percent of Veterans indicated they have not disclosed their sexual orientation to any VA provider; 62% of Veterans reported that none of their VA providers had asked about sexual orientation.
Veterans described numerous fears surrounding disclosure of their sexual orientation to VA providers (e.g., fear of judgment or disparate treatment, fear loss of benefits, fear denial of healthcare, worry about implications of documentation in healthcare record).
Only 28% of Veterans experience VA as welcoming to sexual minority individuals; male Veterans reported finding VA centers more welcoming than female Veterans and no difference were reported between transgender and non-transgender Veterans.
Implications for Program Leaders
Create workshops that include sexual-minority affirming materials in their program (e.g., rainbow), thereby sending the message that their staff are welcoming to all people
Offer classes that use a mindful curricula regarding language (e.g., referring to partners rather than husbands or wives)
Offer support groups for Service members struggling with sexual identity issues or relationship issues
Implications for Policy Makers
Recommend professional development about respectful communication with sexual and gender minority Service members and health disparities faced by these individuals
Continue to support programs that work with LGBT Service members
Continue to support efforts that aim to reduce discrimination in the military based on sexual orientation
Methods
Sexual and gender minority Veterans were recruited through hospital providers, community organizations, and word of mouth.
Veterans participated in a two-hour focus group or individual interview; sessions were held at a VA hospital (either Oklahoma City, OK, or Houston, TX).
Questions explored positive and negative experiences in VA, beliefs about deterrents to VA healthcare, and ideas about how VA can be more welcoming to sexual and gender minority Veterans.
Participants
Fifty-eight Veterans participated in the study; 55% identified as female, 33% as male, and 12% as transgender.
The majority of participants were White (84%), female (55%), and between 40-50 years old (55%).
Eighty-one percent identified as gay or lesbian and 12% as bisexual.
Limitations
Participants in this study were from a limited geographic region (two southern VA hospitals); the extent to which sexual and gender minority Veterans’ experiences differ across the country is not known.
The numbers of some groups of participants (e.g., transgender individuals, bisexual individuals) were rather small, precluding the researchers from specifically analyzing their unique experiences.
Service branch data were not provided, reducing the generalizability of the results.
Avenues for Future Research
Replicate the current study with a sample of Service members still serving in the military and among providers within different branches of the military
Examine further the difference of experiences between LGBT Service members based on sexual orientation utilizing a qualitative research approach
Explore how the military can better support LGBT Service members and reduce fears regarding disclosure of their sexual orientation
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Approximately one million gay and lesbian Americans are veterans, and rates of engagement in the Veterans Affairs (VA) health care system may be increasing for both sexual and gender minority veterans. Very little research has examined the experience of these veterans when receiving care at VA health care facilities. The purpose of this study was to explore the experiences, beliefs, and preferences of lesbian, gay, bisexual, or transgender (LGBT) veterans in their communication with VA health care providers. LGBT veterans (n = 58) participated in focus groups or individual interviews and completed self-report measures at two southern VA hospitals. Approximately 2/3 of veterans report that none of their VA providers have specifically asked about their sexual orientation, and 24% of the veterans indicate that they have not disclosed their orientation to any VA provider. Although some veterans want providers to initiate these discussions, veterans also expressed fears about disclosure and its possible negative consequences. Similarly, LGBT veterans report varied opinions about the appropriateness of routine assessment of minority status. Only 28% of these veterans experience VA as welcoming to them as LGBT veterans. Systematic training is needed for all VA providers about the rationale for assessing sexual and gender orientation. Staff education should include specific skills for initiating these assessments, and ways of responding to veteran concerns about discussing this topic in the VA health care system.
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