Publication year
2013
Citation Title
Sexual victimization, health status, and VA healthcare utilization among lesbian and bisexual OEF/OIF veterans.
Journal Name
Journal of General Internal Medicine
Journal Volume
28
Issue Number
S2
Page Numbers
604-608
DOI
10.1007/s11606-013-2357-9
Summary
Three hundred sixty-five female OEF/OIF Veterans receiving care at two Veterans Affairs (VA) medical centers were surveyed to examine the prevalence of mental health and gender specific conditions, VA healthcare satisfaction, and trauma exposure. Lesbian and bisexual Veterans were significantly more likely to have experienced both military sexual and childhood sexual trauma compared to heterosexual Veterans.
Key Findings
Ten percent of the sample identified as either lesbian (5%) or bisexual (5%).
Lesbian and bisexual Veterans were more likely to have been the victims of military or childhood sexual abuse compared to heterosexual Veterans.
Lesbian, bisexual, and heterosexual Veterans did not differ significantly on most demographics; lesbian and bisexual Veterans were less likely to be married than heterosexual women.
Lesbian and bisexual Veterans were more likely than heterosexual Veterans to rate their current mental health as worse than before deployment, and were more likely than heterosexual Veterans to be smokers and hazardous drinkers.
Implications for Program Leaders
Develop services and outreach specifically to meet the needs of lesbian and bisexual Veterans
Provide education and training to staff about lesbian and bisexual Veterans’ health and psychological concerns
Disseminate information regarding possible symptoms of mental health problems Service members may face after deployment and where individuals and families can find help for those problems
Implications for Policy Makers
Continue to support programs that provide staff training and education about the unique needs of lesbian, gay, bisexual, and transgender health issues and how to provide culturally-responsive services
Encourage the development and continuation of programs that can promote resilience in Service members, their partners, and children
Promote reintegration programs that include attention to assisting Service members who have experienced a sexual assault find help upon their return
Methods
Letters describing the study were sent to 3,251 female OEF/OIF female Veterans enrolled at one Midwestern and one Northeastern VHA facility; 11% returned surveys.
Participants were asked questions about their sexual orientation, post-deployment health status, access to care/utilization, combat trauma, military and childhood sexual trauma, smoking habits, and hazardous drinking.
Statistical analyses compared the demographics, health care utilization and clinical characteristics of lesbian and bisexual to heterosexual Veterans.
Participants
Three hundred sixty-five female OEF/OIF Veterans participated in the study.
The characteristics of lesbian and bisexual Veterans were the following: 55% were younger than 30 years old; 83% were White and 9% were Latina; 74% were not married, while 20% married; and 66% were Army, 20% were Air Force, and 9% were Marines.
The characteristics of heterosexual Veterans were as follows: 56% were younger than 30 years old; 81% were White, 4% were Latina; 52% were not married, while 35% were married; and 69% were Army, 17% were Air Force, and 3% were Marines.
Limitations
The sample of lesbian and bisexual Veterans was small and may not generalize to other Service members.
There were no data on pre-military mental health concerns; elevated rates of mental health issues and problem drinking behavior could have made these Veterans more vulnerable to military sexual trauma.
This research was part of a larger study that was not focused on lesbian and bisexual Veterans.
The researchers combined lesbians with the bisexuals in analyses that could have mis-estimated the associations with other variables.
Avenues for Future Research
Expand this study to include a larger and more diverse sample of lesbian, gay, bisexual and transgender Service members receiving care at a variety of hospitals across the country
Examine other issues of concern to lesbian and bisexual Service members
Gather qualitative data on services, resources, and other supports that help to increase the likelihood female Service members will disclose sexual assaults and other traumas
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Background: Many lesbian and bisexual (LB) women veterans may have been targets of victimization in the military based on their gender and presumed sexual orientation, and yet little is known regarding the health or mental health of LB veterans, nor the degree to which they feel comfortable receiving care in the VA. Objective: The purpose of this study was to examine the prevalence of mental health and gender-specific conditions, VA healthcare satisfaction and trauma exposure among LB veterans receiving VA care compared with heterosexually-identified women veterans receiving. Design: Prospective cohort study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) women veterans at two large VA facilities. Participants: Three hundred and sixty five women veterans that completed a baseline survey. Thirty-five veterans (9.6 %) identified as gay or lesbian (4.7 %), or bisexual (4.9 %). Main Measures: Measures included sexual orientation, military sexual trauma, mental and gender-specific health diagnoses, and VA healthcare utilization and satisfaction. Key Results: LB OEF/OIF veterans were significantly more likely to have experienced both military and childhood sexual trauma than heterosexual women (MST: 31 % vs. 13 %, p?<?.001; childhood sexual trauma: 60 % vs. 36 %, p?=?.01), to be hazardous drinkers (32 % vs. 16 %, p?=?.03) and rate their current mental health as worse than before deployment (35 % vs. 16 %, p?<?.001). Conclusions: Many LB veterans have experienced sexual victimization, both within the military and as children, and struggle with substance abuse and poor mental health. Health care providers working with female Veterans should be aware of high rates of military sexual trauma and childhood abuse and refer women to appropriate VA treatment and support groups for sequelae of these experiences. Future research should focus on expanding this study to include a larger and more diverse sample of lesbian, gay, bisexual, and transgender veterans receiving care at VA facilities across the country.
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