Original Research

Journal of General Internal Medicine

, Volume 28, Issue 2, pp 604-608

Open Access This content is freely available online to anyone, anywhere at any time.

Sexual Victimization, Health Status, and VA Healthcare Utilization Among Lesbian and Bisexual OEF/OIF Veterans

  • Kristin M. MattocksAffiliated withVA Central Western MassachusettsDepartment of Quantitative Health Sciences, University of Massachusetts Medical School Email author 
  • , Anne SadlerAffiliated withComprehensive Access & Delivery Research and Evaluation (CADRE), Mental Health Service Line, Iowa City VA Health Care SystemDepartment of Psychiatry, University of Iowa Hospitals and Clinics
  • , Elizabeth M. YanoAffiliated withVA Greater Los Angeles HSR&D Center of Excellence for the Study of Healthcare Provider BehaviorUCLA School of Public Health
  • , Erin E. KrebsAffiliated withCenter for Chronic Disease Outcomes Research, Minneapolis VA Health Care SystemUniversity of Minnesota Medical School
  • , Laurie ZephyrinAffiliated withDepartment of Veterans Affairs
  • , Cynthia BrandtAffiliated withVA Central Western MassachusettsVA Connecticut Healthcare SystemYale University School of Medicine
  • , Rachel KimerlingAffiliated withVA Central Western MassachusettsNational Center for PTSD, Center for Health Care Evaluation, VA Palo Alto Health Care System
  • , Theo SandfortAffiliated withVA Central Western MassachusettsHIV Center for Clinical and Behavioral Studies, Columbia University
  • , Melissa E. DichterAffiliated withVA Central Western MassachusettsCenter for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center
    • , Jeffrey J. WeissAffiliated withVA Central Western MassachusettsDepartment of Medicine, Division of General Internal Medicine, Mount Sinai School of Medicine
    • , Jeroan AllisonAffiliated withDepartment of Quantitative Health Sciences, University of Massachusetts Medical School
    • , Sally HaskellAffiliated withVA Central Western MassachusettsVA Connecticut Healthcare SystemYale University School of Medicine

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.

KEY WORDS

lesbian health services research Veterans women