No abstract

Background: Lesbian and bisexual (i.e., sexual minority) identity is more common among women veterans than among male veterans. Unique health issues have been identified among women veterans and among sexual minority women, but little is known about women who are both sexual minorities and veterans. This study aimed to compare demographic and health information from sexual minority women veterans with sexual minority women non-veterans and heterosexual women veterans. Methods: Behavioral Risk Factor Surveillance Survey data were pooled from ten U.S. states that elected to ask sexual identity during 2010. The analytic sample was comprised of women who identified both their sexual identity and veteran status (n = 1,908). Mental health indicators were frequent mental distress, sleep problems, low social/emotional support, and low satisfaction with life. Health risk indicators included current smoking, overweight, and obesity. Physical health status was defined by three components: disability requiring assistive equipment, > 14 days of poor physical health in the past 30 days, and activity limitations. Results: Compared with heterosexual women veterans, sexual minority women veterans had higher odds of mental distress (odds ratio [OR] = 3.03, 95% confidence interval [CI]: 1.61-5.70) and smoking (OR = 2.31, 95%CI: 1.19-4.48). After adjusting for demographic correlates, sexual minority women veterans had three times the odds of poor physical health (OR = 3.01, 95%CI: 1.51-5.99) than their sexual minority non-veteran peers. Conclusions: Results suggest sexual minority women veterans may experience unique health disparities relevant to provision of care in both Veterans Affairs (VA) and non-VA healthcare systems. Future research requires availability of data that include sexual minority status.

Prior research indicates that survivors of abuse characterized by very close victimϪperpetrator relationships (VC traumas) are significantly more likely to delay disclosure for 1 or more years, or never to disclose, than survivors of abuse characterized by not very close victimϪperpetrator relationships (NVC traumas) (M. M. Foynes, J. J. Freyd, & A. P. Deprince, 2009, Child abuse, betrayal and disclosure, Child Abuse & Neglect, 33, 209 -217). Nondisclosure of abuse may serve a protective function in that it allows for the maintenance of a necessary, albeit abusive, relationship. This dynamic may be particularly relevant for people who adhere strongly to Asian cultural values of interdependence and may be differentially applicable to disclosure of physical, sexual, and emotional abuse. An online study was conducted with Asian Americans (AAs) and European Americans (EAs; N ϭ 266) to test the hypothesis that Asian values, rather than ethnic group membership, would be associated with decreased disclosure of VC abuse, but not affect disclosure of NVC abuse. The impact of Asian values was expected to be the strongest for disclosure of VC sexual abuse. A series of backward stepwise logistic regressions revealed that Asian values, but not ethnicity, were significantly associated with nondisclosure of VC sexual and emotional abuse, but not VC physical abuse. Neither ethnicity nor Asian values was associated with disclosure of any type of NVC abuse. Female gender increased the odds of VC abuse disclosure only. By examining the impact of cultural values on disclosure of particular abuse types and uncovering the limitations of attending to ethnicity alone, we hope to inform efforts toward facilitating recovery from trauma and creating more supportive environments for survivors.