The prevalence of GID diagnosis nearly doubled over 10 years among VHA veterans. Research is needed to examine suicide risk among transgender veterans and how their VHA utilization may be enhanced by new VA initiatives on transgender care.

Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions.

Using latent class growth analysis, we were interested in investigating how experiences of loneliness emerge in distinct developmental patterns over the course of middle childhood and adolescence (NICHD Study of Early Child Care, N = 832). Second, we examined the role of demographic, mental health, and behavioral variables in association with these discrete patterns of loneliness. Loneliness was measured at 3 time points: age 9, age 11, and age 15. Results indicated five discrete trajectories of loneliness from middle childhood to adolescence. Most children exhibited a stable and low level of loneliness over time. The remaining children were split among moderate increasing, high increasing, decreasing, and chronic loneliness groups. Ethnicity, income, age 7 social skills, age 7 depression, and age 7 aggression were associated with trajectory membership. In addition, the loneliness trajectories predicted self‐reports of social skills deficits, depression, aggression, and suicidal ideation at age 15.

IMPORTANCE Adverse childhood experiences (ACEs) are associated with several adulthood health problems, such as self-directed violence. For some individuals, enlistment in the military may be an instrumental act to escape adverse household environments; however, to our knowledge prevalence of ACEs among persons with a history of military service has not been documented in the United States using population-based data.OBJECTIVE To compare the prevalence of ACEs among individuals with and without a history of military service. DESIGN, SETTING, AND PARTICIPANTS Data are from the 2010 Behavioral Risk Factor Surveillance System. Computer-assisted telephone interviews were conducted with population-based samples of noninstitutionalized US adults from January 1 through December 31, 2010. Analyses were limited to respondents who received the ACE module (n = 60 598). Participants were categorized by history of military service and whether a respondent was 18 years of age in 1973.MAIN OUTCOMES AND MEASURES History of military service was defined by active duty service, veteran status, or training for the Reserves or National Guard. The ACE inventory assessed 11 negative experiences before the age of 18 years. Weighted χ 2 tests and multiple logistic regression analyses were used to examine differences in ACEs by history of military service, era of service, and sex. RESULTSThose with military experience had greater odds of any difference in prevalence of ACEs. In the all-volunteer era, men with military service had a higher prevalence of ACEs in all 11 categories than men without military service. Notably, in the all-volunteer era, men with military service had twice the odds of reporting forced sex before the age of 18 years (odds ratio, 2.19; 95% CI, 1.34-3.57) compared with men without military service. In the draft era, the only difference among men was household drug use, in which men with a history of military service had a significantly lower prevalence than men without a history of military service (2.1% vs 3.3%; P = .003). Fewer differences were observed among women in the all-volunteer and draft eras. CONCLUSIONS AND RELEVANCEDifferences in ACEs by era and sex lend preliminary support that enlistment may serve as an escape from adversity for some individuals, at least among men. Further research is needed to understand how best to support service members and veterans who may have experienced ACEs.