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

Abstract

BackgroundMany 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.ObjectiveThe 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.DesignProspective cohort study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) women veterans at two large VA facilities.ParticipantsThree 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 MeasuresMeasures included sexual orientation, military sexual trauma, mental and gender-specific health diagnoses, and VA healthcare utilization and satisfaction.Key ResultsLB 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).ConclusionsMany 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.

Older Age Associated with Mental Health Resiliency in Sexual Minority US Veterans

“…There is a substantial and growing literature examining the impact of sexual orientation on mental health indicators among veterans, with an emphasis on the experiences of young female veterans [7-9]. This research shows that sexual minority veterans are more likely to experience military and childhood trauma, report less social and emotional support, and report worse mental health than heterosexual veterans.…”

Association of Alcohol Misuse With Sexual Identity and Sexual Behavior in Women Veterans

“…For example, sexual minority status (determined either by self-identity or sexual behavior) was associated with higher odds of binge drinking among a general population of women (Lindley et al, 2012). Among veterans, a handful of studies have also demonstrated greater rates of substance use among lesbian and bisexual veterans compared to their heterosexual counterparts (Booth et al, 2011;Cochran et al, 2013;Mattocks et al, 2013).…”

“…In a study comparing sexual minority and heterosexual women veterans, those who reported having had any sexual partnerships with women were more likely than those who reported only having had sexual partnerships with men to meet criteria for a lifetime substance use disorder, although alcohol misuse was not specifically examined (Booth, Mengeling, Torner, & Sadler, 2011). While two previous studies identified higher prevalence rates of alcohol misuse among sexual minority veterans compared to heterosexual veterans, both studies used only dichotomous measures of alcohol misuse (Cochran, Balsam, Flentje, Malte, & Simpson, 2013;Mattocks et al, 2013). Moreover, no previous study has assessed associations between sexual minority status and alcohol misuse severity among women veterans across the lifespan.…”

Setting the Stage: Research to Inform Interventions, Practice and Policy to Improve Women Veterans’ Health and Health Care

“…Lehavot and Simpson provide their perspective on how this important topic can be better examined in research studies 16. Mattocks et al conducted a cross-sectional study of OEF and OIF women Veterans at two VA facilities, asking also about sexual preference 17. LB women reported more sexual victimization both within the military and as children compared to heterosexual women.…”