Online Program

Lesbian, gay, bisexual, and transgender veterans' experiences in the VA health care system

Monday, November 4, 2013 : 5:00 p.m. - 5:15 p.m.

Michael Kauth, PhD, LGBT Program Coordinator, VACO; Co-Director, South Central MIRECC, Michael E. DeBakey VA Medical Center, Houston, TX
Michelle Sherman, PhD, Director, Family Program; South Central MIRECC, Oklahoma City VA Medical Center, Oklahoma City, OK
Little is known about the experiences of lesbian, gay, bisexual, and transgender (LGBT) veterans in the Department of Veterans Affairs (VA) healthcare system. To begin to address this issue, we conducted six focus groups with 58 LGBT veterans at two large VA medical centers. We asked about positive and negative experiences with the VA healthcare system, barriers to access, and solutions for making the VA setting more welcoming. Consistent themes emerged across the two hospitals: (1) LGBT issues were rarely raised by VA clinicians. Mental health clinicians were more likely to raise the topic and were generally viewed as supportive compared to other disciplines. (2) Sexuality and sexual behavior were viewed as personal and private. Many believed that clinicians should not ask about sexuality and behavior. Some saw value in tailoring health care based on their sexual behavior and associated unique needs. (3) Barriers to care for LGBT veterans included clinicians who lacked knowledge and sensitivity about LGBT issues, equating the VA with the military where many had had negative experiences, and fear of discrimination. (4) Suggestions for making the VA more welcoming included staff training, signs denoting an inclusive and safe environment, LGBT community resource lists, and an onsite LGBT advocate. The data suggests the need for VA clinician education about the benefits of assessing sexuality and unique health risks. The strategies that emerged for promoting a welcoming environment for LGBT veterans can guide the VA system in creating LGBT-sensitive policy and staff training.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Provision of health care to the public
Public health or related education
Public health or related research

Learning Objectives:
Describe two common experiences of LGBT veterans in the VA health care system. Name three barriers to care for LGBT veterans.

Keyword(s): Veterans, Special Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a clinical psychologist. I have published several papers, chapters, and a book on sexuality. I teach the human sexuality course at Baylor College of Medicine, where I am a Professor in Psychiatry. At the VA, I'm the “LGBT Program Coordinator for Patient Care Services”. The position involves advising VA Patient Care Services on policy and procedures related to treating LGBT veterans.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.