An Empirical Investigation of Challenges and Recommendations for Welcoming Sexual and Gender Minority Veterans Into VA Care.

Approximately 1 million gay and lesbian Americans are veterans. With the repeal of the "Don't Ask, Don't Tell," the Veterans Affairs (VA) health care system is focusing on the unique needs of lesbian, gay, bisexual, and transgender (LGBT). veterans. As a result of research in the private sector documenting stigmatizing attitudes and discrimination toward LGBT individuals in health care settings, the Institute of Medicine and The Joint Commission published recommendations for responding to the needs of LGBT individuals. However, minimal research has examined the unique needs of LGBT veterans and their experiences in VA. This 2-site (Oklahoma City, OK; Houston, TX), mixed-methods study included 202 VA providers and 58 LGBT veterans. Experiences at VA, comfort in providing/receiving care, barriers LGBT veterans face in coming to VA, and recommendations for making VA more welcoming were assessed. Six focus groups and 6 individual interviews were conducted with veterans, and providers completed anonymous surveys. Less than one third of LGBT veterans and providers viewed VA as welcoming to LGBT veterans. Half of providers indicated they do not assess sexual orientation with any of their patients. Furthermore, half of providers reported that they do not alter their treatment plans even if they know the veteran is lesbian, gay, or bisexual. Many constructive suggestions regarding how VA can be more welcoming arose in the veteran inquiry and the provider survey. Based on our findings and the broader literature, recommendations for providers and administrators are described. [ABSTRACT FROM AUTHOR]

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