Hoy-Ellis Charles P, Shiu Chengshi, Sullivan Kathleen M, Kim Hyun-Jun, Sturges Allison M, Fredriksen-Goldsen Karen I
College of Social Work, University of Utah, Salt Lake City.
School of Social Work, University of Washington, Seattle.
Gerontologist. 2017 Feb;57(suppl 1):S63-S71. doi: 10.1093/geront/gnw173.
Converging evidence from large community-based samples, Internet studies, and Veterans Health Administration data suggest that transgender adults have high rates of U.S. military service. However, little is known about the role of prior military service in their mental health later in life, particularly in relation to identity stigma. In this article, we examine relationships between prior military service, identity stigma, and mental health among transgender older adults.
We used a subsample of transgender older adults (n = 183) from the 2014 survey of Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS). We employed weighted multivariate linear models to evaluate the relationships between psychological health-related quality of life (HRQOL), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D] scores), identity stigma, and prior military service, controlling for background characteristics.
Identity stigma was significantly related with higher depressive symptomatology and lower psychological HRQOL. Having a history of prior military service significantly predicted lower depressive symptomatology and higher psychological HRQOL. The relationships between psychological HRQOL, identity stigma, and prior military service were largely explained by depressive symptomatology. Prior military service significantly attenuated the relationship between identity stigma and depressive symptomatology.
By identifying the role of military service in the mental health of transgender older adults, this study provides insights into how prior military service may contribute to resilience and positive mental health outcomes. Directions for future research are discussed.
来自大型社区样本、互联网研究以及退伍军人健康管理局数据的越来越多的证据表明,变性成年人在美国军队服役的比例很高。然而,对于先前的军事服役经历在他们晚年心理健康中的作用,尤其是与身份耻辱感相关的作用,我们知之甚少。在本文中,我们研究了变性老年人先前的军事服役经历、身份耻辱感和心理健康之间的关系。
我们使用了2014年“骄傲老龄化:全国健康、老龄化与性取向/性别研究”(NHAS)中变性老年人的一个子样本(n = 183)。我们采用加权多元线性模型来评估心理健康相关生活质量(HRQOL)、抑郁症状(流行病学研究中心抑郁量表[CES-D]得分)、身份耻辱感和先前军事服役经历之间的关系,并对背景特征进行了控制。
身份耻辱感与较高的抑郁症状和较低的心理健康相关生活质量显著相关。有先前军事服役经历显著预测了较低的抑郁症状和较高的心理健康相关生活质量。心理健康相关生活质量、身份耻辱感和先前军事服役经历之间的关系在很大程度上可以由抑郁症状来解释。先前的军事服役经历显著减弱了身份耻辱感与抑郁症状之间的关系。
通过确定军事服役在变性老年人心理健康中的作用,本研究深入了解了先前的军事服役经历可能如何有助于恢复力和积极的心理健康结果。文中还讨论了未来研究的方向。