a Department of Veterans Affairs , LGBT Health Program, Office of Patient Care Services , Washington , DC , USA.
b Women's Health Sciences Division , National Center for PTSD , Boston , MA , USA.
J Trauma Dissociation. 2018 Jul-Sep;19(4):461-475. doi: 10.1080/15299732.2018.1451973.
Past research suggests that rates of trauma exposure and Posttraumatic Stress Disorder (PTSD) are elevated among lesbian, gay, bisexual, and transgender (LGBT) veterans compared to heterosexual and cisgender veterans. Given higher rates of trauma exposure and PTSD, and the culture associated with the Department of Defense's history of policies excluding LGBT people, it is important to understand if LGBT veterans are seeking PTSD treatment following discrimination-based traumatic events, where they seek care, and if they are satisfied with treatment. This study aimed to describe the experiences of discrimination-based trauma-exposed LGBT veterans' (n = 47) experiences with PTSD treatment, including location of treatment (Veterans Health Administration [VHA] versus non-VHA) and satisfaction with care. The majority of veterans had received a PTSD diagnosis from a health-care provider in their lifetimes (78.72%, n = 37), and over half reported currently experiencing PTSD symptoms. Approximately 47% of LGBT veterans with discrimination-based trauma histories preferred to seek PTSD treatment exclusively at VHA (46.81%) or with a combination of VHA and non-VHA services (38.30%). Veterans who received PTSD treatment exclusively from VHA reported higher satisfaction ratings (7.44 on 0-9 scale) than veterans who received PTSD treatment exclusively from outside VHA (5.25 on 0-9 scale). For veterans who sought PTSD treatment at both VHA and non-VHA facilities, there were no significant differences regarding satisfaction ratings for their PTSD treatment in the two settings. Results are discussed in terms of VHA's continued efforts to establish equitable, patient-centered health care for all veterans and the importance of non-VHA facilities to recognize veteran identities.
过去的研究表明，与异性恋和顺性别退伍军人相比，女同性恋、男同性恋、双性恋和跨性别（LGBT）退伍军人的创伤暴露和创伤后应激障碍（PTSD）的发生率更高。鉴于创伤暴露和 PTSD 的发生率较高，以及与国防部历史上排除 LGBT 人群的政策相关的文化，了解 LGBT 退伍军人是否在遭受基于歧视的创伤性事件后寻求 PTSD 治疗、他们在哪里寻求治疗以及他们对治疗是否满意非常重要。本研究旨在描述经历过基于歧视的创伤暴露的 LGBT 退伍军人（n=47）的 PTSD 治疗经历，包括治疗地点（退伍军人事务部 [VHA] 与非 VHA）和对治疗的满意度。大多数退伍军人一生中都曾从医疗保健提供者那里获得过 PTSD 诊断（78.72%，n=37），超过一半的人报告目前有 PTSD 症状。大约 47%的有基于歧视的创伤史的 LGBT 退伍军人更愿意专门在 VHA 寻求 PTSD 治疗（46.81%）或在 VHA 和非 VHA 服务的组合中寻求治疗（38.30%）。专门在 VHA 接受 PTSD 治疗的退伍军人报告的满意度评分（0-9 分制中的 7.44 分）高于专门在 VHA 以外接受 PTSD 治疗的退伍军人（0-9 分制中的 5.25 分）。对于在 VHA 和非 VHA 设施都寻求 PTSD 治疗的退伍军人，他们对这两种环境中 PTSD 治疗的满意度评分没有显著差异。结果从 VHA 为所有退伍军人建立公平、以患者为中心的医疗保健的持续努力以及非 VHA 设施承认退伍军人身份的重要性方面进行了讨论。
