1 Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Program, Office of Patient Care Services, Veterans Health Administration , Washington, District of Columbia.
2 Women's Health Sciences Division, National Center for PTSD , VA Boston Healthcare System, Boston, Massachusetts.
LGBT Health. 2018 Jul;5(5):303-311. doi: 10.1089/lgbt.2017.0179.
This study aimed to compare experiences related to healthcare of LGBT women and non-LGBT women in a sample of routine users of Veterans Health Administration (VHA) primary care services and examine the impact of those experiences on delaying or missing appointments for VHA care.
Women veterans (N = 1391) who had at least three primary care visits in the previous year at 12 VHA facilities were surveyed by phone in January-March 2015 in a baseline wave of a cluster-randomized quality improvement trial. The majority identified as non-LGBT (1201; 85.6%) with 190 (14.4%) women identified as LGBT, based on items measuring sexual orientation and gender identity.
In models controlling for demographics, health status, and positive trauma screens, LGBT identity was predictive of women veterans experiencing harassment from male veterans at VHA in the past 12 months, as well as feeling unwelcome or unsafe at their VHA. Compared with non-LGBT women veterans, LGBT women veterans attributed missing needed care more often in the previous 12 months to concerns about interacting with other veterans. Participant descriptions of harassment indicated that male veterans' comments and actions were distressing and influenced LGBT women's healthcare accessing behavior.
Compared with non-LGBT women, LGBT women were more likely to report harassment and feeling unwelcome at VHA. Some LGBT women reported delaying or missing needed care, primarily due to concerns about interacting with other veterans. Additional work is necessary to help LGBT women veterans feel safe and welcome at VHA facilities and, thereby, reduce barriers to LGBT women veterans accessing needed care.
本研究旨在比较 LGBT 女性和非 LGBT 女性在退伍军人健康管理局 (VHA) 初级保健服务常规使用者样本中的医疗保健体验，并探讨这些体验对延迟或错过 VHA 护理预约的影响。
在一项以退伍军人健康管理局为基础的聚类随机质量改进试验的基线波中，通过电话对 12 个退伍军人健康管理局设施中过去一年至少有三次初级保健就诊的女性退伍军人（N=1391）进行了调查。大多数人自认为是非 LGBT（1201；85.6%），190 名（14.4%）女性根据测量性取向和性别认同的项目被认定为 LGBT。
在控制人口统计学、健康状况和阳性创伤筛查的模型中，LGBT 身份预测了过去 12 个月内女性退伍军人在退伍军人健康管理局遭受男性退伍军人骚扰的经历，以及在退伍军人健康管理局感到不受欢迎或不安全的经历。与非 LGBT 女性退伍军人相比，LGBT 女性退伍军人更有可能将过去 12 个月内错过所需护理归因于担心与其他退伍军人互动。参与者对骚扰的描述表明，男性退伍军人的言论和行为令人痛苦，并影响了 LGBT 女性的医疗保健获取行为。
与非 LGBT 女性相比，LGBT 女性更有可能报告在退伍军人健康管理局受到骚扰和不受欢迎。一些 LGBT 女性报告说延迟或错过所需的护理，主要是因为担心与其他退伍军人互动。需要做更多的工作来帮助 LGBT 女性退伍军人在退伍军人健康管理局设施中感到安全和受欢迎，从而减少 LGBT 女性退伍军人获取所需护理的障碍。
