VA Connecticut Healthcare System, West Haven, Connecticut, USA.
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
LGBT Health. 2023 Sep;10(S1):S61-S69. doi: 10.1089/lgbt.2023.0074.
The purpose of this study was to examine the prevalence of military sexual trauma (MST) by sexual orientation, characteristics of sexual minority (SM) and heterosexual veterans who have experienced MST, and associations between sexual orientation and mental health symptoms among veterans who have experienced MST. Data were analyzed from a nationally representative web-based survey of 4069 U.S. veterans (4.9% SM), which assessed sociodemographic (e.g., age, sexual orientation) and military (e.g., branch) characteristics, and lifetime and current mental health symptoms. Bivariate analyses compared sociodemographic and military characteristics and mental health symptoms among veterans who have experienced MST by sexual orientation. Multivariable logistic regressions examined associations between sexual orientation and mental health symptoms among veterans who have experienced MST, while controlling for differences in sociodemographic characteristics and non-MST traumatic events. The prevalence of MST (7.5% of weighted sample) was higher among SM veterans compared to heterosexual veterans, with bisexual/pansexual/queer veterans endorsing the highest prevalence (22.7%), followed by gay/lesbian (17.0%) and heterosexual (6.5%) veterans. SM veterans who experienced MST were more likely than heterosexual veterans to screen positive for lifetime and current posttraumatic stress disorder (odds ratio [OR] = 3.06 and 3.38, respectively), and current drug use disorder (OR = 3.53). This study adds to growing evidence that mental health symptoms associated with MST disproportionately impact SM veterans relative to heterosexual veterans. Approaches to reducing barriers and tailoring MST-related care to SM veterans, including through addressing cumulative effects of minority stress, are discussed.
本研究旨在探讨性取向对经历过军事性创伤（MST）的性少数群体（SM）和异性恋退伍军人中 MST 发生率的影响，以及经历过 MST 的退伍军人中性取向与心理健康症状之间的关联。该研究的数据来自一项针对 4069 名美国退伍军人（4.9%为 SM）的全国性网络调查，评估了社会人口统计学（如年龄、性取向）和军事特征（如分支），以及终身和当前的心理健康症状。采用双变量分析比较了经历过 MST 的退伍军人中，性取向对社会人口统计学和军事特征以及心理健康症状的影响。多变量逻辑回归检验了经历过 MST 的退伍军人中，性取向与心理健康症状之间的关联，同时控制了社会人口统计学特征和非 MST 创伤事件的差异。MST（加权样本的 7.5%）的发生率在 SM 退伍军人中高于异性恋退伍军人，双性恋/泛性恋/酷儿退伍军人的发生率最高（22.7%），其次是同性恋/女同性恋（17.0%）和异性恋（6.5%）退伍军人。与异性恋退伍军人相比，经历过 MST 的 SM 退伍军人更有可能出现终身和当前创伤后应激障碍（优势比[OR]分别为 3.06 和 3.38）和当前药物使用障碍（OR 为 3.53）的筛查阳性。本研究进一步证明，与异性恋退伍军人相比，与 MST 相关的心理健康症状对 SM 退伍军人的影响不成比例。讨论了减少障碍和针对 SM 退伍军人定制 MST 相关护理的方法，包括通过解决少数群体压力的累积效应。
