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Transgender Veterans' Satisfaction With Care and Unmet Health Needs
Keren Lehavot1, Jodie G Katon, Tracy L Simpson
1*Health Services Research and Development (HSR&D) Center of Innovation (COIN) †Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA Departments of ‡Psychiatry and Behavioral Sciences §Health Services, University of Washington ∥Center of Excellence in Substance Abuse and Treatment (CESATE), VA Puget Sound Health Care System, Seattle, WA ¶LGBT Health Program, Veterans Health Administration, Washington DC #VA Boston Healthcare System **National Center for PTSD, Women's Health Sciences Division ††Boston University School of Medicine, Boston, MA.
Background:
Transgender individuals are overrepresented among Veterans. However, little is known regarding their satisfaction with Veterans Administration (VA) care and unmet health needs.
Objectives:
This study examined transgender Veterans' satisfaction with VA medical and mental health care, prevalence of delaying care, and correlates of these outcomes.
Research Design:
We used data from transgender Veterans collected in 2014 through an online, national survey.
Subjects:
In total, 298 transgender Veterans living in the United States.
Measures:
We assessed patient satisfaction with VA medical and mental health care and self-reported delays in seeking medical and mental health care in the past year. Potential correlates associated with these 4 outcomes included demographic, health, and health care variables.
Results:
Over half of the sample used VA (56%) since their military discharge. Among transgender Veterans who had used VA, 79% were satisfied with medical care and 69% with mental health care. Lower income was associated with dissatisfaction with VA medical care, and being a transgender man was associated with dissatisfaction with VA mental health care. A substantial proportion reported delays in seeking medical (46%) or mental (38%) health care in the past year (not specific to VA). Screening positive for depression and/or posttraumatic stress disorder was associated with delays in seeking both types of care.
Conclusions:
Although the majority of transgender Veterans are satisfied with VA health care, certain subgroups are less likely to be satisfied with care. Further, many report delaying accessing care, particularly those with depression and/or posttraumatic stress disorder symptoms. Adapting health care settings to better engage these vulnerable Veterans may be necessary.
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