Abstract
This chapter explores the experiences and status of lesbian, gay, bisexual, and transgender (LGBT) older veterans and service members. Examined are the history and background of LGBT veterans, the efforts of the Department of Veterans Affairs to address the recognition and needs of these service members and veterans, and the creation of the VA Office of Diversity and Inclusion (US Department of Veterans Affairs, 2014 VA Diversity and Inclusion Strategic Plan for FY 2012–2016) and key policies and procedures that have addressed the discriminatory practices that have been a part of the military and post military experiences of LGBT individuals. A meta-analysis of elder LGBT veterans and military personnel is offered as are mental health and psychosocial adjustment issues for LGBT elder veterans. Discussed is the Transitional Accommodation Syndrome providing insight into understanding the process faced by LGBT veterans. Finally, clinical considerations with elderly LGBT veterans are offered as are a set of resources and references that may be beneficial for further inquiry into understanding of the issues faced by LGBT veterans across the life span.
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Acknowledgments
The author wishes to acknowledge the guidance and assistance of James C. Holsinger MD PhD, University of Kentucky and former Chief Medical Director Department of Veterans Affairs; Monica Roy PhD VA medical Center and NE VA HealthCare, Boston MA; Katie Miller, Research Assistant for the LGBT Research and Communications Project at the Center for American Progress; Andrew Cray, Policy Analyst for the LGBT Research and Communications Project. Special appreciation is extended to Jillian C. Shipherd, PhD National Center for PTSD, Women’s Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine, Boston, Massachusetts, and Michael R. Kauth, PhD with the VHA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center (MIRECC), and Michael E. DeBakey VA Medical Center, Houston, TX; and Baylor College of Medicine, Houston, for their guidance and resources in the completion of this chapter.
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Editors and Affiliations
Appendices
Resources
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US Department of Veterans Affairs’ (VA’s) Office of Diversity and Inclusion (ODI)
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Jillian C. Shipherd, PhD Michael R. Kauth, PhD. Lesbian, Gay, Bisexual, and Transgender (LGBT) Program Coordinators Office of Patient Care Services (10P4Y) at VA Central Office, Washington, DC
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VHA Office of Health Equity, Washington, DC
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Case-Based Transgender E-Consultation with Department of Veterans Affairs
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Three regional Transgender E-Consultation programs: Loma Linda, CA (VISN 22), Minneapolis, MN (VISN 23), Tucson, AZ (VISN 18)
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VHA Transgender & LGB Education SharePoints: Contact: Michael.Kauth@va.gov or Jillian.Shipherd@va.gov
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American Psychological Association: www.apa.org/pi/lgbt/resources/
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World Professional Association for Transgender Health: www.wpath.org
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Healthy People 2020 available at: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25
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Gay, Lesbian Medical Association: www.glma.org
Learning Exercises
Self-Check Questions (5 questions)
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1.
What are transitions that LGBT veterans face that are not faced by those elders who are not veterans?
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2.
Explain the significance of the “Don’t Ask, Don’t Tell” policy.
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3.
Discuss discrimination faced by LGBT elder veterans.
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4.
Discuss and explain the “Trauma Accommodation syndrome.
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5.
What are particular challenges of aging faced by LGBT veterans?
Experiential Assignments
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1.
Visit a VA medical Center and request an appointment with the Director of the facility to discuss policies and procedures in addressing the healthcare needs of LGBT veterans
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2.
Vet Centers provide community outreach. Meet with one of the counselors in the Vet Centers in your area to discuss screening and treatment interventions offered through the Vet Center program
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3.
Contact the VA Office of Diversity and Inclusion (ODI) and ask for information about their annual report and how they are addressing their mission and vision statement.
Multiple-Choice Questions (10)
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1.
What is not a key feature of the mission statement of the US Department of Veterans Affairs’ Office of Diversity and Inclusion?
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a.
Silence
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b.
Respect
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c.
Integrity
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d.
Commitment
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a.
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2.
The population of LGBT elder veterans is
-
a.
Nonexistent
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b.
Totally unknown
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c.
Easily identifiable
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d.
Identified somewhat
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a.
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3.
Coupled gay men who are veterans or report training in the guard or reserve, when compared to heterosexual veterans
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a.
Similar
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b.
Predominantly Asian
-
c.
More often African-American and Hispanic
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d.
More often from urban areas
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a.
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4.
Coupled gay women who are veterans or report training in the guard or reserve, when compared to heterosexual veterans
-
a.
More often white
-
b.
Predominantly Asian
-
c.
More often African-American and Hispanic
-
d.
More often from urban areas
-
a.
-
5.
Challenges that LGBT elders face include all these except
-
a.
Isolation
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b.
Threat of discrimination
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c.
Adequate social services
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d.
Fear of abuse
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a.
-
6.
The policy regarded as the most discriminatory for LGBT veterans was
-
a.
Social Security
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b.
Don’t Ask, Don’t Tell
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c.
Medicare
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d.
Elder Justice Act
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a.
-
7.
What are ways that the Veterans Administration is working to help LGBT elders?
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a.
Training of the workforce
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b.
Training the military
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c.
Adapting clinical standards for treatment
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d.
All of the above
-
a.
-
8.
In the past, mental health care for LGBT veterans has been
-
a.
Excellent
-
b.
Fairly adequate
-
c.
Good
-
d.
Poor
-
a.
-
9.
Historically, LGBT Elder veterans have been treated _____ by the Veterans Administration:
-
a.
Fairly
-
b.
Unfairly
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c.
Adequately
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d.
Appropriately
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a.
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10.
Stages of the “Trauma Accommodation Syndrome” for LGBT Veterans include all the following except:
-
a.
Secrecy
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b.
Helplessness
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c.
Accommodation
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d.
Reimbursement
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a.
Key (For Multiple-Choice Questions)
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1-a
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2-d
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3-c
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4-a
-
5-c
-
6-b
-
7-d
-
8-d
-
9-b
-
10-d
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Miller, T.W. (2016). Elder LGBT Veterans and Service Members. In: Harley, D., Teaster, P. (eds) Handbook of LGBT Elders. Springer, Cham. https://doi.org/10.1007/978-3-319-03623-6_11
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DOI: https://doi.org/10.1007/978-3-319-03623-6_11
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