Male-to-Female Transgender Veterans and VA Health Care Utilization

ABSTRACT

This study examined rates of military veteran status in an American male-to-female transgender community sample (n = 141). Thirty percent were veterans (n = 43), a rate that is triple the proportion of veteran status noted in the general population (10.1%). Among the veteran subsample, we examined health care utilization, including Veterans Health Administration (VA), health, and barriers to care. Use of VA services was higher among transgender veterans (transvets) than published rates of VA use in the general population of veterans (annual 6.2% to 15.8%), with 16.3% of all transvets seeking some VA care in the past 6- months. The most common physical health problems treated at the VA in the past year were high cholesterol, blood pressure, and vision problems. Irrespective of VA use, the majority of transvets reported getting routine health care (88.4%), and their physical health ratings were commensurate with population norms. Mental health services (e.g., depression, posttraumatic stress disorder, and gender identity counseling) were also utilized (9.3% VA, 25.6% non-VA) at levels consistent with the relatively low mental health functioning scores in this sample (SF-12 = 32.6, SD = 8.3). Barriers to care were endorsed more for medical than mental health treatment. In particular, transvets were concerned about medical providers’ reactions to their gender identity or sexual orientation. Given elevated rates of transvets in this community sample and reported barriers to care, culturally sensitive treatment is a priority for transvets in both VA and non-VA health care systems.

KEYWORDS:

• Transgender
• transsexual
• gender
• veteran
• service utilization
• barriers to care

Notes

According to VHA Directive 2011–024: Providing Health Care for Transgender and Intersex Veterans (Department of Veterans’ Affairs, 2011): “Male-to-female (MtF) transsexuals are individuals who are male sex at birth, but self-identify as female and often take steps to socially or medically transition to female, including feminizing hormone therapy, electrolysis, and surgeries (e.g., vaginoplasty, breast augmentation)” (p. 1).

*p ≤ .05 one-tailed test of differences.