Examining Health Care Mobility of Transgender Veterans Across the Veterans Health Administration

Wang, Karen; McAvay, Gail; Warren, Allison R.; Miller, Mary Lou; Pho, Anthony; Blosnich, John R.; Brandt, Cynthia; Goulet, Joseph L.

doi:10.1089/lgbt.2020.0152

Cited by 7 publications

(8 citation statements)

References 38 publications

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“…However, avoidable hospitalizations predicted greater suicidality among both groups (Progovac et al, 2020). Additionally, Wang et al (2021) observed that GM veterans within the Veterans Health Administration were more likely than non-GM veterans to access multiple health care systems, which was related to disparities in depression and other chronic conditions, although this utilization of multiple systems decreased among GM veterans aged 61 and older. In contrast to these findings regarding health care access from studies using administrative records, Fredriksen-Goldsen et al (2014) identified greater fears of accessing health services among GM older adults compared to non-GM sexual minority older adults, which partially explained disparities in self-reported depression and stress.…”

Section: Resultsmentioning

confidence: 99%

“…Four quantitative studies (Fredriksen-Goldsen et al, 2014;Progovac et al, 2018Progovac et al, , 2020Wang et al, 2021), three qualitative studies (Elder, 2016;Fabbre & Gaveras, 2020;Putney et al, 2018), and the mixed methods study (Witten, 2014) discussed broader issues of health care access and quality in relation to mental health concerns among GM older adults, with somewhat mixed findings. Quantitative analyses of claims data from the same sample of Medicare beneficiaries found greater needs-adjusted mental health service utilization (Progovac et al, 2018) and fewer avoidable hospitalizations, interpreted as a proxy for preventative health care barriers (Progovac et al, 2020), among GM compared to non-GM beneficiaries aged 65 and older.…”

Section: Risk Factors For Mental Health Concernsmentioning

confidence: 99%

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Mental health of gender minority older adults in the United States: A systematic review.

Kerr,

Davoudpour,

Phillips

et al. 2024

Psychology of Sexual Orientation and Gender Diversity

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Section: Resultsmentioning

confidence: 99%

Section: Risk Factors For Mental Health Concernsmentioning

confidence: 99%

Mental health of gender minority older adults in the United States: A systematic review.

Kerr,

Davoudpour,

Phillips

et al. 2024

Psychology of Sexual Orientation and Gender Diversity

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“…Both mental health problems (Becerra-Culqui et al, 2018; Oswalt & Lederer, 2017; Paquette et al, 2021; Reisner et al, 2015, 2016; Wang et al, 2021) and IPV (Bukowski et al, 2019; Henry et al, 2021; Peitzmeier et al, 2020; Whitfield et al, 2021; Whitton et al, 2019) are elevated in TGNC populations. Additionally, TGNC individuals are at high risk for identity-specific IPV (Peitzmeier et al, 2019; Woulfe & Goodman, 2021).…”

Section: Discussionmentioning

confidence: 98%

“…Anxiety estimates range from 26.7% (Reisner et al, 2015) to 38.9% (Becerra-Culqui et al, 2018), and PTSD estimates from 6.2% (Beckwith et al, 2019) to 36.5% (Sherman et al, 2020). Additionally, research consistently shows that these prevalence estimates are significantly higher in TGNC individuals than in their cisgender counterparts for depression and anxiety (Becerra-Culqui et al, 2018;Oswalt & Lederer, 2017;Reisner et al, 2015Reisner et al, , 2016, as well as PTSD (Paquette et al, 2021;Wang et al, 2021). In fact, the magnitude of the disparity in mental health problems between TGNC and cisgender individuals has been observed to be as large as sevenfold in one study (Becerra-Culqui et al, 2018).…”

mentioning

confidence: 97%

“…A growing body of literature suggests that transgender and gender nonconforming (TGNC) individuals are at especially high risk for mental health problems, including depression, anxiety, and posttraumatic stress disorder (PTSD; Becerra-Culqui et al, 2018;Beckwith et al, 2019;Oswalt & Lederer, 2017;Paquette et al, 2021;Reisner et al, 2015Reisner et al, , 2016Wang et al, 2021). Prevalence estimates vary across studies, but past research has found the prevalence of depression in this population to be between 37.9% (Beckwith et al, 2019) and 61.5% (Becerra-Culqui et al, 2018).…”

mentioning

confidence: 99%

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The role of internalized transphobia and negative expectations in the relationship between identity-specific intimate partner violence and mental health outcomes in transgender and gender nonconforming young adults.

Taber¹,

Stults²,

Song³

et al. 2023

Psychology of Sexual Orientation and Gender Diversity

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Transgender and gender nonconforming (TGNC) individuals are at increased risk for mental health problems, including depression, anxiety, and posttraumatic stress disorder (PTSD). The Gender Minority Stress Model posits that this disparity can be explained by several pathways, with proximal stressors (e.g., internalized transphobia, negative expectations) mediating the relationship between distal stressors (e.g., intimate partner violence [IPV]) and mental health. The current study sought to assess one such pathway by testing the hypothesis that internalized transphobia and negative expectations would mediate the relationship between identity-specific IPV (i.e., transgender-related IPV, identity abuse) and depression, anxiety, and PTSD. All variables were measured concurrently using an in-person survey with 200 TGNC young adults. As hypothesized, negative expectations were found to likely mediate the relationships between identity-specific IPV and mental health; the proportion mediated by negative expectations ranged from .253 to .487. Contrary to expectations, internalized transphobia was not found to be a likely mediator in any models, although it was associated with mental health in bivariate correlations. More research is needed to determine why negative expectations, but not internalized transphobia, may be a mediator between identity-specific IPV and psychopathology. However, the present results indicate that clinical work with TGNC IPV survivors should account for identity-specific experiences and may benefit from targeting cognitive distortions related to negative expectations. Future research should assess this pathway with a longitudinal design, as well as test additional Gender Minority Stress Model pathways to gain a more thorough understanding of the factors affecting mental health disparities in the TGNC population.

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Let’s Connect: Impact Evaluation of an Intervention to Reduce Mental Health Disparities Among People Who are LGBTQ+

Facente,

Davila,

Kowell

et al. 2024

Community Ment Health J

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Lesbian, gay, bisexual, transgender, queer, or similarly identified (LGBTQ+) people experience substantial mental health disparities compared to heterosexuals. The “Let’s Connect” intervention was designed to improve mental health outcomes for LGBTQ+ people. This impact evaluation aimed to assess effectiveness of this intervention during its pilot phase, using a single arm pilot trial. Respondents completed baseline surveys at intervention start, a post survey on the last day of the intervention (at 6 weeks), then a follow-up survey 6 weeks after the intervention ended (at 12 weeks). Pre-post differences in outcomes were analyzed using paired t-tests, chi-square tests, and generalized estimating equations to evaluate impact on mental health outcomes at 6 and 12 weeks, and identify characteristics associated with loss to follow-up. The average value of all three outcome measures decreased substantially between the baseline and post surveys; all of these differences were highly statistically significant, and further decreased between the end of the intervention at 6 weeks and the 12 week follow-up survey. Let’s Connect participants did experience substantial improvements in mental health outcomes, on average, between the start and end of this intervention. Further study of this intervention using a randomized design and control group is warranted.

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Examining Health Care Mobility of Transgender Veterans Across the Veterans Health Administration

Cited by 7 publications

References 38 publications

Mental health of gender minority older adults in the United States: A systematic review.

Mental health of gender minority older adults in the United States: A systematic review.

The role of internalized transphobia and negative expectations in the relationship between identity-specific intimate partner violence and mental health outcomes in transgender and gender nonconforming young adults.

Let’s Connect: Impact Evaluation of an Intervention to Reduce Mental Health Disparities Among People Who are LGBTQ+

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