Health Disparities Among Sexual Minority Women Veterans

Abstract

Background: Lesbian and bisexual (i.e., sexual minority) identity is more common among women veterans than among male veterans. Unique health issues have been identified among women veterans and among sexual minority women, but little is known about women who are both sexual minorities and veterans. This study aimed to compare demographic and health information from sexual minority women veterans with sexual minority women non-veterans and heterosexual women veterans. Methods: Behavioral Risk Factor Surveillance Survey data were pooled from ten U.S. states that elected to ask sexual identity during 2010. The analytic sample was comprised of women who identified both their sexual identity and veteran status (n = 1,908). Mental health indicators were frequent mental distress, sleep problems, low social/emotional support, and low satisfaction with life. Health risk indicators included current smoking, overweight, and obesity. Physical health status was defined by three components: disability requiring assistive equipment, > 14 days of poor physical health in the past 30 days, and activity limitations. Results: Compared with heterosexual women veterans, sexual minority women veterans had higher odds of mental distress (odds ratio [OR] = 3.03, 95% confidence interval [CI]: 1.61-5.70) and smoking (OR = 2.31, 95%CI: 1.19-4.48). After adjusting for demographic correlates, sexual minority women veterans had three times the odds of poor physical health (OR = 3.01, 95%CI: 1.51-5.99) than their sexual minority non-veteran peers. Conclusions: Results suggest sexual minority women veterans may experience unique health disparities relevant to provision of care in both Veterans Affairs (VA) and non-VA healthcare systems. Future research requires availability of data that include sexual minority status.

A Systematic Review of the Literature on Weight in Sexual Minority Women

“…Kavanaugh, 2009). Six studies found no differences in weight by sexual orientation (Blosnich et al, 2013(Blosnich et al, , 2014Bogaert, 2010;Farmer et al, 2013;Hatzenbuehler et al, 2013;Polimeni et al, 2009;Richmond et al, 2012). The remainder found lesbian/bisexual women to be significantly heavier or more likely to be obese with the exception of one study that had no heterosexual comparison group (Fredriksen-Goldsen et al, 2012a).…”

Psychological and behavioral moderators of the relationship between trauma severity and HIV transmission risk behavior among MSM with a history of childhood sexual abuse

“…For MSM, sexual minority stress and stigma may influence psychological and behavioral vulnerabilities, including problematic substance use (Boroughs et al, 2015; King et al, 2003) and low self-esteem (Berg et al, 2013; Zervoulis et al, 2015), which may affect high-risk behaviors (Hatzenbuehler, 2009; Meyer, 2003). Studies have identified that sexual minority men and women have greater levels of psychological distress and drug use than their heterosexual peers (Blosnich et al, 2013; King et al, 2003), which could be due to ego depletion (Baumeister et al, 1998) or negative reinforcement pathways (Baker et al, 2004) associated with minority stress. Further, sexual minority individuals also have significantly greater prevalence of mental and physical illnesses, possibly linked to discrimination (Lehavot et al, 2016; Warner et al, 2004).…”

Differences in Chronic Disease Behavioral Indicators by Sexual Orientation and Sex

“…Finally, we did not integrate measures of social support and mental health into this analysis; yet, other research suggests this is another area where disparities by sexual orientation may contribute to inequities in physical health outcomes. 3,20 …”