Serving All Who Served: An Analysis of the VA's Visual and Digital Rhetorics for Welcoming Sexual and Gender Minority Veterans Into VA Care

Abstract

Nearly one million veterans identify as lesbian, gay, bisexual, and transgender (LGBT) and could be eligible for services provided by the United States Department of Veteran Affairs (VA). Historical criminalization of service members prior to and during the Don't Ask Don't Tell policy created social and cultural barriers to LGBT veterans seeking VA care. To date, no studies have assessed the implementation of the VA's efforts to create a welcoming environment for LGBT veterans. This study fills that gap by using rhetorical genre studies to analyze how official http://VA.gov websites position and address LGBT veterans. Our results indicate that rhetorical and discursive strategies deployed on the VAMC web sites betray information asymmetries reflecting varying levels of ambition and commitment to inclusion of LGBT veterans. With a focus on techne, we conclude with research‐based recommendations for VA practitioners, administrators, and policymakers to improve patient‐provider communication through public digital rhetorics.

Primary sources of health care among LGBTQ+ veterans: Findings from the Behavioral Risk Factor Surveillance System

“…Importantly, VHA has taken steps in recent years to improve the care of LGBTQ+ veterans at VHA 4,18,20 . For example, beginning in 2016, every VHA designates at least one LGBTQ+ Veteran Care Coordinator to address the needs of LGBTQ+ veterans and disseminate best practices to providers.…”

“…Importantly, VHA has taken steps in recent years to improve the care of LGBTQ+ veterans at VHA. 4,18,20 LGBTQ+ or veteran-specific care. [15][16][17]48 VHA has placed considerable focus on improving health care access, such as through initiatives to provide Internet connection and tablets for telehealth visits at no cost to eligible veterans.…”

“…For instance, LGBTQ+ women veterans report greater harassment at VHA and are more likely to miss an appointment due to concerns about the environment compared to non‐LGBTQ+ women veterans 26 . Additionally, under the previous Department of Defense policy known as “Don't Ask, Don't Tell (DADT),” which barred LGB individuals from openly serving in the military, LGB individuals may have been dishonorably discharged, 4 making them ineligible for VHA care 27 . Since the repeal of DADT in 2011, veterans could appeal their discharge to become eligible, 28 but the damage of DADT still erodes LGBTQ+ veterans' trust in VHA despite never being a VHA policy 25 .…”

“…However, little is known about LGBTQ+ veterans' utilization of health care generally or VHA and military health plans specifically, 2 particularly compared to non-LGBTQ+ veterans. LGBTQ+ veterans have experienced a long history of discrimination in military service and in VHA, 3,4 which may contribute to discomfort in seeking care at VHA. Widespread minority stress experiences, some of which may be encountered in the VHA system, are thought to increase risk for mental, physical, and behavioral health concerns, [5][6][7][8][9][10][11] highlighting the need to better understand the health care utilization of this population.…”

Rolling out PRIDE in All Who Served: Barriers and Facilitators for Sites Implementing an LGBTQ+ Health Education Group for Military Veterans

“… 13 Despite gains in the availability of LGBTQ+-affirming services within VHA, 14 – 16 there is still a complete lack of affirming care interventions at many VHA facilities. 17 …”