Lesbian, gay, and bisexual (LGB) Veterans from the Vietnam era report PTSD and poorer mental health more often than their heterosexual counterparts, according to an analysis of data from the Vietnam Era Health Retrospective Observational Study (VE-HEROeS).
A greater burden of potentially traumatic events among LGB Veterans, such as childhood physical abuse, adult physical assault and sexual assault was associated with the differences.
“This study is the first to document sexual orientation differences in trauma experiences, probable PTSD, and health-related quality of life in LGB Veterans using a nationally representative sample,” said Dr. John Blosnich, senior author of the study, published in July 2021 in Psychological Trauma: Theory, Research, Practice, and Policy. Blosnich is a research health scientist with VA’s Center for Health Equity Research and Promotion in Pittsburgh, and an assistant professor in the Suzanne Dworak-Peck School of Social Work, University of Southern California.
Findings based on responses from nearly 19,000 Veterans
Veterans are at high risk for experiencing potentially traumatic events during military service. Evidence also suggests that sexual minorities are at greater risk of PTEs, compared with heterosexual peers. However, few studies have documented how traumatic experiences may differ by sexual orientation among Veterans.
VE-HEROeS sought survey data from more than 45,000 Vietnam-era Veterans, as well as 11,000 matched controls. Data collection was completed in 2018; nearly 19,000 Veterans responded. Multiple studies are underway based on the data collected.
“When initiating VE-HEROes, we sought input from the Vietnam-era Veteran community,” said Dr. Victoria Davey, the study’s senior author. Davey is the principal investigator of VE-HEROeS and an associate chief research and development officer for VA. “That is being done more often in research but hasn’t been done with Veteran research as much as it should be, at least in my opinion. It’s important to bring the community into the research fold, so you hear from them what should be studied and what the approach should be. I think that by doing so, we created a better study.”
About 1.5% of respondents identified as LGB
Approximately 1.5% of responding Veterans identified as LGB; of those, 87% were male. Compared with heterosexual Veterans, LGB Veterans were younger at the time they were surveyed. They also were more likely to be female (13% of LGB Veterans, compared with 3% of heterosexual Veterans) and less likely to have served in combat.
Veterans were asked about exposure to 11 types of potentially traumatic events (PTEs), largely through a 10-question standardized instrument called the Brief Trauma Questionnaire.
“We used the BTQ because it is well-validated in many populations, including military populations, and because we wanted this study to be comparable with other large studies,” said Davey. After consulting with advisors from the Vietnam-era Veteran community, researchers added an eleventh question about witnessing sexual assault during military service. Nearly one-third of heterosexual Veterans and about one-fourth of LGB Veterans reported this type of PTE.
“The Veterans advising us said that one of the most traumatic things they experienced was actually having to watch sexual assaults, either on civilians or on other members of the military,” said Davey.
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