6 March 2024

Closing the Knowledge Gap to Offer Evidence-Based Sex and Gender Specific Care for All Female Service Members

Researcher to Watch: LTC Leilani Siaki, PhD, FNP-BC, FAANP

A high level of physical and mental strength is essential for military service members. This critical state of readiness is required for service members to perform warfighter missions in defense of national interests. However, not all military populations have the same access to optimal healthcare to ensure that readiness.

Women make up almost 20% of active-duty service members, 17.6% of whom self-identify as Gender Diverse Individuals (GDI) e.g., lesbian, gay, bisexual, or transgender. Therefore, given this proportion, healthcare providers need to offer evidence-based, sex and gender-specific care to promote the health and readiness of all female service members.

Nurse scientist and nurse practitioner U.S. Army LTC Leilani Siaki, PhD, FNP-BC, FAANP has focused her research for the past 20+ years on nursing, sleep health, cardiovascular diseases, and most recently, gender-specific care. She previously served as a critical care registered nurse for more than 20 years.

LTC Siaki is the principal investigator for a Geneva-managed study at Tripler Army Medical Center in Honolulu, HI titled “Health and Readiness of Women and Gender Diverse Female Servicemembers: A Scoping Review of the literature 2011-2022.” This study aims to identify and assess the literature relevant to the health and readiness of active-duty women (ADW) and AD-GSD female service members, identify gaps in the knowledge base and the healthcare needs of this population, and explore policy recommendations in the defense health agency to promote their readiness.

LTC Pedro Oblea, Jr, PhD, RN, who conducted the first Geneva-managed study on the experiences and challenges that LGBTQ+ service members have in the military after ‘coming out’, is an associate investigator on this study. He contributed to the study design and data collection and is assisting with data analysis and dissemination efforts of the team to include presentations and manuscript publications.

“For the past decade, the TriService Nursing Research Program’s (TSNRP) Military Women’s Health Research Interest Group (MWHRIG) has focused on building the evidence to support high quality, equitable sex and gender appropriate care to improve the health and readiness of female service members,” explains LTC Siaki. “Based in part on the MWHRIG’s findings, the Defense Health Board (2020) explicitly recommended that the DoD fund and conduct high-quality research on sex and gender-specific care for ADW, emphasizing translation of evidence into practice.”

AD-GSD female service members are three times more likely to attempt suicide than cis-gender ADW. Also, concerningly these populations are nearly twice as likely to perceive unmet healthcare needs which is the difference between services judged as necessary to deal effectively with a health problem and services actually rendered.

“The results of this study will preserve a robust knowledge base to guide future research and identify current and enduring gaps in knowledge,” says Dr. Siaki. “Sustaining a contemporary knowledge base will advance the translation of evidence into practice and policies that enhance the health and readiness of all female service members. We are continuing the legacy started by the MWHRIG founders in 2009.”

Geneva has supported this program since its inception, providing pre-award support for grant submission, upon receiving funding hiring Geneva staff to support the research and provide administrative support such as procurement.


This award is funded by the TriService Nursing Research Program (TSNRP) under award number 11189-N23-B09.


Disclaimer: The views expressed do not reflect the official policy of the Army, the Department of Defense, or the U.S. Government.