30 June 2023

Geneva-Managed Study Explores LGBTQ+ Healthcare Experiences in the U.S. Military

Given the military’s 248-year history, its policy related to lesbian, gay, bisexual, and transgender (LGBTQ+) service members is still relatively new. Some LGBTQ+ service members still worry about living openly for fear of being harassed or discriminated against, but the Department of Defense has explicitly expressed its support for diversity, equity, and inclusivity. In a statement by the Secretary of Defense Lloyd, J. Austin, III in June 2023, he said, “This often-painful history has made something clear: Who you love and how you identify has nothing to do with how bravely you can fight for your country.”

Acknowledgment is Crucial

According to the Institute for State and Local Governance of the City University of New York Equality Indicators report published in 2018, approximately 71,000 active-duty military service members identify as lesbian, gay, or bisexual (LGB), and an estimated 15,000 identify as transgender. 6.1% of the military’s 1.5 million service members self-identified as lesbian, gay, bisexual, or transgender, with 0.6% of those respondents identifying as transgender, based on the 2015 RAND Department of Defense Health-Related Behaviors Survey. The actual number of LGBTQ+ service members may be greater due to underreporting and a historical lack of routine gender-focused data collection.  Acknowledging the distinct healthcare requirements of LGBTQ+ service members is crucial to implementing policies and procedures that can improve their well-being.

Principal Investigator LTC Pedro Oblea, Jr, PhD, RN, the Director of the Center for Nursing Science and Clinical Inquiry and the Director of the U.S. Army Advanced Registered Nurse (APRN) Transition Program at Tripler Army Medical Center in Honolulu, Hawaii, has studied LGBTQ+ healthcare experiences in the military population for several years. LTC Oblea’s long-term research goal is to provide data and recommendations to assist policymakers in designing appropriate healthcare for all military members and their families, including the LGBTQ+ community.

LTC Oblea’s Important Research

Geneva is proud to support LTC Oblea’s study of “Exploring LGBTQ Military Service Members Stressors and Lived Experiences” since 2020. This was the first Geneva-managed study of its kind. Since 2020, LTC Oblea’s research has resulted in three important publications.

The first, titled “Lesbian Gay Bisexual Transgender and Queer Health-Care Experiences in a Military Population,” focuses on former military service members and the data collected from two online surveys. Recent research has found that LGBTQ+ individuals serving in the military encounter significant obstacles that can negatively impact their careers and well-being. Additionally, the study revealed how various aspects of a person’s identity, including their sexual orientation, can impact their experiences as a service member or veteran.

LTC Oblea states that these findings can influence future military research by focusing on the effects of the Don’t Ask, Don’t Tell policy, negative and positive experiences, and the impact of those experiences.

Additionally, his second publication focused on LGBTQ+ sensitivity training among civilian and military healthcare personnel research. “Many healthcare providers, civilian and military, do not recognize or acknowledge cultural differences and may intentionally or unknowingly stereotype others based on ethnocentric perspectives leading to microaggressions towards specific groups of individuals,” says LTC Oblea. “Cultural sensitivity training effectively counters these detrimental attitudes and beliefs to improve health outcomes. We found a statistically significant difference after the training, showing that these findings contribute to the currently limited research exploring LGBTQ+ cultural sensitivity training in civilian and military settings.” LTC Oblea was awarded the Regina Aune Perseverance Award for this study at the 2023 TriService Nursing Research Program (TSNRP) and Evidence-Based Practice Dissemination conference in April 2023.

Finally, a commentary piece was published in the March-April 2023 edition of Military Medicine titled “Looking Back, a View to the Future of the Health and Readiness of Gender and Sexual Diverse U.S. Service Members.” This commentary piece was co-authored by LTC Leilani A. Siaki, PhD, NP-BC, FAANP, AN, with whom Geneva has also supported her research through TSRNP. This article provided a brief overview of the history of gender and sexually-diverse service members, health utilization rates, outcomes, disparities, perceived challenges accessing health care, and gaps in the evidence base underpinning sex- and gender-appropriate care. It also provided strategies for the future to address these issues and optimize healthcare delivery.

Equal Access to Healthcare

“It is important that we remain dedicated to serving all service members no matter their sexuality or how they identify. Everyone deserves equal access to healthcare,” said LTC Oblea. “It is critical to find potential best practices for LGBTQ+ policy and health care for all military members and veterans.”

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