Mollie A Ruben1, John R Blosnich, Melissa E Dichter, Lorry Luscri, Jillian C Shipherd. 1. *US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR) †Massachusetts College of Pharmacy and Health Sciences University ‡VA Boston Healthcare System, Boston, MA §Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh ∥VA Center for Health Equity Research and Promotion ¶Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA #Edward Hines, Jr. VA Hospital, Hines, IL **Department of Psychiatry, Boston University School of Medicine, Boston, MA ††Lesbian, Gay, Bisexual, and Transgender (LGBT) Program, Veterans Health Administration, Washington, DC ‡‡National Center for PTSD, Women's Health Sciences Division, Boston, MA.
Abstract
BACKGROUND: The Veterans Health Administration does not routinely collect and document sexual orientation and gender identity (SOGI) data, despite existing health disparities among sexual and gender minority Veterans. Because of the legacy of previous Department of Defense (DoD) policies that prohibited disclosure of sexual or gender minority identities among active duty personnel, Veterans may be reluctant to respond to SOGI questions. OBJECTIVES: This population-based study assesses item nonresponse to SOGI questions by Veteran status. RESEARCH DESIGN: This is a secondary analysis of data from a population-based sample of adults in 20 US states that elected to administer a SOGI module in the 2014 Behavioral Risk Factor Surveillance System survey. Prevalence of SOGI refusals and responses of "don't know" were compared for Veterans and non-Veterans. SUBJECTS: Veterans (n=22,587) and non-Veterans (n=146,475) were surveyed. RESULTS: Nearly all Veteran respondents (≥98%) completed the SOGI questions, with 95.4% identifying as heterosexual, 1.2% as gay or lesbian, 1.2% as bisexual, and 0.59% as transgender. A significantly lower proportion of Veterans than non-Veterans refuse to answer sexual orientation (1.5% vs. 1.9%). There was no difference between Veterans and non-Veterans in responses for gender identity. CONCLUSIONS: Veterans are just as likely as non-Veterans to complete SOGI items in survey research. Asking Veterans about SOGI is unlikely to yield significant nonresponse. These data suggest that future research should investigate Veterans' perspectives on being asked about SOGI in research settings and as part of routine clinical care.
BACKGROUND: The Veterans Health Administration does not routinely collect and document sexual orientation and gender identity (SOGI) data, despite existing health disparities among sexual and gender minority Veterans. Because of the legacy of previous Department of Defense (DoD) policies that prohibited disclosure of sexual or gender minority identities among active duty personnel, Veterans may be reluctant to respond to SOGI questions. OBJECTIVES: This population-based study assesses item nonresponse to SOGI questions by Veteran status. RESEARCH DESIGN: This is a secondary analysis of data from a population-based sample of adults in 20 US states that elected to administer a SOGI module in the 2014 Behavioral Risk Factor Surveillance System survey. Prevalence of SOGI refusals and responses of "don't know" were compared for Veterans and non-Veterans. SUBJECTS: Veterans (n=22,587) and non-Veterans (n=146,475) were surveyed. RESULTS: Nearly all Veteran respondents (≥98%) completed the SOGI questions, with 95.4% identifying as heterosexual, 1.2% as gay or lesbian, 1.2% as bisexual, and 0.59% as transgender. A significantly lower proportion of Veterans than non-Veterans refuse to answer sexual orientation (1.5% vs. 1.9%). There was no difference between Veterans and non-Veterans in responses for gender identity. CONCLUSIONS: Veterans are just as likely as non-Veterans to complete SOGI items in survey research. Asking Veterans about SOGI is unlikely to yield significant nonresponse. These data suggest that future research should investigate Veterans' perspectives on being asked about SOGI in research settings and as part of routine clinical care.
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