Advocating for minority Veterans in the United States: Principles for equitable public policy

LAY SUMMARY Minority Veterans in the United States are often excluded, whether intentionally or not, from public policy initiatives, leading to approaches that attempt to account for, or include, minority Veterans after the policy process has begun rather than at the foundational stages. This leads to policies and programs that do not adequately serve or that may harm minority Veteran communities. Drawing on their work with the U.S. Senate and House Veterans’ Affairs Committees and the U.S. Department of Veterans Affairs, the authors outline four principles for equitable Veteran public policy to better support minority Veterans and their communities. These principles are grounded in intersectionality theory, a framework that starts from the recognition that everyone has multiple identities and that these identities relate to the inequalities one experiences personally and systemically. The authors hope these principles contribute to more equitable public policy analyses and practices to better serve minority Veterans and lessen instances of inequality or injustice.

Relation between sexual and gender minority status and suicide attempts among veterans seeking treatment for military sexual trauma.

There is limited study of suicidal behaviors among veterans identifying as sexual and gender minorities (SGMs), despite previous research indicating rates of suicide attempts are high within civilian SGM populations. Further, some research incorporating military service members suggests those identifying as SGMs are disproportionately exposed to military sexual trauma (MST), an additional risk factor for negative psychiatric sequelae. To address health care research disparities among minority veterans (i.e., women, those endorsing MST, SGMs), we examined presentations of veterans (N = 277) who attended initial consultation appointments for MST-related treatment and completed a semistructured clinical interview including demographic characteristics, history of suicide attempts (HSA), and a diagnostic evaluation. Twenty-eight (10.1%) veterans identified as SGMs. SGM/non-SGM groups were contrasted on suicidal and psychiatric morbidity outcomes. Overall, endorsement of HSA was high (30.7%). Despite similar clinical profiles, 53.6% of veterans who identified as SGM endorsed HSA in contrast with 28.1% of peers identifying as heterosexual and nontransgender, a significant effect of small-to-moderate size. Findings suggest assessment and clinical management of suicidality is of critical importance for clinicians providing services to veterans pursuing recovery from MST, generally, and may be especially so when delivering care to SGM. Further, results underscore the need for culturally competent delivery of trauma-focused interventions.