title: Perceived Stigma, Discrimination, and Disclosure of Sexual Orientation Among a Sample of Lesbian Veterans Receiving Care in the Department of Veterans Affairs.
abstract: OBJECTIVE
  Many lesbian women experience stigma and discrimination from their healthcare providers as a result of their sexual orientation. Additionally, others avoid disclosure of their sexual orientation to their providers for fear of mistreatment. With the increasing number of lesbian, gay, bisexual, and transgender (LGBT) veterans seeking care from the Veterans Health Administration (VHA), it is important to understand lesbian veterans' experiences with stigma, discrimination, and disclosure of sexual orientation. This article examines lesbian veterans' experiences with perceived stigma and discrimination in VHA healthcare, their perspectives on disclosure of sexual orientation to VHA providers, and their recommendations for improvements in VHA healthcare to create a welcoming environment for lesbian veterans.
  
  
  METHODS
  This is a mixed methods study of twenty lesbian veterans at four VHA facilities. The women veterans participated in a one-hour interview and then completed an anonymous survey.
  
  
  RESULTS
  Ten percent of lesbian veterans had experienced mistreatment from VHA staff or providers, but nearly 50% feared that their Veterans Affairs (VA) providers would mistreat them if they knew about their sexual orientation. A majority of lesbian veterans (70%) believed that VHA providers should never ask about sexual orientation or should only ask if the veteran wanted to discuss it. A majority (80%) believed the VHA had taken steps to create a welcoming environment for LBGT veterans.
  
  
  CONCLUSIONS
  Though many lesbian veterans have fears of stigma and discrimination in the context of VHA care, few have experienced this. Most lesbian veterans believed the VHA was trying to create a welcoming environment for its LGBT veterans. Future research should focus on expanding this study to include a larger and more diverse sample of lesbian, gay, bisexual, and transgender veterans receiving care at VA facilities across the country.
authors.affiliation: 1 Department of Research and Education, VA Central Western Massachusetts Healthcare System , Leeds, Massachusetts.|2 Department of Quantitative Health Sciences, University of Massachusetts Medical School , Worcester, Massachusetts.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Mattocks
authors.affiliation: 1 Department of Research and Education, VA Central Western Massachusetts Healthcare System , Leeds, Massachusetts.
authors.forename: J Cherry
authors.initials: JC
authors.lastname: Sullivan
authors.affiliation: 1 Department of Research and Education, VA Central Western Massachusetts Healthcare System , Leeds, Massachusetts.
authors.forename: Christina
authors.initials: C
authors.lastname: Bertrand
authors.affiliation: 1 Department of Research and Education, VA Central Western Massachusetts Healthcare System , Leeds, Massachusetts.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Kinney
authors.affiliation: 3 Department of Psychology, University of Minnesota , St. Paul, Minnesota.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Sherman
authors.affiliation: 1 Department of Research and Education, VA Central Western Massachusetts Healthcare System , Leeds, Massachusetts.|4 Department of Nursing, University of Massachusetts , Amherst, Massachusetts.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Gustason
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D030881:Disclosure / Q000706:statistics & numerical data; D005260:Female; D018452:Homosexuality, Female / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000592:standards; D063508:Social Discrimination / Q000706:statistics & numerical data*; D057545:Social Stigma; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*
keywords: access to care; lesbian; quality care; sexual orientation