Veterans’ Reported Comfort in Disclosing Sexual Orientation and Gender Identity : Medical Care

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Veterans’ Reported Comfort in Disclosing Sexual Orientation and Gender Identity

Ruben, Mollie A. PhD*,†; Kauth, Michael R. PhD‡,§,∥,¶; Meterko, Mark PhD#,**; Norton, Andrea M. LMSW††; Matza, Alexis R. PhD‡,‡‡; Shipherd, Jillian C. PhD‡,§§,∥∥

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Medical Care 59(6):p 550-556, June 2021. | DOI: 10.1097/MLR.0000000000001543



The Veterans Health Administration (VHA) does not routinely collect and document sexual orientation and gender identity (SOGI) data despite research on health disparities among sexual and gender minority (SGM) veterans. Due to the legacy of previous Department of Defense policies that prohibited disclosure of sexual or gender minority identities among active-duty personnel, minority veterans may be reluctant to respond to SOGI questions on confidential VHA surveys and in discussions with their VHA providers. Veterans may generally find SOGI questions uncomfortable and may not appreciate their relevance to health care.


The purpose of this research was to examine veterans’ comfort in reporting identity characteristics on confidential VHA surveys and in discussion with their VHA providers and whether comfort differed by sociodemographic characteristics.

Research Design: 

The project involves the secondary analysis of quantitative data from a quality improvement survey project.


A total of 806 veterans were surveyed.


Overall, 7.15% endorsed sexual or gender minority identity which is a higher rate than the 4.5% noted in the general US population. Cisgender and heterosexual veterans were more comfortable reporting identity characteristics both on VHA confidential surveys and in discussion with VHA providers compared with SGM veterans.


These data suggest that the majority of veterans feel comfortable reporting their identities both on surveys and in the context of health care. Understanding these perceptions can assist VHA programs in implementing SOGI data collection and disclosure in clinical care, creating a welcoming environment of care for SGM veterans that does not make veterans from other backgrounds feel uncomfortable.

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