Health Services Research & Development

Go to the ORD website
Go to the QUERI website

VA Improves Care for Sexual and Gender Minority Veterans

May 2, 2016

An editorial in LGBT Health highlights the rapid system changes VA has implemented to advance healthcare equity for LGBT (lesbian, gay, bisexual, and transgender) Veterans. Authors Michael Kauth, PhD, from HSR&D's Center for Innovations in Quality, Effectiveness and Safety (IQuESt), and Jillian Shipherd, PhD, VA Boston Healthcare System, open with the fact that 84% (96 of 114) of VA healthcare facilities that participated in the 2016 Human Rights Campaign's Healthcare Equity Index (HEI) survey achieved Leadership status. This means that through fairly rapid system changes, VA has advanced LGBT inclusiveness and clinical competence. In fact, VA has never had policies that prohibit care based on sexual orientation or gender identity, and is likely the largest provider of LGBT healthcare in the world, with more than 250,000 potential LGBT patients.

Many advocates within VA have fought for improved access to care for LGBT Veterans, and a leap forward came in 2011 with the release of the VA transgender care policy - and the repeal of DoD's 'Don't Ask, Don't Tell' policy. However, as more LGBT patients came to VA for care, few VA providers were experienced in transgender care, which led to the formation of a national LGBT Program within the Office of Patient Care Services. Consequently, VA developed a tiered system of information and training for staff to meet a variety of needs, including the establishment of transgender e-consultations at every VA facility. Since this program became fully operational in the spring of 2015, there have been more than 400 e-consults. VA continues to enhance care for LGBT Veterans and will soon add an LGBT Veteran care coordinator to every facility, which should improve communication and best practices across the country. Moreover, a new national directive on LGBT Veteran healthcare is under development. The authors suggest that other healthcare organizations consider how to replicate this success.