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Mental Health

Women’s Well-Being and Reproductive Health in Indian Mining Community: Need for Empowerment

Citation:

D’Souza, Melba Sheila, Subrahmanya Nairy Karkada, Ganesha Somayaji, and Ramesh Venkatesaperumal. 2013. “Women’s Well-Being and Reproductive Health in Indian Mining Community: Need for Empowerment.” Reproductive Health Matters 10 (1): 24.

Authors: Melba Sheila D’Souza, Subrahmanya Nairy Karkada, Ganesha Somayaji, Ramesh Venkatesaperumal

Abstract:

This paper is a qualitative study of women’s well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women’s experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women’s reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women’s well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community.

Keywords: well-being, reproductive health status, gender preference, domestic violence, marital relationship, qualitative design, nursing

Topics: Domestic Violence, Extractive Industries, Gender, Women, Gendered Power Relations, Gender Equality/Inequality, Health, Mental Health, Reproductive Health, Households Regions: Asia, South Asia Countries: India

Year: 2013

Visual Responses: Women’s Experience of Sexual Violence as Represented in Israeli Holocaust-Related Cinema

Citation:

Meiri, Sandra. 2015. “Visual Responses: Women’s Experience of Sexual Violence as Represented in Israeli Holocaust-Related Cinema.” European Journal of Women’s Studies 22 (4): 443-456.  

Author: Sandra Meiri

Abstract:

This article explores the function of Israeli narrative films’ persistent, albeit marginal, portrayal of women as victims of sexual violence during the Holocaust. While the marginalization of such characters may be attributed to the difficulty of representing sexually-related trauma/post-trauma, their portrayal attests both to the ubiquity of sexually-related crimes in the Holocaust and to its aftermath: namely, the persistence of women’s trauma. The first of the two waves of ‘retro films’ examined here evinces the importance of the visual, cinematic representation of women’s trauma. Its main function is to legitimize its disclosure through cinematic aesthetic/artistic mediation, for sexual violence was a crime committed against helpless victims. The second wave includes films made from the point of view of ‘the second generation’, and explores the topic further by dealing with the transmission of post-traumatic symptoms of women’s trauma to the second generation.

Keywords: cinematic visualization, insanity, sexualized violence, the second generation, transmission of women's trauma, unfit motherhood

Topics: Gender, Women, Gendered Discourses, Gender-Based Violence, Genocide, Health, Mental Health, PTSD, Trauma, Sexual Violence, SV against women Regions: MENA, Asia, Middle East, Europe Countries: Israel

Year: 2015

Coming out in camouflage: A Queer Theory Perspective on the Strength, Resilience, and Resistance of Lesbian, Gay, Bisexual, and Transgender Service Members and Veterans

Citation:

Ramirez, M. Heliana, and Paul R. Sterzing. 2017. “Coming out in Camouflage: A Queer Theory Perspective on the Strength, Resilience, and Resistance of Lesbian, Gay, Bisexual, and Transgender Service Members and Veterans.” Journal of Gay & Lesbian Social Services 29 (1): 68–86. 

Authors: M. Heliana Ramirez, Paul R. Sterzing

Abstract:

Lesbian, gay, bisexual, and transgender (LGBT) service members have made profound contributions to the U. S. military despite serving under anti-LGBT military policies. Little is known about their everyday acts of strength and resistance, which is vital information for developing strengths-based services. This article utilizes a queer theory framework to (a) discuss LGBT military contributions and anti-LGBT military policies, (b) explore three LGBT-specific military minority stressors, and (c) identify four strategies of strength and resistance used to manage an antiLGBT military environment. Clinical suggestions are proposed for integrating military and LGBT identities and designing interventions that blend military and LGBT cultures.

Keywords: LGBT, military, Veteran, strengths-based, Resilience, queer theory

Topics: Combatants, Gender, Health, HIV/AIDS, Mental Health, PTSD, Trauma, LGBTQ, Military Forces & Armed Groups, Militaries, Sexual Violence, Rape Regions: Americas, North America Countries: United States of America

Year: 2017

Aging LGBT Military Service Members and Veterans

Citation:

Mankowski, Mariann. 2017. “Aging LGBT Military Service Members and Veterans.” Annual Review of Gerontology & Geriatrics 37 (1): 111–25. 

Author: Mariann Mankowski

Abstract:

The purpose of this chapter is to highlight the experiences and needs of aging sexual and gender minority (SGM) veterans. Significant demographic changes in the composition of aging military veterans have taken place. Most notice- ably since the repeal of "don't ask, don't tell" attention has been drawn to this population of older veterans and their specific mental, physical, and psycho-social health care needs. Recent policy, program, and research initiatives have begun to address the significant health disparities of this population of older adults. SGM veterans are more likely to report higher rates of sexual harassment and sexual assault, and are more vulnerable to homelessness and unemployment when compared to the general population of older lesbian, gay, bisexual, and transgender (LGBT) adults. Aging SGM veterans may also carry a heavy burden as a result of their experiences as service members and may be reticent to disclose their sexual identity with formal veteran service programs. Access to and utilization of social care networks and social support for SGM aging veterans is a serious concern. Isolation, poorer health outcomes, and increased chronic health conditions may exacerbate the marginalization this older adult population has experienced. A majority of SGM veterans will utilize community-based services, and it is essential that all health care professionals understand the unique needs of this cohort of older adults. Future directions for research, policy, education, and service delivery are explored.

Topics: Age, Combatants, Health, Mental Health, LGBTQ, Military Forces & Armed Groups, Militaries, Sexual Violence Regions: Americas, North America Countries: United States of America

Year: 2017

Mental Health of Transgender Veterans of the Iraq and Afghanistan Conflicts Who Experienced Military Sexual Trauma: MST and Mental Health of Transgender Veterans

Citation:

Lindsay, Jan A., Colt Keo-Meier, Sonora Hudson, Annette Walder, Lindsey A. Martin, and Michael R. Kauth. 2016. “Mental Health of Transgender Veterans of the Iraq and Afghanistan Conflicts Who Experienced Military Sexual Trauma: MST and Mental Health of Transgender Veterans.” Journal of Traumatic Stress 29 (6): 563–67.

Authors: Jan A. Lindsay, Colt Keo-Meier, Sonora Hudson, Annette Walder, Lindsey A. Martin, Michael R. Kauth

Abstract:

Little is known about military sexual trauma (MST) in transgender veterans. To address this gap, we examined archival data regarding transgender veterans from the Iraq and Afghanistan conflicts. There were 332 transgender veterans treated at the Veterans Health Administration between 2000 and 2013 (78 men, 254 women; mean age 33.86 years), with most being non-Hispanic White. Transgender status and mental health conditions were identified using the International Classification of Diseases, 9th Revision (ICD-9; World Health Organization, 1980) codes and chart review. Men and women were analyzed separately, using contingency tables and χ2 testing for categorical variables and t tests for continuous variables. Likelihood of having a mental health condition and MST were examined using logistic regression. Among the 15% of participants who experienced MST, MST was associated with the likelihood of posttraumatic stress disorder, adjusted OR = 6.09, 95% confidence interval (CI) [1.22, 30.44] and personality disorder, OR = 3.86, 95% CI [1.05, 14.22] for men and with depressive, OR = 3.33, 95% CI [1.12, 9.93], bipolar, OR = 2.87, 95% CI [1.12, 7.44], posttraumatic stress, OR = 2.42, [1.11, 5.24], and personality disorder, OR = 4.61, 95% CI [2.02, 10.52] for women. Implications include that medical forms should include gender identity and biological gender and that MST treatment should be culturally competent.

Topics: Combatants, Gender, Health, Mental Health, PTSD, Trauma, LGBTQ, Military Forces & Armed Groups, Militaries, Sexual Violence Regions: MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2016

The Psychologist's Role in Transgender-Specific Care with U.S. Veterans

Citation:

Johnson, Laura, Jillian Shipherd, and Heather M. Walton. 2016. “The Psychologist’s Role in Transgender-Specific Care with U.S. Veterans.” Psychological Services 13 (1): 69–76.

Authors: Laura Johnson, Jillian Shipherd, Heather M. Walton

Abstract:

Psychologists are integral to the care of transgender individuals. This article details the many roles for psychologists in transgender-specific care, including diagnosing and treating gender dysphoria; providing treatment for comorbid conditions; referring to medical services such as gender confirmation surgeries, voice modification, and cross-sex hormone therapies; serving as consultants within health care systems; and advocating for addressing barriers in systems in which transgender individuals live and work. Transgender veterans have unique experiences and vulnerabilities related to their military service that are detailed from a review of the literature, and we make the case that Veterans Health Administration (VHA) and community psychologists are well-positioned to provide care to transgender veterans (trans-vets). In this article, the authors describe the experiences that many trans-vets have faced, identify the importance of treatment for gender dysphoria (and draw the distinction between gender identity disorder and gender dysphoria) as well as psychologists’ roles, and clarify which transgender-related services are available to eligible veterans though VHA per policy and how VHA providers have access to training to provide that care. In addition, we describe how veterans can connect to the VHA, even if they have (and want to continue working with) non-VHA psychologists or other community providers.

Topics: Combatants, Health, Mental Health, LGBTQ, Military Forces & Armed Groups, Militaries Regions: Americas, North America Countries: United States of America

Year: 2016

Lesbian, Gay, Bisexual, and Transgender (LGBT) Service Members: Life After Don’t Ask, Don’t Tell

Citation:

Goldbach, Jeremy T., and Carl Andrew Castro. 2016. “Lesbian, Gay, Bisexual, and Transgender (LGBT) Service Members: Life After Don’t Ask, Don’t Tell.” Current Psychiatry Reports 18 (6): 56.

Authors: Jeremy T. Goldbach, Carl Andrew Castro

Abstract:

Lesbian, gay, and bisexual service members can serve openly in the military with the repeal of the Don’t Ask, Don’t Tell policy. The fate of transgender service members remains uncertain as the policy preventing them from serving in the military remains under review. The health care needs of these populations remain for the most part unknown, with total acceptance and integration in the military yet to be achieved. In this paper, we review the literature on the health care needs of lesbian, gay, bisexual, and transgender (LGBT) service members, relying heavily on what is known about LGBT civilian and veteran populations. Significant research gaps about the health care needs of LGBT service members are identified, along with recommendations for closing those gaps. In addition, recommendations for improving LGBT acceptance and integration within the military are provided.

Keywords: gay, lesbian, Transgender, Bisexual, military, Veteran, mental health, Physical health, policy, LGBT acceptance and integration

Topics: Combatants, Health, Mental Health, PTSD, LGBTQ, Military Forces & Armed Groups, Militaries, Sexual Violence Regions: Americas, North America Countries: United States of America

Year: 2016

Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case-Control Study

Citation:

Brown, George R., and Kenneth T. Jones. 2016. “Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case-Control Study.” LGBT Health 3 (2): 122–31. 

Authors: George R. Brown, Kenneth T. Jones

Abstract:

Purpose: There are no large controlled studies of health disparities in transgender (TG) or gender dysphoric patients. The Veterans Health Administration (VHA) is the largest healthcare system in the United States and was an early adopter of electronic health records. We sought to determine whether medical and/or mental health disparities exist in VHA for clinically diagnosed TG veterans compared to matched veterans without a clinical diagnosis consistent with TG status.
 
Methods: Using four ICD-9-CM codes consistent with TG identification, a cohort of 5135 TG veterans treated in VHA between 1996 and 2013 was identified. Veterans without one of these diagnoses were matched 1:3 in a case–control design to determine if medical and/or mental health disparities exist in the TG veteran population.
 
Results: In 2013, the prevalence of TG veterans with a qualifying clinical diagnosis was 58/100,000 patients. Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups.
 
Conclusion: This is the first study to examine a large cohort of clinically diagnosed TG patients for psychiatric and medical health outcome disparities using longitudinal, retrospective medical chart data with a matched control group. TG veterans were found to have global disparities in psychiatric and medical diagnoses compared to matched non-TG veterans. These findings have significant implications for policy, healthcare screening, and service delivery in VHA and potentially other healthcare systems.

Keywords: disparity, gender dysphoria, military, Transgender, Veteran

Topics: Combatants, Health, HIV/AIDS, Mental Health, PTSD, Trauma, LGBTQ, Military Forces & Armed Groups, Militaries Regions: Americas, North America Countries: United States of America

Year: 2016

Sexual Victimization, Health Status, and VA Healthcare Utilization Among Lesbian and Bisexual OEF/OIF Veterans

Citation:

Mattocks, Kristin M., Anne Sadler, Elizabeth M. Yano, Erin E. Krebs, Laurie Zephyrin, Cynthia Brandt, Rachel Kimerling, Theo Sandfort, Melissa E. Dichter, Jeffrey J. Weiss, Jeroan Allison, and Sally Haskell. 2013. “Sexual Victimization, Health Status, and VA Healthcare Utilization Among Lesbian and Bisexual OEF/OIF Veterans.” Journal of General Internal Medicine 28 (S2): S604–8. 

Authors: Kristin M. Mattocks, Anne Sadler, Elizabeth M. Yano, Erin E. Krebs, Laurie Zephyrin, Cynthia Brandt, Rachel Kimerling, Theo Sandfort, Melissa E. Dichter, Jeffrey J. Weiss, Jeroan Allison, Sally Haskell

Abstract:

BACKGROUND: Many lesbian and bisexual (LB) women veterans may have been targets of victimization in the military based on their gender and presumed sexual orientation, and yet little is known regarding the health or mental health of LB veterans, nor the degree to which they feel comfortable receiving care in the VA. 
 
OBJECTIVE: The purpose of this study was to examine the prevalence of mental health and gender-specific conditions, VA healthcare satisfaction and trauma exposure among LB veterans receiving VA care compared with heterosexually-identified women veterans receiving. 
 
DESIGN: Prospective cohort study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) women veterans at two large VA facilities. 
 
PARTICIPANTS: Three hundred and sixty five women veterans that completed a baseline survey. Thirty-five veterans (9.6 %) identified as gay or lesbian (4.7 %), or bisexual (4.9 %). 
 
MAIN MEASURES: Measures included sexual orientation, military sexual trauma, mental and gender-specific health diagnoses, and VA healthcare utilization and satisfaction. 
 
KEY RESULTS: LB OEF/OIF veterans were significantly more likely to have experienced both military and childhood sexual trauma than heterosexual women (MST: 31 % vs. 13 %, p<.001; childhood sexual trauma: 60 % vs. 36 %, p=.01), to be hazardous drinkers (32 % vs. 16 %, p=.03) and rate their current mental health as worse than before deployment (35 % vs. 16 %, p<.001). 
 
CONCLUSIONS: Many LB veterans have experienced sexual victimization, both within the military and as children, and struggle with substance abuse and poor mental health. Health care providers working with female Veterans should be aware of high rates of military sexual trauma and childhood abuse and refer women to appropriate VA treatment and support groups for sequelae of these experiences. 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. (C) Society of General Internal Medicine 2013

Keywords: lesbian, health services research, veterans, women

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, LGBTQ, Military Forces & Armed Groups, Militaries, Sexual Violence, SV against women Regions: Americas, North America Countries: United States of America

Year: 2013

Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care

Citation:

Blosnich, John R., PhD, George R. Brown, MD, Jillian C. Shipherd, PhD, Michael Kauth, PhD, Rebecca I. Piegari, MS, and Robert M. Bossarte, PhD. 2013. “Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care.” American Journal of Public Health 103 (10): 27–32.

Authors: John R. Blosnich, George R. Brown, Jillian C. Shipherd, Michael Kauth, Rebecca I. Piegari, Robert M. Bossarte

Abstract:

Objectives: We estimated the prevalence and incidence of gender identity disorder (GID) diagnoses among veterans in the Veterans Health Administration (VHA) health care system and examined suicide risk among veterans with a GID diagnosis.
 
Methods: We examined VHA electronic medical records from 2000 through 2011 for 2 official ICD-9 diagnosis codes that indicate transgender status. We generated annual period prevalence estimates and calculated incidence using the prevalence of GID at 2000 as the baseline year. We cross-referenced GID cases with available data (2009–2011) of suicide-related events among all VHA users to examine suicide risk.
 
Results: GID prevalence in the VHA is higher (22.9/100 000 persons) than are previous estimates of GID in the general US population (4.3/100 000 persons). The rate of suicide-related events among GID-diagnosed VHA veterans was more than 20 times higher than were rates for the general VHA population.
 
Conclusions: The prevalence of GID diagnosis nearly doubled over 10 years among VHA veterans. Research is needed to examine suicide risk among transgender veterans and how their VHA utilization may be enhanced by new VA initiatives on transgender care.

Topics: Combatants, Health, Mental Health, LGBTQ, Military Forces & Armed Groups, Militaries Regions: Americas, North America Countries: United States of America

Year: 2013

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