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Military Forces & Armed Groups

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

(Im)possible Futures: Liberal Capitalism, Vietnamese Sniper Women, and Queer Asian Possibility

Citation:

Ly, Lynn. 2017. “(Im)Possible Futures: Liberal Capitalism, Vietnamese Sniper Women, and Queer Asian Possibility.” Feminist Formations 29 (1): 136–60.

Author: Lynn Ly

Abstract:

This article examines the ways Vietnamese sniper women have been narrated and imagined in North America. Part nightmare, farce, icon, historical figure, and real person, the weaponized Vietnamese woman was a troubling figure to comprehend for US soldiers and the public alike. Navigating across historical, aesthetic, and performative texts, the article thinks through the different authorized narratives about this figure, and the queer futures made unintelligible in their making. It argues that liberal capitalism plays an important role in the determination of the relationship between past to present, and what may be imagined as possible, now and in the future. Vietnamese women soldiers during the US war in Vietnam (1955-1975) both frustrate and realize a queer Asian diasporic desire for historical ground on which to challenge racialized, gendered, and sexual epistemological regimes of the war. That is, while militant Vietnamese women were used as evidence of liberal capitalist logics, they also often failed to complete its fantasies, opening up important alternative and queer pasts--ones that inevitably fail to reach dominant conceptions post-Vietnam War presents, but also, for that very reason, critically arrive at an alternative modality for living in the present as a queer Asian and Vietnamese woman.

Keywords: liberal capitalism, militarism, queer Asian women, queer of color critique, time studies, transpacific studies

Topics: Armed Conflict, Economies, Gender, Women, LGBTQ, Military Forces & Armed Groups, Militarism, Post-Conflict, Race, Sexuality, Violence Regions: Americas, North America, Asia, Southeast Asia Countries: Vietnam

Year: 2017

Clients, Contractors, and the Everyday Masculinities in Global Private Security

Citation:

Chisholm, Amanda. 2017. “Clients, Contractors, and the Everyday Masculinities in Global Private Security.” Critical Military Studies 3 (2): 120–41. 

Author: Amanda Chisholm

Abstract:

This article explores the intimate relationships between the client and the security contractor. It draws upon autoethnography to bring into focus the client/contractor encounters and demonstrate how such encounters (re)shape the marginal and hegemonic men/masculinities of the security industry – masculinities which work to legitimize not only who and what are appropriate security providers but also how value/valuation of security is understood and practised. As such it contributes to the broader debates about gender and war by (1) demonstrating how the researcher is always embedded in and shaped by the research she produces; and (2) by bringing to the fore the multitude of masculinities, beyond the hegemonic militarized, that emerge in private security markets.

Keywords: autoethnography, military, militarization, private military and security companies, masculinities, feminist political economy

Topics: Gender, Men, Masculinity/ies, Gendered Power Relations, Military Forces & Armed Groups, Private Military & Security, Militaries, Militarization, Political Economies, Security

Year: 2017

Mobilities at Gunpoint: The Geographies of (Im)mobility of Transgender Sex Workers in Colombia

Citation:

Ritterbusch, Amy E. 2016. “Mobilities at Gunpoint: The Geographies of (Im)Mobility of Transgender Sex Workers in Colombia.” Annals of the American Association of Geographers 106 (2): 1–12.

Author: Amy E. Ritterbusch

Abstract:

Drawing from geo-ethnographic data collected during a participatory action research (PAR) project funded by the National Science Foundation and subsequent research conducted in Colombia with marginalized youth populations, this article explores the sociospatial exclusion and (im)mobility of the oppressed, subjugated, and persecuted through the social cartographies, geo-narratives, and auto-photographic images of transgender sex workers that were displaced by paramilitary-led gender-based violence and forced to leave their birth cities and rural communities in Colombia at an early age. As is the case for thousands of victims of the armed conflict in Colombia, displaced transgender populations seek refuge and opportunity in the streets of Bogotá, Colombia. The (im)mobilities of transgender sex workers are explored in two stages—the forced, violent mobilities of their displacement, followed by their experiences of discrimination, sociospatial exclusion, and persecution through hate crimes and social cleansing killings on arrival in Bogotá. This article discusses how research actors constructed their own spaces of cohesion and resistance to the multifaceted discrimination and marginalization from mainstream urban society through PAR. The PAR project presented in this article continues as part of the broader struggle of transgender sex workers to challenge the exclusionary discourses and praxis that limit their mobilities and autonomy in the city. This article concludes with examples of how research actors use the action-driven elements of PAR to negotiate, analyze, and resist the relationships of power and violence embedded within their urban environment and begin to re-present and change the reality of their immobility within the city.

Keywords: Colombia, gender-based violence, gendered (im)mobilities, internally displaced persons, Participatory Action Research

Topics: Displacement & Migration, Forced Migration, Gender, Gender-Based Violence, Gendered Power Relations, LGBTQ, Livelihoods, Sexual livelihoods, Military Forces & Armed Groups, Paramilitaries, Violence Regions: Americas, South America Countries: Colombia

Year: 2016

Locating “Queer” in Contemporary Writing of Love and War in Nigeria

Citation:

Munro, Brenna. 2016. “Locating ‘Queer’ in Contemporary Writing of Love and War in Nigeria.” Research in African Literatures 47 (2): 121–38.

Author: Brenna Munro

Abstract:

The child soldier novel is not usually read in terms of sexuality; however, sexual trauma, sex between men and boys, and the production of damaged masculinities are central to representations of the boy soldier in contem- porary writing about war from Nigeria, including Chris Abani’s Song for Night (2007), Uzodinma Iweala’s Beasts of No Nation (2005), and Chimamanda Adichie’s Half of a Yellow Sun (2006). The queer gures of the perverse adult military man and the violated and violating boy soldier emerge in complex relation to contemporary representations of the Nigerian gay man—and all of these texts negotiate the politics of sex and race across multiple reading publics. Jude Dibia’s gay character Adrian in Walking with Shadows (2005) asserts legibility and respectability in sharp contrast to the queer subjectivi- ties of war writing, for example, yet all of these texts dramatize negotiations with stigma as it circulates across representations of sexuality.

 

Topics: Armed Conflict, Combatants, Child Soldiers, Gender, Men, Boys, LGBTQ, Military Forces & Armed Groups, Non-state Armed Groups, Race, Sexual Violence, Male Perpetrators, Rape, Sexual Exploitation and Abuse, SV against men, Terrorism Regions: Africa, West Africa Countries: Nigeria

Year: 2016

Gays, Cross-Dressers, and Emos: Nonnormative Masculinities in Militarized Iraq

Citation:

Rohde, Achim. 2016. “Gays, Cross-Dressers, and Emos: Nonnormative Masculinities in Militarized Iraq.” Journal of Middle East Women’s Studies 12 (3): 433–49.

Author: Achim Rohde

Annotation:

"Much has been written about gender-based violence against Iraqi women under the thirty-five-year dictatorship of Saddam Hussein and since the fall of the regime in 2003 (Brown and Romano 2006, 56, 60–62; Al-Jawaheri 2008, 108–17; al-Ali 2005, 742–43, 754–55; 2007, 198, 207, 226–29; 2008, 413–16; Smiles 2008, 272–76; al-Ali and Pratt 2009, 78, 80, 157–61; Campbell and Kelly 2009, 24–25; Fischer-Tahir 2010, 1391–92; Ranharter and Stansfield 2015). Although the mass recruitment of men as soldiers and fighters often temporarily expanded spaces for women’s participation in the Iraqi public sphere (Efrati 1999, 28, 30–32; Rohde 2010, 86–91), militarism and militarist discourse before and since 2003 have reinforced gender polarity and heroic forms of masculinity, marginalizing and degrading the noncombat social positionalities of the majority of men and women (Rohde 2010, 124–43; 2011, 100, 104, 109–10; Fischer-Tahir 2012, 93–94; Abdulameer 2014). Nevertheless, organized violence against queer positionalities, or men perceived to violate sexual and gender norms, occurred only after 2003. This essay explores ruptures and continuities in organized violence against sex or gender nonconformity in recent Iraqi history.
 
"For the late Baʿthist period in Iraq, I analyze scholarly and journalistic sources, including items published in Iraqi newspapers and transcripts of a conversation between Saddam Hussein and tribal leaders in 1991 or 1992. For the years after 2003, I systematically analyzed four Iraqi (Arabic) daily newspapers (Al-Zaman, Al-Sabah, Al-Mada, and Al-Manara) and a weekly journal (Al-Esbuʿiyya) from late 2008, 2009, and spring 2012. I draw on other sources as well, including news videos, human rights reports, academic work, and other journalistic sources. Given the dangers and restrictions of research in Iraq, the available sources allow some preliminary analysis that can inform future systematic studies on gender and sexual diversity in Iraqi society" (Rohde, 2016, p. 433-4)

Topics: Gender, Masculinity/ies, Gender Roles, Gender-Based Violence, Gendered Power Relations, Patriarchy, LGBTQ, Military Forces & Armed Groups, Militarism, Violence Regions: MENA, Asia, Middle East Countries: Iraq

Year: 2016

The Reintegration of Former Combatants in Colombia: Addressing Violent Masculinities in a Fragile Context

Citation:

Flisi, Isabella. 2016. “The Reintegration of Former Combatants in Colombia: Addressing Violent Masculinities in a Fragile Context.” Gender & Development 24 (3): 391–407. 

Author: Isabella Flisi

Abstract:

This article focuses on peace-building processes in fragile societies traumatised by violence and conflict. It argues that disarmament, demobilisation, and reintegration (DDR) programmes largely overlook the relationship between violent ‘militarised’ male identities and behaviour, and risks to women’s security. DDR programmes need to work with men to support them to evolve non-violent ways of ‘being a man’. The article draws on research from Colombia to illustrate its argument and show the negative consequences of combatants’ reintegration on women’s lives in that context. It suggests key steps to challenge wartime masculinities that should be included in DDR and peace-building programmes, and considers wider implications for development and humanitarian work in fragile contexts.

Keywords: masculinities, Violence against women, reintegration, gender, post-conflict, disarmament, demobilisation, DDR, Colombia

Topics: Armed Conflict, Combatants, Male Combatants, DDR, Development, Gender, Women, Masculinity/ies, Military Forces & Armed Groups, Militarization, Peacebuilding, Security, Violence Regions: Americas, South America Countries: Colombia

Year: 2016

Living Archives and Cyprus: Militarized Masculinities and Decolonial Emerging World Horizons

Citation:

Agathangelou, Anna M. 2017. “Living Archives and Cyprus: Militarized Masculinities and Decolonial Emerging World Horizons.” Critical Military Studies 3 (2): 206–11. 

Author: Anna M. Agathangelou

Abstract:

Huddled within the most influential theorizations and praxes of war and violence are imaginations of collating masculinities, texts and their embodiments. Interpreting and reading my mother as a non-dominant body, and her stories about war, violence, and Cyprus as re-iterative corporeal insights and practices challenging such toxic masculinities, I argue that such performances and embodiments (what I call living archives), albeit with multiple tensions, re-orient us to emerging decolonial horizons. In doing so, I directly challenge and unsuture the complacent IR historiographies of security and war and the ways they insist on composing and writing by bringing together certain archives (i.e., images of violent places and state documents) and silencing those which systematically and consistently point to modernity’s violent frameworks including their production of violent masculinities on which extinguishment and futures lie. Such an insistence colludes with certain toxic regimes of representation expecting certain subjects, sovereigns, and institutions to order and reiterate (produce) colonial and violent racialized masculine (and racialized feminized) practices between ourselves and the world. Living archives are also those invented signs, imaginations, and excesses that press materiality and its impasses (i.e., in the form of capture, blackness, non-genders, etc. and resolution of signs and fictions), exposing the limits of modernity’s fictioning, and gainst any resolution and labor that produces violence all the while sublating it.

Keywords: militarized masculinities, Cyprus, living archives, the colonial, imperial wars, decolonial struggles, international relations grammars

Topics: Coloniality/Post-Coloniality, Gender, Masculinity/ies, Femininity/ies, Military Forces & Armed Groups, Militarization, Race, Security, Violence Regions: Europe, Southern Europe Countries: Cyprus

Year: 2017

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