ArticleFrontiers in public health2023
Implementation of LGBTQ+ affirming care policies in the Veterans Health Administration: preliminary findings on barriers and facilitators in the southern United States.
Article in Frontiers in public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Policy and Perception: Comparing Attitudes Toward LGBTQ and Gender Equality Between Long-Term Care Staff in Taiwan and Indonesia.The journal of nursing research : JNR · 2026Article
- Methods to design, adapt and apply equity-focused implementation science theories, models and frameworks in healthcare systems: a scoping review.Implementation science communications · 2026Review
- Centering communities in policy implementation research: considerations for the integration of community-based participatory research principles into policy-focused implementation science.Translational behavioral medicine · 2026Article
- Ethnoracial inequities in social stressors and patterns of alcohol use in a population of United States transgender Veterans.Social science & medicine (1982) · 2025Article
- Health-Related Social Needs Among LGB+ Veterans.JAMA network open · 2025Article
- A Scoping Review of Heteronormativity in Healthcare and Its Implications on the Health and Well-Being of LGBTIQ+ Persons in Africa.International journal of environmental research and public health · 2025Article
- Recommendations for promoting affirming healthcare for gender and sexual minorities with intersecting marginalized identities.BMC health services research · 2025Article
- An Examination of Facilitators and Barriers to Care Receipt Among Specific Groups of LGBTQ+ and Cisgender Heterosexual Veterans.Psychology of sexual orientation and gender diversity · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
Background: In the United States Department of Veterans Affairs (VA), veterans who are lesbian, gay, bisexual, transgender, queer, and similar gender and sexual minoritized people (LGBTQ+) experience health disparities compared to cisgender, heterosexual veterans. VA's LGBTQ+ Health Program created two healthcare policies on providing LGBTQ+ affirming care (healthcare that is inclusive, validating, and understanding of the LGBTQ+ population). The current project examines providers' barriers and facilitators to providing LGBTQ+ affirming care and LGBTQ+ veterans' barriers and facilitators to receiving LGBTQ+ affirming care. Methods: Data collection and analysis were informed by the Consolidated Framework for Implementation Research, which was adapted to include three health equity domains. Data collection involved telephone interviews conducted with 11 VA providers and 12 LGBTQ+ veterans at one rural and one urban VA medical center, and one rural VA community clinic. Qualitative data were rapidly analyzed using template analysis, a data reduction technique. Results: Providers described limited education, limited time, lack of experience with the population, and a lack of awareness of resources as barriers. Providers discussed comfort with consulting trusted peers, interest in learning more about providing LGBTQ+ affirming care, and openness and acceptance of the LGBTQ+ community as facilitators. LGBTQ+ veterans described a lack of provider awareness of their needs, concerns related to safety and discrimination, and structural discrimination as barriers. LGBTQ+ veterans described positive relationships with providers, knowledge of their own healthcare needs, and ability to advocate for their healthcare needs as facilitators. Although VA's LGBTQ+ affirming care policies are in place, providers and veterans noted a lack of awareness regarding specific healthcare processes. Conclusion: Allowing more time and capacity for education and engaging LGBTQ+ veterans in determining how to improve their healthcare may be the path forward to increase adherence to LGBTQ+ affirming care policies. Engaging patients, especially those from marginalized backgrounds, in strategies focused on the uptake of policy may be a path to improve policy implementation. It is possible that creating truly collaborative structures in which patients, staff, providers, leadership, and policymakers can work together towards policy implementation may be a useful strategy. In turn, improved policy implementation would result in increased physical and mental health for LGBTQ+ veterans.
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