Evidence map›Paper›PMID 40135108›Full record

ArticlePsychology of sexual orientation and gender diversity2025

An Examination of Facilitators and Barriers to Care Receipt Among Specific Groups of LGBTQ+ and Cisgender Heterosexual Veterans.

Michelle Upham, Kristine Beaver, Cindy J Chang, Cory J Cascalheira, Isaac C Rhew, Kim DeFiori, Krista S Dashtestani, Michael R Kauth, Jillian C Shipherd, Debra Kaysen and 1 more

Abstract read
In one paragraph

Article in Psychology of sexual orientation and gender diversity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Michelle UphamHealth Systems Research (HSR) Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington.ORCID 0000-0003-2799-8758
Kristine BeaverHealth Systems Research (HSR) Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington.ORCID 0000-0001-5206-5680
Cindy J ChangVeterans Affairs San Diego Healthcare System, San Diego, California.ORCID 0000-0002-1997-2665
Cory J CascalheiraHealth Systems Research (HSR) Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington.ORCID 0000-0001-5780-3101
Isaac C RhewDepartment of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington.ORCID 0000-0001-9731-8776
Kim DeFioriJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Krista S DashtestaniHealth Systems Research (HSR) Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington.ORCID 0000-0001-7788-6688
Michael R KauthLGBTQ+ Health Program, Office of Patient Care Services, Veterans Health Administration, Washington, District of Columbia.ORCID 0000-0002-0766-8404
Jillian C ShipherdLGBTQ+ Health Program, Office of Patient Care Services, Veterans Health Administration, Washington, District of Columbia.ORCID 0000-0001-6742-7912
Debra KaysenDepartment of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California.ORCID 0000-0001-7961-2787
Tracy L SimpsonDepartment of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington.ORCID 0000-0002-3333-9735

Funding

RISE PROGRAM AT NEW MEXICO STATE UNIVERSITYR25GM061222 · NIGMS · NEW MEXICO STATE UNIVERSITY LAS CRUCES · PI HOUSTON, JESSICA PEREA, REDDI, LAKSHMI · 2000 to 2022
$21.3M
HSRD VA I01 HX002423NIGMS NIH HHS R25 GM061222NIOSH CDC HHS T42 OH008428RRD VA IK2 RX005350
6 · The paper itself

Abstract

The present study examined rates and factors associated with past-year Veterans Health Administration (VHA) overall healthcare utilization and VA mental health treatment among LGBTQ+ and cisgender heterosexual veterans. Baseline data from a national longitudinal study of LGBTQ+ and cisgender heterosexual veteran VHA users and non-users (N = 1,062) were used in generalized linear models to estimate the predicted prevalence of VHA healthcare utilization for each LGBTQ+ and cisgender subgroup, stratified by gender. Additional multivariable regressions were guided by the Andersen health services utilization model. There were no significant differences in healthcare utilization among women subgroups. Among men subgroups, cisgender gay men had lower predicted prevalence of VHA utilization than cisgender heterosexual and transgender men. In both the women's and men's models, VHA eligibility indicators and perceived lack of service availability were associated with increased odds for any past-year utilization; higher income, difficulty understanding eligibility/benefits, and logistical barriers were associated with decreased odds. Lifetime harassment at VHA was positively associated with past-year overall VHA utilization in women's models. LGBTQ+ specific factors explained significant variance in some models while transgender/gender diverse specific needs did not. These findings suggest that veterans generally need assistance navigating VHA eligibility issues and that LGBTQ+ veterans would benefit from systemic attention to provider sensitivity and availability of services focused on their needs. The high rates of harassment reported across women subgroups (19% to 25%) and by transgender men (38%) warrant institution-wide action.

Indexed as

gender minorityhealthcare utilizationmilitarysexual minorityveterans

Identifiers

PMID40135108
PMCPMC11931685

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.