The Military Reaches Out to Gay Vets through Veteran Affairs
The federal government is reaching out around the nation to gay and lesbian military veterans - most of whom had to spend their military careers in the closet - in its most concerted effort yet to let them know its doors are open to them.
Under a pilot program that began Oct. 1 in six metropolitan areas, including the Bay Area, the Department of Veterans Affairs has dispatched teams of psychologists to community meetings and brought in trainers to work with VA employees. The training deals with everything from how to appropriately ask about relationship status to being more alert about detecting post-traumatic stress caused by antigay discrimination.
The goal, said VA psychologist Stephen Rao, who is helping to oversee the effort in San Francisco, is to "really branch out to the LGBT community, to let them know we are a safe place for them."
So far, Rao's team has run information tables at a half-dozen events in the city and conducted a number of sensitivity seminars for VA staff.
"We're getting several new clients a week coming in, and we anticipate that will really grow in the coming months," Rao said. "The VA is blazing a trail. ... We are all very excited about this."
A starvation-thin, middle-aged gay Army veteran who went only by George notched himself a little place in military history last month in San Francisco because of the outreach program, without even knowing it.
At the nation's first Project Homeless Connect event held specifically for gays, lesbians, bisexuals and transgender people, George gingerly approached a table at the LGBT Community Center marked "Veterans Services" and asked, "Are you for real?"
Rao's answer was a welcoming laugh.
"I mean, really, it wasn't that long ago you guys threw us out for being gay, right?" George pressed on.
"Yes, we're real, and no, we weren't throwing people out of veteran hospitals for being gay," Rao explained. Then he held out a brochure of VA medical services - and with that, George became the first homeless gay man to be drawn in by the new outreach effort.
San Francisco's VA operations already had well-established open-door policies toward LGBT people before the national effort began. But even here - as George's query demonstrated - some people can still use some convincing.
It's all part of a new era for all things military, gay and lesbian in the United States.
Just two years ago, the military was tossing people out for being gay or lesbian. Transgender people are still barred from the services, but all other sexual orientations became accepted with the end of the "don't ask, don't tell" policy in 2011 - and the transformation has constituted a rapid deployment of sensitivity.
Now there are public support organizations such as OutServe-SLDN for gays and lesbians who are still in the military, and dozens of veterans have had dishonorable discharges changed to honorable. The VA, being a separate department from the active forces, hasn't barred gays and lesbians from receiving care for many years, but the repeal of the ban on gays in the services has prompted it to expand its outreach.
The VA maintains a national crisis phone line for gay and lesbian veterans and a website offering advice on specialized care, including a section detailing benefits that is titled, "I am a Lesbian, Gay or Bisexual Veteran." Over the past two years it also began offering hormone therapy and specialized counseling for transgender people, despite their continued exclusion from the military.
In September, President Obama ordered the VA to give same-sex spouses of veterans the same access to federal benefits as straight spouses - an outgrowth of the U.S. Supreme Court ruling striking down the Defense of Marriage Act.
The VA estimates that about 1 million of the nation's 21 million veterans are gay, lesbian, bisexual or transgender. Considering that theVeterans Health Administration runs the biggest integrated health system in the world, "it is likely the largest single provider of health care for sexual and gender minority individuals in the United States," the agency's LGBT program coordinator, Jillian Shipherd, wrote in a June issue of the research journal LGBT Health.
"It's incredibly important that we get the word out that veterans are welcome at the VA no matter what their sexual identity is," Shipherd said in an interview. "We have always provided good care for LGBT veterans, but we are now formalizing our policies and procedures in ways we haven't before."
Discrimination is at the root of many of the problems specific to gay and lesbian veterans, Shipherd and Rao said. VA research shows that the strain from being stigmatized and the target of bigoted hostility can produce higher rates of smoking, alcohol and drug abuse in LGBT vets, as well as a greater risk of anxiety and depression.
"A lot of the LGBT patients I see have experienced severe post-traumatic stress disorder because of discrimination, and how one makes sense of that kind of PTSD is different from having had a mortar explode next to you," Shipherd said. "You need to be sensitive to that as a provider."
LGBT vets also are at greater risk for sexually transmitted diseases, including HIV and some cancers.
Putting people at ease
Putting a patient at ease while handling these challenges can involve anything from being extra-vigilant for certain conditions to simply not asking veterans if they have a "husband or wife."
"We tell people to instead ask in gender-neutral ways, such as asking if they have a partner," Rao said. "You want them to know you are sensitive to various kinds of relationships."
In addition to the Bay Area, the VA is making its push in Boston, Honolulu, Houston, Milwaukee and New Haven County, Conn. Next year, it will be extended to Chicago and San Diego.
For LGBT vets still barely used to the idea that their lifestyle is not conduct unbecoming, this new VA push is like fresh wind.
"It's tremendous," said John Caldera, 59, who kept his orientation secret enough to be honorably discharged as a Navy corpsman in 1987. "The most famous quote by Harvey Milk was, 'You gotta give 'em hope,' and this gives our vets more hope than ever."
He said that with society becoming more accepting of LGBT people, the VA should have an easier time connecting with younger vets.
"Bigotry, to some extent, is generational, and there were more good ol' boys in my generation than in this one," said Caldera, who serves on the San Francisco Veterans Affairs Commission. "I'd say the next big step for the military and even for vets is to reach out and include the transgender community.
“We've still got a long way to go."
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