Attitudes of Iraq and Afghanistan War Veterans toward Gay and Lesbian Service Members
Abstract: U.S. policy banning openly gay and lesbian personnel from serving in its military rests on the belief that heterosexual discomfort with lesbian and gay service members in an integrated environment would degrade unit cohesion and readiness. To inform this policy, data from a 2006 survey of Iraq and Afghanistan war veterans are analyzed in this study. Views of these war veterans are consistent with prior surveys of military personnel showing declining support for the policy: from about 75 percent in 1993 to 40 percent in this survey. Among the demographic and military experience variables analyzed, comfort level with lesbian and gay people was the strongest correlate of attitudes toward the ban. War veterans indicated that the strongest argument against the ban is that sexual orientation is unrelated to job performance and that the strongest argument in favor of the ban is a projected negative impact on unit cohesion. However, analyses of these war veterans’ ratings of unit cohesion and readiness revealed that knowing a gay or lesbian unit member is not uniquely associated with cohesion or readiness; instead, the quality of leaders, the quality of equipment, and the quality of training are the critical factors associated with unit cohesion and readiness.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.