Mental health and well-being of LGBT+ Veterans dismissed from the British Armed Forces before January 2000
Abstract: Between 1955 and January 2000, the UK Armed Forces and Ministry of Defence enforced a ban on lesbian, gay, bisexual, transgender, and related (LGBT+) service, dismissing or forcing the immediate retirement of thousands of personnel because of their sexual orientation or gender identity. They fell on hard times and were left isolated and unsupported by the nation they had proudly stood to defend. Although more than 21 years has elapsed since the ban was lifted, little academic literature has explored the ban’s impact on the mental health and well-being of the United Kingdom’s LGBT+ Veteran community. Anecdotal evidence suggests many still endure consequential hardship and mental health struggles and remain isolated from the military family and traditional support services. Fighting With Pride, an LGBT+ military charity launched in January 2020, and Northumbria University’s Veterans and Military Families Research Hub joined in partnership to remedy this by determining mental health and well-being impacts and consequences and identifying recovery pathways. Lived experience narratives must be used to help build support ahead of the publication of any formal findings. Research-based evidence is vital in helping to develop recovery and support policy and in further shaping support services to develop the best possible impact-related outcomes.
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.