Operation "Do Ask, Do Tell," a conference for LGBT veterans and servicemembers focusing on health needs and resources, was held Oct. 20 at the Northeastern Illinois University student union.
Before and since the repeal of Don't Ask, Don't Tell, the Veterans Health Administration (VHA) has been moving toward clarifying policies regarding services to GLBT veterans. In June 2010, deputy under secretary for health for operations and management issued a policy statement specifically providing for patient visitation rights in support of the needs of LGBT family members. In June 2011 the VHA published a directive spelling out the policy regarding transgender veterans and intersex veterans. Veterans hospitals have developed cultural competency training on LGBT issues, developing an inclusive language guide, and creating an Office of Health Equity to address LGBT health care issues, among others.
The event at NEIU was an initiative to make sure veterans who are GLBT are aware of services and policies and feel welcome to be open about their sexual orientation while seeking care. Lorry Luscri and Mandi Evanson of Edward Hines Veterans Hospital were primary organizers.
The event opened with a color guard from Great Lakes Naval Base, the national anthem and remarks by Daniel Zomchek, Associate Director of Hines VA and Jack Bulmash, M.D. and Hines Chief of Staff.
Speakers, exhibits and breakout sessions covered topics including mental, military sexual trauma, suicide prevention, transitioning home from active duty, an overview of the Women's Health program, and transgender health care in the Veterans' hospitals. Other topics included tips for caregivers and families, substance abuse in the LGBT population, veteran burial benefits and veteran health insurance.
Keynote speaker Lee Reinhart was the first veteran of Don't Ask, Don't Tell from Illinois known to have rejoined the military following the repeal of the law. He is now working with Equality Ohio but returned to Chicago to tell the story of his first successful enlistment in one branch of the service, during which he was fairly out among his shipmates, and then a subsequent career with another branch of service, which ended in a fairly quick discharge in response to his honesty. Since being sworn back in to the Navy in 2011, he has served openly but reminded listeners that GLBTs with families and partners don't enjoy all benefits of military service. His example was the story of a legally married lesbian recently killed in Afganistan who's partner is denied the recognition and support due a military widow.
A panel of veterans who use veterans hospitals as their primary medical care provider was representative of the veteran population. All spoke of finding understanding and quality care. One woman had been told that she'd be in a wheelchair forever and that she would be "crazy forever." She learned at the VA that she would be neither. Another panel member spoke of many years of trying on the hush-hush to secure medical service pre- and post-gender reassignment care, until a doctor encouraged her to seek services without hiding anything. One long term patient with AIDS said that other patients in the system have at times reacted negatively to him, "…but only until they get to know me and get beat by me at bid whist and dominos."
One of the breakout sessions speakers was Dr. Sudha Bhoopalam, Director of Womens' Health at Edward Hines VA hospital, who spoke of the VA's growing service to women veterans.
"The VA has been a predominantly male dominated. Women have the same issues [PTSD, head injuries, substance abuse, depression, suicide, nutrition, immunization] but also face stressors more particular to women, like women who have carried equipment as heavy as the woman herself wearing ill-fitting boots, leading to foot and back pain. Also, while women have the same screening tests and health issues as men, the issue of mammography, for instance, is more of a discussion, in flux in the field and specific to each woman.''
The percentage of women using the VA has doubled over the last ten years, according to Bhoopalam. The age of women using the system is the entire spectrum.
Initiatives include comprehensive health with a designated primary health care provider, women's coordinators at every level for team care, provider competency training including three-day specialized education programs, sensitivity awareness in the layout of rooms and childcare areas with appropriate books and toys. Posters throughout the hospitals, such as the one showing a pair of worndown combat boots with the caption, "She wore these," help build awareness of women in the ranks of veterans among the staff and reassure women using the hospital that the awareness is there.
"Our mission is to provide health care sensitive to what women want and need," said Bhoopalam. "We (Hines VA) also want to be a national leader in women's health care. These are lofty goals from which women will benefit," she said.
"The environment of care begins at the front entrance and follows through all clinics, emergency rooms and specialty clinics. Feedback from women has been good. They've said that they feel recognized. This can only lead to improved outcomes."
About health-related benefits of coming out to your doctor in the veterans system she said, "It is a huge statement to know that who you are and your feelings are respected. That can only build trust and support more positive outcomes."
Laura Labbe conducted a breakout session on the care of transgender veterans in the VA system. The percentage of military men who identify as transgender is statically higher than the number of civilian men who do, she said, although the situation is so often not communicated that it remains under the radar.
It is the policy to provide all care due to any veteran and many types of care specific to transgender and intersex people, with the exclusion of providing or funding sexual reassignment surgery. The VA provides hormone treatment, mental health care, pre- and post-op evaluation and care.
Staff members are taught to reference health care users by the gender-identification which they present themselves and wish to be referenced. Hospital rooms are assigned based on the self-identified gender as long as it doesn't interfere with the privacy of others. A transgender person may have the need for both prostrate and breast health screening, both of which the VA is committed to provide without undue paperwork. It is not required that paperwork be changed to reflect gender for people to receive any such service.
Mariann Blacconiere, LCSW and Hines Suicide Prevention Coordinator, spoke on the high risk of suicide among both the veteran and the LGBT populations and spoke of training within the VA in methods of intervention to prevent veterans from acting on suicidal ideas. A large percent of all suicides are veterans, but studies show that veterans using veteran health care are less likely to carry out successful suicides, to murder or to be involved in violence.
While the numbers are comparable, suicide does not get the discussion that murder does, she pointed out, unless the person who dies is famous or a murderer who then takes his or her own life. She recommended www.veteranscrisisline.net as a resource.
Another online resource has been adopted by the VA for online account management. Patients can monitor their medications, appointments and communicate with healthcare providers at www.myhealth.va.gov .
The conference was planned with input from Hines VA Hospital; Captain James A. Lovell Federal Health Care Center; Jesse Brown VA Medical Center, Equality Illinois, G.L.A.S.S.; American Veterans for Equal Rights (GLBT veterans); Howard Brown Health Center; Northeastern Illinois University; Illinois Supporting All Veterans Equally (ISAVE ); Soldiers Project Chicago; Troops to Teachers.
Exibitors were Hines VA Hospital; Captain James A. Lovell Federal Health Care Center; Center on Halsted; Jesse Brown VA Medical Center; Vet Center, DuPage; Vet Center, Oak Park; Equality Illinois; AVER; Howard Brown; Chicago House and Social Service Agency; Northeastern Illinois University; Soldiers Project Chicago Roosevelt University; Gay Lesbian Active Sailors and Supporters (GLASS); Student Veterans Association; Kellogg School of Management LGBT group; OutServe; Servicemen Legal Defense Network; American Veterans for Equal Rights (GLBT veterans); and Women Veterans United, City of Chicago.
Note: Jean Albright is a retired Air Force veteran.