DOI
https://doi.org/10.25772/81FZ-SP46
Author ORCID Identifier
https://orcid.org/0009-0005-8980-2986
Defense Date
2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Social Work
First Advisor
Dr. Matthew Bogenschutz
Abstract
Transgender adults face well-documented healthcare disparities, but little is known about how military service influences these experiences. This study examined healthcare access and health outcomes among military-affiliated transgender adults using minority stress theory with an intersectional perspective. Secondary data analysis of the 2015 U.S. Transgender Survey examined healthcare experiences among 27,715 transgender adults, including 2,403 with military service history. Bivariate analyses explored the association of military affiliation with indicators of healthcare access. Research Question 2 employed regression analyses to examine relationships among discrimination, identity disclosure, and health outcomes within the military subsample. Military-affiliated transgender adults demonstrated a complex healthcare access profile characterized by simultaneous advantages and barriers. They had significantly higher rates of designated healthcare providers for both transgender-related care (χ² = 274.10, p < .001) and routine care (χ² = 274.09, p < .001), yet faced greater geographic barriers to access trans-related and routine health care. Among military-affiliated participants, both general discrimination (β = .194, p < .001) and medical discrimination (β = .11, p < .05) predicted increased psychological distress. Counterintuitively, complete identity disclosure ("out to everyone") was associated with significantly poorer general health across all categories compared to excellent health (OR = 3.14 for poor health, p = .029). Findings confirm military minority stress processes and suggest benefits of using and expanding an intersectional perspective to military health research with marginalized communities. Military-affiliated transgender adults experience unique experiences within the military institution that require further exploration in future research.
Rights
© Victoria K. Cashio
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
8-6-2025