The Military Acceptance Project (MAP):
Improving Acceptance, Integration, and Health among LGBT Service Members

MAP is one of the first Department of Defense-supported studies of active duty Lesbian, Gay, Bisexual, and Transgender service members’ behavioral health needs. The project is a joint effort between the University of Southern California (USC) and the University of California, Los Angeles (UCLA). Investigators from the USC School of Social Work’s LGBT Health Equity Initiative and Center for Innovation and Research on Veterans & Military Families, along with investigators from the Department of Social Welfare in the UCLA Luskin School of Public Affairs, will join forces to conduct qualitative interviews and quantitative surveys with LGBT service members from each of the four military branches (Army, Navy, Air Force, and Marines). An expert advisory panel comprised of leaders in the military and in LGBT health will help guide this project.

LGBT people are more likely to experience a range of behavioral health problems compared to their heterosexual and cisgender peers. For example, in the general population, LGBT people have higher rates of depression, anxiety, suicide, and substance use than their peers. While the same might be true for LGBT individuals actively serving in the military, little is known about their health and well-being. With the repeal of Don’t Ask Don’t Tell (DADT) in 2011, the ban on LGB individuals serving opening in the military was officially lifted. In the intervening years, however, it has not become significantly easier for most of these individuals to serve openly. A culture of non-acceptance – established prior to the adoption of DADT – remains alive and well, with some LGB service members experiencing interpersonal and institutional discrimination, marginalization, and rejection.

While LGB service members can no longer be involuntarily separated from the military, transgender service members face increased ambiguity about their military future. The DOD is reviewing its current policy that calls for the separation of all transgender service members. Until this review is complete, all military discharges involving transgender service members have been put on indefinite hold. The needs of transgender service members, in particular, demand special attention given the unique experiences this community faces in their interactions with healthcare providers, and the vast disparities faced in numerous mental and physical health diagnoses.

Understanding the issues faced by LGBT service members is important because it helps the military develop programs to address the health needs among individuals in that community. In addition, understanding the needs of LGBT service members may enhance the performance of the military overall through improved unit cohesion. There are several potential clinical applications for the proposed research. For example, this project will help to identify social networks that are supportive of LGBT service members. This information may help programs and policies that work to increase peer support within LGBT service members’ social and professional networks.

MAP will take place over the course of two years. In the first year, qualitative interviews with active-duty LGBT service members from each of the four military branches (Army, Marines, Navy, Air Force) will be conducted to understand the unique stress experiences of these individuals (n=60). In the second year, an anonymous quantitative survey will be conducted online with active-duty LGBT service members (n=240) and matched heterosexual service members (n=240). The expert advisory panel will help guide all procedures during the two-year project.

To help us meet our enrollment goals, key members of the expert advisory panel will provide the study flier and contact number to fellow service members. In turn, we will ask service members who have participated in the research to give the study flier and contact number to service members within their own social networks. Interested service members who see our study flyer, or other study-related publications, are welcome to contact us. Participation in MAP is completely voluntary, and all service members must provide verbal consent before enrolling. The study team will not gather personally identifying information, and any information we collect from service members will remain anonymous. For their participation, off-duty service members will be eligible to earn gift certificates to Amazon.com. Service members in the qualitative interviews will be welcome to participate in the quantitative survey.

This study has the potential to advance the field of behavioral health research and patient care in a number of ways. First, the study will document unique stressors experienced by LGBT military personnel through the development of an LGBT Military Experience Checklist, which may be useful in clinical settings as a diagnostic tool. Second, by documenting factors associated with negative health outcomes among LGBT service members, the DOD can begin to develop programs to improve health and well being among LGBT service members in patient care settings. Finally, we hope that this research will lay the groundwork for future work with this population in military settings.

Co-Principal Investigators: Carl Castro, PhD – USC
Jeremy Goldbach, PhD, LMSW – USC
Ian Holloway, PhD, MSW, MPH – UCLA
Co-Investigators Henry Fisher Raymond, DrPH – UCSF
Sheree Schrager, PhD, MS – CHLA
Project Director Ashley Schuyler, MPH – USC
Project Coordinator Elizabeth Wu – UCLA
Expert Advisory Panelists: Lt. Colonel Victor Fehrenbach (Retired)
Lori Hensic, PharmD, BCAP
Kristen Kavanaugh
CW3 Lindsey Muller
Johanna Olson, MD
Major M. Matthew Phelps, USMC
Christopher Warner, LTC (P), MC
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