An Exploratory Study: Informing Health and Prevention Services for Transgender and Gender Variant Student Veterans

Veterans of recent wars are enrolling in higher education at high rates. Among them are veterans who identify as transgender and gender variant (TGV). People who identify as TGV are more prevalent among the veteran population when compared to the general population and TGV people are more likely to enroll in college in an attempt to increase employment opportunities. Even though TGV people enroll in college at higher rates their, completion rates are lower than the general population. It is not fully understood why TGV students have lower completion rates, however, we know that as a result of societal stigma and discrimination, TGV student veterans experience health needs that differ from the general population and health can affect degree completion.

This study utilized data from a national sample of college students including student service members/veterans (SSM/V) to answer the questions: What are the demographic characteristics of TGV SSM/V? Do physical health characteristics differ by gender among SSM/V? Do mental health characteristics differ by gender among SSM/V? Is substance use, reported academic difficulty, use of nonprescribed medication, mental health service use and existence of a mental-physical comorbid condition different between cisgender and TGV SSM/V?

Methods

Fall 2011-2014 data from the American College of Health Association’s (ACHA) National College Health Assessment (NCHA) was used for this study. Over the four years, 114,816 students responded to the survey; 2,658 identified as SSM/V. Data is based on self-reports in 25 categories of physical health and 16 categories of mental health. Substance use, reported academic difficulty, use of unprescribed medication, mental health service use, and existence of a mental-physical health comorbid condition variables were also included. Fisher’s Exact Tests and two-way ANOVA were used to answer the research questions.

Results

Significant differences in gender were found among American Indian, Alaskan Native or Native Hawaiian (AI-AN-NH) students by military experience. While 0.400% of AI-AN-NH SSM/V were TGV, 5.400% of AI-AN-NH SSM/V were TGV. TGV military SSM/V were more likely than cisgender SSM/V to have all 25  physical health problems. TGV SSM/V were more likely to have a mental health condition than cisgender SSM/V. There were no significant differences by gender for substance use. TGV SSM/V were more likely to use prescription painkillers without a prescription than cisgender SSM/V. No differences by gender were found in perceived difficulty of academics. TGV SSM/V had higher university mental health service utilization rates than cisgender students.

Conclusions and Implications

Research shows that TGV populations, including SSM/V, experience harassment and discrimination that can contribute to negative physical and mental health outcomes and negatively affect education completion. Yet, little research has captured the milieu of college and university settings in terms of how well they are serving and addressing the unique needs of TGV SSM/V. Results provide colleges and universities with data of common health and behavioral risks so they can develop health and prevention services for greater educational and health outcomes. As such, TGV veteran students are likely to address their medical and mental health issues that can lead to better educational outcomes.