Mental Health Care Experiences of Trans Service Members and Veterans: A Mixed-Methods Study

We explored mental health care experiences of trans service members and veterans (TSMVs) through a mixed-methods, convergent parallel design. Quantitative survey data from 50 TSMVs were analyzed using paired-samples t tests to identify differences in perceived stigma and barriers to care in accessing services from nonmilitary versus military-affiliated or Veteran's Health Administration providers (MVAPs). We conducted semistructured interviews with 10 participants, exploring their lived experiences in accessing mental health care from both nonmilitary providers and MVAPs. Integrated mixed-methods results indicate TSMVs are more concerned about anti-trans stigma when accessing care from MVAPs, whereas logistical concerns inform access to nonmilitary providers. Key themes shaping participants' mental health care experiences were (a) access to trans competent care, (b) fear/fear of consequences, (c) therapeutic relationship, (d) transition-related factors, and (e) military systems and culture. Implications for training and practice are discussed.