Race/Ethnicity and Sexual Orientation Disparities in Mental Health, Sexism, and Social Support among Women Veterans

Abstract

Objective: To identify patterns of risk and resilience by the intersections of race/ethnicity and sexual orientation in mental health symptom severity, sexism, and social support among U.S. women veterans.

Methods: A national sample of women veterans (n = 648, 38% sexual minority, 15% racial/ethnic minority) was recruited online in 2013 using social networking websites and listservs. Using cross-sectional survey data, we evaluated main and interactive associations between race/ethnicity and sexual orientation on depression, anxiety, posttraumatic stress, unhealthy alcohol use, sexism, and social support. Models were adjusted for other demographic characteristics.

Results: Across depression, anxiety, and sexism, White heterosexual women reported the least distress and racial/ethnic minority heterosexual women the most distress (race/ethnicity x sexual orientation interactions p < .05). Among White women, sexual minority women reported greater levels of depression, anxiety, and sexism than heterosexual women. The effects were the opposite among racial/ethnic minority women, where heterosexual women reported similar or worse depression, anxiety, and sexism than sexual minority women. There were no race/ethnicity or sexual orientation interaction effects on posttraumatic stress symptoms or unhealthy alcohol use and marginally significant effects on social support.

Conclusions: Among women veterans, race/ethnicity and sexual orientation were associated with mental health and sexism, alone and in combination. Findings suggest that those who were both racial/ethnic and sexual minorities may develop resilience from their lived experience. On the other hand, women veterans with a minority race/ethnicity or a minority sexual orientation appeared more vulnerable to adverse outcomes and may need targeted care.

Keywords: Women veterans; health disparities; intersectionality; race/ethnicity; sexual orientation.

Figures

Figure 1.

Predicted Margins with 95% Confidence Intervals of Race/Ethnicity and Sexual Orientation on Depression.

Figure 2.

Predicted Margins with 95% Confidence Intervals of Race/Ethnicity and Sexual Orientation on Anxiety.

Figure 3.

Predicted Margins with 95% Confidence Intervals of Race/Ethnicity and Sexual Orientation on Past-year Sexist Events.