According to the USA Today article VA Treats 2,500 Veterans, the Veterans Health Administration (VHA – part of the overall Department of Veterans Affairs, or VA), in 2013 treated 2,567 veterans with the diagnosis of gender dysphoria for transgender specific health care.
That’s a significant population of trans veterans in the VA. And, being statistically significant, this population has begun to be studied.
LGBT Heath published a study in mid-December by John Blosnich et al entitled Mortality Among Veterans with Transgender-Related Diagnoses in the Veterans Health Administration, FY 2000-2009. According to the abstract for the study, “The aims of this project were to document all-cause and suicide mortality among Veteran Healthcare Administration utilizers with The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis consistent with transgender status.”
The study found that “[t]he crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses across the 10-year period was approximately 82/100,000 person-years, which approximated the crude suicide death rates for other serious mental illness in VHA (e.g., depression, schizophrenia). The acreage age of suicide decedents was 49.4 years.” The study concluded “[t]he crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses is higher than in the general population, and they may be dying by suicide at younger ages than their veteran peers without transgender-related ICD-9-CM diagnoses. Future research, such as age-adjusted rates or accounting for psychiatric co-morbidities, will help to better clarify if the all-cause and suicide mortality rates are elevated for veterans with transgender-related ICD-9-CM diagnoses.”
There’s another study coming out of Emory University in the National Institutes of Health (NIH) pipeline which also looks at the mortality and morbidity of trans veterans by Goodman et al. “The goal of this [study] is to develop a longitudinal cohort study of the short- and long-term health outcomes among individuals who underwent hormonal and/or surgical gender reassignment interventions. Members of the transgender community and health care providers caring for transgender individuals express concerns about mental and physical health problems in this population; however longitudinal studies of transgender populations in the U.S. have not been conducted.”
Is the trans population large enough for the VA to actually develop a treatment schema specific to trans people and suicide? Well, yes. Is this the end goal for these studies? I don’t think anyone can say that at this point.
The trans population of the VA provides a sizeable enough population that one can draw valid conclusions about, whether it be on mortality and morbidity of trans people, or it be on other aspects of trans health care. To quote one expert in tracking trans studies by the VA, “Suicide is currently a major priority within the DoD and the VA. Right now that’s where there’s funding, so those are the studies we’re going to see out of the gate first.”
The conclusion from the Blosnich abstract calls for more study to create more data. But I’m personally interested in knowing whether the data will actually lead to creating a schema of care for trans veterans in particular, and trans people in general, regarding transgender suicides.
If there is going to be resources put to developing treatment schemas – standards of care, really – to treat trans people specifically for their suicide risk, then the Blosnich and Goodman studies are likely going to form the initial core of the research necessary for such a treatment schema.
But, of course, there are other issues that need studying besides trans suicides. For example, if there are dosing issues related to any medications given to XY females and XX males, as well as if there really are long term issues to trans people’s lifetime use of hormones to treat gender dysphoria.
The VHA database is being used now to study trans people, and that can’t be anything but a good thing. I do wonder though how long it will take for other researchers past Blosnich and Goodman to use the VHA trans population and related data to begin to look at trans lives instead of just looking at trans deaths.
