(PS6-15) Differences in Reproductive Healthcare Utilization Between Heterosexual and Lesbian, Gay, and Bisexual+ Women Veterans

Abstract Text: Lesbian, gay, and bisexual+ (LGB+) women Veterans experience numerous health disparities relative to heterosexual women Veterans. Extant research suggests that LGB+ women Veterans face barriers to healthcare receipt, including experience of sexual orientation-related discrimination. However, little research has examined the effects of this discrimination on use and experience within reproductive healthcare settings specifically. To that end, this study examined rates of gynecological healthcare utilization among LGB+ women Veterans relative to heterosexual women Veterans and the effects of sexual orientation-related discrimination on healthcare utilization and experience. Women Veterans (N = 1,756) recruited via the Department of Defense (15.7% LGB+, N = 275) answered questionnaires related to Pap smear receipt, gynecological care visits, pelvic exam experiences, and experiences of daily discrimination. Logistic regression was used to evaluate likelihood of utilizing gynecological healthcare, controlling for relevant covariates. Linear regression was used in subgroup analyses to assess the effects of sexual orientation-related discrimination and other control variables on four dimensions of pelvic exam-related distress among those identifying as LGB+ and endorsing any level of sexual orientation-related discrimination. Results indicated that LGB+ women Veterans were equally likely to receive Pap smears (87% vs. 88%, p = .691) but less likely to undergo routine visits with a gynecologist (77% vs. 84%, p = .010) relative to heterosexual women Veterans. LGB+ Veterans who experienced sexual orientation-related discrimination reported more physical (B = .021, SE = .005, t = 4.503, p < .001) and emotional (B = .023, SE = .005, t = 4.799, p < .001) distress during pelvic exams relative to those who did not. Findings suggest LGB+ women Veterans may be less likely to use women’s health specialty clinics compared to heterosexual women Veterans, instead accessing preventative screenings in primary or general healthcare settings. Given that Veterans with regular reproductive healthcare providers are more likely to be adherent to breast and cervical cancer screenings, it is important to address factors that may contribute to non-use of gynecological services. Moreover, addressing sexual orientation-based discrimination is paramount to providing safe and effective gynecological healthcare.