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Lgbq Veterans and Sexual Dysfunction

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Lgbq Veterans and Sexual Dysfunction Running head: LGBQ VETERANS AND SEXUAL DYSFUNCTION Sexual Dysfunction: Providers’ Willingness to Ask LGBQ Veterans About their Sexual Functioning by Melanie A. Brayman B.A., Stonehill College, 2014 M.S., Antioch University New England, 2017 DISSERTATION Submitted in partial fulfillment of the requirements for the degree of Doctor of Psychology in the Department of Clinical Psychology Antioch University New England, 2019 Keene, New Hampshire LGBQ VETERANS AND SEXUAL DYSFUNCTION ii Department of Clinical Psychology DISSERTATION COMMITTEE PAGE The undersigned have examined the dissertation entitled: SEXUAL DYSFUNCTION: PROVIDERS’ WILLINGNESS TO ASK LGBQ VETERANS ABOUT THEIR SEXUAL FUNCTIONING presented on February 5, 2019 by Melanie A. Brayman Candidate for the degree of Doctor of Psychology and hereby certify that it is accepted*. Dissertation Committee Chairperson: Roger L. Peterson, PhD, ABPP Dissertation Committee members: Vince Pignatiello, PsyD Stephen Gresham, PhD Accepted by the Department of Clinical Psychology Chairperson Lorraine Mangione, PhD on 3/8/19 *Signatures are on file in the Registrar’s Office of Antioch University New England LGBQ VETERANS AND SEXUAL DYSFUNCTION iii This dissertation is dedicated to those who served in silence or were judged by their sexual identity rather than their ability as service members. This research is for you. LGBQ VETERANS AND SEXUAL DYSFUNCTION iv Acknowledgments I cannot even begin to describe my appreciation for the love and support of my other half and love of my life. Ty, your unconditional love, patience, and ability to keep me focused in what lies ahead are major reasons of why I am where I am today. I love you and am excited for our future together. To Mom, Dad, Leah, Rachel, Jackson, Chig, and Mikael––in some way, you have all contributed to my successes. Whether it was giving me a call to check in and make me laugh or reminding me that I am unconditionally loved and appreciated, you have always been in my corner. I am blessed to have a strong support net to catch me when I crash and then push me to continue on. I love you all so much. A special thanks to my friends Annie Taylor and Madeline Brodt––I am forever thankful for your support and help throughout this crazy process. Thank you for your use of humor and empathy to get me through some of the hardest challenges in graduate school. To my Mimi and Grandpa––though both of you have passed on, your spirits have always been with me through the best and worst of times. Your love and value in hard work has molded me into the professional I am today. Your ability to always be thankful and humble despite the hardships life brings reminds me to be positive and appreciate the time I spend with people I love. I miss you both; my work will forever be dedicated to you. Thank you to the members of my committee, Vince and Stephen. Both of you have played a crucial role in my development as a clinician and as a person. Your ability to challenge me has made me stronger and your commitment to my success holds a special place in my heart. I will forever strive to be half the compassionate and genuine therapists you both are. LGBQ VETERANS AND SEXUAL DYSFUNCTION v Last, but definitely not least, Roger––it has been a wonderful experience working with you and getting to know you on a personal level. From your support through the internship process, recommendations of good books, and your consistent check-ins, you always go above and beyond; thank you so much. LGBQ VETERANS AND SEXUAL DYSFUNCTION vi Table of Contents Acknowledgments....................................................................................................................... iv List of Tables .............................................................................................................................. viii Abstract ....................................................................................................................................... 1 Introduction ................................................................................................................................. 2 Key Constructs ....................................................................................................................... 3 Sexual Dysfunction ........................................................................................................... 3 Differentiating LGBQ Veterans’ Mental Health Issues.................................................... 3 U.S. Military Culture ........................................................................................................ 4 Keeping the Transgender Experience Separate ..................................................................... 5 Theoretical Framework .......................................................................................................... 6 Biopsychosocial Model ..................................................................................................... 6 Implications to Clinical Psychology ...................................................................................... 8 Applied Importance for Clinicians in Training ................................................................. 8 Can Clinicians Properly Assess for SD in LGBQ Veterans? ........................................... 8 Research Questions and Hypothesis ...................................................................................... 10 Literature Review........................................................................................................................ 11 High Prevalence of Sexual Dysfunction in Veterans ............................................................. 11 Negative Mental Health Outcomes Correlated with Sexual Dysfunction ............................. 12 LGBQ Community has High Rates of Mental Health Issues ................................................ 13 Sexual Dysfunction and the Veteran Population ................................................................... 14 LGBQ Veterans Unique Position........................................................................................... 16 Intersections with Critical Topics .......................................................................................... 17 Social Justice ..................................................................................................................... 17 Diversity ............................................................................................................................ 18 Ethics................................................................................................................................. 19 Competence.................................................................................................................. 21 Confidentiality ............................................................................................................. 22 Research Design and Methodology ............................................................................................ 24 Participants ............................................................................................................................. 24 Measure .................................................................................................................................. 24 LGBQ VETERANS AND SEXUAL DYSFUNCTION vii Procedure ............................................................................................................................... 25 Data Analysis ......................................................................................................................... 26 Results ......................................................................................................................................... 26 Demographic Characteristics of Sample ................................................................................ 27 Experience and Caseload ....................................................................................................... 28 Training in Sexual Functioning ............................................................................................. 29 Willingness to Ask ................................................................................................................. 29 Comfort in Asking ............................................................................................................ 29 Requirement to Ask .......................................................................................................... 30 Training and Education in SD........................................................................................... 30 Relevance to Overall Treatment ....................................................................................... 30 Fear of Being Offensive .................................................................................................... 30 Proper Referrals ................................................................................................................ 30 Time Constraints .............................................................................................................. 30 Other Providers Asking.................................................................................................... 30 Relationship Between Training and Willingness to Ask ....................................................... 31 Relationship Between Years of Experience and Willingness to Ask ...................................
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