Health Differences Among Lesbian, Gay, and Transgender Veterans by Rural/Small Town and Suburban/Urban Setting.

Purpose: We explored the relationship between geographic location and health indicators for lesbian, gay, and transgender veterans.
Methods: We solicited participation in an online survey through national and city LGBT organizations and personal contacts to examine differences in depression, anxiety, alcohol and tobacco use, and body mass index among lesbian, gay, and transgender veterans (n = 252) in suburban/urban and rural/small town locations. Bisexual participants were too few to include in the analyses.
Results: As expected, rural/small town lesbian, gay, and transgender veterans spent more time traveling to their primary care provider. Travel time was also positively related to depressive and anxiety symptoms. However, only suburban/urban and rural/small town gay men differed in measures of depression and anxiety and tobacco use. That is, rural/small town gay men reported greater depressive and anxiety symptoms and greater tobacco use than their suburban/urban counterparts. Consistent with this finding, rural/small town gay men reported less community-related identity than suburban/urban men. Suburban/urban lesbian women showed a nonsignificant trend for community identity compared with rural/small town women.
Conclusion: Similar to civilian studies, suburban/urban and rural/small town lesbian, gay, and transgender veterans evidenced few health differences, with the exception of suburban/urban gay men. Although rural/small town gay male veterans evidenced more depression and anxiety and less community identity than suburban/urban men, social networks likely differ for lesbian, gay, and transgender subgroups. Lesbian, gay, and transgender veterans may also differ from their civilian counterparts in ways that we do not yet understand.