In mid October I was asked to give a half hour talk to select staff at a VAMC about what it means to be a Gay Vet.  I was to teach them how to be welcoming and supportive to our kind; to describe what happens when we come out to VA staff and other vets; and I was to talk about what staff can do to show that they are supportive; and among other things, tell them 'what was most helpful for LGBT vets to feel they can TRUST the VA and its staff to meet our needs?'

That last line will make a lot of folks cough and snort incredulously or bitterly.  Trust the VA?  Seriously?  Even straight vets will curl their lip and arch an eyebrow in contempt at the very idea.  I mean, just because I'm paranoid doesn't mean they're not out to screw me!  Right?  None of that even has anything to do with being gay.  Being gay means that you often expect to be discriminated against.  OK, all of that is really out of date, in fact.  Only a decade ago it was a common joke that "The VA discriminates against everyone equally."  You'd walk into a clinic to 'check in' with some nasty rude clerk who glared at you and greeted you with "Yeah, what's YOUR problem? Sit down and wait!"  It went downhill from there.  All that has changed now, employees have been taught to smile and avoid the 'Polite Rudeness' schtick.  But, what about the experience of being a gay vet?

There are over one million living LGBT vets who have served with honor and distinction since WWII.  For many, it was an experience that they want to forget because of the raw hatred they had to endure despite having volunteered to serve their country out of pure patriotism.  In the half century before DADT, including during Vietnam, we 'served in silence,' enduring daily homophobic slurs and vile jokes from everyone around us who assumed we didn't exist among them.  If we were found out, we were often  interrogated for months and then dishonorably discharged in disgrace. Some of us were even murdered; most recently, PFC Barry Winchell was beaten to death with a bat, in his sleep, at Ft Campbell, KY by those who 'thought' he was gay.  In the years under DADT, it was in many ways worse with everyone we served with hunting to find out who the queers were among them.  In those days, bigots had the power to report us to superiors who then had to investigate and discharge us.

With that background, its hard for most gay vets to imagine trusting the VA to keep them well.  Most assume they would have to go back in the closet to use the VA, and assume that if they are found out, they would be denied their benefits.  As a result, a great many gay vets just don't bother to even imagine accessing the benefits they earned through serving their country.  On top of that, most still think the VA has not changed since the 1990s when it had a reputation for negligent service or worse.  Being unwelcome in traditional veteran service orgs, to this day, no one told us that the VA has improved.  Ideally, I suppose, there could be more ad campaigns all about urging more vets to take advantage of their VA benefits.

Who are we?  LGBT Vets are the most diverse people on Earth who served in the most diverse military on Earth.  When American armed forces show up in foreign countries, folks are amazed to see our American diversity.  In most other countries, military units are segregated by ethnic, religious, and tribal identity.  When we show up they see Black and White and Hispanic and Asian Americans all serving together cooperatively; they see Christians and Jews, and Muslims and others working together in harmony.  And then they see a Humvee pull up and a four and a half foot female Asian-American lieutenant gets out, gets saluted, and starts giving orders.  The locals can't believe it!  Gay American veterans are just as diverse as all that.  We are Black, we are White,  Hispanic, Asian, Hindu, devout Christians, orthodox Jews, young and old, everything you can think of.  That is because homosexuality doesn't discriminate anymore than heterosexuality does.  And our multiple identities mean something to us.  We're not just proud to be gay, we are proud to be Black, Christian, and whatever else we are,  AND we are proud to be veterans.  All of that needs to be respected.

After describing 'who we are' to VA staff, I told them that while it helps to know the old gay vet sitting at their desk; they need to understand that he's Not sitting there because he's gay.  Being gay isn't a problem, and its not something we've come to see them about.   I'm 69 years old, I've known I was gay since I was 15, I'm used to it, I told them.  If you look at me, you might think that I don't really 'look gay.'  I look like any other grizzled grumpy old vet.  The reason for that is that I 'am' grizzled grumpy old vet.

If they are a 'housing specialist,' I told them, the reason I'd be sitting at their desk is that I'm a poor grizzled grumpy old vet who needs help finding affordable housing.  So, does it matter that I'm gay?  "Hell yes," I told them.  A gay vets needs housing that is safe and not bigoted against vets who happen to be Black Hispanic, and Gay, for example.  That's not very easy to find, if at all.  But the first step is a mutual understanding that VA staff understand our needs and are working to provide respectful dignified competent assistance.

Do gay vets come out at the VA?  Most, frankly, do not.  If they are recent vets, they need to find work, housing, overcome wounds and or PTSD.  Being gay is an important part of who they are, but the other priorities are more urgent for them.  Older, Vietnam Era vets are too used to expecting discrimination and generally don't come out at the VA to anyone.  Many still believe that their VA benefits will be cancelled if they come out at the VA (not so).  They just do without being open.  IF there were a very supportive treatment group, it might help a lot.  Some such groups do in fact exist, around the country at VAMCs.  There is even an inpatient LGBT PTSD program at the VAMC in Salem Virginia.  There are transgender veteran support groups and specialists at some VA hospitals; yet despite progress, transgender vets still report more discrimination than any other group. There is a VBA LGBT Outreach Coordinator, and a VHA LGBT Program Coordinator for Patient Care.  It was only in mid October that the VA ceased being the last and only federal agency not recognizing all same sex marriages.

Have I come out at the VA?  Yes, to just about everyone, all my doctors.  My digital file includes multiple mentions of my sexual orientation.  I do this because I'm an activist, not because I feel safe doing so.  Gay vets who know me, turn around and run away if they see me at the VA because they are afraid I'll embarrass them by saying hello.  At the VA, they are in the closet.  When I was an inpatient for two months after major surgery years ago, laying in bed, with tubes coming out of me, I was terrified of discrimination and being mistreated.  In the middle of the night, I could hear the night nurses shouting and cackling to each other, all of whom had full access to my file on their computers.  Frankly, I was scared to death about having been open; I was totally helpless.  As an outpatient, as an activist, I'm open to all my physicians.  Twice I have felt it was necessary to file complaints about discrimination.  Once, a primary care doctor was rather openly mean.  About a year or two ago I filed a complaint about a VA Van Driver who told violently homophobic and racist jokes in the van.  He didn't know that I'm gay, but it was obvious that the other Vietnam vet in the van was Black.  The driver also bragged about having been a Lieutenant.  I wasn't impressed.

So, its not surprising that other gay vets think I'm nuts to be out.

Some VA staff put up a 'rainbow themed VA poster' that says, "We serve all who served" that makes it clear that the offices with that sign are 'safe spaces' where being out is welcome.

What gives me the sense that a provider is someone I can trust is if they are able to discuss my needs in a way that includes the context of my being gay, without stereotypical assumptions.  It has actually happened that providers simply stated their assumption 'that my wife could give me an enema,' and I had to tell them that I don't have a wife or anyone else to do that for me.  Frankly, I thought it was a particularly stupid assumption, even regarding straight married vets.  Its not something I'd ask my wife to do even if I had one!

So, providers with enough education and sophistication to simply be normal in accepting who I am, are the most helpful.

What I wish is that there was more ongoing training, such as what I provided, that goes into detail to help willing staff to be able to offer support.  There does need to be enforcement of federal employment rules to make it clear that those who are unwilling to be non-discriminatory need to find other work.  People may believe whatever they want to in this free country; but they cannot use that belief to discriminate in their work with those who have served our nation with honor and distinction, American veterans.

I'd expected that some of the 50 staffers I addressed would be sitting there with arms crossed over their chests, signaling their discomfort or hostility about being told that their jobs now included being welcoming and supportive of LGBT Vets.  That didn't happen.  They were all attentive, took notes, and asked intelligent questions.

Overall, in its own plodding way, the VA is trying to do a good job training staff to be welcoming and supportive of LGBT veterans.  In a giant bureaucracy like the VA, its extremely difficult to create change.  Directives, edicts, and training are well and good, provided that there is an organizational culture encouraging progress.  In some major VAMC hospitals, there is a giant LGBT welcoming poster in the lobby, with rainbow dog tags and the the words, "We Serve All Who Served."  In others, the poster is non existent.

While its easy to find things to complain about, and I do, I would continue to use the VA even if I won a million in a lottery.  For those considering accessing the VA medical benefits that they earned serving our nation, I can only say that I'm alive due to the care I receive there.  When I was working and had health insurance, I had to run all over hell and back to see different doctors, specialists and go to commercial medical test centers, and constantly beg insurance companies to approve and pay for every procedure.  At the VA, there's none of that; its all in one big building.  A doc types into the computer that I need a CT scan, I take the elevator upstairs, and I get the CT scan, no paperwork, no begging, no hassle.  They have saved my life several times with major surgery.  So, even though some imbecile at the VA suggested to me that my "wife could give me an enema," I wouldn't go anywhere else for my healthcare.