(334) 844-3299
Detailed Record
Share this Article

Mental health and health risk behaviors of active duty sexual minority and transgender service members in the United States military

APA Citation:

Holloway, I. W., Green, D., Pickering, C., Wu, E., Tzen, M., Goldbach, J. T., & Castro, C. A. (2021). Mental health and health risk behaviors of active duty sexual minority and transgender service members in the United States military. LGBT Health, 8(2), 152–161. https://doi.org/10.1089/lgbt.2020.0031

Abstract Created by REACH:

This study examined differences in mental health and health risk behaviors among active-duty Service members based on their sexual identity (i.e., heterosexual or sexual minority, such as gay, lesbian, or bisexual) and gender identity (i.e., cisgender or transgender). 544 Service members selfreported their sexual and gender identities, mental health symptoms (i.e., overall mental health, suicidality, and anxiety, depressive, or posttraumatic stress disorder [PTSD] symptoms), health risk behaviors (e.g., hazardous alcohol use, smoking), and demographics (e.g., age, race, officer vs. enlisted status). Generally, cisgender sexual minority Service members and transgender Service members reported poorer mental health and greater health risk behaviors than cisgender heterosexual Service members.


Mental health
Substance use
Physical health

Branch of Service:

Multiple branches
Air Force
Marine Corps

Military Affiliation:

Active Duty

Subject Affiliation:

Active duty service member


Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


Quantitative study
Cross sectional study


Holloway, Ian W., Green, Daniel, Pickering, Chad, Wu, Elizabeth, Tzen, Michael, Goldbach, Jeremy T., Castro, Carl A.


Purpose: The aim of this study was to examine health risk behaviors and mental health outcomes among sexual minority and transgender active duty military service members and their heterosexual and cisgender counterparts. Methods: Participants (N = 544) were recruited by using respondent-driven sampling between August 2017 and March 2018 and completed an online survey by using validated measures of cigarette smoking, alcohol use, anxiety, depression, post-traumatic stress disorder (PTSD), and suicidality. Bayesian random intercept multiple logistic regressions were used to understand differences between sexual minority participants and heterosexual participants as well as between transgender participants and both their cisgender sexual minority and cisgender heterosexual peers. Results: Cisgender sexual minority women service members were more likely to meet criteria for problematic alcohol use (adjusted odds ratio [aOR] = 10.11) and cigarette smoking (aOR = 7.12) than cisgender heterosexual women. Cisgender sexual minority men had greater odds of suicidality (aOR = 4.73) than their cisgender heterosexual counterparts. Transgender service members had greater odds of anxiety, PTSD, depression, and suicidality than their cisgender peers. Conclusion: Military researchers and policymakers who seek to improve the overall health and well-being of sexual minority and transgender service members should consider programs and policies that are tailored to specific health outcomes and unique sexual minority and transgender subgroups.

Publisher/Sponsoring Organization:

Mary Ann Liebert, Inc

Publication Type:

REACH Publication

Author Affiliation:

University of California, IWH
University of Southern California, DG
University of California, CP
University of California, EW
University of California, MT
University of Southern California, JTG
University of Southern California, CAC


mental health, health risk behaviors, sexual minority, military

View Research Summary:

REACH Publication Type:

Research Summary

REACH Newsletter:

  December 2022

This website uses cookies to improve the browsing experience of our users. Please review Auburn University’s Privacy Statement for more information. Accept & Close