WASHINGTON, DC -- The Department of Veterans Affairs is reaching out to the LGBT media nationwide for help in urging LGBT veterans to complete an online survey.

The confidential survey will ask a series of questions about your physical health (for example, diagnoses and concerns), mental health, or personal life (for example, your income or sexual orientation).

Your responses are anonymous, and the VA promises that it has no way of linking your responses to you.

Before your enter the survey, please ensure that you are in a private space and/or on a private computer. Do not use a government-owned computer, for example.

To take the survey, click HERE.

The first page of the survey reads like this:

The Experiences of Lesbian, Gay, Bisexual, and/or Transgender Veterans

Informed Consent Form

Purpose of the Study:

This is a study in Veterans health care that is being conducted by Katharine Bloeser, LICSW, Social Worker at the War Related Illness and Injury Study Center at the Washington, DC VA Medical Center. The purpose of this study is to learn about the experiences of lesbian, gay, bisexual, and/or transgender Veterans and their unique health care needs.

What will be done:

You will complete a survey, which will take about 45 minutes to complete. The survey includes questions about your experiences as a gay, lesbian, bisexual, and/or transgender person, your experiences with discrimination and violence, and any stigma you might experience. If you were deployed to a combat zone or in support of a combat operation, you will be asked about how you were prepared for your deployment, what the working environment was like during your deployment, any combat experiences you had, and your experiences after deployment. If you were not deployed, we will ask you about your unit.

After these questions, we ask about health outcomes including your physical health, any problems you have because of your physical health, how well you do in social situations, and any pain you may have. We will also ask about your mental health and any difficulties you have because of emotional problems. Finally, we will ask you about access to health care and your satisfaction with your health care.

After you complete these questions, we will ask you if you are interested in being interviewed about your experiences. You do not have to agree to be interviewed over the phone or in person to complete the survey and you will not have any negative consequences if you say no to the interview or the survey.

Benefits of this Study:

You will be contributing to knowledge about lesbian, gay, bisexual, and/or transgender Veterans and their experiences. With this knowledge, we hope to improve the health care we provide to these Veterans.

Risks or discomforts:

No risks or discomforts are anticipated from taking part in this study. It may cause discomfort to report your experiences with discrimination, violence, combat, lack of unit cohesion, or difficulties coping with stress.

If you feel uncomfortable with a question, you can skip that question or withdraw from the study altogether. If you decide to quit at any time before you have finished the questionnaire, your answers will still be recorded unless you request for them to be removed.

If you decide to quit before you've finished the questions you will be asked if you want to submit the questions you have already answered. If you say that you do not want to submit your answers, they will NOT be recorded.

Confidentiality:

Your responses will be kept completely confidential. We will NOT know your IP address when you respond to the Internet survey. Only the researchers will see your individual survey responses. The responses are kept in a secured VA server. Qualtrics, the company who administers this survey, will not have access to your IP address or your responses.

This means however, that we will have no way of contacting you after you input your responses. Anything that you include cannot be linked back to you. If you wish to communicate with us, please contact us directly.

Decision to quit at any time:

Your participation is voluntary; you are free to withdraw your participation from this study at any time. If you do not want to continue, you can simply leave this website. If you do not click on the "submit" button at the end of the survey, your answers and participation will not be recorded. You also may choose to skip any questions that you do not wish to answer.

How the findings will be used:

The results of the study will be used for scholarly purposes and to inform VA policy only. The results from the study will be presented in educational settings and at professional conferences, and the results might be published in a professional journal in the field of public health.

Other important information:

You are not required to take part in this study: your participation is entirely voluntary. You can refuse to participate now or you can withdraw from the study at any time after giving your consent. This will not interfere with your regular medical treatment, if you are a patient. There will be no costs to you for any of the treatment or testing done as part of this research study. Eligibility for medical care is based upon the usual VA eligibility policy and is not guaranteed by participation in a research study. The VAMC will provide necessary medical treatment if you are injured as a result of your participation in this study unless you were injured because you did not follow the instructions that you were given. Additional compensation may or may not be payable in the event of physical injury arising from this study under applicable federal law. Further information about compensation may be obtained from the medical administration service at this VA medical center.

Contact information:

If you have concerns or questions about this study, please contact Katharine Bloeser, LICSW at 202-745-8000 ext. 5-4647 or by email at Katharine.Bloeser@va.gov or if you would like talk to someone who is not a part of this research to discuss problems, concerns, and questions, including questions about your rights, or think you have been injured you can contact:

Associate Chief of Staff for Research & Development,

Dr. Marc Blackman, at 202-745-8133

Chairman of the Human Studies Committee,

Dr. James Finkelstein, at 202-745-8373

You can also call them if you want more information or you want to give additional input.

If you are experiencing thoughts of harming yourself or would like to speak with someone immediately, please call the Veterans' Crisis Hotline at 1-800-273-8255 (press option 1).

By beginning the survey, you acknowledge that you have read this information and agree to participate in this research, with the knowledge that you are free to withdraw your participation at any time without penalty.

I agree to the above and will proceed with the survey

I do not agree to the above