(PS9-63) Shame and Guilt in LGBTQ+ Women Veterans with MST Presenting to a Research Study

Introduction/

Background: Due to their disproportionate exposure to multiple types of trauma, such as combat and military sexual trauma (MST), veterans are at an increased risk of developing trauma-based shame and guilt. Women veterans – especially LGBTQ+ women veterans – are even more likely to experience MST compared to their male, cisgender, heterosexual counterparts. LGBTQ+ individuals also report more identity-based shame due to both external and internalized stigmatization of minority sexual and gender identities. Thus, LGBTQ+ women veterans with MST are at risk of experiencing shame from both their trauma and identity, contributing to overall worse mental health outcomes like PTSD. While there is research on shame and guilt in LGBTQ+ individuals, veterans, and sexual assault victims separately, there is little on the intersection of these groups. There is also conflicting research on the relationship between aging and different mental health outcomes of those within the LGBTQ+ community. This project hopes to address this gap by directly comparing shame and guilt in LGBTQ+ and non-LGBTQ+ women veterans with MST.

Methods: A sample of 161 women veterans (cisgender = 160; transgender = 1) with MST enrolled in a PTSD treatment study comparing Skills Training in Affective and Interpersonal Regulation (STAIR) to Present Centered Therapy (PCT) and completed the State Shame and Guilt Scale (SSGS) as part of a baseline assessment. Participants who identified as cisgender and heterosexual were considered non-LGBTQ+ (n = 119); those who identified as transgender, mostly heterosexual, bisexual, mostly gay/lesbian, gay/lesbian, queer, or uncertain/questioning were considered LGBTQ+ (n = 42). Two-tailed independent sample t-tests were used to analyze differences in average shame and guilt scores for LGBTQ+ vs. non-LGBTQ+ participants. Pearson correlations were used to conduct exploratory analyses examining age and the relationships between shame and guilt scores.

Results: Data analysis did not show a significant difference in shame and guilt scores between non-LGBTQ+ and LGBTQ+ participants (shame: t = -.141, p = .888; guilt: t = .135, p = .893). Exploratory analysis revealed that age and shame were significantly negatively correlated for the LGBTQ+ group (r = -.31, p = .046), but not for the non-LGBTQ+ group (r = -.11, p = .164). Age and guilt were not correlated for either group. Shame and guilt were significantly positively correlated for both non-LGBTQ+ and LGBTQ+ participants (non-LGBTQ+: r = .73, p < .001; LGBTQ+: r = .76, p < .001).

Discussion: LGBTQ+ participants did not endorse greater shame or guilt than non-LGBTQ+ participants, which may be due to the decrease in stigmatization of sexual minority identities in urban centers, such as Palo Alto and San Diego, where the study was conducted. Interestingly, older LGBTQ+ adults endorsed less shame than younger LGBTQ+ adults, possibly due to resiliency developed because of having to survive as a sexual or gender minority.