We explored mental health care experiences of trans service members and veterans (TSMVs) through a mixed-methods, convergent parallel design. Quantitative survey data from 50 TSMVs were analyzed using paired-samples t tests to identify differences in perceived stigma and barriers to care in accessing services from nonmilitary versus military-affiliated or Veteran's Health Administration providers (MVAPs). We conducted semistructured interviews with 10 participants, exploring their lived experiences in accessing mental health care from both nonmilitary providers and MVAPs. Integrated mixed-methods results indicate TSMVs are more concerned about anti-trans stigma when accessing care from MVAPs, whereas logistical concerns inform access to nonmilitary providers. Key themes shaping participants' mental health care experiences were (a) access to trans competent care, (b) fear/fear of consequences, (c) therapeutic relationship, (d) transition-related factors, and (e) military systems and culture. Implications for training and practice are discussed.

中文翻译：

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跨服务人员和退伍军人的心理健康护理经验：混合方法研究

我们通过混合方法、收敛并行设计探索了跨服务人员和退伍军人 (TSMV) 的心理健康护理体验。使用配对样本t分析了来自 50 个 TSMV 的定量调查数据测试，以确定在从非军事与军事附属或退伍军人健康管理提供者 (MVAP) 获得服务时，感知耻辱感和护理障碍的差异。我们对 10 名参与者进行了半结构化访谈，探索他们从非军事提供者和 MVAP 获得精神卫生保健的生活经历。综合混合方法结果表明 TSMV 在从 MVAP 获得护理时更关注反跨性别歧视，而后勤方面的担忧告知非军事提供者的访问。塑造参与者心理健康护理体验的关键主题是 (a) 获得跨能力护理，(b) 对后果的恐惧/恐惧，(c) 治疗关系，(d) 与转型相关的因素，以及 (e) 军事系统和文化. 讨论了对培训和实践的影响。