Lesbian, Gay, Bisexual and Transgender Veteran Care - VA Pacific Islands Health Care System
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VA Pacific Islands Health Care System


Lesbian, Gay, Bisexual and Transgender Veteran Care

The Department of Veterans Affairs (VHA) is committed to providing quality care to all Veterans including lesbian, gay, bisexual and transgender (LGBT) Veterans. Excellent care has no boundaries.

We Serve All Who Served poster

VA Pacific Islands Health Care System seeks to promote the health, welfare, and dignity of LGBT Veterans and their families. We are committed to making sensitive and high quality health care accessible. Our policies and practices focus on ensuring a safe, welcoming, and affirmative environment of care for LGBT Veterans. Our employees receive training in clinically competent care that is responsive to the unique needs of LGBT Veterans.

June Veterans Pride Newsletter LINK

Over A Million Strong: An estimated one million Veterans identify as Lesbian, Gay, Bisexual, or Transgender (LGBT+). More than 36,000 gay men and lesbians are on active duty, and likely up to 87,000 men and women in the service are gay or lesbian, including the National Guard or Reserves.

The VA Pacific Island Health Care System (VAPIHCS) is committed to providing top quality care to all Veterans, including lesbian, gay, bisexual, and transgender (LGBT+) Veterans. We are here to ensure that all veteran’s get the care they need in a safe and competent environment.

Image of an LGBTQ flag with a sky background

Welcome LGBT+ Veterans. We thank you for your service!

Our Purpose is to foster an inclusive, knowledgeable, and affirming atmosphere for Lesbian, Gay, Bisexual, and Transgender Veterans at the VA PIHCS as well as to work toward resolving the health disparities that exist for LGBT+ Veterans.

Striving to create an inclusive, knowledgeable environment for LGBT+Q Veteran healthcare.

We at the VAPIHCS commit to work tirelessly to create a safe environment and ensure that all Veterans, including LGBT+ Veterans, are treated with the respect and care they deserve. We know LGBT+ Veterans face unique challenges in accessing quality healthcare.

To address these challenges, VAPIHCS has implemented and continues to develop new programs to meet the needs of LGBT+ Veterans. These programs include:


  • training staff in culturally and clinically competent care for LGBT+ Veterans;
  • individual and group counseling services tailored to support LGBT+ Veteran needs;
  • the Veteran can benefit from interdisciplinary care and assessment in an inpatient facility;
  • effort to create clinic wide safe-zone to insure a safe environment for LGBT+ Veterans;
  • recognition of providers who display special efforts toward high quality LGBT+ healthcare;
  • outreach efforts to improve the VA's support of LGBT+ Veterans in the community.

We hope you choose VAPIHCS and join our growing team of Veterans and staff to support our LGBT+ Veteran community and help build a better health care system in this exciting time of increasing inclusion and improving access to care.

Info on Providers/Residents

The VA Pacific Islands Health Care System has a Psychology Postdoctoral Fellow program specializing in Inter-professional LGBT+ health care. Our current fellow is stationed at the Spark M. Matsunaga Medical Center Ambulatory Care Center (ACC).

The fellowship was established nationally to promote LGBT+ affirmative knowledge and practices across VA Medical Centers and to propel the Veterans Health Administration (VHA) to become a leader in LGBT+ health care.

The LGBT Special Emphasis Program

The LGBT care program works closely with the LGBT Special emphasis Program. This program is run by a committee formed of LGBTQ/allied VA PHIC employees and community members. The Purpose of this program ”is to foster an inclusive and affirming atmosphere for LGBTQ employees, consumers and visitors at the VA PIHCS. We will do this by working with allies and others to maintain a respectful, safe and positive environment that recognizes and celebrates the diversity of our workforce and patient population. Our goals include providing a support system for each other, participating in community outreach and in-service educational programs and implementing LGBT friendly policy as provided by VA. Observance of Special Events and Memorials showcase our Pride and increase visibility of our Diverse Community.“

Photograph of four people iat a table with VA distribution items

Goals of LGBT Special Emphasis Program (SEP)

LGBTQ+ and Allied VA staff are invited to participate in the LGBT+ Staff and Allies Special Emphasis Program of the Equal Employment Opportunity Office.

The Goals of this group are to:

  • raise awareness about LGBT+ Veterans and staff at VAPIHCS
  • provide support and social opportunities for LGBT+ staff
  • increase hiring at VAPIHCS of LGBT+ persons, particularly Veterans
  • increase enrollment at VAPIHCS among LGBT+ Veterans
  • to provide mediation for LGBT+ concerns and issues

The VA Pacific Islands Health Care System (VAPIHCS) participates yearly in the Human Rights Campaign's Healthcare Equality Index survey to make public its commitment to LGBT Veterans and their families.

Graphic saying Leader is LGBTQ Healthcare Equality 2017 on the Healthcare equality index from the Human Rights Campaign

Thanks to the efforts of staff from all over the facility, the VA Pacific Islands Health Care System continues to receive the designation of Leader in LGBT Healthcare on the Human Right's Campaign's Health Equality Index.

Overview of Program

With additional support from VA staff, the LGBT Care Coordinator and LGBT Veteran Mental Health Fellow provide group, couples, and individual psychotherapy services for Veterans identifying as LGBT Q. Services include support groups for individuals identifying as LGB or Transgender and safe and inclusive individual and couples counseling services to address a number of behavioral health concerns. The team also consults with medical providers to assure the delivery of sensitive, competent care.

Transgender Care

Your primary care team can help arrange specialized transgender services. Although prohibited by Congress from providing gender-confirming surgeries, the VA offers otherwise complete transgender medical/mental health care including:

  • Cross-sex hormone therapy
  • Voice retraining therapy
  • Gender-confirming pre/post operative care

Specific Individual services

Individual Counseling for LGBT+ Veterans

Individual psychotherapy is available and can address many topics from the unique challenges faced by LGBT+ vets to more general difficulties with depression, anxiety, and stress. All services are delivered by providers that are competent and sensitive to LGBT+ issues.

Specific Group Services

Transgender Identity Group and LGB Support Group

The ACC offers Transgender and LGBTQ support groups. These groups are largely focused on developing a supportive community for LGBT+ Vets, identifying personal and community resources to cope with challenges, and to provide a safe space to discuss personal issues and ongoing LGBT+ care at the VA. These groups are structured around a check-in with group members and an activity or topic of the day for group discussion.

Two blue colored tables the first says Identity and Wellness Group on Wednesdays from 12 to 1 pm and the second says Living Out Loud Group is on Thursdays from 12 to 1 pm

The groups are facilitated by the psychology fellow in Inter-professional LGBT+ Health Care, Staff members of the Behavioral Health Interdisciplinary Program (BHIP), and other members of VAPIHCS medical staff.

No Need to Watch Your Pronouns:

The VA has never had a “Don't Ask, Don't Tell” policy. You do not have to hide who you are, what you do, or whom you love. You do not have to be careful about using gender-neutral pronouns when speaking with your medical providers. You also may ask VA staff to use your preferred pronouns.

Some people just want to learn more about what LGBT+-related services and supports are available. We can provide consultation directly to Veterans and to providers in those cases. Every Veteran has the right NOT to be “outed” as LGBT+ in their medical record by any provider. Our providers know that gender expression, identity, and sexuality can be personal issues, especially for our Veterans. Each Veteran has the right to decide what works best. We encourage very open and collaborative conversations with your health care providers about this personal choice.

Outreach Events

The LGBT+ Staff and Allies Special Emphasis Program is actively involved in the recruitment of LGBT+ Veterans and distribution of information about VA health care services available through outreach at community events, round table community discussions, pride festivals, and parades.

A graphic with an image of a patient and medical staff talking in a a clinical setting the graphic says Let's Talk Secual orientation and gender identity matter in health care LGBT Health Awareness Month Lesbian, Gay, Bisexual and Transgender Program Office of Primary Care Services LGBTProgram@va.gov with a VA logo in the bottom right corner

Relevant Policies and Service

Non-discrimination: Our non-discrimination policy prohibits discrimination based on sexual orientation or gender identity (actual or perceived) (VHA Directive 1019).

Visitation: VAPIHCS allows for a same-sex partner, family member, friend, or other individual to be present with the patient for emotional support during the course of their stay. Same-sex partners are recognized as the patient’s family, even if the parties are not legally married.

Advanced Directives: Patients may designate any person as a decision-maker for care should they become unable to make these decisions. This includes designating a same-sex partner as a surrogate decision-maker. Advanced Directives agents are chosen by the Veteran and do not need to be biologically related.

Documentation in Medical Records: Honolulu VA maintains the confidentiality of information about sexual orientation and sexual behavior, as it does with all other private health information. We encourage all Veterans to inform their health care team of sexual orientation, gender identity, and sexual activity so we can provide the most appropriate care. This includes confidential testing for sexual transmitted infections, mental health care, and appropriate screenings.

Changing Your Name and/or Gender in Your Medical Record: Your name in the medical record will reflect your legal name. You have the right to request that name and gender are updated as appropriate. There are established procedures for changing your name and gender, available from the VAPIHCS Privacy Officer Allison Tanaka at (808) 433-0660.

Concerns and/or Complaints: If you feel you are not being provided with compassionate care at Honolulu VA, we encourage you to make your concerns known. Concerns regarding a specific Service (e.g., Mental Health, Primary Care) should be directed to the corresponding contact person for that Service. This information can be easily found on this website through the Services page. In addition, you are encouraged to discuss any concerns with our Patient Advocate Office or the LGBT Veteran Care Coordinator Dr. Mary Harlinger at (808) 433-7348.

Commitment to LGBT Veterans: The Veterans Administration (VA) is committed to addressing the health needs of LGBT Veterans and reducing health disparities for them and members of other vulnerable communities. The VA defines “family” as anyone a Veteran identifies as his or her family. This may include persons not legally related to the Veteran. Veterans and their family members will not be discriminated against in the VA for any reason, including sexual orientation, gender identity or expression. Veterans may select any person as their surrogate healthcare decision maker for times they might become unable to make decisions for themselves.


Fact Sheets


Find out more at VA.gov or scan the QR codes below with your phone.

Eligibility                                    VA Benefits                        VA LGBT Care
A scannable QR code for VA eligibility         A scannable QR code for VA benefits         A scannable QR code for VA LGBT Care

Additional Links Below:

External Resources:

LGBT Veteran Care Coordinator (VCC) Program

As of March 2016, each VA facility has a local LGBT Veteran Care Coordinator (VCC) who is appointed by their facility leadership. The VCC is responsible for promoting best practices for serving LGBT Veterans and connecting LGBT Veterans to services.

Health Information

To learn important information about the unique health risks of LGBT Veterans, download these relevant fact sheets. Here you can also find information about relevant services offered by VA.

Gay and Bisexual
Health Care Fact Sheet

Gay and Bisexual Men Health Care Fact Sheet

Lesbian and Bisexual
Health Care Fact Sheet

Lesbian and Bisexual Women Health Care Fact Sheet

Health Care Fact Sheet

Transgender Women Health Care Fact Sheet

Health Care Fact Sheet

Transgender Men Health Care Fact Sheet


Mary Harlinger, PHD
LGBT Veteran Care Coordinator


LGBT Updates