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‘Everything Usually Comes Back to Respect’ for LGBT+ Veteran Care

Two women standing next to each other.
Sarah Merlina (right) and Dawnelle Paldino have improved VA care for LGBT+ Veterans locally and nationally.

As we say goodbye to Pride Month 2020, we’d like to share this in-depth Q&A with our outgoing* LGBT Veteran care coordinator (VCC), Sarah Merlina.

In her answers, Merlina highlights best practices for improving VA LGBT+ Veteran health care and experience, including creating a welcoming environment, strong leadership support, respect for all Veterans, educating staff and community outreach.

When were you appointed as LGBT VCC? Did you have a strong background in coordinating care for LGBT Veterans? I joined Dr. (Dawnelle) Paldino as one of the VA Pittsburgh LGBT Veteran care coordinators in 2017. Prior to that, I had been the point of contact for completing the annual Healthcare Equality Index for the Human Rights Campaign at VA Pittsburgh since 2015. This really helped me to learn VA policy and all of the different ways an organization can create a welcoming environment for all, which ultimately helped to prime me for the LGBT VCC role.

Tell me about leadership support? We have always been fortunate at VA Pittsburgh to have strong leadership support. Previous and current leadership have attended VA Pittsburgh LGBT events and have always expressed their priority to welcome and serve all Veterans at VA Pittsburgh.

During your years as LGBT VCC, what did you learn about LGBT Veterans and what they want/need from VA in terms of care? I have certainly learned a lot while in this role. However, everything usually comes back to respect. All Veterans deserve our respect. As VA employees, it is our responsibility to educate ourselves so we can create a safe space for all Veterans, particularly those who may be hesitant to access VA health care because they have been stigmatized or mistreated at some point in their lives.

What was good? What was lacking? Were you able to advocate for and/or improve or add services?  With the support of VA Pittsburgh leadership and employees, we as an organization have really grown and have been recognized within VA and within the community for providing comprehensive and welcoming care to LGBT Veterans. We have also worked hard to educate and provide support to VA Pittsburgh employees and staff and expand our presence and outreach in the community.

Do you think VA Pittsburgh providers’ knowledge of LGBT care has improved? What about their general attitude of or interest in LGBT care, even if they don’t have LGBT Veterans on their schedule? Over the last several years, there has certainly been a focused effort at VA to implement policy and provide education and support to employees so that culturally sensitive care is provided to LGBT Veterans. This effort has been reflected locally here at VA Pittsburgh, as providers, clinicians, supervisors and individual employees regularly reach out to increase their knowledge and better equip themselves to provide competent care for LGBT Veterans.

What would you tell Kristen Lyons, who assumed your role in early June, to look out for? What are some good resources for her, Veterans and VA staff?  Thanks to Dr. Paldino, one of VA Pittsburgh’s greatest resources for staff and Veterans is our Interdisciplinary Transgender Treatment Team. This team consists of over 20 clinicians in various areas and specialties who are true experts in providing LGBT Veteran care within their respective fields. This team is an invaluable resource to VA Pittsburgh staff and is a best practice for providing comprehensive care to Veterans who identify as transgender or a related identity.

*Merlina continues to partner with the White Oak Vet Center for an LGBTQ Veteran Support Group meeting. The meeting allows Veterans to share thoughts and feelings, explore creative ways to cope with challenges, and learn from one another. The meeting also offers group discussions, education and support on coming out to friends and family, LGBT history, intimate relationships, social support, readjustment issues, mental health issues, sexual orientation and community resources. Veterans interested in joining the group may contact Merlina at 412-216-3711 or Abbie Lieberum (White Oak Vet Center) at 412-678-7704.

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