Reviewer ’s report  
 
Title:  Experiences with VHA Care: A Qualitative Study o f U.S. Women Veterans with Self -
Reported Trauma Histories  
 
Version: 0 Date: 01 Feb 2017 
 
Reviewer:  Kristin  Mattocks  
 
Reviewer’s report:  
 
This is a well -written manuscript that describers women Veterans' experiences with VHA care.  
While I don't know that it necessarily adds anything new to the qualitative literature of women 
Veterans' experiences, it was interesting and well -writte n.  A few suggestions below.  
 
1. The title indicates that the study population is comprised of former PTSD disability applicants.  
However, I don't see how these experiences are unique to former PTSD disability applicants at 
all.  I was expecting narrative  that focused on being a woman with PTSD, but I didn't see that.  
Also, the word "former" applicants throws me a little.  "Former" applicants seems to imply in 
some way that they no longer have the benefit?    I am just not sure I understand the use of the  
word former.  I think it throws me off more than it helps me.  
 
2.  I think it  might be good to clarify what exactly you mean by women -specific  treatment 
options.  My assumption is that the women were talking about women -specific PTSD treatment, 
but ther e are also gender -specific treatment groups for pain, depression, and MST.  The general 
language regarding women's groups should be clarified to indicate if you are only referring to 
PTSD -specific groups.  
 
3.  The first theme is largely focused on inpatien t care (both for physical and mental health 
conditions).  Given there is virtually no literature about inpatient care experiences for women 
Veterans, might you want to consider revising these theme and making it specific to inpatient 
care?  I don't believe  I have read any studies that focus solely on women's inpatient experiences, 
and this might be an important contribution to the literature to indicate that this (theme) is 
focused on inpatient care.  
 
4.  On page 12, you use the term 'segregated services'.  Elsewhere, you use gender -specific and 
sometimes women -specific.  I would suggest that you standardize your use of a term across the 
paper so there is no confusion between segregated, gender -specific, and women -specific.  
 
5.  This is definitely not the fi rst in -depth accounting of first -person experiences women 
Veterans have had with the VA as suggested on page 15.  Here's a few I know of below.  You 
might want to do a more comprehensive search, as I know there has been other qualitative work 
published spe cifically about women Veterans' experiences.  
 
Wagner C, Dichter M, Mattocks K.  Women Veterans' pathways to and perspectives on Veterans 
Affairs Health Care.  Women's Health Issues. 2015 Nov -Dec;25(6):658 -65. doi: 
10.1016/j.whi.2015.06.009. Epub  2015 Sep 1.  
 
Mattocks K, Sullivan C, Bertrand C, Kinney RL, Sherman S, Gustason C.  Perceived stigma, 
discrimination, and disclosure of sexual orientation among a sample of lesbian veterans in VHA 
care.  LGBT Health. 2015 Jun;2(2):147 -53. doi: 10.1089/lgb t.2014.0131. Epub 2015 Mar 31.  
  
Mattocks K, Borrero S, Haskell S, Brandt C, Justice A, Yano E.  Unmet reproductive health 
needs among women Veterans in care at the Veterans Administration.  Women's Health Issues, 
2011; 21 -2; 124 -129. 
 
Are the methods app ropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain o r lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your r eply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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