Tip Sheets

Issues facing female veterans and women on active duty

"We're much more willing to acknowledge what guys do in combat – both the negative and heroic ...
but as a culture, we're not yet willing to do that for women." (Erin Solaro)

More than 182,000 women have deployed to the current conflicts in Iraq and Afghanistan, Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) respectively. The Joint Economic Committee cites nearly half of all active duty women (including reservists) have deployed to the current conflicts since 2001. The report specifies further that nearly 40% of active duty women have children. Single mothers comprise 11% of the female force. American women have a long history of serving in the military. Dating back to the Civil War they have played an integral part when our nation has chosen to take up arms. There were 7,500 women who served in Vietnam and almost 41,000 deployed women during the Gulf War. The total number of women who have served in the Iraq and Afghanistan theaters is more than double Operation Desert Storm and Vietnam combined.

The Pentagon reports that more than 100 female service members have died and close to 600 have been wounded. A VA study found that female service members are also reporting other medical problems as a result of deployment. Contributors to other health problems are: carrying heavy loads, the climate conditions, lack of adequate personal hygiene, and the many risk factors for traumatic brain injury (TBI). The VA found 29% evaluated women veterans returned with genital or urinary system problems, 33% had digestive illnesses and 42% had back troubles, arthritis and other muscular ailments (AP).

Psychological wounds are another aspect of the fallout of this war. The Associated Press wrote in December of 2006 that according to the VA, "More than a third of 23,635 women veterans from Iraq and Afghanistan evaluated from 2002 to last August[2006] had a preliminary diagnosis of a mental disorder." In a sample of 220,000 Iraq veterans, 23.6% of the women surveyed had a mental health concern, while only 18.6% of the surveyed men reported a mental health issue. Women veterans made up 14% of the 27,000 new veterans treated for PTSD in 2006.

As these women are returning from the combat zones, they are reporting a trove of physical and mental health injuries. In 2006 alone there were nearly 3,800 women treated for Post Traumatic Stress Disorder (PTSD) at the VA. For CY06 and FY07, the DoD documented cases of military sexual trauma in the Central Command Region of Iraq, Afghanistan, and Kuwait. Of the documented cases, there were 206 in CY06 and 174 in FY07. Conversely, the private Miles Foundation received 976 reports of sexual assault and harassment in the same region since they began documenting GWOT cases in 2002. Their research has shown an increase of 10 to 15% each quarter. Physical and mental effects of combat and sexual trauma combine to create a hot zone of PTSD for OIF/OEF female service members.

Thomas Berger of Vietnam Veterans of America comments, "The fact is, if a woman veteran comes in from Iraq who's been in a combat situation and has also been raped, there are very few clinicians in the VA who have been trained to treat her specific needs." The affects of war are seen in the present, and later in life. The Journal of Interpersonal Violence published a VA study that found that, "More than a decade after being raped or physically assaulted in the military, women veterans have reported severely decreased health-related quality of life, with limitations of physical and emotional health." MST is a critical issue facing this new era of OIF and OEF veterans.

In conjunction with the stress of combat, women in the military face sexual assault and harassment both during wartime service and on bases in the U.S. Sexual assault and harassment in a military setting are collectively called Military Sexual Trauma (MST). MST survivors, both women and men, are discouraged from reporting due to existing stigmas and potential loss of their careers. The seriousness of MST is becoming even graver as investigations into wrongful deaths and suicide that coincide with sexual assaults are surfacing, especially in combat zones. Both the CY06 and FY07 DoD reports on sexual assault in the military included a section specifically on the Central Command areas of Iraq and Afghanistan. This inclusion is unprecedented and speaks volumes to the extent of the affects of MST.

Professor Kingsley Browne has written extensively the serious gender issues our government must now face due to its modern warfare choices, "The military has consistently glossed over problems and denied them, denied access to information that could reveal problems...to a large extent it is in nobody's larger interest to reveal that information." The collective denial of the Army as to the extent women are in combat and our nation's painful ubiquitous oversight to military sexual trauma has compounded into a very deadly cocktail. The actual reported or investigated cases of unsubstantiated deaths and suicides of female service members following sexual assault is a new deadlier phase of an ongoing epidemic. The fact that pregnant women Marines are being buried in fellow Marines back yards and women in theater are being assaulted, murdered, and burned in their tents is a travesty our nation is as yet unwilling to address.

Writing for The American Conservative, Kelley Beaucar Vlahos comments, "While the Bush administration initially appeared less interested in integration than its predecessor, the decision to invade Iraq in 2003, the miscalculation of the subsequent insurgency and civil war, and the desire to wage a global terror war have made it impossible for the all-volunteer force to function without women in combat roles. Reality has taken over." She goes on to state that, "If this and future administrations want to continue waging protracted asymmetrical wars with multiple fronts, wars in which everyone- not just combat troops and Marines- has to be on point, the negative consequences of shock integration will have to be acknowledged and addressed."

Captain Adam N. Wojack of the U.S. Army wrote an article titled, "Integrating Women into the Infantry," in 2002. Captain Wojack argues that, "Given the contemporary operating environment, women are in close proximity to combat regardless of where they are on the battlefield, so they might as well be allowed to fight offensively." His article goes on to examine the various societal and military concerns for integration as well as examines a historical perspective. His findings point out that women not only have to "prove themselves" in the present, but also must overcome the stigma built against them over generations. Captain Wojack concludes that a high enough percentage of women in a unit or class will translate their status from a gender-based to that of individual achievement.

Military Sexual Trauma (MST)

Military sexual trauma (MST) is sexual assault and sexual harassment in a military setting. The perpetrator can be a member of the military or an intimate partner. Sexual assault is defined by Dr. Amy Street and Dr. Jane Stafford as, "any sort of sexual activity between at least two people in which one of the people is involved against his or her will. Physical force may or may not be used. The sexual activity involved can include: unwanted touching, grabbing, oral sex, anal sex, sexual penetration with an object, and/or sexual intercourse." Sexual harassment can be gender specific verbal harassment, unwanted attention of a sexual nature, and coercion. Sexual trauma is unique in a military setting both during peacetime and war for several reasons including the following:

• Survivors of MST commonly live and work with their perpetrators, during and after their trauma.
• Many survivors are dependent on, or report to their perpetrators. This power dynamic makes it difficult to report for fear of retribution. Sexual assault by a superior is commonly called "Command Rape."
• A survivor, male or female, faces serious stigmas for reporting assault or harassment. They may not be trusted by their counterparts, and are often accused of breaking unit cohesion or are harassed by others for sexual favors.
• A survivor's military career may be extremely affected when they report harassment and/or assault. The stigmatization that happens after reporting Command Rape and other forms of MST often lowers the possibility of advancement in rank. Survivors may be encouraged to remain silent to keep their career.

The National Center on Domestic and Sexual Violence documents that only 16 % of rapes are ever reported. This statistic enforces the assumption that the amount of reported assaults in the armed forces may not be entirely accurate. Christine Hansen of the Miles Foundation makes the following cautionary statement regarding MST statistics, "Sexual Assault is an underreported crime that is deeply traumatizing and stigmatizing for its victims. The assessment of the prevalence of sexual assault among U.S. Armed Forces is difficult to obtain due to varying methodologies and definitions among surveys and reports associated with the Department of Defense, the military services, the Veterans' Health Administration." Hansen goes on to point out that the DoD has failed "To adopt current research protocols entailing the protection of human subjects, anonymity for respondents, and behavioral based questionnaires."

The stigma and effects on one's career taint the collection of data the DoD receives. The preliminary reports of sexual assault and harassment in Iraq and Afghanistan prompted former Defense Secretary, Donald Rumsfeld to order a task force to investigate in 2004. Changes have also been made effective as of 2007 to the Uniform Code of Military Justice (UCMJ) that further define rape, harassment, and consent. These changes to the military law books may prove to affect the rates of prosecution of MST, not necessarily the rates of occurrence; yet there is no data insofar as to illustrate changes in policy and practice.

The Department of Veterans Affairs (VA) financed a study revealing one in four women using VA health care report sexual trauma while they were on active duty. Research published in the American Journal of Public Health found that 3% of active duty women and 1% of active duty men are assaulted in the military each year. The rates of sexual harassment are higher with 8% of women reporting sexual coercion and 27% reporting unwanted sexual attention. Active duty men, on the other hand, have an annual rate of coercion and unwanted sexual attention at rates of 1 and 5%. A 2003 DoD lists one-third of female veterans had experienced rape or attempted rape while they were in the military. The NY Times reports 37% of the surveyed group was raped multiple times, while 14% were gang-raped. The DoD has made policy changes in light of these statistics.

After Congressional intervention, the Sexual Assault Prevention and Response program was founded in 2005 along with the option of "restricted reporting" for survivors. Restricted reporting allows the survivor to seek medical attention and confidentially report his or her assault without the military automatically investigating. Reported sexual assaults rose by 24% from 2005 to 2006 as per the 2006 DoD report. This rise could be because survivors have the option of confidentially reporting their assault and are therefore coming forward. Regardless of the reporting options, almost 3,000 soldiers reported sexual assault and rape by other soldiers during the calendar year of 2006.

The following are statistics from a 2006 DoD report:

• Of the 2,947 cases of sexual assault reported in 2006, less than half (1,400) were investigated.
• In more than half of the 2,947 cases, commanders dropped the charges due to lack of evidence.
• 756 of the 2,947 cases were reported confidentially through the "new" Restricted Reporting Program.
• In 86 of the confidentially reported cases, victims pursued further action.
• 292 of the investigated cases from 2006 were taken to court martial (military court).
• 243 of the investigated cases led to non-judicial punishment ( letters of reprimand or demotion).
• 245 of the investigated cases led to discharge or administrative action.

The following are statistics from the FY07 DoD report:

• There were 2,688 reports of sexual assaults for FY07
• Of the 2,085 unrestricted reports, with service members as either subject or victim, 1,511 (72%) involved service members as victims of alleged sexual assault. 868 (57%) were for alleged rape.
• 705 restricted reports were made by service members with 102 (14%) opting to change to unrestricted reports
• 1,955 investigations were completed for FY07 involving 2,212 subjects
• Of the 2,212 subjects, commanders had sufficient evidence of a crime to support taking action on 1,172 (53%) subjects
• Of the 1,172 subjects 600 (51%) had further action taken as follows: 181 (30%) courts-martial, 201 (34%) non-judicial punishments, 218 (36%) administrative actions and discharges, with 572 (49%) pending disposition action

Accurate analysis between DoD reports of sexual assaults in the Armed Services is nearly impossible since the Congressional implementation beginning 2003. The documented cases have been monitored on two alternating systems, either calendar year (CY) or fiscal year (FY). This leads to unavoidable overlap. The FY07 DoD report states, "While previous year reports exist, we cannot make side-by-side comparisons of the current year data to previous year data due to an unavoidable overlap in reporting...the period of data collection changed from calendar year (CY) to fiscal year. This was driven by the changes to the Uniform Code of Military Justice (UCMJ) definitions of the crimes comprising sexual assault." Rudimentary analysis shows almost double the amount of sexual assaults from 2004 to 2006, then a slight decline in 2007. As the amount of MST actually reported is debatable, one can only speculate to the true extent of harassment and assault both stateside and in combat zones.

Beyond what these statistics reveal, MST carries with it a complex emotional fallout. Stephanie Sacks, a clinical director for the Sexual Assault Center of Pierce County writes, "Many still believe that if a woman is sexually assaulted in the military it is at least a little bit her fault because she didn't really belong there to begin with." Sacks goes on to say that, "Even other female service women seem upset with them [survivors] for ‘allowing' themselves to be sexually assaulted and creating a ‘bad name' for all service women." The alienation by fellow male and female service members only adds to the pain and vulnerability caused by the assault or harassment. Compounding on the interpersonal levels of betrayal, survivors of MST also feel alienated by their command and the government as a whole. The emotional wounds of military sexual trauma coincide with the psychological trauma inflicted. According to the research findings of the American Journal of Public Health, "Among traumatic events, rape holds the highest conditional risk for posttraumatic stress disorder (PTSD); these data and data specific to military samples confirm that sexual trauma poses a risk for developing PTSD as high as or higher than combat exposure."

Military Sexual Trauma is not only an under-reported crime, but survivors often do not know about the programs that can help them. Compensation for MST is granted as a service-connected disability. Through Public Law 102-585 survivors are entitled to treatment through the VA for sexual assault and harassment. The Department of Veterans Affairs also has a program called "Disability Compensation for Sexual or Personal Trauma." This particular disability claim is for veterans with PTSD and those who have "lingering physical, emotion, or psychological symptoms" from traumatic events including: rape, physical assault, domestic battering and stalking. The application is titled, "Veterans Application for Compensation or Pension," and the form is VA Form 21-526.

In response to the decades of reported assaults in the military and Congressional pressure, the DoD has held various commissions and task forces resulting in reports and trainings. There have been at least 20 such task forces and commissions within the last 17 years alone. Christine Hansen of the Miles Foundation comments that, "In all of these recommendations, we have seen very few of them implemented. Our concern is, at what priority level is this?" In 2005 Hansen issued the following warning, "Violence against women choosing to serve in the Armed Forces is a public health concern. Women who are raped or assaulted while on active duty are more likely to report chronic health problems, prescription medication use for emotional problems, failure to complete college, and annual incomes of less that $25,000." MST is a public health concern and as such requires more thorough attention and analysis.

Survivors of military sexual trauma lack resources necessary for recovery both while on active duty and as veterans. The Department of Defense (DoD) has made increasing efforts to provide trainings on sexual assault and harassment prevention, as well as creating channels for survivors to report MST. Their efforts backfire, however in that there is no confidentiality awarded to the survivors leading to stigma, backlash, and quite possibly the termination of the survivor's career. The very nature of military life including close living quarters of personnel who live and work together is a unique characteristic of the Armed Services that adds to the systemic lack of privacy in MST cases for females and males. With the implementation of restricted reporting, there is confidentiality; however few perpetrators have been held accountable under this program. Conversely, private organizations such as rape crisis centers and research organizations work to both document these cases and provide services to the survivors. These private organizations may or may not be trained in issues specifically facing the female veteran demographic.

Veterans and active duty personnel with MST often seek help from both rape crisis centers and the Veterans Health Administration, commonly known as the VA hospital. Staff at the VA hospital are most likely trained in MST or on issues surround sexual assault and harassment in general. However, there is no guarantee that they have received any cultural competency training on military culture, and how this affects the veteran. In addition, the VA hospital may be an uncomfortable atmosphere for a survivor of sexual assault, as it is highly dominated by male patients. Other considerations, such as holding clinic hours not conducive for veterans with full time jobs or school responsibilities, and operating facilities without childcare or childcare reimbursement options.

Community providers such as rape crisis centers and private hospitals and clinics have excellent and diverse care options for trauma survivors. Like the VA hospitals, they too may not be trained in military culture or even in the issues of military sexual trauma. Many community providers are also under the impression that veterans do not need their services because they have the VA hospital. Unfortunately, the need is far greater than the capacity of the VA, some veterans do not want to go to a government facility, and VA programs are often not located in rural communities. Even with the increase of women veterans into the system, the VA hospital is highly male dominated. A sea of male faces when female veterans are seeking mental health services in particular can only further exacerbate their trauma. Due to these and other factors, survivors of military sexual trauma do need the community. The community cannot only provide services, but also a support system for their veteran counterparts. To sensitively address the needs of female veterans, community organizations in the greater Bay Area of California need Swords to Plowshares to provide cultural competency trainings. The positive affects of these trainings will be evident on both the interpersonal level and as a larger advocacy tool.

The Department of Defense and U.S. lawmakers are working to make changes to the military's policies regarding women service members. The RAND Corporation was commissioned in 2007 to analyze specifically the Army's assignment policy for female soldiers. Changes to the DoD and the Army's policies regarding women in combat have not changed. However, Research by RAND illustrates the efforts of bureaucracy to catch up with real-life procedures of today's deployed soldiers. United States lawmakers are also addressing the needs of female service members returning from Iraq and Afghanistan. Senator Patty Murray has backed a bill to raise awareness and attention to female veteran specific issues. The bill highlights gender-specific issues, MST specific treatment, and an independent review of the health care women veterans receive. Furthermore, the needs of female service members that are mothers are being recognized. Recommendations by the Joint Economic Committee address the effects of longer deployments, the need for additional childcare services, and mental health resources specific for mother and child.

When interviewed by the Air Force Times, Joy Ilem, assistant national legislative director for Disabled American Veterans, said the following, "Female veterans also face different issues when they return home from combat ... they serve as primary caregivers to their children or are expected to fall back into the role of a wife without any time to readjust. For that reason, the legislation will call for women's retreats for female veterans that could help them reconnect with their husbands and children, as well as learn about VA benefits...as primary caregivers, it may be more difficult for them to make it to VA facilities for health care, so the legislation will call for childcare services." Addressing the needs of women both in their roles as members of the Armed Forces and as civilians will increase the quality of life for both active duty and veterans.

Works Consulted:

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