PTSD: Doubly Disabling for Female Vets

Vol. 35 No. 2

By

Penny Wakefield is a human rights lawyer in Washington, D.C., who focuses particularly on legislative and policy issues affecting women. Director of the IRR Section from 1991 to 2004, she currently serves on the Human Rights editorial board and in the leadership of the IRR and International Law Sections’ International Human Rights Committees.

Female veterans currently number more than 1.7 million, or 7 percent, of all veterans in the United States today. But with women comprising almost 15 percent of active duty personnel in today’s military, the number of female veterans could double within the next five years.

Neither federal laws and regulations nor military and veterans programs and policies adequately address this dramatic shift in population and the current and future needs of women in today’s service. One particular concern put into stark relief by the ongoing conflicts in Iraq and Afghanistan, where 11 percent of active duty forces are women, is the lack of appropriate health care available to many female service members and veterans who suffer from posttraumatic stress disorder (PTSD).

Like their male counterparts, more and more female service members are experiencing the kinds of incidents in and around war zones that trigger PTSD. But for many servicewomen, PTSD also has been triggered by a more personal threat: attacks by fellow soldiers. Almost a third of female veterans have reported having been sexually assaulted or raped while on active duty; many more experienced serious sexual harassment. Yet most programs established to help those with PTSD have been geared primarily to the symptoms and responses of men, not women. For example, women have been placed in group therapy sessions with men, even when assaults by men may have been an underlying cause of these women’s PTSD.

U.S. military and Department of Veterans Affairs (VA) medical facilities are only beginning to grapple with the problem. The department promises more PTSD clinics, but currently only four—in Bay Pines, Florida; Boston, Massachusetts; Cincinnati, Ohio; and Palo Alto, California—focus on women, and most military facilities lack the trained personnel and specialized programs to treat women suffering from the mental and physical effects of personal assault along with combat.

One proposal to help address these concerns is the Women Veterans Health Care Improvement Act (H.R. 4107), introduced in November 2007 by Rep. Stephanie Herseth Sandlin (D-SD) and pending in the House Subcommittee on Military Personnel. The legislation would require the VA to:

  • assess barriers to comprehensive health care for servicewomen;
  • assess all health care services and programs for servicewomen;
  • provide training for mental health counselors to female veterans suffering from sexual trauma;
  • identify, develop, and apply treatments for PTSD and other conditions attributable to combat or sexual trauma that have proven effective for women;
  • assess the provision of readjustment counseling and related mental health services for female veterans at VA facilities; and
  • conduct a long-term epidemiological study on female veterans who served in Iraq and Afghanistan.



On the Senate side, Sen. Patty Murray (D-WA) in April introduced the Women Veterans Health Care Improvement Act of 2008 (S. 2799), which similarly would require the VA to provide Congress a comprehensive assessment of VA services and programs for female veterans and a plan to address the full range of their health care needs, particularly the health consequences for women who have served in Iraq or Afghanistan. This bill, like the House legislation, also would require additional VA programs and services to address the effects of sexual trauma, the need for neonatal and child care, and the challenges of transitioning out of the service for female veterans.

Both bills also would require female veterans program managers at VA facilities.

Murray’s bill was approved by the Senate Veterans’ Affairs Committee on June 26 as part of the Veterans’ Health Care Authorization Act of 2008 (S. 2969).

The VA historically has been understaffed and underfunded, and the huge influx of veterans of Iraq and Afghanistan who require VA care even while relatively young has strained available resources for all former service members. But, critics contend, the VA, established for and historically run by men, must change quickly to meet the dramatically different needs of a changed military.

According to Herseth Sandlin, more than 177,000 women have served in Iraq and Afghanistan since September 2001; more than 27,000 are there now. Such measures as enhanced PTSD treatment for women are “essential” to guarantee that female veterans “have access to services that they are entitled to when they return,” Herseth Sandlin said in introducing the bill.

At the June 26 hearing on the Senate legislation, Murray noted that “[p]lanning for the wave of new women veterans is going to be a difficult and complex task.” But, she said, with women increasingly serving and sacrificing on the front lines, we must “ensure that women have equal access to VA health care benefits and services, and that the VA health care system is tailored to meet the unique needs of women veterans.”

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