"F*ck This Shit": Female Veterans, Trauma, Informed Consent, and Working Towards Something Better

Monday, February 16, 2015 by Meg   •   Filed under General

War comes at a great cost to the people who fight. 

We are great at programming people to be soldiers. At this point, we can adjust the brain at will in order to make sure that the people we send to fight our battles will do what we need them to, to protect American interests. 

But we suck terribly at reintegrating people. I’ve seen men hang on desperately to the notion that, “All Commies are the devil,” because they needed to believe it lest they recognize that they murdered women and children who could have been theirs. I have also seen the ones who recognized that these things were not true reduced to such horrendous guilt that they were never able to function again. 

This is the real cost of war. Sure it’s about money and about political interests and a whole lot of other shit, but the price we pay is too high to justify it unless we assume that the “greater good” outweighs the lives of the people who volunteer to protect these interests. Which for the most part, we do as a nation. And, for the most part, veterans assume that their ultimate sacrifice is  for something greater than themselves, and they face this with trepidation but ultimately nobility. 

But this post isn’t about whether it’s worth it to us as a nation. It’s about informed consent. Because while these men and women go in with the knowledge that they might die, they are not often informed that the emotional issues acquired during their stints may persist throughout the rest of their lives.

They don’t always know that PTSD changes the brain permanently and that in times of war this is more likely. They don’t know that these issues can render them unable to work for long periods of time. They don’t know that PTSD and depression and a number of other stress induced conditions often lead to suicide, which affects veterans at more than twice the rate of the general population (22 a day14 and probably far more because there is no standard method for reporting veteran deaths). They definitely aren’t made aware that if they get hurt or have these psychological conditions that they may be left without healthcare, without psychological services.

They don’t know that they might end up homeless because of a combination of these issues, and that veteran status makes you far more likely to end up on the streets15. They don't know that female veterans are twice as likely to be homeless than non-veteran women1. And though there have been some programs set up for veterans, safe housing for female veterans in particular has not yet caught up.

But it’s not about raging against these very real, very upsetting issues, at least not today, because if I get on that soapbox I might not come down. The issue is not whether men and women should join the military, whether war is necessary. 

The issue is informed fucking consent and making individuals aware of the nature of their sacrifice beforehand. Risks matter. 

And these risks are even more pronounced for women.  

Female Veterans and Rape

30% of women in the military reports rape13 and many of them are raped more than once. In 2013 alone, reports of sexual assault climbed 50%1, not because there were more assaults, but because people are actually talking about it. 

Not that the reporting is helping a great deal in terms of care; 31% of VA hospitals are unable to provide care for those with military sexual trauma, and a third of VA hospitals don’t even have a gynecologist on staff1

What. The. Fuck. 

Do we tell women this when recruiting them? Fuck no. Can you imagine that job interview? 

“The pay is okay while you’re working here, and we’ll provide the uniforms. But you might be sexually harassed and raped, once or multiple times during your stay here. Oh, and we don’t have a doctor to treat you for it. When can you start?”

Like the general population, many assaults remain unreported in both men3 and women. And in the military environment, reporting may be especially difficult. Rape is more likely to occur when sexual harassment and unwanted sexual advances are allowed by commanding officers while on duty2. In that environment, how likely is it that you will see your environment as one that will protect you? Plus, it isn’t likely that you’ll leave Afghanistan or end up with another group. And the harassment and physical danger that may occur as a direct result may explain partially why  reporting the rape is not associated with better psychological well being in female vets4, unlike in the general population where reporting and “justice” provide some relief. 

And being a higher status doesn’t necessarily help. In the police force, another male dominated profession, female supervisors are more likely to be sexually harassed, likely due to attempts (subconsciously or not) of the men around them to level the playing field5. If you objectify her, she’s on your level. Sex is often used against us as a great equalizer, in the military and in everyday life. 

“Pull her down by her vagina, fellas. That’s the only way we can stay on top.”

Now the rape issue is complicated because there are a number of reasons that men rape, but the environment that mimics the ones in our evolutionary past where rape would have been biologically useful for men probably doesn’t help (more here). It also doesn’t help that the sociological environment is so accepting of it. These are not excuses or justifications. Understanding the why is not accepting it. But we need to know about the “why” so we can MAKE IT STOP. 

Women Veterans and PTSD

Women and men are exposed to the same traumatizing experiences on the battlefield, but women have higher rates of PTSD symptoms than men6 (many studies put women at twice the rate for developing PTSD). Women are also more likely to have depressive disorders or other conditions that go along with it6, such as stress related disorders, chronic pain and trouble with physical functioning8, issues with cardiac rhythms and heart rate variability9 and eating disorders11

Some of this may be related to a lack of sleep during PTSD10, which may effect us differently than men. But a bigger issue is likely pituitary adenylate cyclase-activating polypeptide (PACAP) a protein that is involved in the stress response and the modulation of fear. In women, but not in men, this chemical circulates at higher rates and causes issues in the amygdala and the hippocampus, both areas involved in trauma and depression6

So if we are trying to decide to join the military and we see that the PTSD rates for those involved in Operation Iraqi Freedom is between 11% and 20%7, we might assume that these are the numbers that will be most useful to us. However, most of these numbers do not look at lifetime PTSD rates. PTSD rates in those returning from Vietnam were initially reported at around 15% but a later study found that once you included cases that began after the initial return home (and excluded the ones who committed suicide related to it), PTSD rates jumped to 30% of all returning veterans7. That’s a big difference. And if the stats are based on males by default due to their numbers, our risks might be higher. And once you add in the possibility of sexual trauma on top of the combat related PTSD, we end up in a potentially scary position. 

Again, not to say we shouldn’t join. Fuck having to change our dreams just because some asshole might want to rape us or because we might experience trauma. But we need to be informed so we know what’s happening and can seek assistance.

And getting assistance might be that much harder for female veterans as well. 

Female Veterans and Isolation

While 20% of new recruits are women, we remain a minority which makes us more prone to isolation1. But it isn’t just an issue on the battlefield or the mess hall. When women come home, they remain isolated from support at a rate far exceeding their male counterparts1

Female veterans are less likely to be married than other women, but more likely to be divorced or part of nontraditional families1. They are more likely to be single parents with dependent children1. Women veterans even have higher rates of unemployment than veteran men, non-veteran men and non-veteran women1, which cuts out the office as a support outlet.

Women also have more trouble reintegrating once they return home because of societal norms which lead them to balance family, work and community in a way not experienced by men1. As Helen Fischer laments in The Anatomy of Love, just because we have leveled the playing field in some areas does not mean we have caught up in all of them, particularly in those dealing with the home and children. So it is no wonder that female vets report more interpersonal stress than the fellows1

Support is critical for social reasons, such as networking for employment and meeting new people. But it is also critical for stress management and biological reasons (more here in Tend and Befriend: The Female Response to Panic). 

Everyone needs support. The fact that female veterans often have a hard time finding others who have shared similar experiences is a lonely place to be. This may be compounded by the lack of peer support groups available to women specifically.

That's a whole lot of shit to fix. So what to do? 

For more on the treatments for trauma, see PTSD and Treatment Alternatives, and check the related links below. If you are struggling with depression, Check out Depression and Brain Changes for more resources. You might also like Girls Come Marching Home, The: Stories of Women Warriors Returning from the War In Iraq or a few of the other books listed below this post.

With any of these issues, please consider seeking professional assistance through the VA or though a local clinic. Don’t try to handle it all by yourself like a bad ass. Even bad asses need support. Speaking of which, check out Grace After Fire and Women Veterans Rock, two amazing organizations working hard to fight for the rights of female veterans and provide the support they so desperately need. You can even try this link at Meetup.com for a social group in your area or Women Veteran’s Interactive on Facebook.

But there is more to it than treating individuals. We must all continue to fight for the rights of our brothers and sisters who sacrifice so much. We must ensure that they are fully informed of the nature of their sacrifice and that they are prepared to address it when issues arise. We must make sure that we provide proper care and support to those returning home so that they can get back to a normal-as-possible life. They need access to appropriate medical and therapeutic care, to promised disability payments, to respect.

Aside from contacting your congressperson (which you should do) we need to support the organizations working towards these goals which is why I donated more than my husband is going to be happy about to Women Veterans Rock this week. But whatever. He’ll live. Unlike many of them.  

Donate, support, understand. They deserve better than they get.

Related Posts: 

  1. https://transition.unca.edu/sites/default/files/documents/Veterans_2012.13/women-veterans-study%20by%20DAV.pdf
  2. http://www.ncbi.nlm.nih.gov/pubmed/12594773
  3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3067991/
  4. http://www.ncbi.nlm.nih.gov/pubmed/12775177
  5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544188/ 
  6. http://www.ncbi.nlm.nih.gov/pubmed/24516127 
  7. http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp
  8. http://www.ncbi.nlm.nih.gov/pubmed/23071345
  9. http://www.ncbi.nlm.nih.gov/pubmed/22899708
  10. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2970918/
  11. http://www.ncbi.nlm.nih.gov/pubmed/23113442
  12. http://www.ncbi.nlm.nih.gov/pubmed/21567476
  13. http://www.ncbi.nlm.nih.gov/pubmed/12594773
  14. http://www.va.gov/opa/docs/suicide-data-report-2012-final.pdf
  15. http://www.va.gov/HOMELESS/docs/Prevalence_Study.pdf 

Topic-Relevant Resources

Girls Come Marching Home, The: Stories of Women Warriors Returning from the War In Iraq
Honest portrayals of the challenges of female veterans both on the battlefield and coming home.

Mindsight: The New Science of Personal Transformation
New techniques for mindfully altering the wiring of your own brain, leading to increased happiness.

The Anatomy of Love
An in depth look at a history of human mating. Sex, anthropology and more sex. What more could you want?

When Panic Attacks
Detailed overview of cognitive behavioral techniques for changing negative thought patterns

The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms
A useful tool in exploring personal trauma, with an emphasis on healing.

Against Depression
Detailed explanations of the systems involved in depression along with personal stories of success from psychiatrist Peter Kramer.