November/ December 2013 Women, War, and PTSD

Are female warriors more likely to be traumatized by combat?

By Laura Kasinof

“There are social theories, economic theories, biological theories” for gender disparities in PTSD, and the way that people experience the illness, Jaycox said. “It’s not like one [explanation] is right. It’s probably a complicated combination of factors. And that is expected to be the case when looking at rates within the military as well.”

So what’s the right thing to do? Should we as a nation pass laws that protect female soldiers, as well as their families back home, as we once protected fathers and their wives and children back home, from the horrors and aftereffects of war? Should we hold off on integrating women into direct combat roles until sufficient research determines the risk to female soldiers’ mental health?

These are tough, controversial questions, but the consensus I found among female veterans was a little clearer, and twofold: They applauded the DOD’s decision to lift the combat ban, if for no other reason than it might increase awareness among both the public and the government that female soldiers returning from combat situations of all kinds are veterans in the same way male soldiers are. But the female soldiers with whom I spoke also believed that we should give women the unique—and, yes, gender-specific—support that they may need both abroad and after returning home.

Take, for example, the experience of female veterans at the VA, an organization long designed to cater largely to men. In January 2011, the VA Office of Inspector General released a study finding that women have had a harder time than men receiving treatment from the VA for service-related PTSD because they technically have not served in combat roles. Even after they’ve been diagnosed, the challenges are often formidable. On an afternoon last spring, I accompanied Pacanowski to the Philadelphia VA, which she described to me beforehand as “creepy.” The crowded waiting rooms were packed with older men whose leering gazes caused her to become noticeably uncomfortable. Her movements became stilted, and she began to stutter her words. At the receptionist’s desk, a stout, bearded vet who’d been at the counter before us ogled us. “I’ve been waiting all day to keep that spot warm for some pretty ladies,” he said. “Is that warm for you?” We moved out to the hallway to wait for her appointment to see a psychologist for her PTSD.

The VA has begun taking steps to improve some of those problems, establishing a new women’s veteran hotline to answer any questions about services provided, and awarding the largest number of grants ever to thirty-three of its facilities to expand health care tailored to women. But as of now, the standards for women’s health are not the same at VAs countrywide. The VA Medical Center in Washington, D.C., for example, has a complete women’s clinic with physicians and therapists available Monday through Friday, but in Fort Worth, Texas, the VA women’s health clinic was staffed in early 2013 by a single registered nurse and was only open three mornings a week, during work hours. A spokesperson at the VA told me that no new research on women and PTSD has been funded as a result of the elimination of the combat ban. But potentially “those researchers who have been examining impacts of combat exposure will be pursuing work in this area in the near term,” he said.

While it may be impossible to tease apart MST and sexual harassment from the prevalence of PTSD in women, or to quantify the various ways in which a woman’s experience differs from that of a man, the original questions remain. If we are poised to send women into war in greater numbers, or at least into official combat roles for the first time in our history, what can we do to guarantee their success in an arena that has historically been male and remains so today?

I posed this to Olson, the retired Air Force colonel who runs Grace After Fire. “If a veteran suffered violence in the service and he or she needs a safe place to come to seek treatment, we need to accommodate that. We owe them that,” she said. “These kids volunteered to go in harm’s way for the benefit of the 99 percent of us. And if this is what they require, then we ought to give it to them, full stop.

Laura Kasinof is a freelance journalist based in Washington, D.C., where she is at work on a book about her three years as a reporter in Yemen. The reporting for this story was generously supported by the Fund for Investigative Journalism.


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