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  • History MST

     

    Tells her graphic story to let others know they are not alone

    (This story contains a graphic personal account of sexual trauma. The name of the survivor has been abbreviated to respect her privacy. Dr. Nicole Anders (pictured above), Military Sexual Trauma counselor at the VA Southern Nevada Healthcare System, is her counselor.)

    When K. H. walked into the VA Southern Nevada Medical Center in 2017, she decided she was finally going to seek counseling. After seeing a poster for survivors of military sexual trauma, K.H. realized it was time. “I decided to speak out and get the help I felt I so desperately needed.”

    Now 56 years old, K.H. has suffered through a lifetime of abuse from family, friends, and fellow servicemembers. “I was the baby of six kids,” she said, “and my father was a pedophile since I can remember.” This abuse was the first of several instances of sexual trauma that K.H. would endure in her lifetime.

    In order to improve her self-esteem, K.H. wanted to find a career that she could be proud of. “I joined the military right after high school,” she said, “I wanted to prove to myself I was worthy of the respect I gave to the military men and women. K.H. graduated from her training at Fort Sill, Okla. to become a field artillery radar operator, and was first stationed in Hanau, Germany.

    “That is where my life was changed forever,” K.H. said. She had met several new friends, including a few officers, despite being a junior-enlisted soldier herself. One of those friends was a second lieutenant. “We got to be good friends and she invited me to a party with the officers,” K.H. said. “I had no reason not to just trust her as we went on vacations together with other officers.”

    While at the party, K.H. had a few drinks and blacked out. That was when she was attacked by an unknown man. “The next thing I know, I was coming to and being sodomized. I tried to stop him, and his response was a slap on my buttocks telling me he was done anyway.” K.H. is unsure of whether or not she was drugged but remembers that she didn’t drink very much. After regaining consciousness, she realized the extent of her injuries. “I woke up with blood all over my face, I was told I fell downstairs, yet received no other injuries except my bloody face and the sexual assault.”

    “Somehow, I must have deserved it.”

    Scared, K.H. hoped to find comfort from a friend. “When I told the lieutenant what had happened, she said ‘Please do not say anything, I could lose my rank, and it would be your word against an officer.’ So I said nothing.” K.H. blamed herself for going to a party with officers.” “I blamed myself for all of the abuse my whole life,” she said. “And this just confirmed the fact that I deserved everything I ever got. Somehow I must have deserved it.”

    K.H. would experience another sexual assault during her military career. A man at a party raped her, despite her telling him no. She did not report either incident, for fear of reprisal. “Again I suffered in peace. My pedestal I had put the military and officers on came crashing down. My father stole my childhood and the military tore me to my most inner core.”

    K.H. stayed in the active reserves for eight years. Throughout her service, she did not want to seek professional help but would turn to other methods to help her cope with the pain and avoid men. “I would rip off my toes nails just so I wouldn’t have to run in front of the men in a T-shirt,” she said. “I drank often to try to forget. I even overdosed on alcohol.” Her mental health issues continued after her time of service ended. “I am filled with anxiety and depression. I was angry all the time. I don’t trust. I turned to alcohol and drugs,” she said.

    Finally, K.H. decided to seek counseling from the VA. “I have used the VA off and on for years. It was only about 18 months ago I decided I really need and wanted help,” she said. “I saw a poster when I went to get medication for my depression and decided to speak out and get the help I fell I so desperately needed.”

    “The rewards outweigh the fear.”

    K.H. began her counseling program with Dr. Nicole Anders (picture above) and the Military Sexual Trauma counselors at the VA Southern Nevada Healthcare System. “The MST program was very hard,” she said. “But the rewards outweigh the fear and anxiety of starting the program. I felt very comfortable with Doctor Anders and her intern, Amber Hassan.”

    “When she first came in, she was incredibly traumatized,” said Anders, a clinical psychologist who oversees VASNHS’ MST program. “She had full-blown PTSD symptoms, a lot of avoidance, and self-injurious behavior. We added her into the program, and she was hesitant at first. But we started doing a lot of rapport-building and eventually brought her into the PTSD program formally.”

    In time, K.H. was able to move to an MST process group therapy, led by Anders and Hassan. “The group class was as amazing as it was hard,” she said. “To see other women and hear their stories made me feel like ‘Wow, I am not the only one.’ The tools I learned, and I’m still learning to use, have made my life livable. Never did I feel judged or blamed for what happened to me.”

    Next, K.H. participated in cognitive processing therapy, a 12-week psychotherapy program, and by the end of it, she made several huge changes in her life. “She has made great improvements in socializing and relationships and her anxiety had diminished,” said Anders. “She was an ideal patient, and the team really has been proud of her progress.”

    “Letting go of the guilt and shame was a huge turning point.”

    Between the group therapy and one-on-one counseling, K.H. is beginning to see some improvements in her mental health. “I finally believe none of these traumatic experiences are my fault,” she said. “Letting go of the guilt and shame was a huge turning point for my recovery. I won’t lie, it will never be gone, but I stand a better chance with all the tools I have learned in the MST/PTSD program.”

    One in five women and one in 100 men have experienced military sexual trauma. The VA Southern Nevada Healthcare System offers a variety of services to assist Veterans who have experienced MST. Treatment for all mental and physical health conditions related to MST is free, and you may be eligible to receive free MST care even if you are not eligible for other VA care.

    K.H. recommends this program to any Veterans who have suffered through MST in silence.

    “I know it’s hard to talk about,” she said. “But with the awesome program offered by the VA, I pray anyone who is suffering comes to get the help that is offered from this program. It really does help. I can honestly say I don’t know how I managed this long, or where I would be if I hadn’t found this program with such great staff who really wanted to help me in my recovery.”

    Source

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  • Female Problems

     

    From body armor to health care, theUS military has been slow to adapt to women in its ranks. Female service members are paying the price, often with lifelong consequences.

    WASHINGTON — They didn’t want to complain — being a woman in the US military, the last thing you want to be seen as is weak — but the sharp abdominal pain was becoming debilitating. Military doctors dismissed it as “female problems,” period cramps. It was “normal,” they were told. It was said or implied that they were overreacting. They were given painkillers and birth control, and told to report back to duty.

    Those orders landed six of the more than a dozen female service members interviewed by BuzzFeed News in the hospital, fighting for their lives. One was in the ER a few weeks later with a “baseball-sized cyst,” bleeding internally. Another underwent an experimental, highly invasive, and botched surgery by a military doctor. Several had hysterectomies. All now live with infertility; chronic, debilitating pain; and sky-high medical bills. It wasn’t period cramps.

    Interviews with more than a dozen current and former female service members — spanning different branches, decades, and deployments — revealed striking similarities in the way they were brushed off, misdiagnosed, and provided the wrong treatments by US military doctors around the world. In the cases of at least six of the women who spoke to BuzzFeed News, military doctors' inability or unwillingness to properly diagnose women’s health problems put their lives at risk and often created serious new medical issues. For many, it ended their military career. Most said they were properly, quickly, and easily diagnosed by civilian doctors after meeting dead ends with military doctors for years.

    While the Defense Department hasn’t done a comprehensive survey of women’s health issues in 30 years, female service members have long reported receiving inadequate medical care and higher rates of infertility, especially when deployed abroad, in smaller-scale, targeted studies and surveys. More recently, a study released in December by the Service Women’s Action Network (SWAN) found that the roughly 800 current and former female service members surveyed were about 30% more likely to struggle with infertility than civilian women.

    This year, Pentagon-contracted researchers are expected to begin the first comprehensive study of female service members’ health issues since 1989. Experts say it will provide sorely needed data to back up decades of often horrific anecdotal evidence — usually suppressed and only shared among female service members in private — of the real cost of moving too slowly to adapt to women in the ranks.

    At a time when more women are serving in the US military than at any other point in history, military leaders and lawmakers are realizing that not taking the health issues of female soldiers, Marines, sailors, and airmen seriously is impacting military readiness.

    But it's taken women rising to leadership positions — four-star generals, combatant commanders, and lawmakers on armed services committees — for this issue to gain any traction.

    “I laugh when [the Pentagon] says they take care of women in the military,” Rebecca Lipe, a retired Air Force captain who served in Iraq, told BuzzFeed News. “No. Women in the military take care of other women in the military.”

    There is a pervasive problem in the medical community writ large of dismissing women’s pain as false or exaggerated, but it is exacerbated in a mostly male military environment with a lingering resistance to women in their ranks, and a lack of understanding of how military service impacts women differently than men. And there’s evidence the problem hasn’t gotten better as more women have entered the military; the women who spoke to BuzzFeed News described having similar issues in the late 1990s and early 2000s as others did in the past few years.

    “I was treated as if I was in the wrong”

    Lipe was an Air Force captain and deputy staff judge advocate (a senior lawyer) in Iraq in 2011. Only 27 years old at the time, she was in charge of overseeing five bases’ compliance with military and federal law as well as advising local Iraqi criminal courts, a job that required a lot of off-base travel by helicopter and convoy. This meant she was constantly wearing body armor — body armor that was designed for men.

    “Theoretically if you get shot in the side, there’s side panels, but I couldn’t even wear those, because I couldn’t get it to fit or stay on correctly,” she said. “So if I ever were to get hit in the side that would— that would be a bad thing,” she told BuzzFeed News.

    Like many of her female colleagues, Lipe had to adapt the body armor as best she could. The only way it would protect her vital organs the way it was meant to was if she stuck foam rubber under the shoulder straps to lift it up, she said.

    It wasn’t until later that she found out that wearing this ill-fitting equipment weighing more than 40 pounds, while sitting at the 90-degree angles forced by military convoy seats for hours and days on end, likely caused multiple “sports herniations” in her pelvis. When she went to the doctors on base seeking treatment for intense pelvic pain, they insisted it was not a hernia, medical records reviewed by BuzzFeed News show. Instead they became convinced it was symptoms of a sexually transmitted disease, and repeatedly tested Lipe for STDs despite her insistence that there was practically no way she could have one. She was married and faithful to her husband, she told them, but they kept asking her if she was having an extramarital affair.

    “I was treated as if I was in the wrong,” Lipe, now 36, told BuzzFeed News, speaking from her office in Chicago where she works as an attorney after retiring from the Air Force. “Clearly they thought I must have been this adulterous, excuse me, whore who was doing something wrong. And I was like, look, I’m the lawyer here, I’m the one enforcing these rules, you have to be kidding me.”

    All the STD tests came up clean, records show, but the pain got worse. It got so bad that she stopped being able to walk to the dining facility for meals. The doctors told her it was her endometriosis (a common disorder that leads to unusually painful menstruation) but she had knew what that felt like, and this wasn’t it. Within a few days she had to be medically evacuated to the Landstuhl Regional Medical Center in Germany, a trip that only exacerbated her injury, Lipe said. No one believed she was in as much pain as she was. She could barely get up, but they made her walk and carry her own bags to the plane, where the nurses refused to give her the amount of painkillers the doctors had prescribed her for the flight, records reviewed by BuzzFeed News show.

    At first, the military doctors in Germany refused to admit her, saying it was just period cramps, Lipe said, until a higher-ranking officer insisted on her behalf. The records show Lipe was told she had developed a pelvic infection in Iraq from unknown causes (a diagnosis her OB-GYN later wrote in her records, after consulting with nonmilitary specialists, was incorrect and made “without any objective evidence”). Not knowing what else was wrong with her, she was shipped back to the US, to Eglin Air Force Base in Florida for further treatment.

    “I spent the next two years having to advocate for myself to the point of defending my mental health,” Lipe said, echoing a sentiment expressed by every woman who spoke to BuzzFeed News. “I was constantly in pain … I got to the point where I was suicidal because I was literally being told this was all in my head. There’s only so much you can be told that before you start to think you’re going crazy.”

    Finally, almost exactly a year after Lipe first started experiencing the pain, a private, nonmilitary reproductive endocrinologist and general surgeon in Jacksonville, Florida, figured out what was wrong with her — multiple small pelvic hernias caused by the ill-fitting body armor. It took two one-hour appointments, her records show, and they knew exactly how to fix it. After extensive surgery to fix eight areas of her abdominal wall, she began to improve.

    However, due to the delay of proper treatment and the many procedures and medications military doctors prescribed for problems she did not have, Lipe had become hormonally depleted. It caused nerve damage and vaginal atrophy, her medical records show, that prevented her from having sex with her husband, and she had trouble conceiving naturally.

    “I won’t ever go back to a military medical facility,” Lipe said.

    While Lipe’s case was extreme, the military’s own surveys show a widespread problem with women getting access to health care.

    According to a 2006 military study of female soldiers who served in Operation Iraqi Freedom, 44% could not access gynecologic care during their deployment. A later study in 2009 found that 35% of female soldiers had at least one gynecologic problem while they were deployed in Iraq, with 11.5% having to take the risk of traveling by ground convoy and 28% by air to obtain care.

    Many other women described similar ordeals to BuzzFeed News, with misdiagnosis of fairly common medical issues as “female problems” — a term every woman who spoke to BuzzFeed News used to refer to menstruation, saying it was what men in the military said as well — not only interrupting their military careers but causing long-term injuries.

    All the women who spoke to BuzzFeed News said the pressure to “suck it up” and fight the perception of being seen as weak was especially acute as female service members. Many of the men they served with or who treated them saw women as “problem soldiers” — especially if they complained about pain, they said. They all said some of the men made it clear they thought the military was no place for women at all.

    “I can only guess a lot of other women feel this way, but I never want to be perceived as a whiner. I don’t wanna be a complainer,” retired Air Force Maj. Annie Morgan, who experienced similar issues, told BuzzFeed News. “I feel a certain need to be tough, and I don’t know if the military’s telling me that or if I’m imposing this on myself because I know I’m in the minority.”

    If you have to repeatedly tell your superiors and the medics on site that you’re in pain, “it proves their thinking that women shouldn’t serve in certain capacities,” Catherine Harris, who retired last year as a first sergeant in the Army, told BuzzFeed News said. “So you think, OK, I’m gonna keep quiet so I don’t ruin someone else’s chances of doing this.”

    But the pain got so bad for the women who spoke to BuzzFeed News that they couldn’t keep quiet anymore. It was interfering with their jobs, their military service, and their lives. Three of the women were accused of malingering while they were experiencing chronic, debilitating pain. All of them said that this constant denial of their pain took a mental toll on them.

    “We don’t want special care, we want the same level of quality care that the men have,” Harris said.

    A recent analysis of military medical research put out between 2000 and 2015 found that “research on the US military has until recently focused almost exclusively on the health of male service members,” and that gynecological care had the highest percentage of low-quality articles and information available to service members.

    For Harris, 47, her problems started after an accident in the early 2000s in Fort Jackson, South Carolina. She was on duty driving two soldiers when the rear axle of the truck gave out, rolling over several times, she told BuzzFeed News. Harris said she went to the hospital complaining of lower abdominal pain, which continued and got more severe over time. As with five other women who spoke to BuzzFeed News, she said the military doctors dismissed her pain as connected to her period — “female problems” — and prescribed her several different kinds of birth control, none of which worked.

    Harris told BuzzFeed News she had trouble with infertility after that, and lost two pregnancies. During a third pregnancy, she said she was sent to a nonmilitary doctor, because she was considered to have a “high-risk” pregnancy. That doctor discovered large ovarian cysts that endangered her life and her pregnancy, requiring her to undergo a risky operation. Luckily, she and her daughter survived both the procedure and the birth.

    But Harris's pain continued for years, as military doctors continued to insist it was only period cramps, she said. It grew worse in 2013 after she deployed to Afghanistan, where she underwent several physically traumatic experiences, including being in an aircraft that came under fire and being proximate to an explosion, she said. The pain came to its peak in 2015 when she was stationed at the US Army garrison in Vicenza, Italy. Before she deployed, a doctor had installed an IUD in an attempt to help the issues caused by the abdominal trauma, but it had to be removed when it started causing her pain. By the time she left the military, in June 2017, she had to have a hysterectomy, Harris said. She went into early menopause at 45 years old.

    Military doctors and Pentagon officials told BuzzFeed News they could not discuss specific cases, but insisted their priority is to maintain the health and well-being of all service members, men or women, so they can fulfill their mission.

    But the women who spoke to BuzzFeed News said that the “one size fits all” approach, from health care to body armor, simply does not work as the number of female service members continues to rise. For example, 12.3% of female recruits developed hip stress fractures compared to 2.4% of their male counterparts, partly because hip belts and the metal frames for their packs are designed for men’s bodies according to one analysis of US Army recruits. It cites a study — conducted more than 20 years ago — that suggested that female soldiers would not only be able to avoid injury but also close the time gap between them and male soldiers if packs could be designed for the female anatomy.

    Such experiences not only hurt female service members, but also damage the military as a whole in the long term, experts say.

    “The military invests in every single person that enters, man or woman, they lose just as much losing a woman as they do a man, from an investment perspective,” said Sarah Meadows, a senior sociologist at the RAND Corporation, the nonprofit think tank that was commissioned by the Pentagon for the upcoming study on female health issues in the military.

    It was a perspective echoed by more than a dozen US Army, Navy, Air Force, and Pentagon officials questioned by BuzzFeed News.

    “Anything that gets in the way of them being able to serve, just like any other soldier, is bad news for everyone,” one US Army recruiter, who spoke on the condition of anonymity, told BuzzFeed News in January,

    The US Army added eight new sizes of body armor to fit smaller sizes in 2016, and the Marine Corps is adding a helmet that accommodates women’s hair. Gen. Joe Dunford, the chair of the Joint Chiefs of Staff, last year pressed the service branches to move more quickly to get the new body armor to female troops in the field.

    But there are increasing concerns that the lag in adapting to female service members’ medical needs may lead to women leaving military service at a time when the US military is struggling to recruit and retain service members.

    “This is important not just for warfighting but also for retention,” Sen. Tammy Duckworth, a retired Army lieutenant colonel, told BuzzFeed News in an interview. After losing both her legs when her Black Hawk helicopter was shot down in Iraq in 2004, she has been outspoken about the need to extend coverage of fertility treatments for wounded Veterans. She said she hopes the upcoming Pentagon study will provide more data and help fight the stigma around female service members’ health and infertility issues.

    “If we don’t address these issues, women are more likely to leave the military, and taxpayers lose a lot of money when skilled soldiers, airwomen, and sailors leave,” Duckworth said.

    “Girly Problem”

    Even women whose medical issues were not directly caused by their military service told BuzzFeed News they faced dismissiveness and negligence from military medical professionals that worsened their conditions and caused lasting, debilitating medical issues.

    One former Air Force medic, who asked not to be named, had an undiagnosed, rare genetic condition while in the military with symptoms that included pelvic pain. Even though she worked in the medical field, her pain was often dismissed by her colleagues as related to her period.

    “I was the only female officer in a fighter squadron, so it was all officers and all men, and here I was with this girly problem,” she said. Unlike the other servicewomen interviewed for this story, she said her problems weren’t even connected to her reproductive organs, “but if it’s that part of your body, they don’t want to know about it.”

    When the pain was at its peak in the early 2000s, a US military physician at the Royal Air Force Lakenheath base in the UK, which hosts US Air Force personnel, recommended she undergo an invasive surgery. He ended up performing the surgery incorrectly, she told BuzzFeed News, which resulted in lasting problems with urination and pelvic pain.

    “There’s nothing wrong with you. You’re being ridiculous. Tough it out,” she said the doctor told her, assuring her the pain was normal. When she insisted, he refused to keep seeing her. She complained to the head of the hospital as well as the base commander, but is unaware of any action being taken.

    She never fully recovered from the misperformed surgery, and never went back to being active duty again.

    Similarly, Morgan had months of abdominal pain dismissed as menstrual cramps by the military doctors at Lakenheath starting in 2011, according to medical records reviewed by BuzzFeed News. A different OB-GYN at Lakenheath told her she had a “tender cervix” and was told “to take some aspirin,” she said. Weeks later, while on leave back in the US, she ended up doubled over in pain in a civilian ER. Doctors found she had a “baseball-sized cyst” on her ovary that had caused internal bleeding, and performed emergency surgery, according to her records.

    In the following years, as Morgan continued serving in the Air Force as a judge advocate, military doctors performed several exploratory surgeries, her medical records show, including having her right ovary removed. None of them made the pain better.

    “It’s hard not to take this personally and think, Maybe I’m the problem. Maybe I’m being a big baby,” Morgan told BuzzFeed News. “I started to doubt myself. It’s hard when keep having these encounters with medical professionals where they say nothing’s wrong. You start to think, Maybe I’m the crazy one.”

    In a statement, the commander of the 48th Medical Group at Lakenheath told BuzzFeed News that they take the care provided by the base’s OB-GYN clinic “very seriously” and that service members have several options to raise concerns, including patient advocates, email and survey feedback, and filing complaints about doctors and medical staff. Like other military officials contacted by BuzzFeed News, US Air Force Col. Thomas Stamp said he could not respond to questions on individual cases due to privacy laws.

    “Every Airman and civilian staff member working in our hospital is expected to operate at the highest level of professionalism, without exception,” he said. “They trust us to take care of them and in return we are committed to providing world-class healthcare.”

    One servicewoman, who asked to only be referred to by her middle name, YVette, described facing similar experiences with military doctors in the 1990s. She had chronic fibroids (uterine cysts) that caused her a lot of pain, she told BuzzFeed News, but during her time in the military they were repeatedly dismissed as period cramps. Like the others she was prescribed different kinds of birth control and painkillers, and eventually was accused of malingering, she said. By the time she was properly diagnosed by a civilian doctor, nearly 20 years after the pain started, the damage was so bad she had to have a hysterectomy. Another woman, who is currently serving in the Army and asked to remain anonymous, told BuzzFeed News a nearly identical story that happened last year.

    In mid-February the advocacy group SWAN brought Lipe and several other women to Capitol Hill to meet with the staff of 30 members of Congress about the medical and infertility issues facing servicewomen. Two weeks later, staffers for two Senate offices and one House office (who asked to remain anonymous as their offices were not yet ready to go public with this information) told BuzzFeed News there were ongoing discussions about including funding to research the issues brought up by the servicewomen in the next National Defense Authorization Act.

    Duckworth attributed much of the spotlight on the issue in recent years, including legislation and the upcoming study, to more women being in senior leadership roles both in the military and in Congress.

    These women in senior positions “looking out for these issues adds to the momentum that is just now starting to build when it comes to health in the military for women,” she said.

    Lipe and Morgan, both lawyers with prestigious positions in the military, said they were aware of the privilege their positions gave them as they battled for their medical issues and infertility to be taken seriously.

    “If this is my experience, I can’t even imagine what our younger enlisted officers are dealing with,” said Lipe, who had direct access to commanders throughout her infirmity. “I’m worried how many females enlisted who have had similar problems haven’t had a chance to voice them because they’re afraid to speak up, and don’t have the platform to do it.”

    A constant stream of reports have brought to light environmental health hazards service members may have been exposed to — lead poisoning in military base housing, water contaminants, burn pits — but a lack of research into how they might affect women’s health issues down the road, including fertility, means for many there’s nothing to do but wonder.

    “Am I a fluke? I mean, I don’t think I was exposed to a lot of chemicals or equipment or radiation, but I don’t know, a lot of women don’t know,” said Amanda Lurer, a 39-year-old US Navy chaplain who was told there was no medical explanation for her fertility problems when she started trying to conceive in her early thirties. After several expensive rounds of IVF, she was able to have a daughter, who is now 2.

    Like several female service members and lawmakers who spoke to BuzzFeed News, Lurer said she hopes the Pentagon’s upcoming study will provide some scientific data, and finally some answers.

    “It’s good they’re finally doing this, but the military moves at a glacial pace,” Lurer said. “Maybe if my daughter grows up and wants to enlist, there’s hope it’s a better one for her.”

    Source

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  • 1 Star Gen

     

    After reporting her sexual assault, a now-retired lieutenant colonel with the West Virginia Army National Guard was retaliated against by a brigadier general, the Defense Department's inspector general said in a new report.

  • Sexual assault 003

     

    The Defense Department in September released a first-of-its-kind study that estimates the risk of sexual assault service members face at different installations. The estimates were based on more than 170,000 survey responses service members completed in 2014 on whether they had personally experienced sexual assault. The data has limitations, but military officials will use it to help identify high-risk areas and see what additional steps can be taken to increase safety for men and women assigned there. The data is searchable by service, risk, location and estimated number of assaults.

    Service members can use the chart below, drawn from the detailed data tables published by RAND, to search for individual military installations and ships.

    The study conducted by the Rand Corporation includes two key measurements:

    Overall Sexual Assault Risk: This number indicates the average expected risk for the average men and women at the individual installations. For example, a 10 percent risk for sexual assault means it’s likely that one in 10 service members at that installation or ship will experience a sexual assault during the year. This number is affected by many factors, such as the age, rank or gender of the personnel assigned there. For example, installations with many younger, unmarried and junior ranking personnel (all risk factors) tend to have higher risk solely based on those demographic risk factors.

    Installation-specific risk: This number measures the risk for sexual assault that controls for all those personal factors and aims to more directly answer the question: Are individuals more at risk for a sexual assault here than elsewhere? This installation-specific risk may be associated with installation characteristics such as command climate, the community outside the gates of the installation, or other factors. A positive number indicates service members at that installation face an elevated risk for sexual assault, and a negative number indicates the risk there is lower than expected for a base of that size and demographic. For example, an installation with an installation-specific risk of 1 percent (or -1 percent) means that troops at that location are one percent more likely (or less likely) to experience a sexual assault compared to the average for a base of that size and demographic. To calculate installation-specific risk, RAND employed a number of analytical tools and computer models to create its best estimate on the probability a service member may face sexual assault at that location. The percentages reported are RAND’s best estimate based on its analysis of the 2014 survey data.

    Sexual assaults by service, gender and location

    (Click Source to view charts)

    Source

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  • Sexual Harassment

     

    Traditional methods can backfire, but ideas like teaching bystanders to intervene and promoting more women have proved effective.

  • Sex Trauma Denied

     

    WASHINGTON – The Department of Veterans Affairs improperly denied hundreds of military sexual trauma claims in recent years, leaving potentially thousands of Veterans suffering from post-traumatic stress disorder without benefits, a VA inspector general investigation found.

  • MST Task Force

     

    The Defense Department has created a sexual assault task force to study and make recommendations on improving how the armed services handle and prosecute sex crimes.

    Pentagon officials said Tuesday that Acting Defense Secretary Patrick Shanahan ordered the establishment of a Sexual Assault Accountability and Investigation Task Force on March 27. That was the day after a Pentagon advisory committee released a report finding disparities in documentation of sexual assault cases across the services. Among the discoveries were incomplete files on how commanders made prosecution decisions.

    The move also followed the January release of a report on sexual assaults at the service academies, which found that the estimated number of students who experienced unwanted sexual contact had increased 47 percent in the last two years.

    The task force includes Dr. Elizabeth Van Winkle, executive director of the DoD office of Force Resiliency, and the services' top lawyers, who will review the processes used by the military to investigate sexual assault charges and prosecute cases.

    The group will make recommendations "that will improve existing processes to address sexual assault while ensuring our formations, our communities, the rights of the victim and the accused and the integrity of the legal process are protected," Shanahan wrote in a memo to the service secretaries, the Joint Chiefs of Staff and other high-ranking Pentagon leaders.

    "The importance of this work cannot be overstated," Shanahan said. "Only through diligence and innovation will we eliminate this reprehensible crime from our ranks."

    Some Democrats in Congress have renewed efforts to amend the Uniform Code of Military Justice to remove the authority for deciding whether to prosecute sexual assault cases from military commanders.

    Advocates for the change say it’s needed because the current system yields low prosecution and conviction rates and allows for retaliation against victims.

    But a panel appointed by Congress in 2013 to study the command authority issue concluded that the incidence rates of sexual assault would not be reduced by removing convening authority from commanders.

    That group, the Response Systems to Adult Sexual Assault Crimes Panel, also noted that, in the sexual assault investigation process, subordinate leaders such as noncommissioned officers and civilian supervisors were often the ones who ignored reports of sexual assault or retaliated against victims.

    "Training and accountability for these leaders is imperative," the panel noted.

    A different group, the Defense Advisory Committee on the Investigation, Prosecution and Defense of Sexual Assault, published its own report March 26. In the report, the group said it had reviewed 164 cases of penetrative sexual assault across the services and found that command decisions to refer charges were "reasonable" in 95% of the cases.

    But members also noted that documentation justifying the decisions was spotty across the services. The advisory committee recommended that services have standard requirements for documenting command disposition and furnishing rationale for each decision.

    Shanahan said the new task force's recommendations will complement the work of the advisory committee, and he pledged to continue preventing sexual assaults and supporting victims.

    In his letter, Shanahan said the report on the service academies report and discussions with Sen. Martha McSally, R-Arizona, a retired Air Force fighter pilot who revealed during a hearing March 6 that she had been raped as a junior officer, led to his decision to create the task force.

    "I pledged to do more, and I intend to carry out this commitment," Shanahan said. "Sexual assault impacts the entire force across all Military Services. None of us are immune to this crime and all of us are responsible."

    The task force is expected to provide its findings in a final report to Shanahan by April 30.

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  • MST Claims Denied

     

    More and more active US service members are reporting sexual abuse. So are Veterans—but a recent report found that at least 1,300 sexual trauma claims may have been wrongly declined by the Department of Veteran Affairs.

    In 2017 alone, more than 5,200 active members (pdf, p.9) of the US military reported they’d been sexually abused during service. This is a 10% increase over the previous year, likely linked to increased attention and legislative action in recent years. Still, the cases that get reported are only a small percentage (pdf, p.11) of total incidents, according to the Department of Defense’s estimates.

    Veterans were even more likely to come forward with stories of sexual abuse or harassment in the military. Over the past three years, the Department of Veterans Affairs (VA) says it processed about 12,000 claims annually for disability compensation and other benefits due to sexual trauma. Seventy-nine percent of claimants were women.

    Since 2011, VA guidelines have supported victims in their process of coming forward. The agency applies a so-called “liberal approach” to to the kind of evidence of abuse it accepts: For instance, it looks for circumstantial “markers” that would corroborate the survivor’s claim, such as changes in behavior, substance abuse, unexplained leave of absence, changes in relationships.

    Yet the Office of the Inspector General (OIG) found that many claims have been reviewed inadequately. According to a report released on Aug. 21, about 1,300 claims of Post Traumatic Stress Disorder (PTSD) connected to sexual trauma during military service were denied without following the correct procedure between April and September 2017 alone.

    The OIG sampled 169 claims filed during that period and found that half—82 cases—had been mishandled and wrongly rejected for simple procedural errors. The causes of such mishandling have been found to be primarily procedural: In 28% of cases, survivors who qualified for medical examinations to confirm their claims were not given one. In 13% of cases, there was a failure in gathering evidence. In 11%, the Veterans filing the claims were not contacted by the VA’s officers reviewing the claims. And in 10% of cases, the OIG found that reviewers misjudged claims of sexual abuse due to incomplete and controversial information.

    This only reflects a few months worth of processing, which means that thousands more claims may have been mishandled over the years. According to the report, reviewers may not have received adequate training, and did not follow guidelines and procedures. Senator Jeanne Shaheen of New Hampshire has issued a letter to the VA demanding specific details about how it intends to move forward in the review process.

    The VA told Quartz that it concurs with and approves of the OIG’s recommendations, and that it will begin implementing right away. “We know this is an area where the department can improve,” a spokesperson said, adding that the VA has required all officers processing claims to take specific training to handle military sexual assault.

    Further, the agency will review all denied claims decided between October 2016 and June 2018. “If mistakes were made,” the spokesperson said, “we will fix them in order to ensure affected Veterans are getting all of the support, benefits and services they have earned.”

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  • Piece of Meat

     

    WASHINGTON — Corey Foster spent her Army career caring for wounded troops, both as a flight medic in the Iraq war and at Walter Reed hospital, so she looked forward to one of the most celebrated benefits of military service — health care for life from the Department of Veterans Affairs. Then she walked through the door at a V.A. medical center in Temple, Tex.

    “You felt like you were a piece of meat,” said Ms. Foster, 34, who retired as a sergeant. “Standing in line at the registration desk, I was getting comments from the male patients behind me, looking me up and down. It was a major source of discomfort.”

    The treatment was the same at the Veterans Affairs medical center in Murfreesboro, Tenn., where Ms. Foster moved after living in Texas. At that point she gave up, and opted for her husband’s insurance outside the department. “They need to make the facilities not feel like an old soldier’s home,” Ms. Foster said.

    An entrenched, sexist culture at many Veterans hospitals is driving away female Veterans and lags far behind the gains women have made in the military in recent years, Veterans and lawmakers of both parties say. Although the Department of Veterans Affairs has scrambled to adjust to the rising population of female Veterans and has made progress — including hiring more women’s health care providers, fixing basic privacy problems in the exam rooms and expanding service to women in rural areas — sexual harassment at department facilities remains a major problem.

    Women say it is galling that such a demeaning atmosphere persists, especially for the roughly 30 percent of female Veterans who have reported being harassed or assaulted while serving in the military. That number includes Senator Martha McSally, Republican of Arizona, who spoke at a congressional hearing last week about being raped by a superior officer while serving in the Air Force.

    “Changing the culture has been an ongoing, overarching goal,” said Dr. Patricia Hayes, the chief consultant for Women’s Health Services at the Veterans agency. “We want women Veterans to feel respected and safe and secure.”

    At a recent hearing with Veterans agency officials on Capitol Hill, Representative John Carter, Republican of Texas, described the treatment of female constituents trying to obtain V.A. health care. “It’s like a construction site,” he said.

    Mr. Carter cited the same medical center in Texas that Ms. Foster had used — and noted that the Women’s Trauma Recovery Center within it was moved last year to a female-only facility in Waco so that women, who said they feared for their safety, could receive treatment without facing harassment.

    Representative Will Hurd, Republican of Texas, was visibly frustrated as he described women abandoning the center in his district because of harassment. “This is the biggest concern I hear from female Veterans,’’ he said.

    While the number of women using Veteran health services has tripled since 2000 — to about 500,000 from 159,810 — they still make up only 8 percent of all users of health care at the V.A. Officials expect that the number will increase. Two million women are in the American Veteran population, or about 10 percent, and yet they make up 16 percent of the active-duty military force.

    “I believe that we still have a tsunami wave of women Vets coming in,” said Dr. Hayes, of Veterans Affairs.

    For now, many female Veterans say they are made to feel as if they do not belong at the V.A., as they describe front-desk employees asking for a husband’s Social Security number when they check in or being passed over for items like complimentary coffee, which employees say are “for Vets.”

    “It’s hard to walk into a place and feel like everyone is looking at you wondering why you are there,” said Kristen Rouse, 45, founding director of the NYC Veterans Alliance, who described a sense of loss every time she glanced at the department’s motto affixed to her center in New York City: “To care for him who shall have borne the battle and for his widow, and his orphan.” Her organization supports changing the motto.

    “Over the 24 years I have served my country, I have never been any of those,” said Ms. Rouse, who remains a reservist in the Army. “And I never will be.” (That portion of the motto, coined by President Lincoln, is now the subject of legislation.)

    Some centers, like the one in Washington, have removed benches from entryways so that men no longer have a place to linger and badger women, or have created separate facilities, like the one in Texas. Every center now has at least two providers focused on women’s health and nearly 6,000 providers have been trained in the practice; about 98 percent of them are women.

    While the V.A. is still trying to address the needs of pregnant Veterans — the centers do not provide full obstetrics care on site — many of the centers across the country now have baby showers around Mother’s Day, offering diapers and other baby supplies.

    Yet the culture remains an impediment for many.

    Brandy Baxter, who served as a senior airman in the Air Force, loves the care she receives at the women’s health clinic through the Veterans Affairs center in Dallas. But she hates the elevator ride to get there.

    “The male Vets give me the once over with their eyes,” she said. “I look them right in the eye, just to tell them, ‘I’m checking your height, your weight, your skin color — just in case I need to report you.’ ”

    This year, the House Veterans Affairs Committee will establish a task force to address women’s health care, and harassment issues are expected to be front and center. “This is about the physical transformation of our facilities,” said Representative Mark Takano, Democrat of California and the new chairman of the committee.

    A model for what women’s health care can be is on display at the Jesse Brown V.A. Medical Center in Chicago, where the vast majority of doctors and staff members are women. The five exam rooms and waiting area are only for women, and beyond offering basic health care, the center offers women a number of programs like a golf team, a weight loss group and art therapy.

    “I think women Veterans really want programming that speaks to their entire identity,” said Jenny Sitzer, the coordinator for women at the center.

    Staff members wear badges that read, “My name is not ‘Hey baby,’” and banners all over the campus feature the faces of female Veterans describing the pain of being harassed on their way through the broader V.A.

    Lori Brown, 58, is grateful for all these services, but most of all for the ability to walk into the medical center without facing harassment, and to have only women for her care. “I can allow myself to be who I am in front of the doctor or nurse and not be intimidated by men,” said Ms. Brown, who was an Army sergeant.

    Many other challenges face the V.A., like a shortage of providers for specialty services. Some women say they still struggle to get all of their birth control needs fulfilled at some facilities, and complex laws governing certain fertility treatments remain another area of complaint.

    Many women do not use the medical facilities because they lack child care, which the department is largely not legally able to provide. Another issue is reaching homeless female Veterans, a serious problem that also affects the male population.

    Women also have mental health care needs — over 40 percent of female Veterans who use the V.A. are diagnosed with at least one mental health condition, compared with about 25 percent of men.

    Bills touching on these issues are expected to come up in this Congress, and some Veterans’ organizations have made services for women a top legislative priority, especially Iraq and Afghanistan Veterans of America, all in the name of making the V.A. a better place for women.

    “One must be persistent,” Dr. Hayes said. “Culture change does not happen overnight. We want to continue to get the message to women that we want you here.”

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  • Fewer Male Vet PTSD

     

    The Department of Veterans Affairs approves claims for post-traumatic stress disorder related to military sexual assault at significantly lower rates for men than women -- a gap the former director of the VA's Center for Women Veterans says shows "systematic discrimination" against men in an era of #MeToo.

    In an editorial published Feb. 11 by The Hill, Kayla Williams, a senior fellow and director of the Military, Veterans and Society Program at the Center for a New American Security, said the Veterans Benefits Administration (VBA) has closed a gap that once existed between approval rates for combat-related PTSD and claims for military sexual trauma (MST), but a disparity still exists between the genders for MST-related claims.

    The grant rate in 2018 for sexual-trauma PTSD claims was 57.7 percent for women and 44.7 percent for men. While those rates represent a large increase from the respective 41 percent and 26.9 percent approval rates in 2011, they show a continued lack of understanding within the VBA of the scope of the problem among men, Williams said in an interview Feb. 14.

    Women in the military, who make up just 15 percent of the total force, do get assaulted at higher rates, statistics show. But more than half of all survivors of sexual assault in the military are men. And male victims are less likely to report sexual assault, often dismissing an incident as hazing or harassment, according to Williams.

    Because they are less likely to report, men don't have a paper trail or proof to back their disability compensation claims for MST-related PTSD, which are subsequently dismissed, she said.

    She added that there is a cultural bias within the VBA that "doesn't think this happens to men."

    "This is thought of as a women's problem," Williams said. "Even when I've talked to senior leaders in the military, I raise certain [hazing] practices -- you've heard of 'tea-bagging' -- and they don't realize it's sexual assault. For someone who has been a victim of sexual assault as a child or anyone who doesn't want someone's genitals pressed onto their face, it is sexual assault."

    In 2011, the VA launched a concerted effort to close the gap between PTSD claims granted for military sexual trauma and those granted for combat and other causes. The effort raised the approval rate for MST claims by 20 percentage points. In 2018, the approval rate was 56.6 percent for MST-related claims while the PTSD grant rate for other traumas was 54 percent.

    Williams said she noticed the gender disparity for MST claims while serving as director of the women's center from 2016 to 2018, adding that she told VBA officials of the difference but "they didn't believe they had a problem."

    She did not raise her concerns with higher-ups, saying that it isn't a secretarial-level concern.

    She believes the VBA could solve the problem by training claims reviewers specifically on male military sexual trauma and bias. She also recommends that supervisors conduct spot checks of claims.

    "If you look at the improvements that VA was able to make in accepting women's claims, I really think this is a solvable problem.... Men deserve equitable disability compensation from VA," she said.

    The VA did not respond to a request for comment.

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