More so than at any other time in American history, female soldiers are serving in the front lines of military operations. One out of every seven soldiers serving in Iraq are female. Already, more than 160,000 women have served in Iraq and Afghanistan. Only 7,500 female soldiers were ever deployed to Vietnam. Particularly in Iraq, female soldiers are more directly involved in combat operations and are also exposed to combat trauma in non-combat duties due to the particular nature of guerrilla warfare. But while the needs for veterans’ health care for female soldiers has never been higher, disparity in the offered care by the Veterans Administration, whether intentional or otherwise, puts female veterans in particularly dire straights.
From Elise, who was kind enough to allow me to participate in this series with one of my pet issues:
Feminisms is a series of weekly feminist diaries. My fellow feminists and I decided to start our own for several purposes: we wanted a place to chat with each other, we felt it was important to both share our own stories and learn from others', and we hoped to introduce to the community a better understanding of what feminism is about.
Needless to say, we expect disagreements to arise. We have all had different experiences in life, so while we share the same labels, we don't necessarily share the same definitions. Hopefully, we can all be patient and civil with each other, and remember that, ultimately, we're all on the same side.
The problems in care for America’s female veterans are particularly acute in cases of Post-Traumatic Stress Disorder. Fully one-third of veterans from military operations in Iraq and Afghanistan have been diagnosed with a mental disorder. Post-Traumatic Stress Disorder has been diagnosed in at least 34,000 veterans of these operations, with nearly 3,800 of those cases (over 10%) being female veterans. Data from the American Psychological Association shows that despite women in general being exposed to fewer traumatic events than men are four times as likely to be diagnosed with PTSD than men. Meanwhile, a pre-war study from the American Psychiatric Association showed that female veterans were less likely to be diagnosed with PTSD and substance abuse disorders, despite remarkably similar tests and symptoms. While the APA endorsed further training to help diagnose female veterans correctly, the probability is that these distortions in diagnoses are still present. Further, in addition to the PTSD risks of combat-related trauma, female soldiers in Iraq face ridiculously high risks of sexual trauma. A 2003 study showed that fully one-third of female veterans visiting the Veterans Administration for health care reported having been subject to rape or attempted rape during their service. Of that group, 37 percent said they were raped multiple times, and 14 percent reported they were gang-raped. And the Veterans Administration is badly unprepared to meet the steep increase in female veterans needing treatment.
There is positive movement, such as a newly approved $6 million study of PTSD among female veterans, the first VA study to focus exclusively on women. But the gap between need and available care is still very wide; f the some 1,400 V.A. hospitals and clinics, currently only 27 house inpatient PTSD programs, and of these, just 2 serve women exclusively. According to the VA, several more women's residential treatment programs are in the planning stages. And this progress is bound to be hampered by the policies of the Bush administration; despite increasing VA health-care financing by 9 percent for 2008, it has proposed consecutive cuts of about $1.8 billion for 2009 and 2010. And already the VA has a backlog of 400,000 benefits claims. Current policy will only make it harder to address critical problems.
This disparity in available inpatient treatment is cause for particular concern. Data shows that despite the greater needs for care for PTSD per capita, female veterans are less likely than male veterans to make use of outpatient treatment. Further, those female veterans who do seek treatment have are far more likely to seek treatment for non-mental health issues as well; this data suggests that female veterans are more likely to not be seeking treatment for various physical ailments as well. Class and gender role issues contribute to the problem and cannot be addressed merely by resolving failings in veterans health care, but we owe it to our female veterans to make sure that there is available and adequate treatment for all women seeking it.
This results not only in many female veterans not receiving the care they need at all, but also in their not receiving the care that can benefit them most. Earlier this year, the Journal of the American Medical Association released a study which showed that Cognitive Behavior Therapy was more than twice as likely than present-centered therapy (which is the predominant form of therapy used at VA centers) to result in the total remission of PTSD symptoms. In light of this evidence, it is essential that we not only provide equal treatment and access to care for female veterans, but that we provide them with the therapy that has the best chance of success. Instead, the VA has chosen to put much of its resources in failed attempts to see if norepinephrine blocking drugs such as Guanfacine and Propranolol can inhibit signal transduction trauma-induced enhancement of memory encoding due to excessive norepinephrine production. These studies have valid scientific merit despite their failures, but money spent towards those studies could be better employed on expanding the availability of CBT to veterans (of course, ideally, we could fund both the studies and the CBT programs – at an annual cost of about a day’s operations in Iraq).
Meanwhile, it is not only in PTSD where disparities exist for female veterans. Right now there are an estimated 8000 homeless female veterans, and that number is expected to rise significantly in coming years as more veterans from the current wars leave the service. Yet, out of the 260 programs in the National Coalition for Homeless Veterans' network that give counseling, shelter, and other services to homeless veterans, only eight have special programs for women. Meanwhile, female veterans are finding it particularly difficult to be part of the civilian workforce, which perhaps has something to do with the fact that female veterans are four times as likely to become homeless than other American women. With women making up 20% of all new military recruits, this is a problem that is going to grow exponentially if we do not address it now.
It is not my belief, nor is it my intention to assert, that these disparities are the result of deliberate discrimination against female veterans. The military was not prepared for the reality of the increased use of female soldiers in war, and the VA was likewise unprepared for the vast increase in treatment needs for female veterans. But as we all know by now, due to the work of many fabulous people (in particular our own Ilona Meagher), war does not end for our soldiers simply when they come home. Inadequate care for all of our veterans is a travesty, but inequal care for our female veterans cannot be tolerated by Americans who care not only about veterans, but about equality and equitable treatment.
The House Committee on Veterans Affairs can be reached at (202) 225-9756. Its members can be seen here.
The Senate Committee on Veterans Affairs Majority office can be reached at (202) 224-9126. Its members can be seen here and includes Presidential candidate Barack Obama and netroots candidates Jim Webb and Jon Tester.
I hope you will join me in calling on them for not only improved care for all of or veterans, but swift steps to ensure that female veterans do not face a disparity in their level of care. We have an extraordinary opportunity, with several strong Presidential candidates, to make sure that this issue gets the visibility it badly needs this election cycle. It is important that we let our leaders, and most importantly our candidates, know that not only improved care for all our veterans, but particular attention paid to the unserved needs of our female veterans, are key issues for us. And perhaps most importantly, you can contribute to or join the United Female Veterans of America, a non-profit organization formed in 2006 to help address these growing concerns.