ATrain Education

 

Continuing Education for Health Professionals

Sexual Trauma in the Military

Module 2

The Military’s Two-fold Challenge

The military faces a two-fold challenge because it must confront and deal with sexual violence that occurs among those on active duty and it must also deal with the results of that sexual violence as they manifest among those who have left active duty and joined the community of veterans. Survivors still on active duty and veterans face similar yet different effects, and complications of sexual trauma can affect physical health, mental health, working relationships and career trajectories, personal relationships, and even the ability to acquire and retain food and shelter—the basic needs of life.

For those on active duty there is a mechanism for reporting sexual violence but many victims do not make reports, for a variety of reasons that will be discussed here. All veterans who seek care at VA health centers are screened for experiences of sexual violence while they were on active duty. Whether or not incidents were reported at the time they happened can affect later outcomes for the survivors, positively and negatively.

For the military, the point at which the problem is being addressed will affect how it is defined and who is responsible for managing it, as well as the range of responses available.

Department of Defense (DoD)

Sexual violence involving active duty service members is handled by one of several Department of Defense programs. If the report is one of sexual assault by an adult against an adult then the Sexual Assault Prevention and Response (SAPR) program is the responsible entity. Sexual assault between spouses or intimate partners comes under the Family Advocacy Program (FAP). Complaints of sexual harassment are handled through the Office of Diversity Management and Equal Opportunity (ODMEO) (SAPRO, 2017; SAPRO, n.d.-4).

Definitions Used by DoD

The Sexual Assault Prevention and Response Office (SAPRO) establishes the broad policy for DoD “guided by five critical focus areas”: prevention, victim assistance, investigation, accountability, and assessment. Prevention is a critical element of the wider policy because it is seen as the means to end sexual violence of any kind and comply with the “zero tolerance” directive given by the secretary of defense in 1994 (SAPRO, 2017; VA, 2004).

Sexual assault includes rape, sexual assault, forcible sodomy, aggravated sexual contact, abusive sexual contact, and attempts to commit these offenses.

Sexual harassment involves unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when:

  • Submission to such conduct is made either explicitly or implicitly a term or condition of a person’s job, pay, or career, or
  • Submission to or rejection of such conduct by a person is used as a basis for career or employment decisions affecting that person, or
  • Such conduct has the purpose or effect of unreasonably interfering with an individual’s work performance or creates an intimidating, hostile, or offensive environment (SAPRO, 2017, Appendix H).

The DoD makes the distinction between sexual assault and sexual harassment because, while acknowledging that there is a clear relationship between the two, “behaviors that constitute sexual harassment do not always rise to the level of criminal misconduct” and it “requires a different response than the crime of sexual assault” (SAPRO, 2017).

Department of Veterans Affairs (VA)

When service members who were affected by sexual violence while on active duty retire and seek care at any facility of the Department of Veterans Affairs (VA) Veterans Health Care Administration (VHA), VA is the responsible agency.

Definitions Used by VA

Military Sexual Trauma (MST) is “experiences of sexual assault or repeated, threatening sexual harassment that a Veteran experienced during his or her military service.” This definition is taken from federal law (Title 38 US Code 1720D), and is “psychological trauma, which in the judgment of a VA mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty, active duty for training, or inactive duty training.” Sexual harassment is further defined as “repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character” (VA, 2015).

MST includes any sexual activity where the service member was involved against his or her will. This includes having been:

  • pressured with threats of negative consequences or implied better treatment, or
  • unable to consent (such as when intoxicated, asleep, or unconscious), or
  • physically forced into sexual activities.

Other experiences that are considered MST include unwanted sexual touching or grabbing; threatening, offensive remarks about a person’s body or sexual activities; and threatening and unwelcome sexual advances.

“The identity or characteristics of the perpetrator, whether the service member was on or off duty at the time, and whether he or she was on or off base at the time, do not matter. If these experiences occurred while an individual was on active duty, active duty for training, or inactive duty for training, they are considered by VA to be MST” (VA, 2015).

VA is careful to point out that “MST is an experience, not a diagnosis.” VA’s focus is on providing trained screening for MST and offering a range of appropriate treatment options for any veteran who was affected by MST regardless of the veteran’s disability status (VA, 2015).

Key Events of the Last Thirty Years

Military sexual violence is, of course, not new, but a changing social focus and the steadily increasing participation of women in all branches of the service fueled a new interest in what the military was or was not doing to deal with that violence.

 

Sources: (VA, 2004; SAPRO, n.d.-1; Lawhorne-Scott et al., 2014; CRS, 2013; Anderson & Suris, 2013; Tilghman, 2016; Kimerling et al., 2007).

Key Events for DOD and VA since 1990/1991

Year

Event

1991

US Navy Tailhook scandal

1992

Hearings before the Senate Veterans Affairs Committee

 

Veterans Health Care Act of 1992 (Public Law 102-585) mandated free counseling for women Veterans with MST (contains definition of MST)

1994

Veterans Health Programs Extension Act of 1994 (Public Law 103-452) extended services to men; required VA to screen all veterans for MST

1994

Secretary of Defense establishes a “zero tolerance” policy for sexual harassment and all branches had to make their policies compliant

1996

Scandals at: Army’s Aberdeen Proving Ground in Maryland, Ft. Leonard Wood in Missouri

2003

Scandal at the Air Force Academy in Colorado

2004

Veterans Health Program Improvement Act of 2004 (Public Law 108-422) made treatment services for MST a permanent benefit; extended benefit to those who had been on “active duty for training”

2004

Secretary of Defense directs a review of DoD’s process for treatment and care of victims of sexual assault throughout the military and by the end of the year task force recommendations are implemented and in

2005

Sexual Assault Prevention and Response Office (SAPRO) is formed as the DoD’s single point of authority for enforcing the policy across all branches of the military

2011

Ike Skelton National Defense Authorization Act for Fiscal Year 2011 (Public Law 111-383) requires DoD to provide Congress with an annual report on the number of sexual assaults in the military

2012

Release of documentary The Invisible War

 

2012 National Defense Authorization Act requires a standardized response to victims and more professionalized victim advocacy roles

2013

Scandals at West Point, the Naval Academy, and an Air Force Joint Base in Texas

2014

National Defense Authorization Act for Fiscal Year 2014 includes more protection for whistleblowers, extension of victims’ rights, and numerous other changes

 

In 1991 the U.S. Navy’s Tailhook incident and the subsequent 1992 hearings before the Senate Veterans Affairs Committee brought to the fore the issue of female veterans who had been traumatized by sexual harassment and assault while on active duty. In 1992 legislation was passed mandating healthcare services for women who had experienced MST, and in 1994 the law was extended to cover men who had experienced MST. In 1999 a new law extended the VA authority to provide counseling and treatment for sexual trauma through December 31, 2004, and mandated that the Military Sexual Trauma Program in VA continue (VA, 2004).

Also in 1994, the Secretary of Defense established a zero tolerance policy for sexual harassment, and all branches of the service had to evaluate and, if necessary, modify their policies against sexual harassment to make them compliant with the new guidelines. Additional scandals in 1996 at the Army’s Aberdeen Proving Ground in Maryland, and at Ft. Leonard Wood in Missouri, and again in 2003 at the Air Force Academy in Colorado, signaled a continuing problem.

In February 2004, the Secretary of Defense directed a review of the DoD’s process for treatment and care of victims of sexual assault in all branches of the military. A task force gathered information and submitted recommendations. Another task force was established to be the single point for accountability in creating a new sexual assault policy.

Acting on recommendations from the original task force and a congressional mandate, the DoD sent a comprehensive policy on prevention of and response to sexual assault to Congress in January 2005. The policy became permanent in October and the task force transitioned into the Sexual Assault Prevention and Response Office (SAPRO), which is the DoD’s single point of authority for enforcing the policy across all branches of the military, as well as a resource point and training provider (SAPRO, n.d.-1).

Most improvements to the program came about in 2012 and later (DoD, 2017) with at least some of them pushed along by the release of an award-winning documentary entitled The Invisible War, which focused on sexual assault in the U.S. military. It helped to highlight the wide disparity between reported incidents and actual incidents and also between incidents reported and perpetrators convicted. The film argued that in most cases the military promised far more than it delivered in terms of solving the problem and caring for its victims. Additional scandals in 2013, including at West Point, the Naval Academy, and an Air Force Joint Base in Texas, led to public outrage, Congressional hearings, and more pledges to improve (Lawhorne-Scott, 2014).

Legislation proposed in Congress in 2013 would have removed prosecution of sexual assault cases from the chain of command but it met with opposition from the military and was never passed. However, new regulations were put in place that were intended to offer more support to alleged victims, standardize handling of cases, and ensure that senior commanders were made aware of every reported incident (Lawhorne Scott, 2014).

After the Persian Gulf War, more attention was focused on the kinds of stress that impact women service members—both from military service itself and as related to sexual harassment and abuse. A 1998 study that included women service members from World War II, Korea, Vietnam, and the Persian Gulf era, suggested that “both sexual stress and duty-related stress contribute separately and significantly to the development of PTSD. The researchers noted that their findings were consistent with their earlier study of Vietnam War female service members and with other studies for the Persian Gulf era (Fontana & Rosenheck, 1998).

The renewed focus on sexual trauma in the military (among active duty personnel and veterans) is linked to events in the larger society, raises important questions and concerns, yet has also reinforced knowledge that the problem has existed for a long time and has affected a great many male service members over the years. In Understanding and Treating Military Sexual Trauma, Kristen Zaleski observes that “The political attention of military sexual trauma (MST) experiences a kind of ‘episodic amnesia’” in this country and that leaders—political and military—only act when pressured by “scandal or media scrutiny” (Zaleski, 2015).

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