Sexual assault is a pervasive problem in the United States, including in the Armed Forces. Public beliefs and attitudes about sexual assault lead to complacency and acceptance of a “rape culture” in the United States where rape is normalized, excused, tolerated, and even condoned. This acceptance creates an environment that makes it nearly impossible for sexual assault victims, in both the military and civilian systems, to obtain justice and discourages them from reporting and seeking help.

Both men and women are victims of sexual assault perpetrated by military service members. However, nearly 25% of women veterans who seek health care services from the Department of Veterans Affairs report experiencing at least one sexual assault while in the military compared to slightly more than 1% of male veterans. Women who enter the military at younger ages, those of enlisted rank, and those who experienced sexual assault prior to entering the military, appear to be at increased risk of sexual assault while in the military.

Victims of sexual assault in the military do not report the assault for many of the same reasons as victims outside of the military, embarrassment, fear, shame, etc. However, in addition, less separation exists between a person’s private and professional lives in the military. That creates fear that others will find out and that they will be perceived as weak and unable to accomplish the mission. They fear this might affect promotion and assignment to good jobs or lead to separation from the military.

A sexual assault victim in the military may make a “restricted report” that allows disclosure to specified individuals (i.e., sexual assault response coordinator (SARC), sexual assault prevention and response victim advocate (SAPR VA), or healthcare personnel). The victim can receive medical treatment, including emergency care, counseling, and assignment of a SARC and SAPR VA, without triggering an official investigation. However, exceptions limit the ability to make a restricted report.

A victim may also make an “unrestricted report” without requesting confidentiality or restricted reporting. Under these circumstances, the victim’s report provided to healthcare personnel, the SARC, a SAPR VA, command authorities, or other persons is reported to law enforcement and may be used to initiate the official investigative process.

When an unrestricted report is made, the alleged offender’s commanding officer has a great deal of discretion about what action to take. He/she may take disciplinary, administrative, or legal action against the offender. He/she may also decide to administratively separate the service member from the military. As in the civilian system, many people feel that sexual assault offenders in the military are often not held accountable, which has the effect of minimizing, excusing, and condoning sexual assault and reinforcing sexist attitudes and behavior toward women.

The military can and sometimes does take disciplinary or legal action against sexual assault survivors for infractions committed related to the sexual assault (underage drinking, fraternization, adultery). In addition, survivors have been separated from the military for mental health or disciplinary reasons, and they have limited recourse when this occurs. This and other negative actions directed at survivors are often perceived as retaliation for reporting and can have devastating effects on the survivor’s sense of safety, trust, and well-being and lead to a complex array of problems that affect the survivor’s future significantly beyond leaving the military.

Congress has taken many legislative actions through the National Defense Authorization Act over the past several years to strengthen and improve the response to sexual assault in the military. The Department of Defense has also made many policy changes. However, some have argued that unless the prosecution decision-making power is taken out of the hands of commanding officers, other changes will not result in the type of systemic and cultural changes that are needed to eliminate sexual assault in the military.

Active duty sexual assault survivors have access to health and mental health care within the military system. There is a Sexual Assault Prevention and Response Program guided by Department of Defense regulations on each installation. Every command has a SARC and SAPR VAs available to provide advocacy and support for survivors. When a person leaves the military, services for sexual assault survivors are available within the Department of Veterans Affairs and in community-based programs.

Military Sexual Trauma and the Department of Veterans Affairs (VA)

Sexual assault survivors experience myriad long-term health and mental health consequences from that trauma. They may struggle with anger, guilt, shame, inability to trust, self-blame, etc. They often experience mental health issues such as post-traumatic stress disorder (PTSD), other anxiety disorders, depression and substance abuse. This can lead to unemployment, homelessness, disruption of interpersonal relationships, further victimization, physical problems, and suicide.

The Department of Veterans Affairs is the largest health care system in the country. A veteran is a person who has served in any branch of the military. Not all veterans are eligible for VA benefits and health and mental health care from the VA. Generally, they must meet the VA eligibility requirements. Survivors of military sexual assault include both male and female veterans, but nearly a quarter of women veterans who seek health care from the VA report experiencing at least one sexual assault while in the military (1.2% of male veterans).

The VA definition of “military sexual trauma (MST)” 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 or active duty for training.” (38 U.S.C. 1720D)

This definition includes sexual harassment as well as sexual assault.

The VA has MST Coordinators at all VA medical centers throughout the country. Currently, the VA provides all health care for mental and physical health conditions related to MST free of charge. Veterans do not need to have a service-connected disability or be seeking disability compensation to be eligible for MST-related counseling and care. Veterans also do not need to have reported such incidents to the Department of Defense or possess documentation or records to support their assertion of having experienced such trauma. The determination of whether a veteran’s condition is MST-related is strictly a clinical determination made by the responsible VA mental health provider. Finally, veterans need not be enrolled in VA’s health care system to qualify for MST-related treatment, as it is independent of VA’s general treatment authority.

Through the VA, survivors can access a variety of services to address needs related to their experiences of violence, including medical and mental health care, trauma-informed therapies, and links to supportive social work services for housing and employment counseling. Women veterans have the benefit of access to both community-based civilian services and VA-based services. Community-based civilian services may provide more specialized trauma-informed care. VA-based services may be more sensitive to the particular needs of women veterans and may be able to link patients to care both within and outside the VA. However, women veterans are not always comfortable seeking services from the VA and do not always perceive the VA as being friendly to women veterans.

The threshold for documentation required to determine eligibility for VA disability compensation for PTSD related to MST is currently higher than what is required for combat-related PTSD. This results in many MST survivors being denied VA disability compensation for the sexual trauma and co-occurring health and mental health conditions that are often part of the aftermath of sexual assault.

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