Thank You for Hearing My Voice – Listening to Women Combat Veterans in the United States and Israeli Militaries

The military service of combat soldiers may pose many threats to their well being and often take a toll on body and mind, influencing the physical and emotional make-up of combatants and veterans. The current study aims to enhance our knowledge about the combat experiences and the challenges that female soldiers face both during and after their service. The study is based on qualitative methods and narrative analysis of in-depth semi-structured personal interviews with twenty military veterans. It aims to analyze the narratives of American and Israeli female combat soldiers regarding their military service, with emphasis on the soldiers’ descriptions, in their own words, about their difficulties, challenges, coping and successes during their service and transition to civilian life. A recurring theme in the interviews with the veterans of both militaries was the need to be heard and the fact that societies, therapists, and military institutions do not always truly listen to female veterans’ experiences and are not really interested in what actually ails them. Our research suggests that conventional methods used in research relating to veterans might at times be inadequate, because the inherent categorization might abstract, pathologize, and fragment a wide array of soldiers’ modes of post-combat being. Moreover, female veterans’ voices will not be fully heard unless we allow them to be active participants in generating knowledge about themselves.

“It’s a sign of weakness:” Masculinity, Help-Seeking Behaviors, and Gender-Specific Experiences Accessing VA PTSD Care

Background: Male veterans delay post-traumatic stress disorder (PTSD) treatment and are less likely to engage in help-seeking behaviors or receive adequate mental health treatment. Male veterans face additional stigma seeking mental health care due to traditional masculine ideologies perpetuated by military culture. This study presents the gender-specific perspectives of veterans accessing VA PTSD care, focusing particularly on the help-seeking behaviors and barriers to care experienced by male veterans. Methods: Semi-structured interviews were conducted with 25 U.S. veterans seeking treatment in VA primary care. Qualitative data analysis was coded using Atlas.ti, and thematic analysis was used to develop and refine themes. This study is part of a larger study examining veterans’ initiation of PTSD treatment. Results: Findings indicate that male veterans may be reluctant to initiate PTSD care due to stigma, distrust of the military or mental health care, and a desire to avoid reliving their trauma. Social support may encourage help-seeking behaviors among this population. Both male and female veterans reported a need for non-combat PTSD care and resources for military sexual trauma (MST). Conclusions: Findings indicate that male veterans face unique challenges accessing mental health services and PTSD treatment, while both male and female veterans may benefit from increased VA services focused on MST and non-combat specific PTSD.

Exploring the impact of gender-specific challenges during and after military service on female UK Veterans

LAY SUMMARY Currently, research on the experiences and challenges of being female in the UK Armed Forces is lacking. The current study aimed to explore some of the challenges and obstacles women have experienced both during their military service and as Veterans. In total, 750 female Veterans from the army were surveyed on their experiences during their military service and as Veterans and on their current physical and mental health problems. The results indicate that women experience several gender-based challenges, such as sexism and discrimination, during military service and as Veterans, and these challenges are linked to current physical and mental health difficulties.

Suicide among Scottish military veterans: follow-up and trends

ObjectivesThe risk of suicide among UK military veterans remains unclear. Few recent studies have been undertaken, and most studies found no clear evidence of increased risk. We used data from the Trends in Scottish Veterans Health cohort to investigate suicides up to 2017 in order to examine whether there have been any changes in the long-term pattern of veteran suicides since our earlier study to 2012, and to compare trends in the risk of suicide among veterans with matched non-veterans.MethodRetrospective cohort study of 78 000 veterans and 253 000 non-veterans born between 1945 and 1995, matched for age, sex and area of residence, using survival analysis to examine the risk of suicide in veterans in comparison with non-veterans overall and by subgroup, and to investigate associations with specific mental health conditions.ResultsUp to 37 years of follow-up, 388 (0.5%) veterans and 1531 (0.6%) non-veterans died from suicide. The risk of suicide among veterans did not differ from non-veterans overall. Increased risk among early service leavers was explained by differences in deprivation, and the previously reported increased risk in female veterans is now confined to older women. Suicide was most common in the fifth decade of life, and around 20 years postservice. A history of mood disorder or post-traumatic stress disorder was non-significantly more common in veterans.ConclusionsVeterans are not at increased risk of suicide overall. The highest risk for both men and women is in middle age, many years after leaving service.

Sex-specific differences in physical health and health services use among Canadian Veterans: a retrospective cohort study using healthcare administrative data

IntroductionMilitary occupations have historically been, and continue to be, male dominated. As such, female military Veteran populations tend to be understudied, and comparisons of the physical health status and patterns of health services use between male and female Veterans are limited outside of US samples. This study aimed to compare the physical health and health services use between male and female Veterans residing in Ontario, Canada.MethodsA retrospective cohort of 27 058 male and 4701 female Veterans residing in Ontario whose military service ended between 1990 and 2019 was identified using routinely collected administrative healthcare data. Logistic and Poisson regression models were used to assess sex-specific differences in the prevalence of select physical health conditions and rates of health services use, after multivariable adjustment for age, region of residence, rurality, neighbourhood median income quintile, length of service in years and number of comorbidities.ResultsThe risk of rheumatoid arthritis and asthma was higher for female Veterans compared with male Veterans. Female Veterans had a lower risk of myocardial infarction, hypertension and diabetes. No sex-specific differences were noted for chronic obstructive pulmonary disease. Female Veterans were also more likely to access all types of health services than male Veterans. Further, female Veterans accessed primary, specialist and emergency department care at greater rates than male Veterans. No significant differences were found in the sex-specific rates of hospitalisations or home care use.ConclusionsFemale Veterans residing in Ontario, Canada have different chronic health risks and engage in health services use more frequently than their male counterparts. These findings have important healthcare policy and programme planning implications, in order to ensure female Veterans have access to appropriate health services.

The Impact of Post-Traumatic Stress on Symptom Presentation of Women With Gulf War Illness

Background: Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder characterized by fatigue, muscle pain, cognitive problems, insomnia, rashes, and gastrointestinal issues affecting an estimated 30% of the ~750,000 returning military Veterans of the 1990–1991 Persian Gulf War. Female Veterans deployed to combat in this war report medical symptoms, like cognition and respiratory troubles, at twice the rate compared to non-deployed female Veterans of the same era. The heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. This is exacerbated by the presence of co-morbidities. Defining subgroups of the illness may help alleviate these complications. One clear grouping is along the lines of gender. Our aim is to determine if women with GWI can be further subdivided into distinct subgroups based on post-traumatic stress disorder (PTSD) symptom presentation.Methods: Veterans diagnosed with GWI (n = 35) and healthy sedentary controls (n = 35) were recruited through the Miami Veterans Affairs Medical Health Center. Symptoms were assessed via the RAND short form health survey, the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson trauma scale value and performing heteroscedastic t-tests across all measures.Results: Based on the distinct differences found in PTSD symptomology regarding all health and trauma symptoms, two subgroups were derived within female GWI Veterans. Hierarchical regression models displayed the comorbid effects of GWI and PTSD, as both conditions had measurable impacts on physical and social outcomes of poor health (ΔR2 = 0.08- 0.672), with notable differences in mental and emotional measures. Overall, in women with GWI individuals with PTSD, a cut point analysis indicated poorer health outcomes within all measures in comparison to those of women without PTSD symptoms and healthy controls.Conclusions: Our current findings support the understanding that comorbid symptoms of GWI and PTSD subsequently result in poorer experienced health outcomes, along with establishing the possibility of varying clinical presentations.

G.I. Jane Goes to College? Female Educational Attainment, Earnings, and the Servicemen’s Readjustment Act of 1944

The 1944 Servicemen’s Readjustment Act (the “G.I. Bill”) provided returning WWII veterans with educational benefits sufficient to cover tuition, fees, and living expenses at almost any U.S. university or college. While several studies examine subsequent educational attainment and earnings for male veterans, little is known about how the G.I. Bill affected the 330,000 American females who served in WWII. Using data from the 1980 5 percent Census Public-use Microdata Sample, I find that female WWII veteran status is associated with a 19 percentage point increase in the proportion who report any college attendance, a 7.8 percentage point increase in college completion, and earnings that are 19.8 percent greater relative to comparable females who are not veterans. Because service was entirely voluntary for females, I use service eligibility requirements, enlistment records, 1940 Census data, and the G.I. Bill’s retroactive nature to establish a causal relationship among veteran status, educational attainment via the G.I. Bill, and increased earnings. To help separate the effect of the G.I. Bill from the effect of military service itself, and because benefits increased with longer service, I instrument for female veterans’ educational attainment using age at the time of the G.I. Bill’s announcement. My instrumental variables estimates imply that female veterans’ earnings increase by $1,350 (11.6 percent) per year of G.I. Bill-induced education, explaining 73 percent of the overall difference between veteran and non-veteran females’ earnings in 1980.