On Veterans Day, The US And The VA Are Still Failing Women Veterans

How bad is the situation for women veterans? One in four VA facilities doesn't have a full-time gynecologist on staff, and some even lack women's restrooms. Yes, really.
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November 11, 2014
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As Veterans Day -- or Armistice Day -- is marked around the world, the usual flurry of pieces celebrating military service and reminding people to think of veterans is swelling up across the media. One group of veterans, however, is getting short shrift. Perhaps unsurprisingly, since the VA is giving them short shrift too.

Despite the fact that women are the fastest-growing group of U.S. veterans, actually increasing in number overall while the number of veterans is on the decline as survivors of Vietnam and the Second World War begin to die, they're less likely to access VA services. Moreover, women veterans are actually more likely to experience service-related health problems and disability.

If that sounds topsy-turvy to you, it should. It's time for women veterans to get the services they need, and the services they were promised in exchange for their service, whether they only completed one term of enlistment, or were career members of the military. As civilians and veterans alike mark the holiday today, it's important to consider women veterans -- and to remember them the other 364 days of the year, too.

How bad is the situation for women veterans? It starts with the lack of health care services for women at the VA. One in four VA facilities doesn't even have a full-time gynecologist on staff, and some even lack women's restrooms. (Yes, really.) This is a particularly acute problem in rural areas, where 920 community-based clinics are designated to fill gaps for veterans who would otherwise have to travel significant distances for care. 140 of these clinics do not have women's health care providers.

When women veterans are referred to outside facilities for services not provided at their local VA hospital or clinic, such as mammograms, prenatal care, and other basic needs, the VA doesn't always compensate them promptly (assuming they have the funds to pay for services in the first place), fights outside hospitals and bills, and may refuse to pay women their traveling expenses, although it is legally bound to. Furthermore, women are more likely to be placed on what's known as the Electronic Wait List, which bars women from accessing care for 90 days; again, despite the fact that women veterans are more likely to need health services than male veterans.

Many VA health care providers don't know how to handle patients going through menopause, seeking contraceptives, or needing care during pregnancy. They're also not aware of the importance of fertility issues among women seeking health services through the VA. Shockingly, one in two women veterans of childbearing age reports being given medications known to cause congenital impairments, in contrast with one in six through conventional insurers and health care providers. This may be related to the nature of the survey used and the fact that women vets are more likely to experience PTSD and mental illnesses because of their service -- psychiatric medications are infamous for causing problems with fetal development. However, even with that mitigating information, the study's findings are still grim.

While women veterans are still outnumbered by men, as they are in the armed forces as well, their ranks are growing. 15% of our current active duty military is female, and women make up 18% of the National Guard and Reserves. These numbers are projected to increase, which will lead to a mounting number of women veterans seeking services, yet currently only one in six women vets fully understands and takes advantage of the services available to her.

This isn't because women in the military lack the skills or ability to understand VA benefits. It's because transition services aren't targeted towards women, and the VA is failing to educate and reach out to women vets to make sure they're aware of what they're entitled to under the law. Gender-specific education, support, and training for women veterans is woefully lacking at the VA, despite pressure to increase services for women vets and make sure they can access them.

This is important not just on an intrinsic level, because women who served should be able to get health care. It's also important because women veterans experience a higher rate of health problems than male veterans, especially psychiatric problems related to their service, because exposure to interpersonal violence occurs at an extremely high rate for military women. In fact, there's a term specifically used to describe the violence military women experience: Military Sexual Trauma (MST). The exact rate of sexual violence in the military isn't quite known, because of poor reporting and prosecution rates, but it's believed to be higher than that in the civilian population, with serious mental health consequences including PTSD and an increased risk of depression, anxiety, and other mental health conditions.

Women aren't just more likely to experience sexual violence in the military. They're also more likely, overall, to be disabled than male veterans, with a growing number of female veterans going on full or partial disability. Some 56% of female veterans have musculoskeletal disorders, with 51% having endocrine and metabolic health conditions. 45% have mental health and substance abuse problems, while 37% experience cardiovascular disease and another 31% have reproductive health problems (some of which may be attributed to MST and mental health stress). Fibromyalgia and chronic fatigue are also common among women who've served, and the VA often refuses to pay out disability for them unless they meet very narrow criteria. That such large numbers of female veterans experience a broad assortment of often concurrent medical conditions is a testimony to the stresses of combat and military service.

This isn't an indicator that military women are somehow weaker or not up to the task when compared with men. Instead, it's an indicator that something is going seriously wrong when it comes to the military's support of women in the military as well as veterans. Women should not be experiencing medical problems at such an outrageously high rate, and because they are, the VA should be rising to the challenge to treat women and develop aggressive preventative care plans to help military women avoid or mitigate health problems before they start -- and one area to start is with a crackdown on military sexual assault and its subsequent serious health ramifications for victims/survivors.

The VA also faces a strange doublebind with women who have served in combat roles. The changing nature of modern warfare, and updates to outdated Pentagon policy, has resulted in gender parity on the front lines -- progress for women, but a step back in terms of their health care, because the VA is not prepared to treat women with combat injuries. Women are less likely to be fitted for prosthetics, for example, and more likely to have prosthetic limbs that don't fit properly. They're also more likely to be denied benefits based on service-related disabilities, because admitting that said disabilities are service-related could open a can of worms for the VA. Thus, issues like Traumatic Brain Injuries from explosions are attributed to other mysterious causes by the VA, forcing female vets to jump through hoops and be aggressive if they want to get compensation for their injuries.

For women veterans, accessing health services should be a snap, but it's not: In addition to the overall unconscionable clog at the VA that's delaying benefits for all veterans, they're facing additional obstacles to health care services. Even media that cover veterans issues year-round often glide over this issue, which makes it hard for women to gain traction in their push for medical services.

We should do better than this. We can do better than this. We owe it to women who have served in the military. So what do we do about it? For one thing, increase the profile of coverage on the health care problems and VA obstacles facing women vets, to ensure that the public is aware of the extent of the issue. For another, taking up pens and phones to contact representatives to lean on them, requesting intervention to improve services at the VA. If your representative happens to sit on the House Armed Services Committee or the Senate Armed Services Committee, you're in a particularly strong position as a direct constituent of a policymaker who can make a difference for military women; and it's worth noting that the U.S. didn't elect a woman veteran to Congressional office until 2012, with Tammy Duckworth.

As more and more women join the ranks of military veterans, these issues are only going to get worse if not addressed. It's time to do justice to military women and their service.