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On March 4, 1865, U.S. President Abraham Lincoln made a commitment to veterans, "To care for him who shall have borne the battle and for his widow, and his orphan." In Veterans Administration (VA) hospitals across the United States, these words have welcomed veterans. For military service members returning to civilian life, the words can evoke a sense of belonging and homecoming to something greater than themselves. Some years ago, as an honorably discharged female Airman, I walked past these words when I sought treatment at my local VA. Except I did not feel a sense of belonging or homecoming. Instead, I felt an all-too-familiar sting of invalidation and rejection. These words did not welcome me; they welcomed "him." Thousands of women veterans walk past these words every day, enduring a small slight in the larger struggle to be acknowledged.

That struggle to be acknowledged begins in one’s initial military training and persists across one’s service career. Cisgendered women service members learn, both implicitly and explicitly, that their feminine qualities are no longer desired (Maples, 2017). Some progress has been made in recent years on balancing the need for uniformity with individual necessity in terms of grooming standards. However, many male-centric notions persist in many aspects of military life, such as uniform standards, lack of emotional expression, traditional male social activities and overt displays of strength. These notions are some examples of the expectations placed on women that work to downplay conventional western notions of femininity and continue to signal that women must compete on a playing field designed by men, for men, if they want to succeed (Maples, 2017). The male standard becomes so ingrained that women do not realize they have absorbed the message that adding "female" to something diminishes it (Maples, 2017). In the interest of blending in, female service members must often strike a balance, conforming to traditional male sensibilities while also managing the reluctance to lose their feminine identity (Herbert, 1998). This process is made even more difficult for women subject to overt gender harassment, which military women perceive as more negative than sexual harassment (Rosen & Martin, 1998).

In effect, military women are encouraged to be part of a group while being constantly provided reminders that they will never be part of that group. Sexual harassment, sexual assault and the frequent instances of institutional betrayal following such incidents are among the more significant issues plaguing the military (Wood & Toppelberg, 2017). On a smaller scale, commissaries at deployment sites often still lack a variety of feminine care products. Women are often left out of experiences—especially those that foster bonding and a sense of "brotherhood”—because they are often placed in separate living quarters, sometimes completely alone. Despite these microaggressions, military women must go above and beyond what is expected of their male counterparts to prove their "toughness." Filing complaints is seen as a sign of weakness and neediness, especially if the complaint brings unwanted attention to the service member’s gender. This belief persists even in grave circumstances, such as deciding whether to report sexual harassment/assault. 

Military women engage in a parallel process upon transitioning to veteran life. Their direct and assertive way of speaking often makes their civilian female counterparts feel intimidated. They will once again be required to “blend in.” Sexual harassment (Fenwick et al., 2021) or lack of resources has led some VA hospitals to relocate their women’s clinic outside of the main hospital building, thereby reaffirming the women’s status as “outside of the group.”

As a newly separated Airman, I read the Abraham Lincoln quote and kept walking. Partly because I was accustomed to feeling unacknowledged and partly because the burden of managing the emotional gymnastics of “complaining” did not outweigh the very real likelihood that nothing would change. Now, as an early-career psychologist, I can acknowledge that we have come a distance since President Lincoln’s second inaugural address, and the VA has made great efforts to support its female veterans (e.g., more women’s clinics across VA hospitals, maternity care benefits, full-time medical staff dedicated to women, anti-sexual harassment campaigns). Yet, at times I struggle to remain optimistic when we have such a long way to go to make female veterans—and LGBTQ+ veterans—feel like these are their VA hospitals, too. (To read more direct quotes from female veterans see Washington et al., 2007).

At the time that President Lincoln made his speech, the statement was incredibly relevant; however, today, his pledge is needlessly exclusive, especially given the strides women have made in expanding their presence in the military, both in terms of the overall percentage of the armed forces they represent and in the increasing presence they have in traditionally male military occupational specialties. In fact, several veteran organizations petitioned the VA to change the motto to read “to care for those 'who shall have borne the battle' and for their families and survivors.” It made little progress in Congress.  

My hope lies, in part, in mental health providers. Change from the bottom can be as impactful as change from the top. If you work with female veterans, here are a few ways you can acknowledge their service:

  1. Advocate for appropriately staffed women’s clinics at all VAs, including psychologists and PTSD specialists.
  2. Provide a space for connection, peer support and “sisterhood” among female veterans. Develop women-only treatment groups and support groups. If your practice does not have that capability, know where you can refer them locally.
  3. Consult with an expert on female veterans, such as a Women Veterans Program Manager, about how you can improve your practice (e.g., adding female-specific elements, as appropriate, to your intake interviews, such as an interpersonal violence assessment and a reproductive health assessment).
  4. Help a female veteran enroll in VA health benefits by providing the contact information for the Women Veterans hotline: 1-855-VA-WOMEN (1-855-829-6636).
  5. Say “thank you for your sacrifice” to a female veteran on Veteran’s Day—or any day! Chances are she’s been mistaken for a veteran’s wife more than once.
  6. As appropriate, correct male veterans when they use non-inclusive language to describe service to country (e.g., “lots of brave men have fought to win the war against terrorism” can be reframed as “lots of brave service members have fought to win the war against terrorism”).

About the Author

Ana Abu-Rus, PhD, is a senior member of the Trauma Research Institute at Alliant International University and an unlicensed postdoctoral clinical psychology resident at Jerry L Pettis Memorial Veterans Hospital in Loma Linda, California. She is a former staff sergeant in the United States Air Force where she served seven years as an air traffic control watch supervisor. Her research centers around trauma, resilience, heart-rate variability, dissociation, and veterans. For questions or comments please email ana.aburus@gmail.com.

References

Fenwick, K. M., Golden, R. E., Frayne, S. M., Hamilton, A. B., Yano, E. M., Carney, D. V., & Klap, R. (2021). Women Veterans’ Experiences of Harassment and Perceptions of Veterans Affairs Health Care Settings During a National Anti-Harassment Campaign. Women's Health Issues.

Herbert, M. (1998). Camouflage isn’t only for combat: Gender, sexuality, and women in the military. New York, NY: New York University Press.

Maples, S. (2017). The inconvenience of being a woman veteran. The Atlantic.

Rosen, L., & Martin, L. (1998). Psychological effects of sexual harassment, appraisal of harassment, and organizational climate among U.S. Army soldiers. Military Medicine, 163, 63-67.

Washington, D. L., Kleimann, S., Michelini, A. N., Kleimann, K. M., & Canning, M. (2007). Women veterans' perceptions and decision-making about veterans affairs health care. Military Medicine, 172(8), 812-7. 

Wood, E. J., & Toppelberg, N. (2017). The persistence of sexual assault within the US military. Journal of Peace Research, 54(5), 620-633.