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Since September 11, 2001, more than 200,000 women have been deployed to Iraq in Operation Iraqi Freedom and to Afghanistan in Operation Enduring Freedom (Burrelli, 2012). The percentage of women veterans who have served in combat zones has increased from 7% since before the 1990s to 24% among those who have served since 1990 (Patten & Parker, 2011). Indeed, active duty military women comprise a unique group, exposed to a complex sociocultural environment in which they remain the minority.
 
Perhaps partially as a result of this complex environment, unwanted sexual contact among female service members is an important public health concern and has gained publicity in recent years. In particular, The Department of Defense 2012 Workplace and Gender Relations Survey of Active Duty Members reported an overall prevalence of unwanted sexual contact of 6.1% in women and 1.2% in men (Department of Defense, 2012). More recently, however, the 2014 RAND Military Workplace Study indicated that almost 5% of female service members experienced past-year sexual assault and almost 22% experienced past-year sexual harassment (National Defense Research Institute, 2014). As a comparison, male service members reported 1% and 6%, respectively (National Defense Research Institute, 2014). These numbers suggest that women in the military experience unique, gender-based stressors in their work environments.
 
Previous studies have identified numerous health-related consequences of unwanted sexual contact. Among studies examining female veterans, women with a history of sexual assault were more likely to experience depression, post-traumatic stress disorder, and substance use (Davis & Wood, 1999; Suris, Lind, Kashner, Borman, & Petty, 2004). Notably, however, one recently conducted qualitative study of U.S. service women deployed overseas indicated that being in a high-stress, sexist environment could facilitate unwanted sexual contact (Burns, Grindlay, Holt, Manski, & Grossman, 2014).  In particular, women in the military may face additional gender-related stresses as compared with men, such as elevated levels of stress due to sexual harassment (Vogt et al., 2011) and gender harassment (Kabat-Farr & Cortina, 2014), and greater levels of stress due to family separation and perceived loss of intimate relationships (Skopp et al., 2011). However, there is a lack of quantitative research on the association between military and gender-related stress with unwanted sexual contact.
 
Because of this, we conducted a study of existing data in order to help bridge the gap between women’s experience of unwanted sexual contact and what we know about military-related stressors (Stahlman et al., 2015). In particular, is it mental health, substance use, or stress related to the military environment that plays a primary role in female service members’ experiences of unwanted sexual contact?
 
Despite limitations, the Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel (HRBS) offers an opportunity to identify aspects of the active duty military environment that might facilitate unwanted sexual contact. Using data from over 7,000 active duty military women surveyed in the 2008 HRBS, we confirmed previous associations between mental health (e.g., depression, anxiety, posttraumatic stress disorder) and unwanted sexual contact. Perhaps more importantly, we identified strong positive associations of unwanted sexual contact with family/personal-life stress, military-related stress, and gender-related stress.
 
These associations have implications for the need to make military structural and cultural changes, in order to limit the amount of stress to which service women are exposed.  One potential way to accomplish this is by prohibiting the use of derogatory terms (e.g., “pussy” or “bitch”) that facilitate discrimination against women (Clemmitt, 2009). Further, although there are arguments against military gender integration, so far it has had no proven negative effect on military readiness (Clemmitt, 2009; Titunik, 2000). We suggest that further integration is necessary to create a cultural shift to reduce unwanted sexual contact.

Further, concerns regarding lack of confidentiality are likely to discourage reporting of unwanted sexual contact and should be taken into consideration for the improvement of reporting structures. One way that this has been handled by college campuses, an environment arguably similar to that of the military, is through the use of anonymous reporting systems. Some campuses also offer amnesty for victims who were in violation of other school policies when assaulted (e.g., while under the influence of drugs) (American Association of University Professors, 2012), which could potentially be applied to a military setting. Perhaps it is time to explore the feasibility of implementing an anonymous military reporting system. 

We believe that we owe it to the women who serve our country to continue to scrutinize the military environment and to explore and test new opportunities to reduce unwanted sexual contact. Based on our findings, we encourage a shift in military gender norms to reduce sexism, enhance strict sexual harassment policies, and refine reporting systems with effective investigation and prosecution procedures. These actions have the potential to make service women feel safer in their work environment and mitigate unwanted sexual contact (Bell, Street, & Stafford, 2014; Burns et al., 2014).

Link to the recently published JTS Article.
 

Discussion Questions

 
What has been done in other environments such as schools or workplaces to prevent sexual harassment? Which of these, if any, do you think could be translated to the military environment?
 
What could be done to increase gender equality and reduce gender-related stress in the military workplace?
 

Author Biography

 
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Shauna Stahlman, PhD, MPH
, is currently a postdoctoral fellow at the Johns Hopkins Bloomberg School of Public Health Department of Epidemiology. This article was written as part of her PhD dissertation at the UCLA Fielding School of Public Health.
 
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Alison B. Hamilton, PhD, MPH
, is a Research Health Scientist at the VA Greater Los Angeles Healthcare System and an Associate Research Anthropologist in the UCLA Department of Psychiatry and Biobehavioral Sciences. Her work focuses on women’s health and health services.
 

References

 
American Association of University Professors. (2012). Campus Sexual Assault: Suggested Policies and Procedures.  Retrieved November 22, 2014, from http://www.aaup.org/report/campus-sexual-assault-suggested-policies-and-procedures#note28

Bell, M. E., Street, A. E., & Stafford, J. (2014). Victims' psychosocial well-being after reporting sexual harassment in the military. Journal of Trauma & Dissociation, 15, 133-152. doi: 10.1080/15299732.2014.867563

Burns, B., Grindlay, K., Holt, K., Manski, R., & Grossman, D. (2014). Military sexual trauma among US servicewomen during deployment: a qualitative study. American Journal of Public Health, 104, 345-349. doi: 10.2105/ajph.2013.301576

Burrelli, D. F. (2012). Women in Combat: Issues for Congress.  Retrieved from http://www.fas.org/sgp/crs/natsec/R42075.pdf.

Clemmitt, M. (2009). Women in the Military. CQ Researcher (Vol. 19, pp. 957-980).

Davis, T. M., & Wood, P. S. (1999). Substance abuse and sexual trauma in a female veteran population. J Subst Abuse Treat, 16, 123-127.

Department of Defense. (2012). Workplace and Gender Relations Survey of Active Duty Members.  Retrieved from http://www.sapr.mil/index.php/research.

Kabat-Farr, D., & Cortina, L. M. (2014). Sex-based harassment in employment: new insights into gender and context. Law and Human Behavior, 38, 58-72. doi: 10.1037/lhb0000045

National Defense Research Institute. (2014). Sexual Assault and Sexual Harassment in the Military: Top-Line Estimates for Active-Duty Service Members from the 2014 RAND Military Workplace Study, from http://sapr.mil/index.php/research

Patten, E., & Parker, K. (2011). Women in the U.S. Military: Growing Share, Distinctive Profile. Pew Research Social & Demographic Trends. Retrieved from http://www.pewsocialtrends.org/2011/12/22/women-in-the-u-s-military-growing-share-distinctive-profile/2/#a-snapshot-of-active-duty-women

Skopp, N. A., Reger, M. A., Reger, G. M., Mishkind, M. C., Raskind, M., & Gahm, G. A. (2011). The Role of Intimate Relationships, Appraisals of Military Service, and Gender on the Development of Posttraumatic Stress Symptoms Following Iraq Deployment. Journal of Traumatic Stress, 24, 277-286. doi: 10.1002/jts.20632

Stahlman, S., Javanbakht, M., Cochran, S., Hamilton, A., Shoptaw, S., & Gorbach, P. (2015). Mental Health and Substance Use Factors Associated with Unwanted Sexual Contact among U.S. Active Duty Service Women. Journal of Traumatic Stress, In press.

Suris, A., Lind, L., Kashner, T. M., Borman, P. D., & Petty, F. (2004). Sexual assault in women veterans: An examination of PTSD risk, health care utilization, and cost of care. Psychosomatic Medicine, 66, 749-756. doi: 10.1097/01.psy.0000138117.58559.7b

Titunik, R. F. (2000). The first wave: Gender integration and military culture. Armed Forces & Society, 26, 229-+. doi: 10.1177/0095327x0002600204

Vogt, D., Vaughn, R., Glickman, M. E., Schultz, M., Drainoni, M. L., Elwy, R., & Eisen, S. (2011). Gender differences in combat-related stressors and their association with postdeployment mental health in a nationally representative sample of U.S. OEF/OIF veterans. Journal of Abnormal Psychology, 120, 797-806. doi: 10.1037/a0023452