Why many survivors choose not to report their experiences to protect themselves.

Advertisement

President Biden announced Friday that he supports a recommendation by the Independent Review Commission on Military Sexual Assault (IRC), which recently suggested that military sexual trauma cases be investigated and prosecuted outside the military chain of command.

"Sexual assault is an abuse of power and an affront to our shared humanity. And sexual assault in the military is doubly damaging because it also shreds the unity and cohesion that is essential to the functioning of the US military and to our national defense," President Biden said in a statement issued by the White House. The announcement comes after Secretary of Defense Lloyd J. Austin III released a statement earlier this month, recommending that President Biden remove "the prosecution of sexual assaults and related crimes from the military chain of command."

What-Is-Military-Sexual-Trauma-GettyImages-535055972-88995269
Credit: Getty / Photo Illustration by Jo Imperio

While this potential policy shift could help military sexual trauma survivors report their assaults more comfortably, they still face a unique set of challenges after being attacked.

There are multiple reasons for this: Individuals serving in the military are sometimes worried that if they report their assault, they'll be retaliated against, possibly physically—or that there won't be any consequences for their attacker and, therefore, reporting their assault is pointless. Health spoke to policy and mental health experts to find out how many people experience MST and what their treatment options are after serving.

What is military sexual trauma—and how common is it?

The Department of Veterans Affairs (VA) defines military sexual trauma (MST) as "experiences of sexual assault or repeated, threatening sexual harassment that a Veteran experienced during his or her military service."

It affects many people—mainly women—who serve in the US military: According to VA data, about one in three women and one in 50 men report experiencing MST while serving in the military, Margret Bell, PhD, VA national deputy director of military sexual trauma, tells Health. However, these numbers might not be 100% accurate, as they're based off the number of veterans who both access VA health care after serving and choose to report an incident, Lory Manning, retired captain in the US Navy and director of government operations at Service Women's Action Network (SWAN), a nonprofit advocacy group for military women, tells Health.

Regardless, the numbers are high, and haven't changed in a while. "The percentage of people, both men and women who are sexually assaulted, hasn't really budged since they began keeping the statistics," Manning says, adding that this happened over 10 years ago.

What health problems can military sexual trauma lead to?

Like any other sexual assault experiences, MST can cause a range of health conditions. Post Traumatic Stress Disorder (PTSD), depression, and substance abuse are three of the most common mental health conditions that affect sexual assault survivors, Kia-Rai M. Prewitt, PhD, a psychologist at Cleveland Clinic's Center for Adult Behavioral Health and former VA employee, tells Health.

Aside from those diagnosable health conditions are basic human emotions that sometimes take over after an attack. "With any person who experiences sexual trauma, oftentimes they experience feelings of shame and guilt," Prewitt says. Survivors often feel like it's their fault that they were attacked, she adds. "Sometimes people feel like if they [had] seen signs sooner, maybe something different would have happened, [but] oftentimes people who sexually assault others don't come with a sign on their head saying, 'I'm going to sexually assault you.'" Instead, attackers often gain the trust of those they assault beforehand. "Sexual assault is not uncommon for it to happen by someone you know," Prewitt explains.

Why is it so difficult for soldiers and veterans who've experienced military sexual trauma to report their experiences?

It can be difficult to come to terms with the fact that your attacker is a fellow member of the military, Laura Palumbo, communications director of the National Sexual Violence Resource Center, tells Health. "The fact [that] their job is to protect one another and keep one another safe—that is part of the betrayal," Palumbo says. Prewitt echoes this, saying, "In the military, they teach you're supposed to have each others' back, [but] it doesn't work out that way."

Workplace sexual assault in any capacity is incredibly difficult for the victim to navigate—but it can be all the more so for members of the military, which prioritizes a rigid chain of command. Soldiers are technically able to report their sexual assault to any commissioned officer, Manning says. However, sidestepping protocol and going around your superiors to report assault—which might be necessary if a superior is the one who has assaulted you—can cause anxiety to the survivor, Prewitt explains. "Already there's this fear: What could happen if I go around this person?"

The problem with the existing structure of reporting sexual assault to any commissioned officer is compounded by the fact that many soldiers don't know or understand that they can actually do this—and that reports must be leveled up, Manning adds. "You can report military sexual assault to any commissioned officer, [and] they have to take it forward," she says. "They can always skip the person in the chain of command who's assaulting them [and] go to that person's boss. They just don't know they can." Manning says that ways to report sexual assault—without involving the attacker(s)—need to be continuously communicated to active duty members of the military so they know their options should they need them.

But Manning says that survivors of MST aren't wrong to be worried about retaliation when they report their experience. And "retaliation" in this context doesn't just mean repeated assaults—it could mean whether or not you're permitted to take leave over the holidays to visit your family. Even though retaliatory acts resulting from a report of sexual violence are a huge problem in the military, officers rarely get punished for them. "People get away with it. I've never even heard of anybody taken to task over retaliation, [and] it's very common," Manning says.

Aside from retaliation, MST survivors might also worry about what speaking up might do to their team. "They can feel the pressure of how reporting could impact their unit's cohesion—the other soldiers in their unit, as well as the fact that they might need to live and work with the person who has perpetrated against them," Palumbo says, adding that these considerations add insult to injury to someone who's already grappling with the trauma of having been abused: "Those are factors that really compound the trauma of sexual assault."

And while it's difficult for anyone to report MST, it can be especially difficult for men to divulge that information, Prewitt says, in part because of the culture of masculinity the military emphasizes. "We think of the military as this hyper-masculine field [that provides] a lot of reinforcement of what it means to be masculine, to be a man," she says. "A lot of men who experience military sexual trauma feel a lot of shame, a lot of embarrassment. If they ascribe to these traditional male gender roles, they may see themselves as weak, that they weren't 'strong enough.'"

What do MST survivors need to know?

Many soldiers never report their MST experiences. But advocates want veterans and active members of the military to know that mental health resources are always available to them if they've experienced MST.

For those looking to access mental health treatments following MST, a good starting point is your local VA center, Bell says, explaining that staffed at each VA facility is an MST point person who can help you get the treatment you need.

Experts warn that it's important to get help when you need it, even if that realization comes years after the actual experience of MST. Some survivors don't even understand that they have PTSD until years after the traumatic incident, Prewitt says, adding that MST can cause lifelong suffering if the survivor doesn't receive the proper treatment. "I worked with quite a few people who experienced military sexual trauma, [and] it's just painful for a lot of people. There's a lot of anger, frustration with the system," Prewitt says. And new stories about MST that survivors hear on the news or elsewhere could be re-triggering, Manning warns. Which is all the more reason to reach out to your local VA for help, especially if you've been experiencing suicidal thoughts, self-harming practices, or you're scared when in the presence of other people, Prewitt says.

Importantly, at the VA, you don't have to make a case for yourself to receive help for mental health conditions caused by MST, Bell says, explaining that veterans need not provide documentation or proof of any kind that they were assaulted. "You don't need evidence," she says. Additionally, anyone who has served can come forward to get help if they experienced MST, not just those who served for a certain amount of time. While some benefits are accessible only if you served for at least two years, that doesn't apply here, Manning says. For instance, she explains, if you experienced MST during boot camp—and didn't even make it through boot camp—you can get help from a local veterans' center.

If you suspect that a veteran or soldier in your family experienced MST and is suffering, you can reach out to the VA as the family member of a military member and ask for advice and guidance on what to do next, Manning says.

For more on resources for military sexual trauma survivors, visit: https://www.mentalhealth.va.gov/msthome/ or call the National Sexual Violence Hotline at 800-656-HOPE (4673)