1. Violence Against Women in the Military
Martin Donohoe

2. Outline Definitions History Data
Characteristics of abuse victims/perpetrators
Consequences of abuse (including PTSD)
Recent developments (DOD Review, Iraq/Afghanistan, available programs)
Advice for female armed services members
Reducing VAW in the military

3. Violence Against Women
Direct: physical, sexual, emotional
Global health burden comparable to that of HIV, tuberculosis, and cardiovascular disease
Institutional: social, legal, educational, and political marginalization

4. Rape as a War Crime Common
Comfort women (WW II Japan)
Sudan
Rwanda
Bosnia
etc.
Notions of war/militarism and excessive “masculinity”

5. Violence Against Women Around Overseas U.S. Bases
> 200,000 incidents involving military personnel and Japanese nationals (male and female) since 1952 (> 1000 deaths)
> 300 rapes of Japanese citizens committed by U.S. personnel since 1945
Adverse effects on military agreements, support for U.S. troops

6. Women in the U.S. Military
More than 210,000 women are on active US military duty
1.8 million female veterans (out of 23 million total veterans) – 425,000 getting at least some care through VA
Almost 60,000 female troops have been deployed in Iraq and Afghanistan
1 in 7 US military personnel in Iraq is female

7. Victims Active duty troops Army > Marines > Navy > Air Force
Female, civilian spouses of active duty personnel

8. 1991 Tailhook Scandal
>100 officers at a Navy convention sexually assaulted and harassed dozens of women
None convicted
Investigation found that Navy brass had tacitly approved such behavior for years

9. Other Reports of Violence
1996: Sexual assaults at Aberdeen Proving Ground in Maryland led to charges against a dozen Army drill instructors
several officers reprimanded
2004: 3 returning veterans who had served in Special Forces in Afghanistan killed their spouses
Other homicides, suicides among returning vets since

10. Violence and Homicides
: >10,000 cases of spouse abuse per year occurred in the armed forces
14 homicides
Likely a large underestimate (e.g., girlfriends not counted, under-reporting)
: 218 domestic murders in the US military

11. Violence
22% of active duty military women report physical abuse and/or sexual assault while in the service
2004 Pentagon survey of the 3 military academies: 1/7 female cadets had been a victim of sexual abuse during the previous 5 years
Only 1/3 of incidents reported

12. Violence
2004 DOD study:
7.4% of Air Force Academy cadets reported that they were victims of rape or attempted rape

13. Sexual Assault U.S. Navy Study: Female victims Attempted rape (9%)
Completed (36%) rape
Male perpetrators
Attempted rape (4%)
Completed rape (11%)

14. Violence
: 18% increase in alleged sexual assaults committed by U.S. service members
Pentagon acknowledges 80% of rapes never reported
Child maltreatment more common during deployments
Suggests victims becoming perpetrators

15. Sexual Assault
Completed and attempted sexual assaults much more common among female soldiers than among other government employees

16. Violence
National phone survey of 558 Vietnam (and subsequent era) women veterans (response rate 96%)
48% admitted experiencing interpersonal violence during military service, including rape (30%), physical assault (35%), or both (16%)
5% reported repeated rape
5% gang rape

17. Violence Baltimore VA study (response rate 52%)
68% reported at least 1 form of abuse
Sexual abuse (55%)
Physical abuse (48%)
Rape (41%)
All 3 (27%)
National sample of women Veterans’ Administration (VA) outpatients
23% reported military-related sexual assault

18. Violence VA Study (191 inpatients; 411 outpatients)
24% under age 50 report domestic violence in the past year (7% over age 50)
90% under age 50 report a history of sexual harassment (37% over age 50)

19. Female Perpetrators
Female on male violence more common in military than among civilians
Moderate aggression: 13% vs. 10%
Severe aggression: 4.4% vs. 2%
LGBT violence under-reported
Lack of provider awareness
Don’t ask / don’t tell
One study found higher percentages of aggression among female ADM than among male ADM

20. Common Characteristics of Abuse Victims
low self-esteem
guilt
self-blame
denial
traditional attitudes regarding women’s roles
have children
poor financial resources
few job skills
less education
few friends
history of childhood abuse

21. Common Characteristics of Abusers
low self-esteem
dependency
jealousy
poor communication skills
unemployed/underemployed 21

22. Common Characteristics of Abusers
abuse alcohol/other drugs
have witnessed or experienced abuse as children
if immigrants, are more likely to have been victims of political violence
abuse their own children

23. Frequent family separations Dangerous work assignments
Military families face unique stressors, which increase the risk for family violence
Relocations
Long work tours
Frequent family separations
Dangerous work assignments

24. Combat stress and PTSD increase likelihood of males perpetrating abuse
Veterans with combat exposure and PTSD have more marital problems
1/3 of male veterans with PTSD engage in partner violence
Rate 2-3X higher than that for non-PTSD veterans and non-PTSD civilians

25. Health Consequences Victims suffer higher rates of:
chronic pelvic pain
dysmenorrhea
abnormal periods
PMS
dissatisfaction with sexual relations

26. Victims More Likely to Report
Chronic health problems
Lower health-related quality of life
Prescription medication use for emotional problems
Failure to complete college
Annual income < $25,000
Depression (3X higher rate)
Alcohol abuse (2X higher rate)

27. Victims More outpatient visits Poorer self-rated health status
History of childhood violence and post-military violence more common

28. Victims High levels of secondary victimization Feelings of guilt
Depression
Anxiety
Distrust of others
Reluctance to seek further help

29. PTSD
Risk of PTSD after sexual assault similar in both female and male veterans to that seen following high levels of combat exposure
Female veterans who had suffered sexual assault while in the military 9X more likely to have PTSD

30. PTSD Patients
Males: 6.5% of combat veterans and 16.5% of non-combat veterans reported in-service or post-service sexual assault
Females: 69% of combat veterans and 87% of non-combat veterans reported in-service or post-service sexual assault
Combat and sexual assault are the 2 most potent predictors of PTSD

31. Under-reporting by victims and spouses
Concern about husbands’ prospects for continued service and promotion
Perceived/real lack of confidentiality and privacy
Limited victim services

32. Under-reporting by victims and spouses
Fear of retaliation and damage to their careers or being portrayed as disloyal
Those who do report are often punished, intimidated, or ostracized
Perpetrators of the most vicious crimes often transferred to another base or offered marriage counseling and anger management classes in lieu of more severe punishment

33. Under-reporting by victims and spouses
< 10% of severely-abused Air Force women have reported abuse (2010)
48 % of female active duty military think abuse should be reported to commanding officer
73% of female ADM (vs. 43% of female civilians) think mandatory reporting increases women’s risk of further abuse
82% of ADM think routine screening makes women less likely to disclose abuse to a health care provider

34. Prosecution and Punishment Rare, Promotion not Uncommon for Perpetrators
Since 1992, nearly 5000 accused sex offenders in the Army, including rapists, have avoided prosecution and the possibility of prison time

35. Prosecution and Punishment Rare, Promotion not Uncommon for Perpetrators
: 80% of abusers who left the military received honorable discharges
Of those who remained in the military, 54% were promoted (compared with 65% of the overall military population)
Over the past 10 years, twice as many accused Army sex offenders were given administrative punishment as were court-martialed

36. 2004 DOD Policy Review Notes Major Problems
Incomplete and poorly integrated data systems and records
Significant gaps in documentation of victim treatment and case disposition
Inconsistent policies and procedures aimed at preventing sexual assault

37. 2004 DOD Policy Review Notes Major Problems
Many barriers to reporting, including junior personnel who were not aware of reporting options
Only 20% of battered women in the U.S. seek treatment following an injury
Victims’ perceived (and in some cases real) lack of privacy and confidentiality.
New confidentiality provisions now in place

38. Iraq and Afghanistan
1/7 female veterans of these conflicts seeking medical care at the VA had suffered sexual trauma (2008 study)
A deployed female soldier is more likely to be raped by a fellow soldier than killed by enemy fire

39. Iraq and Afghanistan Many victims did not receive basic medical care:
emergency contraception
rape evidence kits
testing for sexually transmitted infections
prophylactic treatment or testing for HIV
rape crisis counseling

40. Iraq and Afghanistan Prosecution of crimes often delayed indefinitely
Many servicewomen continued to serve in the same unit with their assailants

41. Iraq
Disturbing reports of sexual abuse and humiliation at the Abu Ghraib and Guantanamo military prisons
Five American soldiers allegedly raped and murdered a young Iraqi woman, burned her body, and killed three members of her family in their home

42. Recent Developments
1999: VA mandates that all veterans (male and female) be screened for military sexual trauma
Compliance still low
2005: Congress establishes Sexual Assault Prevention and Response Office within the Defense Department
2008 – director ordered by DOD superiors not to testify before Congress re problems with office

43. Recent Developments
DOD requires health care provider training on domestic violence
Domestic violence advocates program and family support programs in place
Utilization still low
Civilian perpetrators barred from bases
Military police to work with local law enforcement

44. Victim Assistance
U.S. Army’s transitional compensation program provides financial and other benefits to the families of service members discharged for child or spouse maltreatment, including victim assistance and offender rehabilitation

45. Victim Assistance
VA provides lifetime sexual assault victims’ counseling to all military veterans
After one leaves the service
Most counseled patients are males, who suffer lower rates of sexual assault but make up a large majority of veterans

46. Recent Developments Military Domestic Violence and Sexual Response Act
Would reduce sexual assault and domestic violence involving members of the Armed Forces and their family members and partners through enhanced programs of prevention and deterrence, enhanced programs of victims services, and strengthened provisions for prosecution of assailants
In House and Senate subcommittees since mid 2009

47. Advice for Female Armed Services Members
Women on the front lines, who risk capture and being held as a prisoner of war (which puts them at even higher risk for sexual assault), should strongly consider commencing birth control pre-deployment with an intrauterine device or implant

48. Advice for Female Armed Services Members
Victims should report abuse and consider contacting local domestic violence organizations or the Miles Foundation, a Connecticut-based advocacy group for military victims of domestic violence (telephone: ; Web page:

49. Reducing Violence Against Women in the Military
Change in the sexist ideologies and practices long associated with militarism and war
Improvements in victim services, including enhanced confidentiality
Appointment of a central authority within the DOD to investigate and prosecute violent crimes
Enhanced curricular offerings to teach trainees and practicing clinicians how to recognize and manage the sequelae of domestic violence

50. Reducing Violence Against Women in the Military
Increased funding of domestic violence shelters
Laws to decrease the easy availability of firearms
More funding for research, treatment, and prevention
Changes in law and policy to protect victims and to improve the status of women

51. International Vehicles to Decrease Violence Against Women
Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW): Calls for equality of the sexes in political, social, cultural, civil, and other fields

52. International Vehicles to Decrease Violence Against Women
UN Security Council Resolution 1325: Mandates protection of, and respect for, human rights of women and girls and calls on all parties to armed conflict to take specific measures to protect women and girls from gender-based violence, particularly rape and sexual violence

53. International Vehicles to Decrease Violence Against Women
International Criminal Court (ICC), established in 2002: Codifies accountability for gender-based crimes against women during military conflict by defining sexual and gender violence of all kinds as war crimes

54. International Vehicles to Decrease Violence Against Women
U.S. has not ratified CEDAW, signed UNSCR 1325, nor signed on to the ICC
U.S. should show its commitment to improving women's rights worldwide by taking action on these items
The women and men who risk their lives in service to the ideals for which the United States ideally stands deserve no less.

55. Public Health and Social Justice Website
Contact Information, Slide Shows, References, etc.
Public Health and Social Justice Website