Female Service Members and Their Mental Health

I’ve been working for the military for over 30 years in many different roles. While my gender makes me obviously different from my male counterparts, I’ve never focused on it as a barrier because my parents raised me to do my best, and to accomplish the goals I set in my mind and heart, regardless of my gender.

Early in my career, I broke into the previously gender-restricted missile operations career field. That experience strongly shaped my perspective, and throughout my career has caused me to think about the challenges for military females.

Years after my missile crew duty was over, I worked as the aerospace psychologist with the Euro-NATO Joint Jet Pilot Training program as the first female jet pilot trainees were integrated into the school. I watched with dismay as some of the same difficult gender dynamics that I’d experienced also unfolded with this newer generation of pioneers. As a clinical psychologist, I’ve treated many female service members who identified in therapy that their primary challenge was longing to thrive and be fully accepted in their unit when they were the only female in the shop.

Recently, I had the honor of participating in the Coming Home Dialogue (link is external), a program sponsored by the Naval Academy and George Mason University and supported by a grant from the National Endowment for Humanities. In a small room, we were six veterans, strangers at the start, but friends when we finished.

We spent two days with trained facilitators exploring and integrating decades of poetry, literature and experiences as we contemplated service, honor, duty, courage, sacrifice and death. We even discussed the enduring challenges females have faced and still face while serving in the military. We agreed there are enormous complexities related to being a female in the military, difficulties most males typically don’t face, and some that most people don’t think about.

Our female warriors are brave, are dedicated to risking their lives to defend our country, and often juggle a whole lot of other responsibilities at the same time they’re performing their military duties. The problems they face can involve leadership acceptance, childcare, the biological impact of estrogen, societal role expectations, sexual harassment and assault, and ostracism by peers due to gender differences and can directly impact psychological health. Females appear to cope with combat-related stress as well as men, but they are more likely to experience higher rates of sexual assault and sexual harassment. They’re also more likely to be treated for depression than men, and appear less likely to endure negative impact from deployment if they experience strong social support pre and post-deployment compared to men.

While psychological health research may show us that over time in some situations women do things differently and respond to events differently than their male counterparts, different doesn’t mean better or worse, it just means different. Fortunately, we’re making forward progress; some of DoD health research is now focused on how to better understand and help military females with a variety of psychological issues, as well as how we can help the culture better support and respect differences amongst us. We also now have a standing DoD work group dedicated to supporting the mental health needs of women in the military, developed and implemented at the Deployment Health Clinical Center.

What can you do as a clinician to be more supportive to military females who seek treatment?

• Ask the right questions. Know that gender is likely a factor in unit dynamics, and may be an important aspect of the problem, depending on the patient’s assigned career field. In careers that are predominantly or previously solely male, a female service member may feel isolated, powerless to improve her situation, or may simply need to talk openly about how she feels about her gender in the military environment to a supportive and understanding therapist.
• Be familiar with resources available for females, especially those with children, or in abusive relationships.  The Family Advocacy Program (link is external) and the Sexual Assault Prevention and Response Office (link is external) programs have many services and benefits available to support females who have experienced domestic violence or sexual assault.
• Make sure you are knowledgeable about other types of support (Inspector General, legal, security forces) in order to help refer your female military patient to the right resources if she’s struggling with unfair treatment, abuse of command, illegal behaviors, ostracism or bullying.
• Learn the basics about your role and responsibilities as a health care provider from the relevant DoD Instructions and service guidance for substance use disorders, family advocacy, sexual assault, and equal employment opportunity (EEO), and keep current on your annual re-training.