Violence Against Women in the Military

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, DRC, Rwanda • Bosnia and Herzegovinia • Egypt, Libya, Syria • 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 • 2012: Similar scandal at Lackland AFB

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 • 1997-2001: >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) • 1995-2004: 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 • 2007-2010: 18% increase in alleged sexual assaults committed by U.S. service members • 2011: 60% rise in reported sexual assaults at U.S. military academies • 2011: 3,192 reported sexual assaults (Pentagon) • Estimates 19,000 occurred

15. Violence • Pentagon acknowledges 86% of rapes never reported • Less than 8% go to court martial • Child maltreatment more common during deployments • Suggests victims becoming perpetrators

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

17. 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

18. 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

19. 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)

20. 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

21. Common Characteristics ofAbuse 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

22. Common Characteristicsof Abusers low self-esteem dependency jealousy poor communication skills unemployed/underemployed

23. Common Characteristicsof 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

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

25. 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

26. Health Consequences • STDs • Pregnancy • Abortion covered only if life of mother at risk • vs. State Dept. employees, where there are no restrictions on abortion coverage • See slide shows on violence against women and rape on phsj website for further details

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

28. 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)

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

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

31. PTSD • Risk of PTSD after sexual assault similar in both female and male veterans to that seen following high levels of combat exposure • Combat and sexual assault are the 2 most potent predictors of PTSD

32. PTSD • Female veterans who had suffered sexual assault while in the military 9X more likely to have PTSD • 1/3 of Iraq/Afghanistan female vets with PTSD have suffered military sexual trauma (2011 study)

33. 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

34. 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

35. 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

36. 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

37. 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

38. Prosecution and Punishment Rare, Promotion not Uncommon for Perpetrators • 1988-1993: 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

39. 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

40. 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

41. 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

42. 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

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

44. 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

45. 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

46. 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

47. 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

48. 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

49. 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

50. Recent Developments • H.R. 1529 and S.B. 1018: Defense Sexual Trauma Response Oversight and Good Governance Act (Defense Strong Act) • Would guarantee access to military lawyer, allow victims to transfer from where assault occurred, ensure confidentiality, and institute rape prevention training for men and women • In committees (2012)