Violence Against Women in the Military

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					Violence Against Women in the
        Martin Donohoe
• 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
       Violence Against Women
• Direct: physical, sexual, emotional
  – Global health burden comparable to that of
    HIV, tuberculosis, and cardiovascular
• Institutional: social, legal, educational,
  and political marginalization
           Rape as a War Crime
• Common (comfort women of WW II Japan,
  Sudan, Rwanda, Bosnia, etc.)
• Notions of war/militarism and excessive
• > 300 rapes of Japanese citizens committed by
  U.S. personnel since 1945
  – Adverse effects on military agreements, support
    for U.S. troops
     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)

• Almost 60,000 female troops have been
  deployed in Iraq and Afghanistan
  – 1 in 7 US military personnel in Iraq is female
• Active duty troops
  – Army > Marines > Navy > Air Force

• Female, civilian spouses of active duty
             Recent History
• Tailhook Convention (1991)

• Aberdeen Proving Grounds sexual assaults

• Homicides, suicides among returning vets
        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
• 2007-2010: 18% increase in alleged sexual
  assaults committed by U.S. service members
• Pentagon acknowledges 80% of rapes never
• Child maltreatment more common during
  – Suggests victims becoming perpetrators
  Violence and Sexual Assault Among
   Active Duty Soldiers and Veterans
• Multiple studies with widely varying
  percentages – see long version of this
  slide show at
• Active duty military:
   • Abuse rates 20%-35%
   • Sexual assault rates 17% to 33%
Violence and Sexual Assault Among
 Active Duty Soldiers and Veterans
• Female veterans:
   • Abuse rates 24%-70%
   • Sexual assault rates 20%-42%
• Veterans reporting history of sexual
  harassment: 90% < 50 yo; 35% > 50 yo
            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
          Common Characteristics of
              Abuse Victims

• low self-esteem           •   poor financial resources
• guilt                     •   few job skills
• self-blame                •   less education
• denial                    •   few friends
• traditional attitudes     •   history of childhood
  regarding women’s roles       abuse
• have children
        Common Characteristics
            of Abusers
•   low self-esteem
•   dependency
•   jealousy
•   poor communication skills
•   unemployed/underemployed
          Common Characteristics
              of Abusers
• abuse alcohol/other drugs
• have witnessed or experienced abuse as
• if immigrants, are more likely to have been
  victims of political violence
• abuse their own children
 Military families face unique stressors, which
      increase the risk for family violence
• Relocations

• Long work tours

• Frequent family separations

• Dangerous work assignments
 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
   Victims More Likely to Report
• Chronic health problems (esp. gyn)
• Lower health-related quality of life
• Prescription medication use for emotional
• Failure to complete college
• Annual income < $25,000
• Depression (3X higher rate)
• Alcohol abuse (2X higher rate)
• History of childhood violence and post-
  military violence more common
• High levels of secondary victimization
  – Feelings of guilt
  – Depression
  – Anxiety
  – Distrust of others
  – Reluctance to seek further help
• 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
              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
 Under-reporting by victims and spouses

• Concern about husbands’ prospects for
  continued service and promotion

• Perceived/real lack of confidentiality and

• Limited victim services
  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
  Under-reporting by victims and spouses

• 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
 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
• 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)
          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
          Iraq and Afghanistan
• Many victims did not receive basic medical
  – emergency contraception
  – rape evidence kits
  – testing for sexually transmitted infections
  – prophylactic treatment or testing for HIV
  – rape crisis counseling
        Iraq and Afghanistan
• Prosecution of crimes often delayed

• Many servicewomen continued to serve
  in the same unit with their assailants
• 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
         Recent Developments
• 1999: VA mandates that all veterans (male and
  female) be screened for military sexual trauma
  – Compliance still low
• DOD Policy Review notes major problems
• 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
          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
           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
           Victim Assistance
• VA provides lifetime sexual assault
  victims’ counseling to all military
   –After one leaves the service
   –Most counseled patients are males,
    who suffer lower rates of sexual assault
    but make up a large majority of
           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
   – In House and Senate subcommittees since mid 2009
    Advice for Female Armed Services
• 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
     Advice for Female Armed Services
• 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: 203-
  270-7861; Web page:
 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
• 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
 Reducing Violence Against Women in
             the Military
• Increased funding of domestic violence
• Laws to decrease the easy availability of
• More funding for research, treatment, and
• Changes in law and policy to protect victims
  and to improve the status of women
   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
  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
  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
   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.
   Contact Information, Slide Shows,
            References, etc.

Public Health and Social Justice

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