Often Kept Secret, Military Sexual Trauma Leaves Lasting Scars

Update: As of January 17, 2023 all US veterans are eligible to receive emergency mental health care at no cost. This applies even if the individual isn’t enrolled in the VA system. The policy also includes the cost of ambulance rides, up to 30 days of inpatient care, and up to 90 days of outpatient care.

“Doing your duty” is one of the top values of the U.S. Army—and that’s exactly what Sandra Lee upheld the weeks after she was raped by a fellow soldier on two occasions while serving in Iraq in 2004. A staff sergeant and member of the civil affairs unit, she was responsible for overseeing the rebuilding of schools for children in Western Baghdad and providing security to a combat engineer unit.

“I didn’t have the mental capacity or the time to deal with anything personal. At that point, it was about the collective and getting everyone back home safely,” explains Lee, who also survived four roadside bombings. “Anything that had to do with myself just got pushed out of the way—it didn’t matter.”

Lee’s mental health started to spiral when she got home in October 2004, though. The veteran says she thought about suicide and felt angry and depressed. Lee eventually entered into an in-patient treatment program for post-traumatic stress disorder (PTSD) for six months in 2007. That’s when she was able to begin acknowledging the rapes and healing from them. 

But it would take another 10 years and numerous medications, therapies, support groups, and other treatments before Lee would start to feel better.

Lingering Scars From Military Sexual Trauma

Lee’s experience as a survivor of military sexual assault (MST) is far from rare. The Department of Veterans Affairs (VA) estimates that 1 in 3 women and 1 in 50 men who’ve served in the military have experienced MST (defined as sexual assault or sexual harassment during military service).

The effects of MST can impact a veterans’ mental health in profound ways, even years after the incident. It has been linked to an increased risk of PSTD, depression, substance use disorders, and other mental illnesses.

Part of the reason why MST leaves such a lasting impact on survivors is the fact that, in many cases, the crime was committed by someone they live and work with.

“Often there is an additional layer to the event because the person who perpetrated the assault was supposed to be someone the victim could trust to protect their life,” says Zachary Clayborne Dietrich, PsyD, a licensed psychologist at LifeStance Health, which provides virtual and in-person outpatient mental healthcare.

Dr. Dietrich, who enlisted in the U.S. Marine Corps in 2003, continues: “In most sexual assault survivors, you already see a decline in their trust of others and hypervigilance. However, this is often magnified in instances of MST because the perpetrator was supposed to watch their back against danger, not exacerbate the danger.”

That interpersonal trauma can be a significant betrayal. As a result, survivors struggle to feel safe among others and often isolate themselves away from support systems.

Survivors of MST also tend to have higher rates of other types of trauma. They’re more likely to have endured sexual and physical abuse in childhood. Nearly 3 in 4 survivors of MST were also exposed to other significant war-zone stressors (including combat) while deployed. And once they come home, they continue to face a disproportionately high risk of sexual assault outside of military service. Combined, these situations lead to cumulative trauma that can be extremely challenging to cope with and require lots of time from which to recover.

A Culture of Secrecy

Despite the prevalence of MST, around 70% of cases go unreported, largely due to fear, says Brittany Morris, MSC, a licensed clinical social worker from Thriveworks in Chesapeake, Virginia, who has previously lived overseas working with the military. 

“There is the worry that there will be no consequences for the offender, especially if they are a superior officer, the survivor will be punished (forced to change posts), or others will find out and shun them,” she explains. “Military members are often asked to mask their feelings and hide areas of weakness, so many of the survivors I have worked with blame themselves for being weak, not knowing any better, or somehow they were ‘asking for it.’”

Plus, reporting a rape or sexual assault could potentially be its own source of trauma—a major reason why Lee did not tell anyone what happened to her at the time.

“Who’s to say that I wasn’t lying, or making something up, or remembering things differently? There were days that I’d fantasize about suicide and have that ideation, and I wondered what reporting [the rapes] would do to my psyche,” says Lee. “If you’re already at that breaking point and barely hanging on by a thread, and you add something else to that mix—that risk was not something I wanted to do.”

The military’s culture of secrecy can leave to survivors to endure the aftermath of sexual assault on their own, without the support and therapy that could otherwise help them cope with the resulting distress.

Improving Care for MST Survivors

When Lee tried to access additional support for recovering from the effects of MST after her hospitalization in 2007, she found that “there were no resources out there.” 

Since then, advocates have been trying to make improvements for MST survivors. Senators have recently reintroduced a bill to improve access to benefits and healthcare for MST survivors, and boost MST claims processing. Multiple bills focused on caring for MST survivors have also been introduced to the House of Representatives. One of these bills, if passed, would require the VA to designate a peer support specialist to help a veteran filing an MST claim.

“I personally think this could significantly benefit survivors as it does appear that knowing others understand you is such a crucial role in the healing process,” says Dr. Dietrich. 

Lee would eventually like to see the MST reporting system taken out of the military chain of command, which may make survivors feel more comfortable filing a report and increase the likelihood that it's properly addressed.

“That is the first step. There are commanders in the military who are all for their troops and would go to bat for anyone being mistreated, but there are others who don’t, who would rather have it swept under the rug because it would be a blemish on their career,” she says.

In terms of recovery, what’s helped Lee the most has been building a support system that includes healthcare professionals she connects with, finding effective medications, and acting in theater, which allows her to engage with challenging emotions in a more comfortable way. Even after 17 years, she still has her “bad days,” but has been doing much better. 

“It’s not just a matter of having time pass, but what you do with that time that helps you heal,” says Lee.