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Invisible and unheard: how female veterans suffering trauma are let down by US healthcare | Post-traumatic stress disorder

For Felicia Merkel, the PTSD set off is any loud sound – an overhead speaker, a slammed automobile door – transporting her again to the blistering warmth of Afghanistan. For Liz Hensel, it’s wanting into her daughter’s chestnut brown eyes, their coloration reminding her of these of a younger Afghan woman named Medina, who misplaced her mom and leg on the trauma hospital in Kandahar. For Jen Burch, the intrusive reminiscence is of the person who assaulted her earlier than she deployed.

Greater than a decade has handed since these three ladies have been deployed to Afghanistan. It’s now nearly 4 months because the US navy withdrew from Kabul on 30 August. Nonetheless, particular reminiscences devour them. 300 thousand female veterans served within the 19-year warfare, and as media protection dwindles and the nation slowly forgets, Felicia, Liz and Jen proceed to recollect.

Their experiences in Afghanistan differed from these of the male troopers with whom they served. Now, their stateside lives do too. Being a lady in warfare comes with its personal set of distinct traumas. Whereas congressional laws that has just lately been proposed is welcome, important payments are nonetheless being blocked that will assist restore the suffering these ladies have endured for years.

Gender variations exist in trauma publicity. PTSD is twice as widespread in ladies than in males, in accordance with a examine carried out by Kathryn Magruder on the College of South Carolina.

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But they face extra obstacles when searching for help after their deployment.

The Deborah Sampson Act handed in January of this yr made gender-specific providers out there at veteran medical facilities throughout the nation.

Nonetheless, on 6 December, Home and Senate armed service committee leaders tried to dam the Navy Justice Enchancment and Rising Prevention Act, which might allow veterans to report sexual assault to a impartial third get together.


Felicia’s husband says she is rather a lot jumpier now than she was once. Speaking about Afghanistan makes her unhappy, however as she has gotten older, sounds, not reminiscences, set off her PTSD. The anxiousness hits. She breathes deeply. Then tries, with issue, to get her coronary heart fee down.

Felicia Merkel could not shake the memories of the deaths she witnessed.
Felicia Merkel couldn’t shake the reminiscences of the deaths she witnessed. {Photograph}: Courtesy Felicia Merkel/Handout

It was December 2010, the yr of her first deployment. She was mendacity in mattress on the base at Kandahar, watching American tv, when she heard these crashing bumps. Seconds later, the sirens sounded. A rocket had hit. Felicia fell to the ground with a thud and ran for the close by bunker.

It was chilly and dusty in there; a dust observe enveloped in a hole concrete shell. Simply ft away, medics labored on a person wounded within the chest; he had no pulse in his left leg. They referred to as for clothes, something that may be used to cease the bleeding. Because the yells of the medics acquired louder, Felicia’s thoughts traveled additional away.

She couldn’t do something to assist. Eleven years later, she nonetheless feels that guilt and hears these sounds.

She had arrived in Kandahar energetic and excited. She returned to Minnesota a yr later, distant and dejected. The months after coming house have been the worst. Gritting her enamel by weekly remedy classes, she insisted that all the pieces was wonderful. The therapist believed her, even telling her to not come again.

On 4 January 2012, Felicia tried to kill herself. She started with a single antidepressant. Then she took 5 extra. Then the bottle. None of her co-workers, household or associates knew about her medical despair. She spent her twenty second birthday in intensive care.

Publish-military help on the time, she maintains, was considerably missing.

“Female service members have rather more to cope with within the complexity of trauma,” confirmed Jennifer Pacanowski, founding father of the non-profit Girls’s Veterans Empowered and Thriving. “Additionally they have much less entry to providers, which are not as specialised to their wants as these out there to male veterans.”

The Deborah Samson Act, a bipartisan invoice handed by the Senate in January 2021, will set up a coverage to finish gender-based sexual harassment and assault by coaching workers and offering authorized providers for veterans in danger. It’ll additionally workers Veteran Affairs amenities with a everlasting female well being supplier.

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Felicia needs she had entry to those types of assets when she got here house. As a substitute, throughout a 10-minute analysis, it was decided she didn’t have PTSD, and that her grief stemmed solely from her mom’s dying.

She was livid and felt unheard.

Trying again, she believes that higher healthcare insurance policies for female veterans would have inspired her to open up about her experiences and struggles sooner. As a substitute, she dealt along with her emotions alone till she wanted life-saving assist.


After deploying in August 2010, Liz started volunteering at Kandahar’s trauma hospital. She had already witnessed dying. Simply weeks earlier, an injured soldier died together with his head resting on her abdomen. She handled this like all Marine needed to do in any high-intensity fight state of affairs: flip off emotion and focus.

She couldn’t, nonetheless, flip off the reminiscences of the trauma hospital. Because the mom of two younger daughters, it tugged at each maternal intuition she had.

American male service members weren’t permitted to work on the hospitals. Solely as a result of she was female might she see what she now can’t overlook.

The ready room that November day was bustling with uncles, fathers, cousins and brothers.

Nobody waited for Medina. Whoever introduced the three-year-old Afghani woman had left. Her contaminated foot couldn’t be saved, and Liz cradled the kid as she got here out of the anesthesia after the amputation. Reasonably than waking in acquainted arms, Medina’s first sight was this stranger carrying desert camouflage with a pistol at her aspect. The anguish Liz felt reminded her that she might really feel once more after months surrounded by dying.

Liz Hensel thinks about Medina when she looks at photos of her own daughter.
Liz Hensel thinks about Medina when she appears at pictures of her personal daughter. {Photograph}: Courtesy Liz Hensel/Handout

Now, Medina revisits Liz’s ideas again in Virginia. She seems in flashbacks when Liz appears at child images of her youngest daughter. She involves thoughts when Veterans Day is well known on nationwide tv.

Was the woman nonetheless alive? May Liz have accomplished extra to assist her? Was she attending faculty amid the Taliban’s ever-increasing restrictions on ladies’s freedom?

Liz had flown to Afghanistan fearless and decided in 2010 however returned to the US 4 months later, injured and traumatized.

Within the weeks after her deployment, Liz felt as if she have been watching another person’s life in a film. Bodily, she was house, however mentally, she was in Kandahar.

She tried going by the motions anticipated of her as a mom and a spouse. Doing menial duties – cooking dinner, hugging her youngster – issues she had been so able to doing earlier than she left. However it felt to her like a tug of warfare, the previous pulling her again, her thoughts combating to stay current.

It didn’t assist that she felt her ache was invisible to the world. When attending Veterans Affairs medical appointments, the administration workers would typically ask her husband, who got here alongside for help, who he was there to see. He must appropriate them and say the appointment was for his spouse.

It was solely after they took the time to hearken to Liz’s story that folks validated her trauma. Analysis exhibits that post-traumatic stress in veterans varies by gender. If hers had been acknowledged earlier, she wonders, would she nonetheless be battling it 11 years later?


Jen, like Liz, was working in Afghani hospitals as a result of she was a lady. She, too, was haunted by a lady who had misplaced a foot. However, extra, she was haunted by the long-term impacts of sexism and abuse within the navy.

Jen was sexually assaulted by her supervisor at a US navy base, months earlier than she was deployed to Afghanistan in 2010.

She was made to report it by her chain of command, however was rapidly stopped in her tracks. Everybody cherished the person she was accusing.

“We’re so glad to have him again,” mentioned the male officer who dealt with her grievance.

Jen wished to deploy overseas. She knew nobody would consider her. So she stopped, fearing that as a sufferer, she could be remoted.

However trauma builds on trauma. This expertise made Jen extra susceptible to the horrors she witnessed throughout her service in Afghanistan. Statistically, a historical past of sexual assault places a veteran at larger danger for creating PTSD.

Serving at Buckley Area Pressure Base in Denver, Colorado, when she returned stateside from August 2011 to 2014, issues acquired worse.

Jen began to undergo a few of the lowest moments of her life.

Her co-workers assumed that she was being emotional about issues as a result of she was a lady. Somebody she served with in Afghanistan noticed that the one PTSD she had was from consuming the dangerous meals. This went on for a yr and a half.

Jen was assaulted earlier than she arrived in Afghanistan. She labored time beyond regulation within the trauma hospital doing mortuary affairs; developed respiration issues; had glass nodules in her lungs. But she was perpetually made enjoyable of. It was a really detrimental tradition surrounding her post-deployment.

Nobody wished to listen to her story.

Though ladies are the fastest-growing veteran demographic, she believes that some males nonetheless don’t consider ladies serving in roles of excessive stress or publicity.

Presently, the Navy Justice Enchancment and Rising Prevention Act is being blocked. If the act had been handed when Jen was on energetic service, she would have reported her sexual assault.

This is identical for a lot of different ladies within the navy, she believes. And whereas there’s a mountain of laws being handed to help female veterans, that is nonetheless not sufficient.

“If it means sharing the darkest particulars of my story, then I’ll hold doing this,” Jen mentioned, “till the gendered hole in veteran healthcare is lastly closed”.

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