The Department of Veterans Affairs (VA) defines MST as “sexual harassment that is threatening in character or physical assault of a sexual nature that occurred while the victim was in the military,regardless of geographic location of the trauma, gender of the victim, or the relationship to the perpetrator.”
A review of 21 studies found women Veterans reported MST rates of harassment from 55% to 70% and rates of sexual assault from 11% to 48% (Goldzweig, Balekian, Rolon, Yano, & Shekelle, 2006). A review of 25 studies found rates of sexual assault from 20-43% and 7 of those studies included men with rates from 1-4% (Suris & Lind, 2008). Studies on MST incurred in recent conflicts in Iraq and Afghanistan found rates for women from15% to 42% and for men from 1% to 12.5% (Kimerling, et al., 2010; Katz, et al., 2012). Women Veterans may also have multiple events of trauma across their lifespan starting in early childhood and continuing post-military with not only sexual trauma, but also a variety of abusive and unsupportive relationships (Kelly, Skelton, Patel, & Bradley, 2011). Men with MST may have even more difficulties than women including issues of questioning sexuality, masculinity, high risk taking, and higher risk of perpetrating on others.
Consequences of MST
Those with MST had been found to have three times the rate of depression, twice the rate of substance abuse, more obesity, smoking, myocardial infarctions, and hysterectomies before age 40 than those without MST (Frayne, et al, 1999; Frayne et. al, 2003; Hankin, et al, 1999; Skinner et al, 2000). MST may lead to a cascade of negative consequences and compounding life stressors such as Posttraumatic Stress Disorder (PTSD) (American Psychiatric Association, 2013). Although there are many treatments for PTSD, those with MST may suffer from many symptoms in addition to PTSD including feeling betrayed, blaming oneself, resentment, lack of closure or justice, and relationship difficulties. Sexual trauma can affect nearly all systems of a person’s physical, emotional, behavioral health and well-being, relationships, finances, and happiness.
In order to understand MST, it is necessary to understand the context in which these events occur. Several elements may contribute such as training people in aggression, creating a male-dominated hyper-masculine culture, having a minority of women, putting everyone under extreme physical and emotional stress, concentrating the ages between 18 to 30 years old, including a portion of people with pre-military abuse/trauma, confining everyone to an isolated environment for a year or longer, adding alcohol for dis-inhibition, and a possible sense of lawlessness where these things are not prosecuted. Because military personnel live and work in the same environment, victims are “captive” and have to continue to work and live with their perpetrators. They may need to rely on their perpetrators or friends of their perpetrators in combat, for medical help, for promotions, or simply to do their jobs. A minimizing view would focus on a particular act of sexual trauma as a relatively short discrete event. These things are rarely, if ever, a single discrete event. Most sexual trauma (civilian and military) is by a known perpetrator who is either opportunistic or works to gain the trust of a victim (e.g., offers a drink, ride home, help, or friendship). This makes it easy to coax the victim into a vulnerable situation for MST. Afterwards, the victim must not only deal with a sexual violation but also betrayal of trust. The relationship with the perpetrator must be renegotiated as well as all of the relationships connected to the perpetrator. This contributes to victims of MST blaming themselves, not disclosing what happened, and feeling isolated and alone. This may be a contributing factor explaining Fontana and Rosenheck’s (1998) finding that service members were four times more likely to develop PTSD from sexual trauma than from combat.
Sexual Trauma and Abuse Across the Lifespan
Veterans have been found to have multiple events of trauma across their lifespan starting in early childhood and continuing post-military with not only sexual trauma, but also a variety of abusive and unsupportive relationships (Kelly, Skelton, Patel, & Bradley, 2011). Abuse that occurs in the context of family, military, or marriage/intimate relationships have similarities in that there may be on-going, repeated exposure to violence and/or threats of violence where the victim cannot easily escape. The systems of family, military, and marriage have binding legalities and the perpetrator or the system that may support the perpetrator typically controls resources for basic needs including food, income, safety, and healthcare as well as controlling daily functioning (e.g., school, career, and social life) and may also use subtle and overt threats, coercion, emotional abuse such as name calling and put downs, and denying, minimizing or blaming the victim for the abusive behaviors.
Thus, the perpetrator has a continued presence that dominates, intimidates, and controls the victim, while the victim must find ways to negotiate living within an abusive situation and actively anticipate potential danger to try to avoid further trauma and revictimization. Over time, the victim’s self-concept may take on qualities of self-blame (e.g., “Why is this happening to me? I must be bad, stupid, unworthy. I should know better. It must be my fault.”), and internalize a sense of pending danger rendering them as fearful, insecure, unsafe, and distrustful of others. Beyond initial conditions with one’s primary caretaker, these events of trauma in one’s social context may either reinforce a poor attachment style from childhood or interrupt social development and create adult-insecure attachments depending on when the trauma occurred and the extent of it.
Some Common Responses to MST