Military Sexual Trauma in the Context of Veterans' Life Experiences

Military sexual trauma (MST) is defined as “sexual harassment that is threatening in character or physical assault of a sexual nature that occurred while the victim was in the military” by U.S. Public Law #102-585 of the Veterans Health Care Act of 1992. MST is not a disorder, but an experience. Although MST causes distress in almost everyone exposed to it, most people who experience MST do not develop psychiatric disorders.1 Both men and women can experience MST. However, as MST is more prevalent in female Veterans, the historical literature on this topic has emphasized the experience and consequences of MST in women. Recognition of the salience of MST in the lives of both male and female Veterans is important. More recent literature, focused upon the needs of male Veterans who have experienced MST, is developing. Military sexual trauma has been increasingly recognized in the last 2 decades. A corresponding proliferation of MST research has accompanied the recognition of this important problem. Medical and mental health problems are well known to be associated with MST; this literature has emphasized the negative impact of MST on mental and physical health.1-4 These problems occur in a broader longitudinal context that has not been well articulated in existing research.5-7 For many Veterans who have experienced MST, this broader context includes a lifelong journey of difficulties beginning with early childhood and family background problems that continue through adolescence and into military service and well beyond its completion. It would thus be shortsighted to start and end the conceptualization of this experience with entry into and completion of military service respectively. A myopic focus on exposure to sexual trauma in the military in isolation from the longitudinal history of associated problems will undoubtedly overlook an important broader context of trauma exposure that is important to the effective provision of care for these Veterans. The purpose of this article is to briefly review current knowledge of MST and place it in its broader psychosocial context. Relevant knowledge to be presented about MST in this article will include premilitary characteristics and postmilitary experiences of Veterans with a history of MST, which has farreaching implications for effective evaluation and treatment of Veterans’ medical and mental health conditions related to MST. Implications for current clinical practice are discussed in the context of Veterans Health Administration’s (VHA) existing services for Veterans who have experienced MST, ongoing efforts to foster patient-centered practice, and important considerations about the development of personal safety education programs that may be directly applicable to this population.