GritTV hit this issue yesterday -- thanks, Laura! -- but I wanted to amplify it a bit further this morning.

As a female soldier or Marine, you prepare for service with a lot of training with your squad, a lot of extra time in the gym, a lot of mental and physical preparation. But nothing could prepare you for an assault ... a sexual assault ... from one of your fellow soldiers.

What do you do, as a female soldier, when the VA folks in charge of your treatment don't think you merit psych care in the wake of this trauma? Via AnchorageDailyNews:

I asked the briefer, a VA psychiatrist, whether the VA also considered Military Sexual Trauma an experience that can lead to PTSD. He replied "no."

I looked at the physician with amazement. Many peer-reviewed journal articles assert that Military Sexual Trauma, or MST, is especially associated with PTSD. That the Veterans Administration continues to disassociate MST with PTSD is remarkable.

But it may be understandable, considering the military is a culture that ostracizes and ridicules women who "rock the boat" by reporting incidents of sexual assault and violence.

This is not an isolated opinion, unfortunately. Sen. Patty Murray, who has personal experience working with Vietnam vets in the VA system and understands the long-term ramifications of not doing this work properly, has been trying to give this issue a much louder voice on the Hill. Kudos to her. But it's going to be a long road to change.

Via NYTimes:

Women make up some 15 percent of the United States active duty forces, and 11 percent of the soldiers in Iraq and Afghanistan. Nearly a third of female veterans say they were sexually assaulted or raped while in the military, and 71 percent to 90 percent say they were sexually harassed by the men with whom they served.

This sort of abuse drastically increases the risk and intensity of post-traumatic stress disorder. One study found that female soldiers who were sexually assaulted were nine times more likely to show symptoms of this disorder than those who weren’t. Sexual harassment by itself is so destructive, another study revealed, it causes the same rates of post-traumatic stress in women as combat does in men. And rape can lead to other medical crises, including diabetes, asthma, chronic pelvic pain, eating disorders, miscarriages and hypertension.

The threat of post-traumatic stress has risen in recent years as women’s roles in war have changed. More of them now come under fire, suffer battle wounds and kill the enemy, just as men do.

As women return for repeat tours, usually redeploying with their same units, many must go back to war with the same man (or men) who abused them. This leaves these women as threatened by their own comrades as by the war itself. Yet the combination of sexual assault and combat has barely been acknowledged or studied.

Last month, when the RAND Corporation released the biggest non-military survey of the mental health of troops since 2001, it unwittingly reflected this lack of research. The survey found that women suffer from higher rates of post-traumatic stress disorder and depression than men do, but it neglected to look into why this might be, and asked no questions about abuse from fellow soldiers. Terri Tanielian, the project’s co-editor, told me that RAND needs more money to explore these higher rates of trauma among women....

Walter Pincus reported yesterday -- relegated to his usual WaPo A15 page -- that there are substantial concerns about medical costs associated with military retirees and their families, and that cost-cutting in the medical care budget line is a priority for the DOD for their upcoming budget year.

Gates called the rising cost of health care "one area that not only concerns us but where we believe we have to get under control." He said the Defense Department's health-care costs went from $19.5 billion in 2001 to the projected $42.8 billion sought for next year. Within that figure, he said, are military retirees, who are eligible, along with family members, for Tricare medical and dental programs.

Call me crazy, but that should have been one of the concerns discussed long before we ever set foot in Iraq in a war of Bush's choice, shouldn't it? How many years, how many injuries and resources and lives shattered? And we are still tallying costs piecemeal, looking at the long-term consequences of our actions only as they rise up and smack us in the face. At some point, shouldn't long-term, big picture planning occur? Asking all of those "if/then" questions that we keep kicking down the road for the next administration -- the longer we put them off, the worse things seem to get.

It's too late to not go into Iraq in the first place -- that fleet of ships sailed long ago. But it isn't too late to stop treating our nation's military and all the human beings serving in it as though their needs and concerns are less important than saving face for Commander Guy. And when that big picture discussion finally occurs, will the needs of female soldiers be shoved to the side and ignored -- yet again?

(YouTube of NBC Nightly News report on PTSD and sexual trauma for women in the military and a VA treatment center for this issue.)