Military sexual trauma (MST) is a term used by the U.S. Department of Veterans Affairs (VA) to characterize experiences of sexual harassment or sexual assault that occur during military service. The 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.”
Behaviors constituting sexual assault can include rape, aggravated or abusive sexual contact, or any attempts to commit these acts. Sexually harassing behaviors can range from repeatedly telling sexual jokes or displaying sexually explicit pictures or videos to offering a job promotion in exchange for sexual favors.
In 2014, the Department of Defense’s (DOD) anonymous survey of service members found that 4.3 percent of women and 0.9 percent of men experienced military sexual assault within the previous year. Results also indicated that approximately 24 percent of women and 9 percent of men experienced sexual harassment.
Independent research among active-duty military and veterans has found rates of MST to be much higher than what is reported by the DOD. A review of military sexual assault research from 2010 indicated that among women, 10 percent to 33 percent experience attempted or completed rape during military service. When considering sexual harassment and other forms of sexual assault, rates of MST reported by women can range from 22 percent to 84 percent. Data among male victims is more limited, but available research indicates that up to 12 percent of men experience sexual assault and 30 percent experience sexual harassment while in the military.
Assessment and Screening for MST
When working with veterans and military personnel in a clinical setting, it is important to remember that many men and women experience sexual assault or harassment during service; thus, sexual trauma may be having a significant effect on an individual’s health and well-being.
Sexual trauma can be a difficult and sensitive topic to discuss, and victims may not disclose their experiences unless asked directly. When appropriate, clinicians should ask questions about possible MST as part of intake interviews. When initiating this discussion, clinicians can try to normalize the process by incorporating questions within a broader discussion of relationships or by using introductory language such as: “We ask all of our veteran patients about certain types of experiences because we know they are common and can be hard to talk about.” It is important to use behaviorally based language rather than asking about rape or sexual assault explicitly, as victims may not label their experiences in the same way.
Although there are currently no published measures for specifically assessing MST, the VA uses a two-question procedure as part of its universal screening system:
“While you were in the military: a) did you receive uninvited or unwanted sexual attention, such as touching, cornering, pressure for sexual favors or verbal remarks?; b) did someone ever use force or threat of force to have sexual contact with you against your will?”
Effects of MST
Experiences of MST, and sexual trauma in general, have been linked with various physical and psychological health issues, including:
- Post-traumatic stress disorder (PTSD)
- Chronic pain and illnesses
- Medically unexplained physical health symptoms
- Sexual and reproductive health problems
- Eating disorders
- Substance abuse
- Suicidal ideation
Men and women who have experienced MST also may be more prone to adjustment and interpersonal difficulties, greater use of medical services, engaging in risky behaviors and homelessness.
Important Considerations When Seeing Patients with MST
There are a range of factors that can impact how an individual experiences and copes with MST, which should be considered when working with veteran and military populations. Below are a few important examples:
The context in which the trauma occurred. This includes the use of force or weapons, whether it occurred in a deployment setting and the military rank of the perpetrator. All of these factors can influence how the victim responds to the trauma, as well as the environment in which they can report it or seek care.
Past trauma. Prior experiences of sexual trauma, or trauma in general, can play an important role in the disclosure and impact of MST.
Differences among victims. There are important differences between male and female victims of MST and the impact of the trauma, which may result in unique treatment and care needs. Among men, for example, experiences of MST may threaten their sense of masculinity or sexual identity, to a greater extent than among women. Women may be more prone to certain mental health conditions, such as depression and eating disorders, compared to men, after experiencing MST.
In general, it is vital to remember that sexual trauma is an inherently complex and difficult topic, and clinicians seeing military clients should be aware of how to best approach and work with clients who have had these experiences. It is crucial to remain sensitive and empathetic throughout the disclosure and care process in order to assist in the patient’s recovery in the most effective and appropriate manner.
Additional Resources Related to Military and Nonmilitary Sexual Trauma
- U.S. Department of Veterans Affairs: www.mentalhealth.va.gov/msthome.asp
- Rape, Abuse & Incest National Network (RAINN): www.rainn.org
- Protect Our Defenders: www.protectourdefenders.com
Ashley Schuyler is a project specialist with the USC School of Social Work’s Center for Innovation and Research on Veterans and Military Families (CIR). She received her Master of Public Health in 2013 from Columbia University, with a focus on population and family health, particularly related to sexual and reproductive health. During her time at CIR she has worked on a number of research projects, including an assessment of sexual functioning among military populations and a study exploring ways of providing virtual training and support for clinicians administering evidence-based treatment for PTSD.