When Women Veterans Become the Unseen Victims of PTSD

For these women, the challenges they faced on the battlefield were just the beginning

by Stephanie Russell-Kraft
May 25, 2018

In 2005, Elana Duffy was an Army interrogator deployed to Iraq when her vehicle was hit by an IED. Duffy was knocked out and bled briefly from her ears. She didn’t feel she was badly injured though, and continued on with her mission. “I didn’t want to get pulled off the road,” she tells Playboy. “My job was my job, I wanted to keep on doing it.” When she started experiencing symptoms like bad headaches, Duffy hid them: “I covered up for as long as I possibly could.”

Part of the reason she kept quiet, she said, was the fact that she is a woman. Standing at 5’4” and weighing just over 100 pounds, Duffy had worked hard to gain the respect of the infantrymen she served with. “It took initial weeks or months to prove myself to every platoon out there,” she says. But eventually, her symptoms worsened, and she began forgetting names of people and places. A teammate noticed, and she went to seek medical help. She was diagnosed with post-traumatic stress disorder.

The diagnosis didn’t quite fit, however. Duffy’s pain continued, but it wasn’t taken seriously. “They told me I was going crazy, that I was a fragile little lady,” she says. It took nearly two years for an Army doctor to recognize she had a traumatic brain injury and fly her off immediately to surgery, where they discovered a massive brain bleed. Duffy was later awarded a Purple Heart.

After Duffy was medically discharged in 2012, she developed anger problems, but she delayed seeking mental health treatment. “I wouldn’t admit that I couldn’t adjust, because for a woman to do that is so difficult, because the perception is that by admitting you have a problem you’re weak,” she says.

Duffy may be part of a small group of women who have received a Purple Heart, but her experience as a female military service member is quite common. The Service Women's Action Network recently convened a set of focus groups to ask women veterans and service members about their mental health experiences. Nearly all of the groups said they had developed resilience while in the military. But when they dug deeper, the women came to agree it was “fake resilience” that didn’t contribute to their mental well-being.

“The ‘resilience’ that women learn in the military is not really resilience at all but a method of suppressing negative experiences in order to ‘drive on’ which invariably, eventually, takes a toll on their mental health,” SWAN researchers wrote in their report. “You define resilience as being able to get up tomorrow and doing the job you've got to do and whatever it takes to do that, whether it’s healthy or not,” says Army Colonel Angie Holbrook. “If you let the crack in, it will be a watershed.”

Not every service in the VA is bad. There are some things they do correctly. But the culture was created for a man. It was never created with women in mind, and they need to break out of that shell.

Service women and veterans who spoke to Playboy about their mental health all told a similar version of events. Faced with expectations that they, as women, wouldn’t cut it in the military, they put up walls to mask any pain or stress they may have been feeling. For some, this meant taking years, and even decades, to confront their trauma stemming from combat stress or sexual assault.

In December 2006, then-Major Holbrook began a tour in Baghdad that would take her through the deadliest year for U.S. troops since the invasion of Iraq in 2003. As a casualty operations director, Holbrook was responsible for overseeing casualty reports for U.S. service members killed in action.

“They come in very raw, not what you would tell the families, and we would have to reconstruct it so we told the story but in a more palatable way,” she says. “Two things the loved one wants to know are, did my soldier suffer, and did they serve honorably? We didn’t make stuff up, but what we wrote on the narrative was what they read to the families.” During her 15 months in theater, Holbrook said she processed 884 deaths. “It was gross, and it was heinous,” she says.

During her first month on the job, Holbrook was assaulted and anally raped by a fellow service member while walking home one night. She couldn’t see who it was, only that he was wearing a uniform. After he finished, she went home, changed her clothes, and went to bed. She didn’t tell anyone. “Nobody wanted my job, so part of my decision matrix about what I did was, ‘I can’t tell anybody because then they’ll send me home, and who’s going to do my job?’” Holbrook says. “Even though it was not a fun duty, I felt I had a special skill, and I was able to do it well. Reporting my assault would have meant going home and not being able to do that.”

It wasn’t until 10 years later that she reported the assault. “I probably would have waited longer had I not broke. Physically, my body was breaking down so bad that it was affecting my emotional health.” She has since been diagnosed with PTSD stemming from both the assault and her work while on deployment, and she’s in the process of leaving the Army.

In conjunction with the focus groups, the Service Women’s Action Network polled 1,295 military women, including both veterans and active duty service members. Nearly 9 percent of the women polled said they left the service for mental health reasons and more than 50 percent of respondents said they had been diagnosed with PTSD at some point. There are approximately 1,601,292 women veterans, according to the Department of Veterans Affairs. These women are much more likely non-white (34 percent) than their male counterparts (21 percent). They are also more likely to have a service-connected disability, have no personal income and be in poverty, according to the VA. The risk for suicide among women veterans is also 2.5 times higher than U.S. civilian women. Women are also the fastest-growing group of homeless veterans.

When it comes to women, the assumption is her PTSD or her trauma is not combat-related, or it’s not as bad as the man’s, and that's not true.

BriGette McCoy, who served in the Army from 1987 to 1991, says she didn’t even call herself a veteran until the mid-aughts, a decade during which she and her children were homeless off and on. (Veteran homeless shelters often don’t have room for women with children.)

During her time in service, McCoy was raped by a fellow service member, and when she came out, she had bouts of being “super depressed and sullen and isolated.” “The military taught us to support the process of the military and support the guys. It was always about the boys and the guys,” says McCoy. The sexual trauma also impacted her ability to keep a job. But, she says, she resisted seeking treatment for years because she was terrified of a mental health diagnosis. “Because now I’m scared I’m going to lose my children to the system,” she says. “I’m a woman of color, and it just was a concern of mine. I fell into all the problem demographics over and over again.”

Women veterans have historically been far less likely to access VA health benefits, and, although the numbers are increasing, they’re still less likely than men to use services. The VA offers women’s mental health services, but many servicewomen say these programs are either poorly implemented or not widely available. Many women and minority veterans face challenges with access to healthcare in the VA simply because the system was designed for white men. Nearly every woman who spoke to Playboy recounted an experience at the VA in which she was hit on, asked if she was there to visit a man who had served—rather than seek treatment stemming from her own military service.

“Before I go to the VA, I’m already ready for it,” says Michelle Dallocchio, a social worker who served in the Army from 1998 to 2006. “I’m thinking if I gotta fight somebody today.”

Dallocchio, who is Chamorro (an indigenous group of the Northern Mariana Islands), says her mental health struggles have been compounded not just by gender but by race, particularly when those concerns haven’t been taken seriously. “I’ve had a VA psychologist tell me, I don’t know how racism can cause trauma,” she says. “And I shit you not, his name was Dr. White.”

Freshly ousted VA Secretary David Shulkin recently testified before Congress that the VA is short 2,912 mental health providers. Advocates for women veterans hope the vacancies will be filled by clinicians who understand the unique challenges women encounter in the military.

“There are very few female mental health professionals who are also veterans who understand the plight of the female veteran,” says Kathy Platoni, a clinical psychologist and former Army colonel. “I can’t keep up with the number of referrals. I’m a certified non-VA provider, and I know of only one other psychologist who is a male, who is a veteran. Unless you’ve walked in those boots, you don’t get it.”

I have actually had people say to me, ‘How on earth did you get a Purple Heart? You’re a woman, you couldn’t have gotten one. What did you do, get a paper cut?

“If you’ve got trauma and all you’re around is predominantly men, it’s difficult,” says Trina McDonald, who was raped on several occasions while serving in the military from 1988 to 1990. “And people don’t comprehend why that’s a problem.” McDonald didn’t report her assault for a decade, during which time she was unable to find stable housing or a stable job.

Lucy C. Del Gaudio, who served in the Army from 1990 to 1998, is now a veteran advocate in New Jersey who’s working to make her state’s VA facilities more accessible to women. For example, at the VA’s Lyons campus, Del Gaudio says women on their way to the women’s PTSD clinic must walk through the waiting room of the men’s clinic, a process that can be triggering for survivors of sexual assault. Women there describe it as a walk of shame.

“Not every service in the VA is bad,” she says. “There are some things they do correctly. But the culture was created for a man. It was never created with women in mind, and they need to break out of that shell.”

There has been some good news recently. The recently-passed budget omnibus bill includes provisions to expand mental health services for veterans with a less-than-honorable discharge, many of whom were kicked out for reasons related to military sexual trauma or post-traumatic stress. But part of the reason women seek out VA services at a lower rate is that many feel isolated in the civilian world after their time in service.

“There’s a common narrative that we tell about military service, and this narrative has to do with camaraderie,” says Kiersten Downs, a VA researcher at the Center of Innovation on Disability and Rehabilitation Research at James A. Haley Veterans' Hospital (she stressed that she is not speaking on behalf of the VA). “This is a false narrative for so many people, for women and minority veterans.”

“When it comes to women, the assumption is her PTSD or her trauma is not combat-related, or it’s not as bad as the man’s, and that's not true,” says Colonel Holbrook.

Michelle Dallocchio is an Iraq War veteran, and her car has an Iraq War veteran sticker on it. But people have come up to her to ask her to thank her husband for his service. Elana Duffy is a Purple Heart recipient, and even her experiences are dismissed. “I have actually had people say to me, ‘How on earth did you get a Purple Heart? You’re a woman, you couldn’t have gotten one. What did you do, get a paper cut?’” she says.

Duffy has spoken publicly about her own history in part to increase the visibility of women veterans so their mental health challenges will be taken more seriously. “It’s always said that women don’t want to admit they’re weak, and that’s why they don’t want therapy,” says Duffy. “But the rate of suicide among women is much higher, and the rate of women seeking help for non-[sexual assault] issues is much much lower, largely because women don’t want to say, ‘Yeah, I had an issue with the fact that every time I went out on a raid, I was separating families. I had to be the one to walk up to the five-year-old—oh, no, daddy’s coming with us. Because I was the only one who could talk to women and children. That’s on me.’”

“The moral injury on the women who were in combat roles that weren’t combat roles, it’s huge,” she says.