Military Sexual Abuse

Definition & Prevalence

Sexual assault within the military refers to sexual contact characterized by use of force, threats, intimidation, or abuse of authority as well as instances in which the survivor is unable to consent. The definition of sexual assault is consistent with the term military sexual trauma (MST) which was coined by the Department of Veteran Affairs (DVA), not the Department of Defense (DoD). Both the DoD and DVA include sexual harassment and inappropriate touching within the category of sexual violence. Rates of sexual assault are comparable to same-age peers in civilian populations but may vary according to the definition of sexual assault as well as the time frame considered. In civilian populations, it is estimated that 5.2% of college women report sexual assault annually compared to 2.6% of active duty women (Black et al 2011). For males, .28% of active duty males are sexually assaulted each year (2010 Gender Relations Survey of Active Duty Members ).

Consequences of Sexual Assault

Female OEF/OIF Veterans who experienced sexual trauma were 3.5 times more likely to be diagnosed with a mental health condition than were female OEF/OIF Veterans who had not experienced sexual trauma. This suggests that even among this sample of deployed Veterans who are at risk for experiencing mental health problems, sexual trauma is a significant risk factor for negative mental health consequences (Kimerling et al, 2010). The consequences of sexual assault are numerous including:

PTSD
Depression
Suicide
Substance abuse
Insomnia

Military sexual assault (MSA) has numerous psychological consequences due to the nature of the trauma with an emphasis on the trauma context. More specifically, as an interpersonal assault, it is a personal, intentional violation of an individual’s boundaries and personal rights. These assaults are particularly disturbing in the military context. These Service members have been violated within a small community by someone who should be ultimately trustworthy and this violation is completely incompatible with the independent and self-sufficient spirit Service members need to thrive in the military. One of the most troubling issues is that individuals who have been sexually assaulted often know their assailant and work or live in the same environment as the assailant. This convergence of work, play and social environments makes it particularly difficult to report military sexual assaults. Survivors report apprehensions due to power differentials, concerns that they will be chastised by peers, fears about their progression within the military.

MSA is particularly distressing to male Service members. A number of MSA survivors are males who were sexually assaulted by other men. The psychological consequences of MSA are typically worse for men. Following the assault, heterosexual male survivors often report concerns regarding their masculinity and sexual orientation. Although the assault was clearly an act of power and dominance, male survivors often feel that they were targeted for being effeminate or standing out in some way. It is important to provide psychoeducation on male rape myths and emphasize that the assault was not consensual. Health care providers should also underscore that, even if the MSA survivor experienced some sexual arousal during the assault, which does not imply willing participation.

Although males are sexually assaulted by women less often, the impact is still significant. Again, psychoeducation about male rape myths is an important initial step in treatment. Mental health providers should follow psychoeducation with evidence-based psychotherapy (PE, CPT, CBT-D) as symptoms and functioning dictate.

Prolonged Exposure Therapy
Cognitive Processing Therapy
Cognitive Behavioral Therapy for Depression