Authors: Rhea Prag; Meghan Etsey, MD; Yun Weisholtz, MD-PhD on behalf of the Gender Equity Task Force

Mental health conditions are among the most prevalent and enduring consequences of military service, often persisting long after active duty ends. Veterans face elevated rates of post‑traumatic stress disorder (PTSD), depression, anxiety, and substance use disorders as a result of combat exposure, cumulative trauma, and the challenges of reintegration into civilian life (Moore et al., 2023). Women are the fastest-growing subgroup of U.S. veterans, projected to comprise nearly 20% of the veteran population by 2040, underscoring the need for healthcare systems to adapt to their unique needs (U.S. Department of Veterans Affairs, Women Veterans Health Care, 2025)

Within this broader veteran population, female veterans experience disproportionately higher rates of mental health conditions and face distinct, gender‑specific barriers to care (Leung et al., 2020). The Veterans Health Administration (VA) serves as the primary healthcare system for U.S. veterans; however, women remain a minority within this system, which has historically been designed around male veterans’ needs (Leung et al., 2020). Barriers such as gender‑insensitive care environments, harassment, limited availability of women‑centered services, and competing caregiving responsibilities further restrict access to timely and effective treatment (Marshall et al., 2021). Notably, suicide mortality among women veterans is approximately 2.5 times higher than that of civilian women, a gap that continues to widen over time (Leung et al., 2020).

A major contributor to mental health morbidity among female veterans is military sexual trauma (MST), which encompasses sexual harassment or sexual assault experienced during military service, as defined by the VA (Zaccari et al., 2023). MST has been consistently associated with PTSD, depression, anxiety, substance use disorders, and chronic physical health conditions (Sumner et al., 2021). Analysis of VA electronic medical record data involving more than 500,000 women veterans found that approximately 26% screened positive for MST (Sumner et al., 2021). Among those affected, MST was strongly associated with psychiatric comorbidity, including the presence of two or more mental health diagnoses or concurrent mental and physical health conditions (Sumner et al., 2021).

Importantly, the consequences of MST and gender‑based harassment often extend beyond military service itself. Even after discharge, many women veterans report feeling unsafe or unwelcome in VA healthcare settings (Leung et al., 2020). In one national study, nearly one in four women veterans reported experiencing harassment within VA facilities, a factor closely linked to delayed or foregone care (Leung et al., 2020). Such experiences erode trust in healthcare systems and exacerbate existing mental health symptoms, further entrenching disparities in outcomes.

Addressing mental health inequities among female veterans requires coordinated, multi‑level interventions:

  • Patient‑level interventions: Care should be explicitly gender‑sensitive and trauma‑informed, recognizing the high prevalence of MST and its long‑term psychological sequelae. Technology-based and digital mental health approaches may help expand access to care for female veterans who experience barriers to traditional, in-person care (Akwe & Hunt, 2025).
  • Provider‑level interventions: Clinicians should receive targeted education on the unique psychiatric needs of women veterans, including the identification and management of trauma‑related disorders. Improved provider awareness and competency in trauma‑informed approaches are associated with better engagement and clinical outcomes (Alpert et al., 2023).
  • Organizational‑level interventions: Integrated care models may allow female veterans more options on where to receive mental health services, whether that is in primary care or specialty settings. A study of the VA’s Primary Care–Mental Health Integration (PC-MHI) found that women prefer readily accessible mental health care within primary care services, especially since they are noted to prioritize competing demands over medical care (Leung et al., 2020). Furthermore, women veterans were more likely to receive care in hospital-based clinics where women’s health clinics are commonly located (Leung et al., 2020).
  • Policy‑level interventions: System‑wide policy reforms are necessary to strengthen protections against harassment, expand eligibility for gender‑specific services, and enhance continuity of care for both active‑duty servicewomen and veterans. Evidence suggests that policy‑driven support mechanisms can help improve long‑term mental health outcomes among women affected by MST (Obradovic et al., 2025).

Female veterans have served under conditions that expose them to both the traditional stressors of military life and gender‑specific risks that compound psychological harm. Recognizing and addressing these invisible wounds is not only a clinical imperative but also a moral obligation. By implementing comprehensive, gender‑responsive strategies across patient, provider, organizational, and policy levels, healthcare systems can move toward equitable mental health care for those who have served. Such reforms have the potential not only to reduce psychiatric morbidity and suicide risk but also to improve trust, care engagement, and long-term quality of life among women veterans.

References

  1. Akwe, J. A., & Hunt, D. P. (2025). Enhancing Awareness and Care: Addressing Military Sexual Trauma among Women Veterans. Southern medical journal, 118(8), 517–521. https://doi.org/10.14423/SMJ.0000000000001855
  2. Alpert, E., Baier, A. L., & Galovski, T. E. (2023). Psychiatric Issues in Women Veterans. The Psychiatric clinics of North America, 46(3), 621–633. https://doi.org/10.1016/j.psc.2023.04.015
  3. Leung, L. B., Rubenstein, L. V., Post, E. P., Trivedi, R. B., Hamilton, A. B., Yoon, J., Jaske, E., & Yano, E. M. (2020). Association of Veterans Affairs Primary Care Mental Health Integration With Care Access Among Men and Women Veterans. JAMA network open, 3(10), e2020955. https://doi.org/10.1001/jamanetworkopen.2020.20955
  4. Marshall, V., Stryczek, K. C., Haverhals, L., Young, J., Au, D. H., Ho, P. M., Kaboli, P. J., Kirsh, S., & Sayre, G. (2021). The Focus They Deserve: Improving Women Veterans’ Health Care Access. Women’s health issues : official publication of the Jacobs Institute of Women’s Health, 31(4), 399–407. https://doi.org/10.1016/j.whi.2020.12.011
  5. Moore, M. J., Shawler, E., Jordan, C. H., & Jackson, C. A. (2023). Veteran and Military Mental Health Issues. In StatPearls. StatPearls Publishing.
  6. Obradovic, T., Rabin, S., Murphy, D., Fear, N. T., & Sharp, M. L. (2025). Mental health outcomes associated with military sexual trauma in serving and ex-servicewomen: A systematic review. Psychological medicine, 55, e287. https://doi.org/10.1017/S003329172510175X
  7. Sumner, J. A., Lynch, K. E., Viernes, B., Beckham, J. C., Coronado, G., Dennis, P. A., Tseng, C. H., & Ebrahimi, R. (2021). Military Sexual Trauma and Adverse Mental and Physical Health and Clinical Comorbidity in Women Veterans. Women’s health issues : official publication of the Jacobs Institute of Women’s Health, 31(6), 586–595. https://doi.org/10.1016/j.whi.2021.07.004
  8. U.S. Department of Veterans Affairs, Women Veterans Health Care. (2025, April). Facts and statistics. https://www.womenshealth.va.gov/materials-and-resources/facts-and-statistics.asp
  9. Zaccari, B., Higgins, M., Haywood, T. N., Patel, M., Emerson, D., Hubbard, K., Loftis, J. M., & Kelly, U. A. (2023). Yoga vs Cognitive Processing Therapy for Military Sexual Trauma-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA network open, 6(12), e2344862. https://doi.org/10.1001/jamanetworkopen.2023.44862

About the Authors

Rhea Prag, MS3

Rhea Prag is a third-year medical student from St. George’s University. She has a Bachelor of Science in Bioinformatics from Loyola University Chicago. She has worked with multiple organizations, including Humanism Service Organization and Neurodiversity Allies Society, where she worked closely with local youth and helped build supportive, inclusive communities. She is committed to serving underserved populations in her local area, focusing on strengthening relationships and fostering meaningful connections within the community. She is also a member of the Gender Equity Task Force with the American Medical Women’s Association. Outside of medicine, she enjoys discovering new books, experimenting with new recipes, and spending time with her family and friends.

Meghan Etsey, MD

Meghan Etsey is a PGY1 resident in Internal Medicine who earned her medical degree from St. George’s University. She holds a Bachelor of Arts in Biology and a Bachelor of Arts in Nutrition and Dietetics from Bluffton University in Bluffton, Ohio. During medical school, she served as President of the St. George’s University Women in Medicine chapter in St. George, Grenada, where she expanded community partnerships and worked to educate and empower women and youth. She also contributed as a member of the Gender Equity Task Force and the Sex and Gender Health Collaborative Committees within the American Medical Women’s Association. Outside of medicine, Meghan enjoys spending time with friends and family, often going on road trips and exploring new places.

Yun Weisholtz, MD-PhD

Dr. Yun Weisholtz is a physician-scientist and advisor with a deep commitment to mentorship and advancing equity in medicine. She completed her undergraduate studies at Stanford University, where she double-majored in Biological Sciences and Chemistry, and spent a year in Germany as a Fulbright Scholar. She went on to enter the MD-PhD program in Neuroscience at Harvard Medical School and MIT, where she developed her passion for research, teaching, and mentoring. Dr. Weisholtz is a Physician Advisor with MedSchoolCoach and the founder of MD-PhD Advising, a consulting practice dedicated to helping students navigate the medical school and residency application process. Outside of work, she enjoys collecting Delft pottery from the Netherlands and spending time with her family and pets.