WASHINGTON, DC—Sexual assault is a “national problem,” and one that the military is addressing in its ranks according to Dr Kaye Whitley, PhD, director of DoD’s Sexual Assault Prevention and Response Office (SAPRO), at the 2010 MHS Conference.

It is a health issue that can lead to PTSD and a decrease in resiliency in its victims. “We have research that male victims are more likely to get PTSD from sexual assault than from combat. There is research that says women, once sexually assaulted, are less resilient to other stresses,” she said.

Health care providers play an important role in helping victims, though it can be emotionally challenging for victims to step forward to get help. “When someone comes to you and says, ‘I have a cold, or I broke my arm, or was injured in combat,’ there is not a lot of stigma in reporting that. But, if you report a sexual assault, even to a health care professional, it is very difficult.”

In 2005, DoD updated its sexual assault policies to help get more victims to report crimes of sexual assault and seek care. As part of that effort, it developed an avenue for victims to get access to medical care without the involvement of law enforcement, which is known as restricted reporting.

When a victim chooses the option of restricted reporting, that individual can seek medical care without any details of the assault provided to a healthcare provider or to law enforcement. The sexual assault evidence is held for one year and victims who initially choose to make a restricted report can later convert to an unrestricted report and initiate an official investigation if they wish.

Prior to implementing this option, sexual assault victims in the military could not access medical care or advocacy services without the involvement of law enforcement and the command. The lack of confidential reporting was believed by DoD to be a barrier for military sexual assault victims to receive medical care and report the crime. “They didn’t want their commander to know … they were afraid it would hurt their career. They didn’t want to be that person who is pulled away from their jobs,” said Whitley.

In the military, the majority of sexual assault victims that come forward are females. However, it is not just an issue for females, according to Whitley. She pointed out that while the majority of victims that report sexual assaults are female in the military, in the VA the majority are male.This indicates that male victims may not be comfortable coming forward when in uniform.

Congress has mandated that DoD develop a sexual assault incidence database. A database of incidents will help to inform programs and policies, and provide installation-level breakdowns of sexual assault cases.

Sexual Assault Task Force Presents Report

Leaders of the DoD Task Force on Sexual Assault in the Military Services told a House subcommittee last month that while progress has been made in addressing sexual assault in the military, there is still room for improvement. The task force recently completed a congressionally mandated report that it presented to Congress that identified areas that DoD should strengthen in order to improve its response and prevention to sexual assault. “Sexual assault within the ranks is antiethical to the trust and camaraderie that defines military culture,” said Rep Susan Davis, D-CA, chairman of the House Armed Services Committee Military Personnel Subcommittee, at a hearing on the report.

The task force review found that DoD has made progress in addressing sexual assault since it created the SAPR Program in 2005, with improvements to responding to victims’ needs. However, among the findings of the report was that the SAPRO has limited visibility and that oversight of the program should be temporarily elevated to fall under the jurisdiction of the deputy secretary of defense for at least one year.

In addition, the task force stated that there needs to be sufficient funding for the program. “We further recommend that the SAPR Program be given a more permanent complexion. The DoD needs to communicate that the SAPR Program is here to stay, and illustrate that resolve through designated funding,” Louis Iasiello, PhD, who co-chaired the task force, told the House subcommittee.

Air Force Brig Gen Sharon KG Dunbar, who also co-chaired the task force, told the subcommittee that “the prevention of sexual assault should be the number one goal” of the SAPR Program and recommended that the SAPRO establish a very clear overarching prevention strategy.

The task force’s report also directly addressed the issue of male sexual assault victims in the military. In FY 2008, 179 men reported they were sexually assaulted according to the report. A recent anonymous survey, Gender Relations Survey of Active Duty Members, found that 6.8% of women and 1.8% of men in the military experienced unwanted sexual contact in the past 12 months.

The task force noted that civilian terminology and sexual assault prevention and response programs remain focused principally on female victims, and not males. “This terminology and these programs have been adopted by the military without consideration of the fact that the Armed Forces are comprised of 85% males and 15% females. This focus on female victims in a predominantly male environment makes it all the more difficult for male sexual assault victims to seek assistance.”

The report contained recommendations to strengthen the medical care of victims as well. The report recommended that male victims of sexual assault be provided a location other than a women’s health clinic for immediate and follow-up medical care. Currently, military hospitals are conducting SexualAssault Forensic Exams (SAFE) on some victims, including males in obstetrics/gynecology and women’s health clinic areas. In addition, the report found that medical professionals do not consistently offer male victims prophylaxis for HIV.

The report also recommended that DoD ensure that medical records of sexual assault victims are accurate and complete with respect to physical and emotional injuries. The task force found that military health care facilities are not adequately annotating victims’ military health records regarding sexual assaults. When military health records are incomplete, the VA has difficulty adjudicating claims for sexual trauma disability, particularly post-traumatic stress disorder.

The task force also recommended that the secretary of defense direct that military separation physicals include an assessment of sexual trauma, previously disclosed or undisclosed, during active duty service. This would be beneficial for victims seeking future benefits at the VA, the report stated.

The report also stated that Congress should enact a law exempting federal medical personnel from state provisions requiring them to report sexual assaults to civilian law enforcement to ensure all service members have the restricted reporting option. While DoD policy allows for restricted reporting, some state laws are in conflict with the federal Violence Against Women Act and DoD policy.

The task force also directed the secretary of defense to establish a SAFE education program at military teaching hospitals and wherever medics and corpsmen are trained. “Few contiguous Unites States military medical facilities conduct SAFE exams, citing the cost effectiveness of using community resources. This is inconsistent with DoD practice for most medical capabilities in which DoD provides resources to meet operational needs (including rotation in and out of an operational environment) and depends on community resources for shortfalls,” the report stated.

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