The Combat Within: Female Veterans and PTSD Benefits

Courtney E. Martin

Maricela Guzman joined the military for the same reason so many young people do — she needed money for college. Raised in a working class, Mexican immigrant family in South Central Los Angeles, she dropped out of school at 16 so she could work at McDonald’s to supplement her family’s income. (The family was about to lose its home, burdened by a high-interest-rate mortgage that Guzman had negotiated herself at the age of 14 because she spoke the best English.) But Guzman was determined — she went back to school, eventually earned her high school diploma, and then went on to East Los Angeles Community College. Her mother threatened to take on a second job to help her with the tuition, so she did what many loving children would do. She signed up for the Navy.

Guzman tells me this story over a cup of coffee in a Starbucks in the Fairfax District of Los Angeles. She is 32 now and has to pause often to collect her thoughts. She wears her long, dark hair pulled back in a no-nonsense bun, making the dark circles under her eyes even more pronounced. She only slept two hours the night before (a fairly average amount of sleep for her these days). For more than a year after she got out of the military, she was unable to hold a job, lying lethargic and depressed in front of the television for days on end (something she say she never would have been capable of prior to her service). Her marriage dissolved. Suicide seemed like the only option. She had almost every sign of post traumatic stress disorder (PTSD).

And yet when Guzman applied for benefits, the military denied her claim for mental health care. In part, she suspects, this is because she never actually saw "combat" — defined as "active fighting in a war." (Women are still technically barred from combat, though some serve as military police and aboard combat ships.) She was stationed first at Diego Garcia, an island 1,000 miles off the coast of India, and then in Naples, Italy — pretty peaceful settings, you might imagine. But on the inside, Maricela Guzman was fighting the most difficult war of her life — coming to terms with the rape that she had endured in boot camp by a superior officer. She didn’t report it. It was her first sexual experience. "I felt like I died that day," she says.

It makes a certain amount of sense that the Veterans Affairs Office is compelled to differentiate combat from non-combat veterans. Those who have been exposed to improvised explosive devices (IEDs), the stress of direct negotiation, and the trials of patrol on a daily basis certainly have a higher rate of PTSD and other disabilities following their tour than those who have not. But it’s not a zero-sum game. When the sexual assault rates among female veterans are so astronomically high — at least 30, and as high as 70 percent, according to Helen Benedict, author of the new book The Lonely Soldier — the "combat" classification becomes a moot point. Keep in mind that sexual assault is a hugely underreported crime; even the Pentagon admits that only 10 to 20 percent of cases are probably being reported.

Add to this the reality that military culture is built on breaking down some of our most basic psychological instincts through humiliation, deprivation, and submission, and it becomes less and less logical to separate the soldiers who have seen combat from those who haven’t. Everyone who signs his or her name on the dotted line of a military contract is destined for psychological trauma of one kind or another, especially if they’re female.

Even those who do meet the military’s definition of PTSD have a long road ahead. According to the most recent report from the Department of Veterans Affairs, there are 7.8 million veterans in the VA health care system and only 342,624 of them have received PTSD compensation. Rewards vary as much as $7,000 state to state. The VA’s own report states, "Most VA personnel we interviewed suspected that PTSD awards are highly variable because of the perceived subjectivity in those decisions."

A study conducted by the VA in 2004 found that women veterans who had experienced military sexual assault (MSA) were nine times more likely to have PTSD — whether they had been in combat or not. The conclusion reads: "Although women with MSA are more likely to have PTSD, results suggest that they are receiving fewer health care services."

"What does combat even mean?" Guzman asks, with a fierceness she is reclaiming after years of therapy and becoming an activist. "The military uses it to prevent people from getting full benefits, but what’s almost worse is that activists in the veteran’s rights movement sometimes use it to separate people, too."

Even anti-war veterans sometimes sit around, sharing horror stories of their days in Iraq, and inadvertently magnify the importance of the combat classification. For Guzman and other veterans who feel ostracized from military culture, most of them women, this means enduring the indignity — once again — of not being seen as "real" soldiers because they do not share the combat experience.

It’s time that Department of Veterans Affairs got real about rape in the military. As The New York Times columnist Bob Herbert writes, "There is no real desire in the military to modify this aspect of its culture. It is an ultra-macho environment in which the overwhelming tendency has been to see all women — civilian and military, young and old, American and foreign — solely as sexual objects."

And beyond prevention, the VA has to rectify its process for determining veterans’ disability compensation, especially when it comes to mental health. Women like Guzman suffer for years if they leave the military undiagnosed, or almost worse, diagnosed but unable to afford the counseling they need. Guzman is still healing and struggling with the symptoms of PTSD, but she’s channeling all of her anger into activism. She has helped cofound an organization for women veterans called Service Women’s Action Network. And, in her role as the Peace Education Coordinator for the American Friends Service Committee, she does counter-recruitment trainings all over southern California. "I try to find the person I once was within those youth," she explains. "The work heals me."