Women of the Gulf War: Understanding Their Military and Health Experiences Over 30 Years

Abstract

Introduction Women Veterans of the Persian Gulf War (GW) expanded the military roles they had filled in previous military eras, with some women engaging in direct combat for the first time. Many GW service members, including women, had unique combat exposures to hazardous agents during deployment, which might have contributed to the development of chronic health problems. This study aims to understand the experiences of women GW Veterans (GWVs) as it is related to their military service and subsequent health in order to better inform and improve their clinical care. Materials and Methods We conducted in-depth interviews with 10 women GWVs to understand their experiences and perspectives about how their military service in the Gulf has impacted their lives and health. We used an integrated approach of content analysis and inductive thematic analysis to interpret interview data. Results Besides having many of the same war-related exposures as men, women faced additional challenges in a military that was inadequately prepared to accommodate them, and they felt disadvantaged as women within the military and local culture. After service, participants had emergent physical and mental health concerns, which they described as developing into chronic and complex conditions, affecting their relationships and careers. While seeking care and service connection at Veterans Health Administration (VA), women voiced frustration over claim denials and feeling dismissed. They provided suggestions of how VA services could be improved for women and GWVs. Participants found some nonpharmacological approaches for symptom management and coping strategies to be helpful. Conclusions Women in the GW encountered challenges in military and healthcare systems that were inadequately prepared to address their needs. Women faced chronic health conditions common to GWV and voiced the desire to be understood as a cohort with unique needs. There is an ongoing need to expand services within the VA for women GWVs, particularly involving psychosocial support and management of chronic illness. While the small sample size can limit generalizability, the nature of these in-depth, minimally guided interviews provides a rich narrative of the women GWVs in this geographically diverse sample.

A Systematic Review of Military to Civilian Transition: The Role of Gender

“…Womanhood, femininity, and non-heteronormativity were seen as weak and subordinate to military hegemonic masculine norms 31,47 . Service members shifted their values and beliefs to reflect those supported by the military institutions, which were in turn, reinforced through the execution of their military duties 44 .…”

“…These items were often ill-fitting and unsuited to the female statue, often resulting in injury 31 . These biases further extended to gender-specific health needs.…”

“…These biases further extended to gender-specific health needs. There were inadequate health services and medical expertise to manage genitourinary conditions and reproductive health concerns specific to women 13,31 .…”

Military Environmental Exposures

“…15 More than 650,000 troops served in these first Gulf wars, including many women serving in newly expanded military roles (including combat) that potentially exposed them to toxic agents. 16 Following the first Gulf War, there were several other key conflicts, including Operation Iraqi Freedom and Operation New Dawn in Iraq, which collectively lasted from March 2003 to December 2011. 5,14 In addition, any veteran who served in Afghanistan after October 2001, when Operation Enduring Freedom began, may have been exposed to chemical and environmental toxins.…”

“…Notable active military service in the Gulf region began during Operation Desert Shield and Operation Desert Storm from August 1990 to July 1991 15. More than 650,000 troops served in these first Gulf wars, including many women serving in newly expanded military roles (including combat) that potentially exposed them to toxic agents 16. Following the first Gulf War, there were several other key conflicts, including Operation Iraqi Freedom and Operation New Dawn in Iraq, which collectively lasted from March 2003 to December 2011 5, 14.…”