Female veterans need to see the gynecologist, too

In a teaser segment for Full Frontal, the new late-night show, host Samantha Bee offers a scathing look at the state of female veterans’ health care—which is so abysmal, it’s comical.

Bee kicks off the segment by noting that this will be a “historic” year for women in the military, as female troops are now officially eligible to fight alongside men in combat roles. From there, she asks: But when female veterans return home from the front lines, will the scandal-plagued VA healthcare system be ready to receive them?

The answer is: No. It will not. When women return home, they face a health care system that is wildly ill-equipped to handle their needs—mainly because, since its inception, the Department of Veterans Affairs has catered almost exclusively to men. Which is why, some argue, the military should launch a system that caters exclusively to women.

Among other things, Full Frontal’s investigation found that the VA’s computers have not even been updated to code for women-specific health concerns. “The computer system is extremely archaic,” says Jackie Maffucci, Research Director for Iraq and Afghanistan Veterans of America. “Cervical cancers and mammograms are not something you find in the coding system.” #Wut

Perhaps even more ridiculous, an Army Sergeant named Brenda Reed tells Bee that when she needed a prosthetic foot in 2013, the VA gave her a device that was made for a man. “I refer to it as my Frankenstein foot because it was so thick and white,” she says. Indeed, research has shown that women veterans are more likely to be unsuccessful in finding a prosthesis that fits, and women with amputations in the upper extremities are more likely to reject their prosthesis—issues that the VA is not ready to handle.

But the injustices revealed in the Full Frontal segment only scratch the surface of how dire the health care situation is for women veterans.

Women make up the fastest growing community in the veteran population—they currently account for 10% of veterans—and that number is expected to grow over the next few decades. “The VA has many more years of expertise treating men, but it has to catch up fast in terms of treating women with equal expertise in order to win the trust of female veterans,” Helen Thorpe, the author of Soldier Girls: The Battles of Three Women at Home and at War, told me over email.

Just how bad is it? According to a 2014 report from Disabled American Veterans, a third of VA health clinics don’t even have an OBGYN on staff, meaning any female veteran looking for gynecological services, breast care, prenatal and obstetrical care, neonatal care, or fertility services was either outsourced to a different medical facility (which can mean more costs) or they were just shit out of luck.

It’s no surprise that a 2015 report published by the VA itself and titled “Study of Barriers for Women Veterans to VA Healthcare” found that 72% of women don’t use the VA for primary care. Participants’ most commonly cited reason was that the VA facility near them did not provide the specific services they need as women.

In that same report, 75% of women veterans said that having one provider who can handle primary care and women’s services was important to them. And 60% of women veterans who relied on VA facilities endorsed the concept of clinics for women only.

Beyond providing care tailored to women, facilities geared exclusively to women would address another issue: Feeling safe.

According to the VA, one in four women veterans report experiencing military sexual trauma, which includes sexual assault or repeated, threatening sexual harassment. For this reason, many women seeking care when they return home do not feel comfortable going to a clinic that is primarily comprised of male patients and male doctors. In the 2015 report, 20% of women veterans said they avoided VA clinics because of past sexual trauma.

“Given the historically male dominated culture and patient base in VA facilities, women who already have misgivings about seeking care may be even more hesitant when faced with barriers of both mental health stigma and gender sensitivity issues,” stated the report.

Not only that, but women struggling with mental health issues linked to military sexual trauma don’t—for understandable reasons—feel comfortable attending VA-sponsored support groups that are mostly male. “It can be very hard for women who have faced military sexual trauma to be treated in group therapy sessions that include men. This is still the case at many VA locations,” said Thorpe, who has researched women veteran’s care.

The list goes on. In some facilities, VA doctors have prescribed women medications that could lead to birth defects, according to a 2014 investigation by the Associated Press.

That same probe found that female veterans are placed on the VA’s Electronic Wait List at a higher rate than male veterans. (Vets are placed on the list if an appointment is not available for 90 days or more.) Which makes sense—with relatively few adequate providers for women’s health care, fewer appointments are available.

And while this isn’t an issue that affects women exclusively, the VA also refuses to cover infertility treatments such as in-vitro fertilization, even if a patient’s issues are directly related to combat injuries.

The bottom line is that women require certain health services for female-specific issues—gynecological services, prenatal care, breast cancer, cardiovascular disease, PTSD, counseling for military sexual trauma, and so on—and the VA needs to find a way to provide this care. So is a women-only system the answer?

“Women-only clinics or women-only areas inside existing clinics will increase participation,” argues Thorpe. “The more friendly that the VA can become toward women, the more likely women are to obtain services there. Expertise with gynecological issues and issues related to pregnancy is a big need. So are providing tangible signs that the VA welcomes women.”

The numbers to back up Thorpe’s recommendations. According to the 2015 report, the women who were “most satisfied” with their care were the ones attending clinics specifically for women.

Hopefully, the VA will heed Full Frontal’s message—and its own reports.

Taryn Hillin is Fusion’s love and sex writer, with a large focus on the science of relationships. She also loves dogs, Bourbon barrel-aged beers and popcorn — not necessarily in that order.