With so many issues in the U.S. around sexual health what was the impetus for the Military Initiative? Where did the idea come from to do work with wounded soldiers?
The Center of Excellence for Sexual Health convenes a National Advisory Council (NAC). The NAC is an ethnically, racially, religiously, and politically diverse group of individuals from around the U.S. who have demonstrated leadership and commitment to sexual health in a range of settings and who represent many different populations. A member of our NAC who was intimately familiar with some of the unaddressed sexual health concerns among military personnel and their families suggested the Center of Excellence for Sexual Health consider focusing some of our energies and resources in this area. Subsequently, I was fortunate to be invited to participate on a panel that included some of our other NAC members to discuss sexual health concerns in last year’s Road to Recovery Conference hosted by the Coalition to Salute America’s Heroes.
The Road to Recovery Conference brought together 100 severely disabled service men and women injured in either Afghanistan or Iraq, and their families, to a hotel in Disney World for several days of information sharing, networking, education and direct access to service providers. The attendees were hungry for the sexuality information, education, and support we provided. We identified a clear need to reach the thousands of wounded heroes who did not have the opportunity to attend this conference.
What are some of the major sexual health issues you are aware of for soldiers who are returning from duty in Iraq and Afghanistan? First, it is important to note that sexual health encompasses more than the absence of disease and more than reproductive function. Sexual health includes how people feel about themselves as lovable and capable partners; establishing and maintaining intimate relationships; freedom from stigma, discrimination, sexual abuse, coercion and violence; and the ability to enjoy sexual pleasure and satisfaction. With a broad definition of sexual health in mind, the following are some of the sexual health related concerns faced by our wounded heroes and/or their partners:
Today’s service personnel are at high risk of sustaining penetrating, blunt, and burn njuries stemming from exploding munitions including bombs, grenades, land mines, missiles, mortar/artillery shells, and improvised explosive devices (IEDs). Trauma involving the genitals, brain, or spinal cord may directly lead to sexual dysfunction and infertility. Our service personnel are also at high risk for traumatic brain injury (TBI). TBI may cause a variety of sexual dysfunctions, problematic social and sexual behavior, and disruption in intimate relationships.
Individuals who have undergone amputations are likely to experience post-amputation pain, positioning difficulty and poor body image that often contribute to sexual difficulties.
Troops serving in Iraq and Afghanistan are at significant risk for developing post traumatic stress disorder (PTSD) and other mental health problems. Mental health issues such as these are associated with increased relationship difficulties, high-risk sexual behavior, and changes in sexual functioning. Medications used to treat dysfunctions like PTSD and depression may also cause sexual dysfunction.
Sexual violence and harassment may occur with greater frequency in combat zones. Women and men with both combat and military sexual trauma may be especially prone to relationship and sexual difficulties.
Lengthy periods of hospitalization and rehabilitation are very stressful for wounded service personnel and their spouses, whose relationships have already been strained by deployment. These couples are at especially high risk for marital conflict and divorce.
Even after immediate medical and rehabilitation needs are met, many men and women will face a range of long-term psychosocial and sexual challenges. Married veterans and their spouses will have to learn new ways of relating emotionally and sexually when service-related injuries negatively impact sexual functioning, mobility, communication, or mental functioning. Unmarried veterans will face new disability-related barriers to socializing, dating, and developing healthy sexual relationships.
