“No Man Left Behind”: Conceptualizing Functioning and Increasing Access to Care for Male Survivors of Military Sexual Trauma

Kara Hokes

Advisor: Leah M Adams, PhD, Department of Psychology

Committee Members: Lauren Cattaneo, Keith Renshaw

Online Location, Online
April 05, 2024, 11:00 AM to 01:00 PM


Military sexual trauma (MST), or the perpetration of sexual harassment or sexual assault against a member of the military, continues to be a pervasive problem which affects many soldiers’ mental health (Fillo et al., 2018; SAPRO, 2021; Tannahill, 2020). Research on psychological sequelae and healthcare utilization among this population is limited and has primarily focused on female MST survivors (Monteith et al., 2019; Morris et al., 2014). Paper 1 presents an empirical analysis of sex differences in psychological functioning and patterns of healthcare utilization among survivors of MST. To reduce the influence of confounding variables sixty-one male survivors of MST were 1:1 propensity matched to female MST survivors on deployment status, race, age, experiences of military sexual harassment, and experiences of military sexual assault. There were significant differences in PTSD scores and life satisfaction, wherein male MST survivors reported higher PTSD symptomatology and lower life satisfaction than matched female MST survivors. Veteran sex did not significantly predict VA healthcare satisfaction, VA healthcare use, or non-VA (i.e., civilian) healthcare use. Analyses also examined veteran sex as a moderator of the relationship between mental health treatment use and psychological functioning. Paper 2 presents an integrative literature review focusing on the barriers which prevent male MST survivors from accessing effective healthcare within the Veterans Healthcare Administration (VHA). The VHA is a national institution that operates separately from civilian healthcare, with its own training, mandates, and screening processes (Trivedi et al., 2011). This integrative literature review applies an ecological model of healthcare access (Zinzow et al., 2021) to the VHA. Barriers to accessing healthcare for male MST survivors are outlined at each level of the ecological model. Recommendations for remediating these barriers are provided and include military culture interventions, research initiatives, and policy recommendations for changes to the VA’s organization of MST care.