We sent them to war - now we have to treat them

It is no surprise that the military and the VA is lagging behind in the delivery of healthcare services to women - until the early 70's, women in the military could not have dependents. Women who got pregnant were dismissed from service. Back then, they used to say that if the Army wanted you to have a baby, it would have issued you one.

Now, 35 years later, women have made great strides toward equality that coincided with an all-volunteer military, and women now comprise 20% of the uniformed services. I never thought that we would see numbers like that in my lifetime, but here we are, and that number is quite real.

Well, we have come so far that we are now sending women to war - 180,000 have deployed to the wars in Afghanistan and Iraq - and one of the consequences of doing so is presenting itself in the VA health system, because when they come home, they want the benefits they earned. Last year the VA treated just over 250,000 female veterans, but that number is projected to double within five years.

VA officials say they're better prepared to handle female patients than they were several years ago. But they acknowledge "continual challenges" as they move to open the door to a man's world, where pap smears and mammograms could become as common as prostate exams.

And where "military sexual trauma" would be treated as a serious and growing mental health problem, rather than as a subject to be avoided.

"It's not your father's VA — it really isn't," said Patricia Hayes, the VA's national director of women's health care issues. "We have geared up and are gearing up. But there are places that may have gaps."

Others say the agency is far from prepared. And given the VA's chronic budget shortfalls and increasing demands from the rapidly growing number of male veterans, the task could be even harder than expected.

"They aren't ready," said Sen. Patty Murray, D-Wash., said of VA officials. "Absent a proactive, concerted effort and knowing their limited resources, they (VA officials) are struggling with so much this might get lost."

Murray, perhaps the leading VA critic on Capitol Hill, has introduced legislation that requires studying how serving in Iraq and Afghanistan has affected the physical, mental and reproductive health of women, and how the VA is dealing with their problems.

The legislation also would require the VA to start caring for newborn children of female veterans who are receiving maternity care. Currently the VA doesn't cover newborn costs. In addition, it would require increased training for VA personnel dealing with military sexual trauma and post-traumatic stress disorder, or PTSD, in women.

Murray's bill will receive a hearing in the Senate Veterans Affairs Committee tomorrow. "It's a hard issue, and pouring a huge light on this is a risk, as some will say women just shouldn't be in the military," Murray said. "But as more women transition home from the physical and mental wounds of war and step back into lives as mothers, wives and citizens, the VA must be there for them."

It is imperative that the VA be fully funded, and that the services that female veterans will need - and have earned - be implemented and available. To do less would surpass unconscionable and go right to betrayal.