ABSTRACT:

Background: Over the past two decades, increasing numbers of women have served in the military, with women now comprising 17.3% of active-duty personnel and 21.4% of National Guard and reserves. During military service, women often incur painful musculoskeletal (MSK) injuries related to carrying heavy loads and wearing ill-fitting gear. While women may receive initial care for these injuries under the auspices of the Department of Defense (DoD), these injuries often linger and further treatment in required as women transition to Department of Veterans Affairs (VA) care. However, little is known about this transition process, and whether women are given adequate information and support regarding how to access VA care after their military service has ended.

Research Design: To better understand these issues, we interviewed 65 women veterans with military servicerelated MSK injuries about their transition from DoD to VA care. Results: Six major themes emerged from the interviews. Those themes were: (1) Military injuries are often related to ill-fitting gear or carrying heavy loads; (2) Stigma/discrimination related to military injuries; (3) Limited assistance with transition between DoD and VA to manage ongoing injuries and pain; (4) Women have a difficult time managing perceptions and expectations of their weight after military service; (5) Childcare is a substantial burden for veterans in self-care; and (6) veterans desire peer-support services to help them stay healthy.

Conclusions: Based on these findings, DoD and VA should continue to work together to develop programs to educate and support women as they transition from military to VA care. Furthermore, VA should consider developing peer support programs for women Veterans who may require additional support to maintain health, especially among Veteran mothers who have complex family responsibilities that may limit their ability to focus on their own health.

RESEARCH HIGHLIGHTS:

• The authors conducted 65 interviews with women veterans who experienced musculoskeletal injuries related to their military service to better understand their challenges in receiving care through the VA. Participants served in the Air Force, Army, Marine Corps, and Navy and all had separated within the past 10 year.  Interviews were conducted online from October 2022 to February 2023. All participants were recruited from two ongoing VA studies, the Women Veterans Cohort Study (WVCS) and the Center for Maternal and Infant Outcomes Research in Translation (COMFORT) study.
• Throughout the interviews, participants discussed how their military injuries were related to poor-fitting gear and carrying heavy loads of equipment. The women described facing stigma from their peers if they required treatment for the injuries, being made to feel they were not strong or resilient enough. Seeking treatment for lingering injuries through the VA after service also came with challenges, as many participants described the barriers they encountered to enroll in or access care.
• Women veterans noted that managing their weight and fitness post-service was challenging, and not having access to affordable childcare was a barrier to maintaining their health. Participants signaled wanting to engage in peersupport programs as a resource for health and fitness management.