A response to “Down and Out”

“Down and out: Ethical treatment of War Related PTSD in LGBT Veterans,” Professor Jennifer Terry (Respondent: Professor Beth Linker)

Professor Terry’s presentation “Down and Out” focused on the sociopolitical forces that influence the diagnosis and treatment of mental illness in LGBTI armed forces. In particular, she discussed the implications of policies, like Don’t Ask, Don’t Tell (DADT), on post traumatic stress disorder (PTSD) and military sexual trauma (MST). Professor Terry explained that mental illness in soldiers and veterans stems from war culture—not only the psychological trauma of being in battle, but also the treatment and actions behind closed doors in the name of unit cohesion and unquestioned authority. She shared anecdotes of demeaning sexual harassment and abuse imposed by anyone who did not ‘perform’ normative gender roles.  This leads to the phenomenon of “double PTSD” as a condition, coined by veteran Danny Ingram, experienced by LGBTI armed forces wherein they experience war trauma as well as the burden of hiding one’s identity. The volunteer nature of our army, meaning that more committees are of low socioeconomic status and of lower rank in the armed forces, makes soldiers susceptible to psychological trauma. These social factors are combined with policies like DADT, which Professor Terry believes created institutionalized silence and separation. The experience of LGBTI armed forces soon becomes a very isolating experience that deserves the attention of health care professionals. Professor Terry also argues that the repeal of DADT provides the opportunity to combat biolegitimacy by placing LGBTI mental health at the forefront of restructuring treatment for PTSD. She endorses personal and psychotherapy methods, such as counseling and support groups, which has the potential of having cohesive effect on healing communities.

Respondent Beth Linker illuminated the history of stigmatization of mental illness in the armed forces. I found the idea of physical trauma and combat injury as being heralded and mental illness acquired outside of the field of battle as stigmatizing to be striking. Professor Linker took this a step further by suggesting that PTSD diagnosis be split between combat and periphery causes. To me it seems like the periphery causes often relate to identity and status in society, whether as a female or the member of the LGBTI community, and can therefore have a far deeper cutting emotional effect on the patient. Who should be held responsible for the war culture that might be to blame for these experiences? Would changing this culture threaten the unit cohesion and unquestioned authority that serving our country requires? I beg to argue that a change will actually improve prospects in this arena.

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