A groundbreaking policy in 2016 opened every job, unit, and location in the Army to women. However, despite clear guidance from Army Senior Leadership, patterns of frustratingly pervasive sexism and gender discrimination remain within our ranks. A Government Accountability Office study earlier this year found that female soldiers, who make up 15% of the Army, are 28% more likely to leave service than their male counterparts. The similarly disproportionally high rates of sexual harassment and assault military women experience speak for themselves. The brutal murder of Specialist Vanessa Guillen earlier this spring at Fort Hood resulted in a flood of personal stories shared under the hashtag #IAmVanessaGuillen. This was a tipping point that reinforced the need for unit level leaders to drive significant cultural change for our Army to be more inclusive of women. It pushed us beyond ignoring longstanding problems of gender discrimination.

Our Army’s success depends on bringing talented soldiers together in teams built on competence, resilience, discipline, and trust; to ensure every soldier can say with confidence and pride, “This is My Squad.”-GEN James McConville, The 40th CSA, 14 October 2020

Placing “People First” means we must combat gender discrimination. This is the right thing to do. But, more importantly, it is fundamental to our nation’s ability to innovate and outpace our adversaries. Research shows that diversity in the workplace leads to a more talented and competitive workforce. Diversity increases organizational adaptability and enhances problem solving capability, factors that have the potential to increase our effectiveness and military prowess. If our goal is to develop an unparalleled military force, then it is imperative we enable leaders to build teams that tap into unlimited potential. This means eradicating gender discrimination and sexual harassment/assault.  

One word of caution: Many units still have no or very few women serving within their ranks. This reality can lull those leaders to place less emphasis on gender inclusion until more women arrive at their units. We beg you not to fall into that trap. Units cannot simply “flip a switch” on cultural change. If you don’t have women in your unit now, you will. You likely work with other units that already do. Set conditions now for successful integration.

Sexism in the Ranks

Microaggressions, Standards and Corrections, Mentoring Women, Cohabitation, and Family Care Plans

Sexism is the “prejudice or discrimination on the basis of sex or gender, especially against women.” Sexism exists within our units, both overtly and covertly, with malice and without (i.e.: unconscious bias). It is deeply rooted in conventions left over from a male-dominated profession born out of a male-dominated culture. It thrives in comments, gestures, “jokes,” harassment, and preferential treatment toward men. Sexism lurks in our team rooms, on the ramps of our combat vehicles, in our command posts, off-duty, and online. 

Sexism casts a shadow over a unit where women are not fully integrated and equal members of the team. It impairs the performance and growth of those soldiers and gives cover to the elements that actively harm them. Sexism breeds a culture that objectifies and devalues women. It sets the stage for discrimination, sexual harassment, sexual assault, a hostile work environment, and retention issues among military women. To reap the benefits of a diverse and gender inclusive military force, we must address sexism. To this end, we review microaggressions toward sex, gender, and race in accordance with military standards.

On Sexist Microaggressions  

Microaggressions are prevalent vehicles for sexism. Sexist microaggressions are the commonplace verbal or behavioral indignities, whether intentional or unintentional, that communicate hostile, demeaning, or negative attitudes toward women. Some microaggressions are more subtle than others, but all of them speak volumes about who is, and isn’t, part of the team. For example…

“I bet she didn’t have to meet the same standards that I did.”

“She only got the job because she is a woman.”

“Have you noticed she and 1SG spend a lot of time together?” (insinuating a sexual relationship)

“You’re too pretty to be in the Army.” 

“The boys are out here getting after it.” (during a training event that includes women)

A tank named after a prominent female porn star.

“That’s what she said.” (in order to sexually charge an otherwise benign comment)

“Take care of your men and equipment.” (as commander’s guidance) 

“Good morning/afternoon, gentlemen.” (in meetings where women are present)

Sgt. Brittany Farley competes in the sprint, drag, carry at Camp Zama, Japan, June 9, 2020. (Winifred Brown)

These are merely examples, but once you start to listen for such comments, you will likely find aggressive terminology all around us. These kinds of statements diminish the accomplishments of talented women, while not extending the same sentiments to their male counterparts. Furthermore, these microaggressions are alienating and insulting. Leaders must be on the lookout for sexism and make corrections to ensure soldiers understand that sexist innuendos have no place in our Army. Make these corrections immediately, publically, and professionally. Your actions during these moments will set the tone for your unit and give women on your team the confidence that you are serious about their inclusion. Some examples of corrective statements are included below.

“Help me understand your thinking.”

“I’m not comfortable with that.”

“What I’m hearing you say is (harmful belief or stereotype). Is that what you’re saying?”

“That’s not funny to me. Can you explain the joke?”

“We don’t say things like that here.” (and avoid saying things like “we’re all thinking it but you shouldn’t say it out loud.”)

“Would you care to repeat that?” 

“I don’t share that belief.”

“That’s not okay with me.”

“What you just said is harmful.” (and bonus if you can explain why)

“I find that offensive.”        

These corrections should not be made in an effort to belittle or shame the offender. Ideally, they lead to productive discussions that shed light on the problematic nature of such comments. It also reinforces individual responsibility among us all in calling out sexist behavior, and is a clear demonstration of our adherence to the Army Values. 

On Standards and Corrections 

Leaders uphold standards through on-the-spot corrections. A common abdication of this responsibility, and one that signals policies affecting women are not of concern to the command, is a reliance on women to police grooming standards on other women. There is no clearer sign that some service members are not on the team than a leader who can’t be bothered to read three pages of a common regulation on women’s appearance.

That said, we are also mindful that Eurocentric hair standards can be damaging to women of color in the ranks. To achieve current standards for appearance, some women must use relaxers that can irritate or burn the scalp. Protective hairstyles such as braids, knots, twists, weaves, and wigs, while now authorized, are often targeted as “unprofessional” according to women we spoke with. 

Hair should not be a source of stress for a service member. It is often a source of identity, even confidence, for some women (and men). Leaders need to understand the struggles of textured and ethnic hair to reduce stress and prevent alienation among the ranks. Leaders with soldiers who struggle to maintain these standards should not assume they do so intentionally, and should instead engage in empathetic conversation to better understand why. Failing to understand and justly apply female and ethnic hair standards provides a vehicle for microagressions against women and black or non-white soldiers, discouraging them from feeling part of one cohesive Army team. 

On Mentoring Women

Applying standards unevenly extends beyond appearance and grooming. Members of the group recalled leaders who refused to meet with women behind closed doors, or worse, refused to mentor them at all, to avoid the perception of impropriety. Yet these same leaders did so comfortably with other men. A workplace focused on accomplishing the mission should be more concerned with the content of a conversation than the angle of a door. Keeping women at arm’s length, with the assumption that other women will take the junior soldier/officer under their wing, fails in several respects. 

First, it assumes that other women, particularly with more experience and rank, will be available to mentor junior women. Despite the “leaders first” policy for gender integrating combat arms, the overall percentage of women in the Army is low — female mentors simply may not be available, particularly for low-density MOSs. Second, it reinforces the stereotypes that women are by nature nurturing and that their concerns are too radically different from men’s. While this article shows there are some considerations unique to women, it is insufficient to assume such knowledge will be passed down through an informal Army sisterhood. Finally, it is a failure of leadership. If you are unable to competently and comfortably mentor your women as well as your men, then you are not forging the strongest team possible. This group recommends the book Athena Rising, which addresses this topic in detail and inspired the title of this article.

On Cohabitation

Cohabitation in field environments is often contentious and can create unintended sexism. For education and recommendations, we have included an article in the reading list titled “Committing to Gender Integration: Get Rid of the Female Tent,” which recommends units prioritize mission success over comfort, use informal leadership, and be comfortable asking “what’s best for the team?” However, keep in mind that, despite the practicality of these recommendations, you might have soldiers in your unit who remain uncomfortable with cohabitation. These concerns warrant consideration and merit candid and empathetic discussion with your teams to understand the origins of their anxiety so leaders can make informed decisions that balance mission requirements with the individual comfort level of soldiers. Compromises such as private changing areas and ground rules on clothing for all genders can alleviate these concerns. Units can also leverage the Army supply system to acquire individual pup tents, increasing unit field readiness and affording soldiers both privacy and comfort in gender-integrated environments.

On Family Care Plans for Military Women

Lastly, an often overlooked topic is the issue of family care plans and how leaders may approach them with a conscious or unconscious bias against women who serve in either dual military or single family homes. Leaders should be wary of the stereotype of women as primary caretakers and ensure family care plans are discussed equally among men and women in their formations. In dual military families, for example, there are two service members responsible for the family care plan. It is prejudice and irresponsible to assume the caretaker role defaults to the woman just because of traditional gender roles. Furthermore, while women do make up the majority of heads of household for single parent families, men also make up a significant percentage—24% to be exact. Therefore, we recommend you make no assumptions when approaching your soldiers about their family care plans. 

A Soldier assists in the laborious and delicate art of rigging and packing a parachute. (U.S. Army photo by Sgt. Benjamin Vilchez)

Sexual Harassment and Sexual Assault

SHARP Training, Reacting to a Sexual Assault, and Sexual Harassment/Assault against Military Men

#1 on the CSA’s Sexual Harassment/Assault, Response And Prevention (SHARP) Top 10 List is that “Sexual assault and sexual harassment represents an insider threat with the potential to cause significant, irreparable harm to the Army.” According to DoD statistical data, 1 in 4 women report they’ve been sexually assaulted. Unfortunately, this problem is not going away on its own, despite clear focus from senior leaders. Between 2016 and 2019, rates of reported sexual harassment and sexual assault across the DoD grew for both active duty men and women. This group acknowledges an uptick in reports might correlate with the success of programs that have more soldiers reporting who were previously uncomfortable doing so; regardless, we’ve still got a lot of work to do in our formations. 

Sexual harassment and assault are a form of fratricide, plain and simple. They destroy teams, decay unit cohesion, erode trust, and inflict lifelong trauma on victims. According to the DoD Inspector General, our soldiers might be more likely to develop post-traumatic stress disorder from a sexual assault than any other type of traumatic event, including combat. When it does happen, we must take appropriate action under the circumstances while providing support to victims. We also must get beyond a reactionary culture and dig deeper into creating a climate of mutual trust and respect where harassment and assault will not happen. Actions speak louder than words, and your soldiers will watch with great interest when these incidents occur.

Incidents of SH/SA are not naturally occurring phenomena that “happen” to victims. They are acts of violence most often perpetrated by one of the victim’s teammates. The FY19 Annual Report on Sexual Assault in the Military concludes that more than 85% of victims knew their assailant, and alcohol was involved in 62% of the assaults. By and large, our soldiers are not being attacked by the Hollywood depiction of an unknown perpetrator jumping out of the bushes at night. They are being attacked by their brothers and sisters in arms.

On SHARP Training

Units must train often on the prevention of sexual harassment and assault. Training must go beyond an annual handful of PowerPoint slides outlining reporting procedures and showing the “tea” video. Disseminating reporting procedures is certainly an important part of a comprehensive SHARP program, but we must do better. The Army has provided a plethora of SHARP training resources, readily available to all leaders. 

Training and education should make SHARP personal for your soldiers. It should provide a clear understanding that these are not things that happen “somewhere else.” Our soldiers should walk away from this training with a sense of anger and determination not to allow these things to happen to their teammates. 

Of note, this group does NOT recommend asking soldiers to share personal experiences of SH/SA. Instead, sanitized vignettes from previous SH/SA cases may be used as powerful tools to create dialogue and reinforce the humanization of male and female survivors. However, if you find that a survivor of harassment or assault is actively looking to share their story, it is crucial to support their ability to do so safely. We recommend you consult with your behavioral health team to ensure a safe and thoughtful avenue for disclosure. As leaders, we want to be careful to avoid retraumatizing the survivor.  

Sgt. Jasmine Jenkins, an M88 Recovery Vehicle commander, executes Table 4 mounted machine gun range, April 16, 2020. (U.S. Army photo by Gertrud Zach)

Training should also avoid victim blaming. Additionally, discussions on “defensive” strategies for women (e.g.: don’t walk alone at night, don’t drink, don’t be too friendly, wear conservative clothing, etc.) might be more effective if you ask women to discuss their common defensive measures so men can better understand their perspectives. Among our roundtable, the men were astonished to hear stories of women in the group describe complex navigations of social situations that were seemingly innocuous to us, such as drinking at unit functions or having a meeting with a male superior alone. Ultimately, while the reality is that women must still implement defensive measures, we recommend the preponderance of training focus on why SH/SA is unacceptable, the impact it has on victims, and why we should not harass or assault each other. 

SH/SA training should focus extensively on consent and include the concept of “enthusiastic consent,” which is the idea that unless both intimate partners give an enthusiastic “yes,” then there is no true consent. Additionally, it is important to reinforce that consent can be withdrawn at any time for any reason by either party. This is a subject where sexist stereotypes and microaggressions drive distorted perceptions for young adults. Discussions can and should extend beyond preventing rape, assault, and harassment to encouraging healthy sexual relationships.

Training should not center on repercussions for perpetrators. While it is true that SH/SA offenders can be subject to prosecution under UCMJ or the civilian justice system, that is tangential to the rationale for the training. The motivation should not be about avoiding jail time or other forms of punitive action; instead, it should be because in a team we treat each other with dignity and respect. If a leader is asked about false allegations, the leader should respond by educating the soldier on the process. All allegations will be investigated, and sometimes those allegations involve different versions of events from the alleged victim and the suspect. The military justice process is geared toward ensuring the accused maintains their Constitutional rights while determining whether the allegations meet the appropriate burden of proof. 

While each allegation of sexual assault will be investigated based on the facts and evidence presented, data from the Department of Defense indicates that a small percentage (1% in 2019) of accusations are determined to be false or baseless (compared to 63% where misconduct is substantiated) and, therefore, the fear of false allegations should not be the predominant concern for your soldiers if they do not harass or assault their teammates. It is clear that SHARP is rarely used as a tool to “get back at someone,” “get attention,” or “ruin someone’s career,” and instructors should focus the training to the task at hand: to eliminate sexual harassment and assault.

Lastly, we should avoid “fear mongering” or trivializing SHARP. By this, we mean the idea that accidentally bumping into someone, promoting a female soldier (removing and replacing the rank), making a uniform correction, or other clear instances of appropriate physical contact will result in SHARP complaints. When you hear someone make a reference about how someone “got SHARP’d,” use that as another opportunity to delineate appropriate from clearly inappropriate touching. 

Commanders should be deeply involved in the development of the instruction, physically present, and involved during the training. Training should cover the fundamentals of SHARP for every soldier in your unit, but you should also consider advanced education commensurate to leadership positions. For example, a block of instruction that goes into detail on receiving reports and providing support to victims for company commanders and first sergeants. To promote candid and comfortable conversations, commanders should think outside the box for innovative training methods, such as meaningful group participation, external resources, and guest speakers. Lastly, don’t allow someone to rapidly flip through slides while a sign-in roster is passed around. Many of the leaders in our group have experienced such “training,” and allowing this to happen is just as damaging as allowing a microaggression to go unchecked. As with all training, you will set the tone with your level of preparation and involvement, as well as the standards you enforce.

On Reacting to a Sexual Assault in your Unit and Supporting Victims

Commanders should plan and rehearse their Sexual Assault Response Plan with a heavy emphasis on support to victims. Response to a sexual assault is a battle drill that the staff and subordinate commanders must practice before it is put into action. Failure here is not an option. Our default should be that victims get whatever support they want or need within reason, and that they receive our deepest levels of empathy as they begin a long journey to recovery. Additionally, commanders must make a concerted effort to ensure victims (and alleged perpetrators) receive consistent updates on their case. Routinely follow up with them to ensure this is happening and engage the proper agency if it isn’t. 

Although survivors may respond variably to trauma, common, observable reactions to trauma include depressed mood, concentration issues, increased anxiety, being on edge/keyed up/overly alert, sleep problems/fatigue, hyper-sexual behavior, risk taking behavior, avoidance, increased alcohol use, illicit substance use, increased irritability, and isolation. While we, as non-healthcare providers, may not necessarily understand the linkage between these reactions and exposure to trauma, these symptoms are, in fact, well documented and based on decades of psychological research. It is important that we respond with empathy and use resources available to us and our formation, even if survivors seemingly do not match our expectation of “acting like a victim would.” If you observe these behaviors among soldiers who have experienced sexual assault, consult with your embedded behavioral health providers to formulate actionable plans that involve support and treatment. 

We also recommend that leaders be familiar with the legal process of making a report of sexual assault. Leaders should seek to answer the following questions: Who is allowed to know what (i.e.: confidentiality)? How do investigations work? What support is available to victims? What is the role of the special victim counsel? What can be done to alleged perpetrators while under investigation (e.g.: suspension of duties, relocation, protective orders, etc.)? What will we do if the accused is popular or high in rank? How will we prevent a backlash toward the victim or a “rallying” to support the accused while the investigation is ongoing? Some answers to these common questions can be found in the 2014 DoD Report on Sexual Assault Prevention and Response, as well as the Army’s SHARP website. 

It is also crucial to highlight resources in the local area for soldiers in the event they feel uncomfortable using on-post resources or if they are away from their installation when an incident occurs. Consult with your embedded behavioral health providers who will be knowledgeable about off-post referrals and community-based resources. 

We encourage leaders to be proactive in implementing these suggestions and educating themselves about sexual harassment and assault. Doing so will likely minimize potential missteps that may be common when navigating such sensitive and challenging situations. In service of this goal, consider collaborations with JAG and your Behavioral Health Officer to develop leader professional development (LPD) seminars to educate junior officers and noncommissioned officers. Lastly, this group advocates that Commanders send their organic medical providers to the Sexual Assault Medical Forensic Examiner (SAMFE) course in San Antonio. This training can be invaluable in the aftermath of a sexual assault, particularly in a deployed environment.

On Sexual Harassment and Assault Against Military Men

Although this article is focused on the unique issues faced by military women, we would be remiss if we did not acknowledge the occurrence of sexual harassment and sexual assault among military men. Per a VA report, 1 in 100 male veterans have experienced Military Sexual Trauma (MST). Although the rate of sexual harassment and sexual assault is higher among military women, there are significantly more men who are victims of sexual harassment or assault but never report. The lack of discourse and emphasis on male survivors of sexual trauma underscores sexist beliefs that men, or more harmfully put, “real men,” do not experience sexual harassment or assault. These are damaging messages rooted in a culture of sexism that not only disenfranchises women but also disempowers men to speak up when they have been victimized. An often overlooked idea is that sexism in our organization impacts us all, women AND men in uniform.

Army Spc. Catherine Downes moves through an obstacle during the 2020 U.S. Army Reserve Best Warrior Competition at Fort McCoy, Wis., Sept. 5, 2020. (U.S. Army Reserve photo by Staff Sgt. Kenneth D Burkhart)

Issues Impacting the Health of Women in the Army

Self-Advocacy, Field Hygiene, Contraception, Abortion, Family Planning, Fertility, Pregnancy & Postpartum, Miscarriages, and Breastfeeding.

Beyond creating a climate within units that eliminates sexism, sexual harassment, and sexual assault, there are several unique aspects to leading gender integrated units that remain taboo topics among some leaders in the Army. An important aspect of inclusion is to bring these issues to light and educate leaders so they aren’t relegated to hushed whispers between women who rely on generational knowledge passed down from generations to aid one another in survival. If you’re a leader in our Army, you should be familiar with the following women’s health topics so you can provide or enable the level of care and readiness that all of our soldiers deserve. 

On Self-Advocacy and Navigating Healthcare Systems

Statistics show that men and women are treated differently in healthcare settings. For instance, women wait longer to be treated for similar abdominal pain levels than men. The most at risk population for inequities in adequate pain mitigation is African American women. Black, American Indian, and Alaska Native (AI/AN) women are two to three times more likely to die from pregnancy-related causes than white women – and this disparity increases with age, according to research from the Center for Disease Control and Prevention (CDC) report in the MMWR. 

Soldiers’ pain should be acknowledged, and if a soldier is unsatisfied or confused with the care of providers, leaders must act by encouraging her or him to continue to work with the provider. If the soldier is still unsatisfied, resources are available, such as patient advocates and the Interactive Customer Evaluation (ICE) process. Give all soldiers the information they need to take charge of their health and the resources to identify the care they need.

On Field Hygiene & Sanitation

Field conditions present different considerations for women than men. With a proactive approach by leaders, women can be well prepared to remain healthy, avoid inconveniences, and be tactically effective. 

FM 21-10 (Field Hygiene & Sanitation) recommends all soldiers bathe as often as possible and daily for menstruating soldiers. However, this does not mean women must be evacuated to shower facilities, particularly when their male peers are not. Field expedient measures can be sufficient, but leaders must plan when and how they will afford all soldiers the resources and reasonable privacy to accomplish personal hygiene while in the field. There are great commercial options available for portable latrines and shower tents that provide sufficient privacy but do not take up space or require much time to establish.

Vaginitis and Urinary Tract Infections (UTIs) are two common conditions women can experience while in field conditions, but education, hygiene, and precautions can reduce the risk of infections. Check to confirm your medics, field sanitation team, and leaders are educated on ways to prevent these conditions and that all leaders (men and women) and healthcare professionals (i.e.: PAs, medics, etc.) are educating women on preventative measures.

In addition to urinary and vagina infections, women (and men) commonly experience fungal skin infections during field training. Hot and humid weather, excessive sweating, wet conditions, decreased hygiene, restrictive clothing, and pregnancy increase risk for developing a fungal infection. Typical locations include the breast folds, groin, and inner thighs. The preventative measures for fungal infections are good hygiene (frequent cleaning), changing socks and underwear frequently, staying dry, and applying powder to problem areas.  

Packing lists for women should include sufficient supplies of feminine hygiene products, but leaders should ensure unit medics maintain backup supplies of a variety of these products. These items are easily available in the Class VIII supply system and NSNs exist for ordering. Unexpected menstruation, or heavier than anticipated menstruation, should not cause undue stress if soldiers and leaders are prepared.

As a leader YOU are responsible for the complete sustainment plan of your unit. This includes  ensuring there are plans to properly dispose of all waste, including used feminine hygiene products. Soldiers should never be forced to carry these used items with them in Zip-Loc bags in their cargo pockets, as was the case for one of our participants.

A U.S. Military Academy cadet participates in an obstacle course during training at West Point, N.Y., July 20, 2020. (U.S. Army photo by Matthew Moeller)

Leaders should also plan to provide time and space for urination. Women who cannot urinate frequently or during restrictive operations will often limit their fluid intake, leading to dehydration and increasing their risk for other medical problems such as UTIs, heat injuries, kidney stones, and seizures. To assist women with urination, there are several optional Female Urinary Devices (FUD) available in the supply system. FUDs require some preparation and training to use (one source recommends practicing in the shower before going to the field), but the FUD can help women urinate through the fly of the uniform while standing and without having to remove gear. This skill and capability is particularly important for women restricted to the inside of combat vehicles during operations or in areas of high threat, such as IEDs, where dismounting is infeasible. 

On Contraception

Contraceptives have a wide range of benefits beyond preventing pregnancy, including reducing risk of reproductive cancers and regulating menstrual disorders. Access to contraception is also mandated by law. Indeed, Section 718 of the 2016 NDAA required the DoD to ensure “women members of the Armed Forces have access to comprehensive counseling on the full range of methods of contraception.” As such, leaders must educate themselves on various forms of contraceptives available to women. These include pills, implants, injections, vaginal rings, surgical procedures, and intrauterine devices (IUDs). To start, leaders can read about birth control basics here. 

Do not assume your soldiers understand the range of options available to them. Young women, especially those who did not have access to comprehensive sex education, might not know about the variety of available contraceptives or how to access them. To address this, we recommend you engage your unit medical provider to coordinate educational opportunities for your soldiers (e.g.: women’s health expo). You and your soldiers can also obtain contraceptive information and resources from your installation Women’s Wellness Clinic. This service received rave reviews among the women in our group. Lastly, we recommend you ensure leaders in your formation are equally knowledgeable about contraception. Conduct a leader’s recon to engage the staff on what services are available to your soldiers and request education for your leaders.

While healthcare providers strive to provide the best medical care to their patients, a 2019 Congressional Research Service study identified the lack of standardization for training on contraceptive methods among DoD healthcare providers as a potential issue. This specific issue could impact how female soldiers are counseled on the contraceptives available to them, particularly when needing to account for upcoming extended field exercises or deployments. We have no reason to suspect widespread negligence among Army healthcare providers, so we recommend engaging your unit providers to ensure soldiers are getting access to the contraceptives that best fit their needs. In other words, “trust but verify.” Lastly, advocate for your medics and unit providers to have time away from the Troop Medical Clinic for skills sustainment training, including OB/GYN and other specialty fields.

On Emergency Contraception and Abortion

Leaders should also understand and educate soldiers on the availability of emergency contraception. “Plan B” is available in military health facilities without a prescription. Abortions, however, are not performed in military medical facilities, nor are they covered under Tricare, unless the pregnancy is the result of an act of rape or incest, or the life of the mother is at risk. While abortion remains a controversial topic in the United States, and despite your personal beliefs, Army leaders should be aware that soldiers may choose to, and have the right to, terminate an unwanted pregnancy. 

With this in mind, it is worth educating both leaders and soldiers where safe facilities exist, understanding they could be located far away based on the availability of clinics. Depending on circumstances and location, government transportation may be authorized for transporting service members to gain access to an abortion. Women might not be inclined to discuss an abortion with their chain of command, but you should discuss it with the women in your formation so they know and trust you will provide non-judgmental support with aftercare. Understand that they might request time off work, a mileage pass, financial support, or a physical profile. Soldiers might not be comfortable with discussing why. With this in mind, we cannot overemphasize how important it is to develop trusting relationships with our soldiers.   

On Family Planning

Women in the Army face difficult decisions when choosing if and when to have children. The consensus of this group is that there is no magic solution or “perfect time” for women to become pregnant, give birth, and recover. However, across the board, the women within our roundtable were adamant that the empathetic support of leadership in the chain of command was the single greatest enabler to family planning, reduced stress, and a healthy pregnancy when it came to career-related issues.  

Leaders should avoid any assumption that all women want to, or are able to, become pregnant. Avoid asking questions such as, “When do you plan on having kids?” To be clear, these kinds of questions can be just as offensive to male service members afflicted with infertility issues. Rather, as with any soldier, we recommend you shape these discussions around the full spectrum of personal and professional goals. For example, you may choose to ask, “What are your short- and long-term family goals, and how can I support you?” This is perhaps the single greatest conversation driver a leader can ask. 

If a woman decides to discuss pregnancy as part of her goals, the leader should help the soldier develop a comprehensive plan that considers deployments, operational requirements, fertility challenges, options for limited duty, maternity leave, and postpartum recovery. This advice applies to men as well. Part of “People First” is showing soldiers that we care about their families, which includes letting them go to appointments and ensuring they can provide support to their spouse before, during, and after pregnancy.

On Fertility

Fertility is a critical aspect of family planning. With early career pressures, some soldiers might feel compelled to prolong family planning, increasing the risk of fertility issues. Additional risk factors associated with higher rates of infertility among military include exposure to toxins, use of psychiatric medication, and higher rates of sexual trauma. Although military women of various demographic backgrounds may experience fertility issues, infertility rates are highest among women in their 30s, senior enlisted/officers, married women, and non-Hispanic black women.

Fortunately, fertility programs exist for service members, retirees, and dependents at the following installations: Walter Reed (WRNMMC), Tripler (TAMC), Womack (WAMC), Madigan (MAMC), Joint Base San Antonio (SAMMC), and Naval San Diego (NMCSD). Although the Military Healthcare System has adopted these services, several access to care issues exist. For starters, fertility services are not covered by TRICARE, placing an undue financial burden on those seeking fertility treatments.

As leaders, we may not be able to solve organizational challenges to improve access to care; but, we can provide empathy and support to our soldiers struggling with infertility. It is important that we are aware of medical issues that disproportionately impact women in uniform. 

On Pregnancy

First and foremost, pregnant soldiers are not broken soldiers. You shouldn’t wrap them in bubble wrap and separate them from the rest of the unit. You also shouldn’t be upset because their pregnancy puts them in a non-deployable status or they miss the NTC rotation. Leaders must be deliberate in maintaining their inclusivity on the team by assigning them meaningful work that is within their capabilities. Put another way, a pregnancy is a limited time frame in a woman’s career when she is “on profile.” You should afford pregnant soldiers the same respect and latitude you provide to soldiers with any kind of profile. A lengthy profile that precludes someone from deploying doesn’t create a negative environment unless a leader encourages or condones it.

While every pregnancy is an intensely individualized experience, pregnant soldiers want to continue contributing to the team in a fulfilling way. Enabling this might require you to change the environment in which they work or the duties they perform, but you should not separate pregnant soldiers from their units. By including pregnant soldiers in planning and operations, you ensure they can more seamlessly reintegrate into their duty positions when they are postpartum.

While this group had plenty of great discussion on the topic of pregnancy, in the scope of this article we will not attempt to recreate the depth of material available in the Army’s 2010 “Guide to Female Soldier Readiness.”  While ten years old, it contains a wealth of information on environmental considerations for conception, pregnancy counseling, profiles, postpartum considerations, and many more. We highly recommend this document as a starting point for all leaders. However, some specific recommendations from this group are below.

Detailed pregnancy counseling should be done with every soldier, regardless of rank. This counseling should create shared understanding and open dialogue. Leaders must know their soldiers’ rights throughout pregnancy and postpartum. These discussions must also include honest dialogue about family care plans and options for administrative separation from the Army, should the soldier choose. The guide referenced above provides topics, outlines, and examples of effective pregnancy counseling. 

2nd Lt. Nicole M. Leighty establishes communication at the beginning of Cerberus Stakes, a 36-hour, nonstop training exercise executed by Cerberus Battery, 5th Battalion, 5th Air Defense Artillery Regiment. (U.S. Army photo by Sgt. Amanda Hunt)

Pregnancy and Postpartum Physical Training (P3T) is a tremendously beneficial program when executed to standard, and it is not optional. Leaders should familiarize themselves with the P3T programs at their installation. One key consideration is whether the P3T program is centralized or conducted at the brigade or battalion level (each has its advantages and disadvantages). Regardless, P3T programs must be run by individuals who have been properly trained and understand the long-lasting impacts of improper training while pregnant, not as an additional duty or tasking. Lastly, as a commander, you likely do PT with your platoons, but how often do you go do PT with the P3T program? This simple gesture demonstrates your support to all of your soldiers and allows you to spot check the effectiveness of the program.

Additionally, leaders should be aware that pregnant and postpartum soldiers may desire additional medical care that will require more time for appointments and for recovery. For example, soldiers may want to receive a referral to a pelvic floor physical therapy exam between 6-8 weeks postpartum to help alleviate future injuries and help guide soldiers as they begin safely training for the ACFT. This might be a scarce resource and not available on every installation, and it may require soldiers to attend frequent appointments off-post. However, the long term impacts on soldier well-being and ability to continue their physical fitness regimens post-pregnancy may rely on it.

On Miscarriages

Sadly, early loss of pregnancy (miscarriage) happens in up to 31% of pregnancies. While Army Regulation provides clear guidance for women who miscarry beyond 20 weeks, prior to 20 weeks is more heavily dependent on the empathy and decisions of the Chain of Command. With any miscarriage, there is likely tremendous grief that needs to be acknowledged along with physical, mental, and spiritual recovery for both partners in the relationship (if applicable). Commanders should provide extensive support and convalescent leave, if required, to allow for proper recovery after a miscarriage. Lastly, ensure you are engaging your profile providers to understand how they approach recovery for miscarrying soldiers. 

On Breastfeeding

It is critically important that Army leaders support breastfeeding soldiers, and that this support begins when the soldier is pregnant. The American Academy of Pediatrics advocates breastfeeding for the first 12 months of life and the World Health Organization recommends for the first 24 months. Breastfeeding may not be a short-lived experience for some mothers, so we must make it convenient for them. Not only is this the absolute right thing to do for the health of child and mother, it has been Army policy since 2015 with Army Directives 2015-37 and 43, and has been incorporated into the recent publication of AR 600-20.

Commanders are required to designate private and proper space, time, and provisions to express milk during field training, mobility exercises, and deployment (to maintain physiological capability for lactation). There are a variety of readily available resources to assist Army leaders in upholding these requirements and providing maximum support to breastfeeding mothers in your formation. When in doubt, contact a certified lactation consultant to assist you in establishing spaces or procedures to support breastfeeding mothers in your organization.

AR 600-20 articulates a number of requirements to support breastfeeding soldiers. In addition to those, here are some tips for leaders establishing lactation rooms in their organizations:

• A curtain to prevent someone from opening the door and exposing the soldier to people in the hallway, as well as the ability to lock the door from inside.
• A refrigerator for storage of milk (separate from community refrigerator).
• Comfortable chairs or couch with side tables.
• Power outlets easily accessible from chairs or couch. 
• Small lockers or cubbies for storage of pump supplies.
• Microwave to allow for sanitization of supplies between sessions.
• Drying racks for bottles.
• A phone and/or internet connection.
• Lactation consult materials from the clinic.
• Cork board to display pictures of babies. This is not merely a feel-good decoration, but actively aids in releasing hormones necessary for pumping. 

Ensure that leaders (and this may include you) are having candid discussions with postpartum soldiers who are going to the field. Postpartum soldiers may be concerned with maintaining their milk supplies and preventing infections. Uncertainty around pumping can lead to anxiety; therefore, leaders need to have safe field breast-pumping procedures that reduce the risk of medical complications associated with infrequent breast-pumping, such as mastitis. Mastitis occurs in up to 10% of breastfeeding women and is associated with oversupply of milk, infrequent feedings, and maternal stress/fatigue. While most common in the first 12 weeks postpartum, it can occur anytime while breastfeeding.

In addition to breast pumping procedures for the field, leaders will also need to develop a feasible logistics plan to transport breastmilk to a caregiver in the rear. This will require some planning and preparation, but one option would be to place breast milk in a cooler, take the cooler to a refrigeration unit at the field kitchen, transport it to the rear with LOGPAC, and then hand it off to the caregiver. If stored at refrigerated temperatures, breast milk can last up to 72 hours, which is a reasonable window for transportation.

Above all else, postpartum soldiers must know they are supported. A supportive command team will alleviate a good portion of that stress and anxiety, helping soldiers perform their tasks so they can focus on their training while in the field.

Lastly, this group investigated whether shipping breastmilk home while TDY is an authorized expense in accordance with the Joint Travel Regulation. Our assessment is that it can be authorized by a Defense Travel Systems (DTS) Approving Official (AO), and we spoke to women who have successfully done this. Interestingly, the words “breast,” “breastfeeding,” or “breast milk” are not specifically mentioned anywhere in the JTR, which this group recommends as an update to remove ambiguity. One word of caution, however, is that the overnight shipment of breastmilk could cost hundreds of dollars and not be fiscally reasonable given unit travel budgets. Units should forecast accordingly. 

After months of restriction due to Covid-19, a U.S. Army Paratrooper secures her equipment after an airborne operation from U.S. Air Force 86th Air Wing C-130 Hercules aircraft at Rivolto Italian Air Force Base, Udine Italy, June 24, 2020. (U.S. Army photo by Paolo Bovo)

––

The team who wrote this article sincerely hopes it assists unit level leaders in the continued integration of women in our Army. We believe very strongly that, aside from passionate leaders driving cultural change, teaching our leaders about the subjects above and empowering them with resources they need will have the most significant impact in this endeavor. This group encourages leaders to discuss the issues in this article, and our hope is this article provides a framework to lead those conversations. 

One idea is to form an informal “Soldier 2025 Forum” in your unit, where you talk about what your team wants the Army of the future to reflect in diversity and inclusion, and how you can take action at your level. This forum could be used to discuss ideas in this article on gender discrimination, along with other topics on race, ethnicity, sexual orientation, etc. on a monthly rotation. Through candid and engaged discussions such as this, leaders can help create the most integrated winning force our Army has ever seen.  

Army senior leaders have been crystal clear in this effort. In 2016, Under Secretary of the Army Patrick J. Murphy proclaimed, “We’re not going to turn our back on 50 percent of the population.” Support from senior leaders is absolutely necessary, but now the lion’s share of the work rests with leaders at the company and battalion levels.

But to be clear, none of the topics covered in this article are new experiences or solitary incidents. These are topics we, as a culture, have historically designated as “women’s problems” and slapped with a “taboo” label. Many service members have put up with patterns of being ostracized, many have spoken up, and far more have found themselves in command climates where they have not been able to share their concerns or experiences. By opening up this conversation and echoing the voices of women who have felt every shade of sexism, we are sowing the seeds for more empathetic leaders in the future. 

For the older leaders, the Army we joined many years ago is not the same one we are now called to lead. We must adapt.

Commanders must do their duty and crush the organizational and systemic obstacles facing women in their units so they can thrive to their fullest potential. Doing so will increase good order and discipline, improve retention of women in the Army, and enhance combat effectiveness. 

We are the greatest Army in the world, and that means we understand the entire world is watching. Young women who could enhance our military are hearing stories like these and watching with bated breath for our next move. Some may be deterred, but many are not. The next generation of Athenas are waiting in the wings.

Some soldiers may be tempted to fight this movement, but their time in the Army will eventually come to an end…sooner than later without behavioral changes. “People First” does not condone privileging soldiers and prejudicing others because of their gender, race, or religion. To those resistors, we implore you to educate yourselves and search inside your hearts and minds for factual truth: women are fully capable of meeting and exceeding the standards for service in all aspects of our Army. 

This truth has been proven by data, science, precedent, and the sheer grit of women who refuse to allow deep-rooted misogyny to stand in their way. Supporting women with the recommendations in this article is a necessary investment that will reap infinite returns.

To our sisters in arms: we hear you, we see you, and we support you. There are many more of us who wish to see you thrive than there are those who could ever have a hand in your downfall. Your allies will not stop fighting for you. 

Inch by inch, we will continue making this profession safe for you and all those who wish to follow. The changes we make here, the parts of our culture we address now, and the support we give down the line will only increase our Army’s effectiveness as a fighting force. 

This is MY Squad! And it is better because of the amazing women who are in it.

This tank crew, led by 1st Lt. Jillian Collins, shot 934 10/10. When asked, “Why Barbie Dreamhouse?,” 1st Lt. Collins had this to say: “Every little girl dreams of having a Barbie Dreamhouse. For me, it became my Tank. For years, I was told, “No.” I was told, “Armor isn’t open to Women;” but I kept pushing. Thus, I eventually found myself in my dream job with my very own Barbie Dreamhouse.” (Photo from @3rd_Infantry Twitter page)

The views expressed are those of the authors and do not reflect the official policy or position of the Medical Command, US Army, Defense Health Agency, Department of Defense or the US Government.

*Authors Listed Alphabetically

Capt. Ashley Barber received her commission through ROTC at Norwich University in 2013. She is a military intelligence officer currently serving in the 10th Mountain Division G2. She has previously served in MI brigades and IBCTs (LI). She completed her KD time in 2/10 IBCT (LI) as the brigade AS2 and the 2-87 Infantry Battalion S2 through iterations of LTP, JRTC, and a deployment to Afghanistan. She tweets at @BarbtheAsh.

Maj. Chris Barber is honored to serve as an Army Physician Assistant and PA educator. He is currently assigned to the Keller Army Community Hospital at West Point, NY. MAJ Barber spent 10 years as an enlisted infantryman before commissioning and attending the Interservice Physician Assistant Program (IPAP). He has multiple combat, operational, and humanitarian deployments. Any views expressed by MAJ Barber belong to him alone, and do not imply endorsement by the Defense Health Agency or Army Medical Command.

Lt. Col. Ian Fleischmann commissioned from the United States Military Academy in 2004 and is selected to command a military intelligence battalion. He is currently assigned as an operations officer with the Headquarters, Department of the Army, G-8. He is a career MI officer with intelligence assignments from battalion to division level in Infantry, Cavalry, Field Artillery, and Aviation units. He and his wife aspire daily to raise their three boys to be men of character. He tweets at @TecumsehBurning.

Capt. Michelle Gonzalez, PhD, is a clinical psychologist currently serving as the behavioral health officer for the 1st Armored Brigade Combat Team of the 3rd Infantry Division. Capt. Gonzalez has a long standing research and clinical career focused on serving ethnic, racial, economic, and gender minority groups. CPT Gonzalez has specialized clinical training in the treatment of sexual trauma with an emphasis in women’s mental health, having completed a Postdoctoral Fellowship at the Durham VA Medical Center. As a female Army Officer and research scientist, Capt. Gonzalez continues to “fight the good fight” in pursuit of gender equality and equal opportunity.

Lt. Col. Trey Guy received his commission through Army ROTC at the Virginia Military Institute in 2003 and is selected to command an air defense artillery battalion. He is a career Air Defense officer, currently working as an instructor at the Joint Forces Staff College. He has served in short range air defense units as well as joint and combined assignments. He is a proud and loving husband and devoted father to two young ladies and two young men. He tweets at @Treyguy13.

2nd Lt. Gillian Longoria is an armor officer currently attending ABOLC at Fort Benning, GA. She is a proud 3rd generation service member, a TCU grad, and a survivor. She hopes to inspire other young Hispanic women to find their voices in the military.

Capt. Christina Lowry commissioned as a chemical officer and served with the 10th Combat Aviation Brigade, including rotations to Korea and Germany. She is a survivor who pursued law school in the hope of empowering and supporting other survivors. Having graduated from law school through the Funded Legal Education Program, she is currently attending the Judge Advocate Officer Basic Course with orders to Fort Sill.

Lt. Col. Tony Newman received his commission through ROTC at Rochester Institute of Technology in 2003. He served as a logistics officer in tactical, operational, and strategic positions. He is currently assigned to the White House Communications Agency and will take command of a brigade support battalion next summer. He is a husband and father to two daughters and two sons. He tweets at @ABNSupplyGuy.

Lt. Col. Stoney Portis is a PhD student at Duke University and will take command of a combined arms battalion next summer. He tweets at @stoneyportis.

Spc. Sheyla Scholl is a former CBRN soldier of the Minnesota Army National Guard, spouse to an active duty Airman, and a mom of two. After being diagnosed with stage 4 blood cancer in 2017 at 19 years old, she founded a nonprofit called Combat Boots & Cancer to help change the military’s attitude toward injury and disease while serving. She has served as a consumer reviewer on the Congressionally Directed Medical Research Program twice. She is a dedicated public policy advocate for issues affecting national guardsmen, cancer patients, disability in the military, and survivors of sexual violence, while healing from her own military sexual trauma. She tweets at @terminalyill3st.

1st Lt. Neha Sharma is an intelligence officer in the US Army Reserve, pending active orders in USAG Wiesbaden, Germany. Originally from Chennai, India, 1st Lt. Sharma immigrated to the United States right before 9/11. She is currently working on her second master’s degree, is a published researcher, civil rights activist, women’s rights advocate, and a survivor. She tweets at @appasglock.

Lt. Col. Scott Stephens is an armor officer and commander of a combined arms battalion. In his 22 years of service, he has led armor and combined arms units from the platoon to battalion level through multiple combat and rotational deployments, as well as serving in a variety of broadening assignments. He is the proud husband of an Army veteran, and the loving father of one fierce young woman and two amazing young men. He tweets at @scottjstephens.

Capt. Jordan Supan is a logistics officer currently commanding the Brigade Field Maintenance Company for 3rd Brigade Combat Team at Fort Hood, Texas. She was enrolled in the Simultaneous Membership Program while in college, serving in the Georgia National Guard while pursuing her commission through Georgia Southern University’s ROTC Program. The daughter and granddaughter of service members, she has long been an advocate for comprehensive gender inclusion of all military branches and combat roles. As a survivor, she is dedicated to inciting change in our Army to create an organization that will support our personnel, allow them to thrive, and provide them with the dignity and respect owed to all people in our formation. She tweets at @MarchingWith7.

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Recommended Reading

• Army Regulation 600-20
• Athena Rising, by David Smith and W. Brad Johnson
• The GAMe: Unraveling a Military Sex Scandal, by MG(R) Robert Shadley.
• Know My Name, by Chanel Miller
• “The Men Who Mentor Women,” Harvard Business Review
• A Higher Standard, by GEN Ann Dunwoody
• Invisible Women: Data Bias in a World Designed for Men, by Caroline Criado Perez
• A Good Time to be a Girl: Don’t Lean In, Change the System, by Helena Morrissey
• Tough As Nails: One Woman’s Journey Through West Point, by Gail O’Sullivan Dwyer
• 2010 Army Guide to Female Soldier Readiness
• “Committing to Gender Integration: Get Rid of the Female Tent,” by Captain Ashley Barber
• “When Doctors Downplay Women’s Health Concerns” by Camille Noe Pagán
• “Sex Signals,” by Catharsis Productions;
• “Writing About Rape: Use of the passive voice and other distancing text features as an expression of perceived responsibility of the victim” by Gerd Bohner
• That’s What She Said: What Men Need to Know (and Women Need to Tell Them) About Working Together, by Joanne Lipman
• Gender Intelligence: Breakthrough Strategies for Increasing Diversity and Improving Your Bottom Line, by Barbara Annis and Keith Merron
• Red Table Talk: Sexual Consent and What Every Woman Should Know,