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A woman Marine recruit. A new report has concluded that officials need to do more to prevent sexual assaults in the military. (Flickr/Expert Infantry.) Ad Policy

Female veterans who suffered a sexual assault in the military are nine times more likely to develop post-traumatic stress disorder compared to other female veterans, and military officials must do more to prevent these assaults—these are the conclusions of a gripping new government report on the hardships faced by troops returning from Iraq and Afghanistan.

Mandated by the 2008 National Defense Authorization Act, the 794-page study from the Institute of Medicine is a product of over four years of intense research into what troops face as they return from Iraq and Afghanistan. It’s a gripping portrait of post-traumatic stress disorders among some troops, along with traumatic brain injuries, barriers to healthcare, and problems re-adjusting to family and society.

We will be diving into many aspects of this report in the coming days and weeks, but conclusions about military sexual assault were remarkable.

The study found extremely high rates of military sexual trauma, both in men and women. About 48,100 women and 43,700 men reported suffering military sexual trauma, the authors note.

These relatively even numbers are a useful reminder that sexual assault in the military happens not only to women, but men—as was demonstrated at a powerful Senate hearing last week. But women comprise only 14 percent of active-duty military, so even raw numbers don’t reflect the fact that women, in much greater proportions, are the victims of military sexual assault. Over 21 percent of female troops reported military sexual trauma, compared to under 2 percent of men.

And many more assaults no doubt go unreported. The study points to research suggesting as much as 45 percent of female troops experience military sexual trauma. Elsewhere, the Department of Defense estimates that 86.5 percent of violent sexual assaults go unreported.

The study focuses on what these traumas mean for female veteran’s health: as noted, it concludes that women who have suffered a sexual assault in the military are nine times more likely to develop PTSD than female veterans with no history of sexual abuse. Female victims are also at much greater risk for a wide variety of other problems upon return: anxiety, depression, substance abuse and family troubles.

These results explicitly control for other factors that lead to PTSD. Contrary to many conservative talking points when Obama lifted the restriction on women in combat, the research cited in this study found that women handle combat-related stress just as well as men—military sexual trauma is a singular factor bumping up the prevalence of PTSD among women:

Controlling for prior-life trauma and sexual harassment, the authors found only one statistically significant difference that suggested that men may be more likely to suffer substance abuse after exposure to combat. However, the effect was small and considered clinically insignificant. They concluded that the effects of combat-related stressors “may be more similar than different for female and male US service members” and that female OEF and OIF “service members may be as resilient to combat-related stress as men.” A study of UK military men and women (Woodhead et al., 2012) concluded similarly that their investigation showed “little evidence of gender differences in the impact of exposure to combat on mental health.”

PTSD then leads to a whole host of other problems, the study found. Veterans with PTSD are four times more likely to have suicidal thoughts, for example, and suffer disproportionate amounts of depression, anxiety, and difficulty readjusting to family and society. (Interestingly, the study found that women with PTSD are more likely to report health problems and feel depressed, where men are more likely to report feeling more anger.)

So what should the military do? The report recommends instituting a zero-tolerance attitude towards military sexual assault by developing new policies, more strongly enforcing current policies and making effective handling of sexual assault complaints a mandatory part of all performance reviews and promotion systems.

The report comes amidst increasing Congressional focus on military sexual trauma. Senator Jon Tester (D-MT) and Representative Chellie Pingree (D-ME) introduced a bill last month that would make it easier for victims to receive treatment—the law would force the Veteran’s Affairs Department to accept a soldier’s word that his or her disability is related to a sexual assault or rape in the military, barring evidence clearly pointing to the contrary. Titled the Ruth Moore Act, it’s named after a Navy veteran who struggled for twenty-three years to receive full disability benefits for trauma suffered after two military rapes—one of which was allegedly in retaliation for Moore’s reporting of the first assault.

Pingree told The Nation that she welcomed the study, but that it was past time for military leaders to act. “I’m glad we are getting some hard data from this report, but honestly the evidence that sexual assault in the military has been a huge and pervasive problem has been ignored for a long time. This report identified many stressors that come with being deployed in a war zone, but only one—sexual assault—is completely avoidable and has nothing to do with fighting a war,” she said.

“We will probably never be able to completely eliminate the trauma of going to war, but we cannot and should not tolerate any sexual assault within the military,” Pingree continued. “I do not think that commanders will be able to prevent every case of sexual assault, but I do agree that we should examine how they address this issue within their units.”

Senator Kristen Gillibrand (D-NY), meanwhile, explored the idea of independent prosecutors for military sexual assault claims during a Senate hearing last month, and Senator Claire McCaskill (D-MO) will soon introduce a bill that would change the Uniform Code of Military Justice to make it impossible for military commanders to overturn military jury verdicts—as they sometimes do in cases of sexual assault.

Read George Zornick on how Democrats and Republicans worked together … to repeal a sensible tax on medical devices that would have raised $30 billion for healthcare reform over ten years.