Women’s clinics at Veterans Affairs facilities are sometimes located in basements or obscure corners of the buildings, without adequate signage. V.A. facilities still usually do not offer some of the services that women require, such as prenatal care or obstetrics, and very few do mammograms.

Disabled American Veterans, an advocacy and assistance group, recently issued a report called “Women Veterans: The Long Journey Home,” which includes a list of recommended changes. Among them are establishing a culture of respect for women, providing access to peer support networks, requiring every Veterans Affairs clinic to have a gynecologist on staff, removing barriers to mental health services, and adding gender-sensitive mental health programs aimed at women. “One of the most perplexing problems is a culture in V.A. that is not perceived by women as welcoming, and does not afford them or their needs equal consideration,” said Joy J. Ilem, the group’s deputy national legislative director, at this year’s Senate hearing.

Part of the solution is simply explaining that female veterans exist. “We are invisible,” says Kathryn Wirkus, the founder of Women Veterans of Colorado. “Women vets come home and we blend back in. We go back to being mothers, wives, schoolteachers, nurses, doctors, whatever. We don’t hang out at bars wearing funny hats that say ‘World War II vet.’ We aren’t easily identified by our haircuts or the clothing that we wear. If I walked into a room, nobody would think I was a veteran.”

Once, when Ms. Wirkus sought treatment at a V.A. facility in Colorado, she was approached by a male veteran who asked what she was doing there. “I was like, ‘What the hell do you think I’ve been sitting here for 45 minutes for?’ ” she said. “They don’t think you’re a veteran. They think you’re somebody’s spouse, there to pick up meds for somebody else.”

Ms. Wirkus spoke with a woman who had been the victim of military sexual trauma and was suffering from PTSD, and who was told to participate in group therapy, even though the group consisted mostly of men and she was not comfortable in that setting. Congressional staff members on the Senate Committee on Veterans’ Affairs worked with a veteran who had a brain tumor that caused various health complications including weight gain, yet her condition was incorrectly diagnosed and referred to a weight loss clinic, rather than the specialist she needed to see. Only when she went outside the V.A. system did she receive help. Either because they do not believe the V.A. can offer them the care they need or because they do not understand that they qualify for the benefits, eligible women have been approximately 30 percent less likely to enroll in the system than eligible men.