what makes military sexual trauma (MST) different?

This was a regular question we struggled with as we started having critical conversations with the intent to bring about awareness on the true impact of MST. It was hard to articulate because unless you have served in the military it is hard to truly understand the culture and commitments required. By accepting to serve in the military you inherently surrender some rights; the main one being you cannot just go AWOL without explanation. 

If you have been sexually assaulted by someone in the military, it was done by someone you were trained and told you were supposed to trust with your life in a crisis. When that trust is betrayed, it causes a myriad of trauma; moral (and possibly physical injury), institutional betrayal, and post-traumatic stress.

Some differences are, but not limited to:

In the military:

• You usually know your perpetrator.
• You may have to continue working with your perpetrator if you are on a mission or assignment.
• You are racked with concern about your career when trying to decide to report or not.
• You must report through a chain of command, possibly having to be re-traumatized every time you have to relate your assault.
• You may continue to be threatened by your perpetrator to ensure you remain quiet; these can be physical or career threats.

In the civilian world:

• You are less likely to know your perpetrator.
• It is less likely that you may have to continue working alongside them.
• You likely have a better support system readily available; family, close friends, community based resources, and familiar medical practioners.
• You can take time off with less peer questioning.
• If someone at work finds out what happened to you, there is usually sympathy and concern more readily given vice being persecuted for "trying to destroy someone's career".

You will see PTSD-MST sometimes, because MST is not a diagnosis, it is the "mechanism of injury" that leads to PTSD. As research evolves, the term Post Traumatic Stress Injuries (PTSI) is being used more to describe those injuries that lead to a diagnosis of PTSD.  Nuances between MST, Moral Injury, Sanctuary Trauma are being more clearly defined.

In 2018, the Federal Framework on Post-Traumatic Stress Disorder Act (Act C-211) was passed by the Parliament of Canada to address the “clear need for persons who have served as first responders, firefighters, military personnel, corrections officers and members of the RCMP to receive direct and timely access to PTSD support.” 

This Act also called for the creation of a federal framework on PTSD, and the Public Health Agency of Canada (PHAC) was mandated to lead the development of this framework. 

It is important for Clinicians and Researchers to have clearly defined descriptions when treating or researching psychological trauma, and having a reference document is essential.

Having MST defined and included in Version 3.0 of the HPCDP Journal is a huge step in recognizing the unique differences of PTSD-MST from other psychological trauma. We were humbly grateful to be included in the wide reaching consultations on the draft definition to ensure PWLEs believe it to be a realistic definition vs strictly clinical based.