It's Tuesday night and Tammy Figueroa, outreach coordinator for the women veterans organization Grace After Fire, is leading a women's peer support group at Bringing Everyone in the Zone in Killeen.
The meeting's focus is on anger — how it can be used for good, and how it can be less constructive.
There is laughter and there are tears. Figueroa, an Army veteran, listens far more than she speaks. She volunteers personal information, it seems, only to identify with and encourage the women around her.
One such experience — the one Figueroa leads with in her introduction — is military sexual trauma. "I'm a survivor of MST," she tells the group, using the acronym often used to describe the unwanted, persistent advances or sexual assault that one in five female veterans and one in 100 male veterans have experienced, according to the Department of Veterans Affairs.
A growing problem
Some 3,191 sexual assaults were reported in the military last year but due to the historically underreported nature of such crimes, the true incidence of sexual assault likely approaches 19,000, according to a Defense Department estimate. In 2010, the military received 3,158 reports of sexual assault, 1,781 of which involved Army personnel, according to information from the Army.
Although it's unclear whether more incidents occurred or more simply were reported, the trend also was seen at military academies. In December, the Pentagon said 65 sexual assaults were reported at the academies during the 2010-2011 academic year, the highest total on record going back to 2004.
Like their civilian counterparts, veterans who experience military sexual trauma can suffer from an array of resultant problems, including post-traumatic stress disorder.
A recent study published by the Jacob's Institute of Women's Health at George Washington University found that 31 percent of female veterans of the wars in Iraq and Afghanistan suffering from PTSD had experienced military sexual trauma.
Among those with PTSD, veterans with MST had more comorbid mental health diagnoses than those without MST, including depression, anxiety and eating disorders. Men were more likely to receive comorbid substance use disorder diagnoses.
Specific behaviors can include self-isolation, elevated engagement in safety activities, such as checking and rechecking locks or sleeping with a weapon, said Kimberly Bayes-Bautista, a social worker with Carl R. Darnall Army Medical Center.
Victims also may sexually "act out" to take back control or lose all interest in sex, she added. They may blame themselves or abuse drugs or alcohol; depression and suicidal or homicidal thoughts also may be present.
Violation of trust
Although numerous factors can affect how a soldier responds to military sexual trauma, said Bayes-Bautista, "If an offender of a sexual assault was (another) soldier, it is likely the soldier as victim would experience a shattered belief system in the Army values of loyalty, duty, respect, selfless service, honor, integrity and personal courage."
Leona DeLano, an Air Force veteran and counselor at Scott & White Healthcare's confidential Military Homefront Services in Killeen, agreed.
"In the military, the lower-enlisted (personnel) and lower-ranking officers by definition have to rely on those in leadership positions to take care of them," she said. "(But) more often than not, (MST) comes from that very chain of command, and it corrupts that trust."
Quoting the Pentagon's most recent report on MST, with figures from 2010, DeLano said 72 percent of victims are privates through specialists, or lower-enlisted soldiers.
As in the civilian world, said Maureen Jouett, executive director of Bringing Everyone In the Zone, MST "isn't about sex. It's about power and control. A lot of the time, women go into the military, and it appears to me it's their first time away from home, and they're vulnerable."
Figueroa's military sexual trauma began shortly after the then-20-something mother and operating room specialist arrived at her assignment at the former Walter Reed Army Medical Center in 1994. Just ending a bad marriage, she was temporarily in a wheelchair due to a cumulative back injury. One evening, the specialist found herself alone in an operating room with a lieutenant in her company, who exposed himself to her.
Figueroa said nothing and left the building. The next day, she said, the lieutenant found her and told her there would be professional repercussions for not keeping her mouth shut.
The unwanted advances continued, almost on a daily basis, and as the lieutenant began demanding oral sex, his frustration with her refusals grew. Soon, she said, the lieutenant labeled her a "trouble-maker" within the unit — so much so that she lost rank due to vague accounts of "insubordination" and was referred to mental health professionals, who couldn't find anything wrong with her.
Despite the chaos the officer was causing in her life, Figueroa said she didn't report him for fear of losing her job. And, it seemed like he had the power to make that happen, she said. Everything he warned her he would do, he did, during her 18 months in his company.
"I felt shackled, mentally," said Figueroa, now 39. "I felt like I had no one to talk to. It changed my life and how I dealt with people."
Figueroa said she also feared for her safety outside of work, as the lieutenant began to appear at her high-rise apartment building. First, she said, he just sat in the lobby, but eventually began to visit her 11th-floor apartment to "check up" on her and her young son.
'Protect their own'
Instead of outing the officer, Figueroa said she pleaded to change companies. Her wish was eventually granted and she transferred to a company where she was treated well. She was less than disappointed, however, when she was soon medically discharged due to her back injury.
Although the high school track athlete joined the Army to do something "different" and be among the first in her Lubbock-based family to attend college, her experience with the lieutenant all but soured her on the military. "I never thought something like this could happen," she said. "I thought they would protect their own."
Figueroa didn't acknowledge the experience for more than a decade, even though she knew it was affecting her life. She felt a physical aversion to watching violence against women on television or films, hardly went out after dark and carried a Taser in her purse. She only began to deal with the problem several years ago, around the time she met her current husband.
"It was very hard to trust (him) at first," she said. "It took a while to want to be in a relationship, but (when I told him about my MST), it made him want to be a part of my life even more."
Figueroa, who lives in Nolanville, said she has since been diagnosed by the Veterans Administration with post-traumatic stress disorder stemming from her military sexual trauma.
Solutions into practice
In a news conference last month, Defense Secretary Leon Panetta announced a series of initiatives to strengthen victim care and protection, including the standardization of victim advocate training and certification and the expansion of the victim advocacy program to military spouses and dependents.
"(Because) sexual assault cases are some of the toughest cases to investigate and prosecute," said Panetta,
$9.3 million would be set aside for training investigators and military lawyers during the next five years.
The department is creating an integrated data system to track sexual assault reports and monitor case management, too. Panetta also demanded an immediate Pentagon assessment of how commanding officers and senior enlisted personnel are trained on sexual assault prevention and response.
In December, the Pentagon also announced new policies regarding reports on sexual assault. People filing unrestricted reports — which get passed on to their chains of command and law enforcement for investigation — may apply for an immediate transfer from their unit or installation. Additionally, reports to law enforcement officials must be kept on file for 50 years, allowing veterans to file claims at the VA at a later date.
Restricted reports, which do not get passed along to law enforcement or chains of command, must now be kept on file for five years.
Initiatives at Fort Hood
Locally, Army Community Services' Sexual Assault Prevention and Response Program manager Mark Francis said further Pentagon initiatives to curb sexual harassment and assault are under way. The installation is on track for merging its sexual assault and sexual harassment prevention staffs and procedures into one program, Sexual Harassment/Assault Response and Prevention, by the October deadline, he said.
"I think it's a great move," said Francis. Not only does it heighten awareness of the prohibition of sexual harassment, but "Army studies have shown that sexual harassment can lead into sexual assault."
Billy Floyd, manager of Fort Hood's Family Advocacy Program, said the post is committed from its corps commander down to the company level to "making sure the sexual assault services and programs are effective." That includes building an environment where reporting sexual trauma is encouraged, not stigmatized, she said.
Numbers of sexual assaults reported at Fort Hood were not available.
Bayes-Bautista said personnel who have experienced sexual trauma can go to Darnall's emergency department where a medical team, including a social worker will tend to the victim's immediate medical needs.
One of the post's 11 victim advocates also is called to brief victims on restricted or unrestricted reporting options. Regardless of their choice, victims can elect to receive a forensic sexual assault examination at Scott & White Hospital by a sexual assault nurse examiner.
Follow-up medical care is provided by a sexual assault care provider and Darnall's Department of Social Work is contacted to initiate services. Victims who desire treatment can select a variety of options, including individual or group counseling, or both, with the possibility of a referral to a psychiatrist for medication or other medical treatment. Patients having an especially tough time can be referred to in-patient Women's Trauma Recovery Center at the VA in Temple.
Life after trauma
Having worked as a veterans advocate professionally since she left the Army, including at Temple College, Figueroa said her job at Dallas-based nonprofit Grace After Fire has been the first that's allowed her to focus exclusively on female veterans.
Although Figueroa introduces herself as a "survivor" to her clients — some of whom have suffered from military sexual trauma — to "let them know there's hope," she prefers the word "overcomer." Pulling out her iPad, she read the definition of "overcome" — "to succeed in dealing with an opponent, or to defeat, or win. To overpower."
That's the reason Figueroa said she doesn't want to forget her MST, even though she admitted she's still working to change the way she remembers it. "It's changed me as a person," she said. "But I choose life over death. I choose to deal with things."
What is MST?
The Department of Veterans Affairs defines military sexual trauma as psychological trauma resulting from a physical assault of sexual nature, battery of a sexual nature or sexual harassment that occurred while the veteran was serving on active duty or active duty for training. Harassment is further defined "as repeated, unsolicited verbal or physical contact of a sexual nature, which is threatening in nature."
One in five female veterans report having experienced MST, as do one in 100 males.
Active-duty soldiers and family members who have experienced sexual trauma should call Fort Hood's sexual assault and domestic violence hotline at (254) 702-4953.
VA crisis counselors are available 24 hours a day at (800) 273-8255.
Bringing Everyone in the Zone can be reached at (254) 813-5834. Its female peer support group meets at 6 p.m. Tuesdays at 718 N. Second St.
For more support or information on resources, call Grace After Fire at (866) 362-6477 or go GraceAfterFire.org.