Many Veterans Report Sexual Health Problems

It’s relatively well-established that veterans are likely to face mental health problems upon returning from service. And while anecdotal evidence suggests this also includes sexual health issues, a new study shows that’s indeed the case.

Young and Not So Sexually Healthy

Participants were mostly male, white or black, and had a mean age of 31. Just under half had a primary romantic partner. About one-fifth screened positive for sexual health concerns. Participants were more likely to report sexual health concerns if they also reported any of the following:

depression
PTSD
higher service connection rating
problem alcohcol use
a history of military sexual trauma (MST)
unemployment

Gender also played a role with females being more likely to report issues with arousal and lubrication.

Together, these results tell us 1) that there’s a relatively high rate of sexual dysfunction among veterans returning from deployment and 2) there are specific characteristics associated with both overall sexual dysfunction and specific aspects of sexual dysfunction.

Just What is Sexual Health, Really?

One issue with studies like these, and with measures of sexual functioning generally, is the limited view they take on sexual health. This study uses the Arizona Sexual Experience Scale (ASEX) which measures five items:

Libido (“How strong is your sex drive?”)
Psychological arousal (“How easily are you sexually aroused (turned on)?”)
Vaginal lubrication/penile erection (“How easily does your vagina become moist or wet during sex?” or “Can you easily get and keep an erection?”)
Ability to reach orgasm (“How easily can you reach an orgasm?”)
Orgasm satisfaction (“Are your orgasms satisfying?”)

While at first glimpse this list looks fairly inclusive, it’s based on a number of assumptions. First, that sex equals intercourse, or at the least involves penises and vaginas. While this is obviously common, it misses other forms of sex the patient enjoys. Secondly, that being wet is a sign of arousal. In many people with vaginas, getting wet is impacted by everything from stress to certain medications and diagnoses, making this a faulty measure of female physical arousal.

The answers are also extremely subjective. For example, “easily,” to one person may include twenty minutes of foreplay because that’s their norm whereas to someone else that same exact amount of time and effort may be perceived oppositely. And then there’s the obvious question of how much sex they’ve been having while deployed. These questions are always important since sexual health is part of quality of life; however, they might be better asked at later points after a veteran returns home.

That being said, the orgasm satisfaction piece provides a surprising and necessary nuance to the measure. After all, someone could be satisfied with their sex life despite not perceiving their sex drive as high or their ability reach orgasm as easy. We see this in studies showing that people with penises are just as satisfied with sex whether they use condoms or not, even though many men report a disinterest in using condoms because they decrease sensation and pleasure. The downside to the satisfaction question is that many healthcare providers lack the training and expertise to address this range of questions. I’m also curious to know if sex therapy is covered by veterans’ benefits since many insurance programs exclude it.

Small but Important

At 250 participants, the study is relatively small but provides necessary data to inspire future research. While mental health and sexual health remain stigmatized, recent media coverage and societal attention given to these issues in the military, especially MST, have created the perfect time to delve into them more.

In addition to a larger sample size, future studies would benefit from measuring sexual function at multiple times post-deployment. This study only looked at the initial primary care visit upon returning to the states so it misses any problems that arise later.

Despite these limitations, this study adds to our understanding of the issues faced by veterans upon returning home. Hopefully, wider spread acknowledgment and more research will continue to de-stigmatize sexual dysfunction and help our vets have the more pleasurable sex we can all agree that they deserve.