Tracy Keil shares her personal story at Intimacy After Injury, a convening hosted by the Bob Woodruff Foundation, Dec. 11–12, 2014. Photo by Keith Mellnick.

Sex … the Silent Casualty of War

“Let’s talk about sex, baby. Let’s talk about you and me. Let’s talk about all the good things and the bad things that may be … ”

While not my genre of music (but maybe showing my age), the lyrics of Salt N Pepa were stuck in my head, as my train chugged its way south to Washington, D.C.

An understandable (albeit annoying) soundtrack, as I was headed to Intimacy After Injury, a 2-day convening hosted by the Bob Woodruff Foundation, to discuss the impact of combat injury on sexual health, intimacy and fertility—an often overlooked, and uncomfortable topic.

Though I’d sat in meetings, developed messaging, and pitched media prior to it, I really wasn’t sure what to expect once the convening commenced.

Yet I’d get a sneak preview at dinner in the hotel, the eve of the event. Our programs team had invited family members of injured veterans—who were speaking on a panel—to dine with us.

Across the table sat Tracy Keil, who was only six weeks into her marriage when her husband Matt was paralyzed by a sniper’s bullet in Iraq.

Next to her was Andrea Sawyer. Her husband Loyd—whose traumatic brain injury (TBI) would go undiagnosed for years—seemed different from the moment he returned home.

It wasn’t long after sitting down that these brave women started opening up about their experiences. They talked about their kids. They talked about the jobs they gave up. They even shared stories of marital spats with a sense of levity that only those in their shoes could get away with.

Like Kathleen Causey, who has no qualms telling her double-amputee husband Aaron, “I’m the only one with feet around here, so I’m putting my foot down.”

And they joked about their sex lives … or lack of.

Of course, this candor wasn’t in a conference room in front of more than 100 physicians, psychologists and Ph.D.s—as well as representatives from government, the military, media and nonprofits serving veterans—it was in the confines of a seemingly “safe” restaurant.

Would they be as open with the spotlight on them?

More so.

Andrea Sawyer shares her story at Intimacy After Injury. Photo by Keith Mellnick.
Keep your money; I’d rather have sex!

“What’s the VA compensation for loss of sexual function due to combat injury for one family? $96 per month,” said Andrea. “Keep your money; I’d rather have sex!”

They discussed their personal challenges within the military and Veterans Administration healthcare systems to ensure that their loved ones received the care they deserved—in a room filled with these providers.

They shared stories of the emotional toll being a caregiver brings — performing duties that are much more akin to caring for a child … not much of a turn on.

“The military prepares you well for deployment … even that your husband might die,” said Kathleen. “But they don’t prepare you for this.”

This being the role of caregiver and wondering if you’ll ever be able to have a family. If so, to what lengths will you need to go?

“Here we are, six weeks into a marriage and having to discuss fertility,” said Tracy, discussing the apprehension while Matt recovered in the hospital. “As it is, I’m looking at him afraid that I’ll break him.”

Tracy and Kathleen would both find success in becoming pregnant—yet not without struggle, as there is a great deal of confusion regarding infertility coverage for service members and veterans.

Tracy and Matt had to pay out of pocket for in vitro fertilization because it is not covered by the VA. Yet she continues to speak out and lobby for changes, because as she put it, “It’s important that we pave the way for tomorrow’s veterans.”

However, Kathleen and Aaron were able to receive assistance while still on active duty recovering. Yet as Aaron told a reporter during a break, “Who thinks that’s a good time to have a baby?”

Aaron and Kathleen Causey share their successful struggle to conceive with PBS. Photo by Sam Kille.

But there is hope.

Beyond convenings like this, which help bring the discussion to the forefront, the Bob Woodruff Foundation has supported nonprofits like SemperMax Support Fund to fund couples retreats, sexual health and intimacy programs, and even a manual to help the injured.

And the other panels showed a commitment to do better by our injured veterans and their spouses—very important when considering the number of people impacted by combat injuries.

According to Dr. Jean Orman, of the U.S. Army Institute of Surgical Research, 1,291 American service members received urogenital injuries in Iraq and Afghanistan—largely due to improvised explosives.

While it’s difficult to determine the numbers affected psychologically, an estimated 1-in-5 post-9/11 veterans suffer from TBI, post-traumatic stress (PTS) or depression.

According to Dr. Sherrie Wilcox, Ph. D., from the University of Southern California School of Social Work, and a recent Sex & the Military study, those with PTS are 30-times more likely to have erectile dysfunction.

The study also found that only 12 percent of those with sexual functioning problems sought treatment—largely driven by fear and shame.

A stigma that needs to be challenged, because as Navy Capt. Moira McGuire, assistant chief of Integrated Health and Wellness at Walter Reed National Military Medical Center said, “Sex is part of a healthy lifestyle.”

Navy Capt. Moira McGuire discusses Walter Reed’s efforts to alleviate the impact of combat injury on the sexual health and intimacy of service members. Photo by Keith Mellnick.

… so, let’s talk about it.

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