The unique conflict, mental challenges

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Conflicted. Confused. Defeated. Dejected. These are some of the emotions that ran through Sgt. Reagan Hasenfratz last month when news broke that the Supreme Court had overturned Roe v. Wade.

The 24-year-old Army medic, currently deployed overseas, described a unique internal conflict as a service member hearing the news.

“I enlisted in the military to serve my country and save people’s lives and serve the people of the United States. But it had felt like my personal freedoms were being taken away in that moment and the personal freedoms of the people that I fight for,” she says, making clear her perspective is hers alone and does not represent the Department of Defense or the Army.

Experts say military members who can get pregnant face a number of unique factors that make them acutely vulnerable in a post-Roe world, including negative impacts to mental health. 

‘A fight every day’: Roe v. Wade overturn a dire impact on mental health, experts say

What’s different for military women?

Pro-choice military members who can get pregnant face all the same fears someone outside the military does. But service members also have additional factors that make their position challenging, explains Samantha S. Kubek, assistant clinical professor and attorney-in-charge of the Robert W. Entenmann Veterans Law Clinic at Hofstra University.

First is location. Military members don’t get to control where they’re located, both in where they’re stationed and deployed. 

“They go where we send them. And now that may be in states in which there are very limited circumstances in which a woman can obtain an abortion,” Kubek explains.

All 50 states have at least one military base, while some have several, including red states like Texas, for example, which hosts large bases such as Fort Hood, home to about 40,000 soldiers.

And due to the Hyde Amendment, abortions can only be provided through the military in cases of danger to the life of the mother, rape or incest. Kubek says it also prevents the use of TRICARE (the insurance plan for military members). Outside of those instances, time and money become another issue. 

“Women are going to not only need to request the leave that they would always have needed to go to a local hospital or medical facility to get that abortion. But now, they may need to request leave to travel, who knows how far … in order to obtain that abortion. The barrier to their ability to get that abortion is even further than with a civilian woman.”

‘Afraid I’ll get pregnant from my husband’: Sexual anxiety soars post-Roe, experts say

More: Under decades-old Hyde Amendment, millions of Americans already live in a ‘post-Roe’ world

If someone is granted leave to travel somewhere, Kubek adds, “that’s all on their dime.”

“It’s not simply the physical ability to leave and get there. But it’s also once that leave is granted, they then also need to pay for (travel and accommodations) and for the abortion itself.”

On top of all these factors, the rates of sexual assault against women in our military are “incredibly high” and “continue to grow” Kubek adds. 

According to survey data from the Pentagon, there were an estimated 20,500 instances of unwanted sexual contact in 2018, an increase over the 14,900 compared with 2016. The military’s definition of unwanted sexual contact ranges from groping to rape.

While circumstances like rape allow for abortions, that only applies if the woman comes forward and is believed, Kubek points out.

Just like in the civilian world, there are many reasons survivors may not want to report a sexual assault. In the military, high rates of retaliation, a perpetrator in their chain of command, lack of trust in the system and fear over their career standing also keep troops silent. 

Who will the Roe overturn hurt the most? People of color, the poor and other marginalized people, experts say.

The impact to mental health

All these factors create an environment where less choice exists, explains Amy Williams, chief clinical officer of Headstrong, a non-profit organization that provides mental health care for veterans and their families. (Williams spoke from her own perspective and opinion, which does not necessarily reflect that of her organization as a whole.)

Though there is minimal research specifically on military women in this sensitive topic area, Williams says there is a good deal of data on how being denied the choice to have an abortion impacts women’s mental health.

“It seems obvious, but we do know from the research that giving people choice leads to better outcomes for mental health,” she says. 

Not only lack of choice, but lack of voice can impact mental health.

“Any military member has to be careful what they say … because they are representatives of the U.S. military,” she says. “Anytime that we feel less free to be able to speak up, we can feel more isolated.”

Hasenfratz has used social media to share her concerns, posting a video following the decision that now has nearly 200,000 views on TikTok, but she realizes others may not feel safe enough to speak out.

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More: Pentagon upholds ban on flying LGBTQ pride flags on military bases

“I imagine that a lot of us might feel the same feelings that I have, of (conflict), much like other oppressed groups have felt in the past and continue to feel – of how can you continue to serve when you feel as if you’re being denied your freedoms?”

That internal conflict can also create mental health challenges.

“Anytime anyone is put in a position where their values or their beliefs may conflict with something that they’ve already agreed to do, that puts you in a really difficult place,” Williams says. “It’s not that different from the concept of moral injury, where people through their service (in the military) are faced with making choices that maybe don’t line up with their values.”

The dissonance some may feel, Williams explains, can cause anger, sadness and hopelessness.

And while leaving the situation may seem like an easy solution, it’s more complicated than that.

“This isn’t a job that you can just quit,” Kubek explains. “You’ve signed a contract, you’ve made a commitment to the military, you can’t just get up and leave.”

Hasenfratz herself has experienced feeling “purely overwhelmed” by the news especially through social media exposure.

“It’s so easy to be on your phone and doom scroll for hours and see nothing but negative, negative, negative and it felt that way,” she says, adding she had to disconnect for a while because it was “weighing extremely heavy” on her.  

Williams warns that social media can make things worse, advising others to step away if you’re feeling negatively impacted. She also suggests a few other coping mechanisms for people struggling:

  • Don’t isolate. Talk about how you’re feeling with safe peers.
  • Practice good self care.
  • Being kind to yourself.
  • And if needed, seek a professional who can help you process things.

While it’s too soon to tell just a month out from the SCOTUS decision, Williams says she expects to see “increased referrals” for mental health support surrounding reproductive rights and family planning.

Hasenfratz thinks the Dobbs decision will impact enlistment and retention rates too.

“It might intimidate women not to enlist or not to reenlist because they don’t feel that they’re being supported in their right to choose to have a family or not,” she says.

Kubek predicts the same, but hopes change will help better support troops.

“We should be doing all that we can to protect those who are willingly raising their right hand and saying that they want to serve our country. They volunteered to protect us. And now it’s our job to protect them.” 

Contributing: Tom Vanden Brook

If you or someone you know may be struggling with suicidal thoughts, you can call the U.S. National Suicide Prevention Lifeline at 988 any time day or night, or chat online. 

For the Veterans Crisis Line, veterans just need to press 1 after the lifeline number in order to reach the the centralized network. They can also chat live online or text 838255 for support.

Crisis Text Line also provides free, 24/7, confidential support via text message to people in crisis when they dial 741741.

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