Moral injury in women military members and Veterans: What do we really know?

The term moral injury has been used to describe suffering military servicemembers' experience of non-life-threatening traumatic events that violate their moral code, such as killing or injuring a non-combatant, witnessing a fellow servicemember harm a non-combatant, or betrayal by a trusted leader. Servicemembers who experience morally injurious traumas may feel intense shame, guilt, anger, and a lack of forgiveness toward others or themselves. In extreme cases, they may feel unworthy of living. This article examines existing information and knowledge gaps about the morally harmful experiences of women servicemembers and Veterans. Anecdotal findings have shown that women servicemembers face potentially morally injurious events through combat as well as military sexual trauma. Most research on moral injury has been conducted with the military population. However, in the United States, much of the scholarship has primarily focused on the experiences of men servicemembers and Veterans. Although women servicemembers make up 20% of the military population, research is limited to military women's unique morally injurious experiences. Further study is needed to explore and understand what events women servicemembers and Veterans identify as morally injurious and how they experience moral injury. Capturing these perspectives is imperative to identifying and treating moral injuries. LAY SUMMARYMoral injury describes and explains the biological, psychological, sociological, and spiritual wounds service members may develop when they are betrayed by leadership or act, fail to act, or bear witness to acts that are in direct conflict with their moral code. Very little research is focused on moral injury experienced by women service members and Veterans. A woman's experience in the military is often vastly different than a man's because they have a higher prevalence of military sexual trauma (the threat or experience of sexual assault or harassment). To date, little research has been conducted about how betrayal, military sexual trauma, and moral injury interact. This article attempts to decipher moral injury from other psychological and combat stress injuries and highlights the unique aspects of moral injury experienced by women combat Veterans.