Invisible Wounds: Why Women Veterans Deserve Better Gynaecological Care
Women veterans face a double burden when seeking gynaecological care: the systemic failures that affect all women within the NHS, compounded by the unique trauma and barriers inherent to previous military service. As the fastest-growing population in both active military service and the veteran community, their experiences demand urgent attention, yet they remain largely invisible in conversations about women’s health.
For some women, a gynaecology appointment is an inconvenience. For other women carrying trauma, women who are neurodivergent, women who have been dismissed or hurt in medical settings or even their thoughts race. They tell us that they rehearse every possible scenario, trying to prepare themselves for something they can never fully prepare for. Often making the wait unbearable.
By the time they get there, they are already exhausted.
Before a woman veteran ever steps into a gynaecology clinic, she carries statistics that civilian women rarely face. Statistics from Salute Her UK recording systems tell us that one in three women veterans reports experiencing sexual assault or harassment during military service. This isn’t just a number; it’s a foundation of trauma that sets the tone for subsequent healthcare interactions, particularly those involving reproductive health.
Military Sexual Trauma (MST) creates a unique vulnerability. When a woman veteran with MST history faces dismissive care, medical gaslighting, or inadequate pain management during gynaecological procedures, she isn’t just experiencing poor healthcare; she’s being retraumatised over and over again. The speculum becomes a trigger. The dismissive comment becomes a mirror image of being told to “get on with it.” The lack of anaesthesia during a hysteroscopy becomes another violation
Gynaecology waiting lists have grown faster than any other speciality, with women waiting years for diagnosis and treatment of conditions like endometriosis and fibroids. For women veterans, these delays are compounded by geographic barriers many live in rural areas far from specialist women’s health services. One veteran described her impossible situation: “It’s difficult to schedule appointments in general, let alone having to take that long of a journey into account, plus finding someone to look after my kids, and the costs of that and the petrol and the work hours lost.”
Women veterans are often primary caregivers, prioritising their families’ healthcare over their own. When you add years-long NHS waiting lists to childcare barriers and geographic distance, many simply give up. As one veteran asked: “How do we fix a system that doesn’t understand our needs when we aren’t using the system?”
The phrase “suck it up” takes on particular cruelty for women veterans. They’ve already been conditioned by military culture to minimise pain, to push through, to never show weakness. When a gynaecologist tells them their severe endometriosis pain is “normal” or that they’re overreacting, it reinforces the very culture that taught them their bodies don’t matter.
This medical gaslighting, where women’s physical symptoms are minimised, disbelieved, or attributed to psychological causes, is documented across healthcare. But for women veterans, it’s layered onto military gaslighting. Many MST survivors were told their assaults didn’t happen, weren’t that bad, or were their fault. When a doctor dismisses their pelvic pain or abnormal bleeding, it’s not just medical negligence it’s a continuation of institutional betrayal.
Hysteroscopy, coil fitting, and HyCoSy are routinely performed with little or no pain management across the NHS, despite being described by patients as “harrowing,” “excruciating,” and traumatising. For civilian women, this is unacceptable. For women veterans with MST, it’s torture.
I want you to close your eyes and consider what these procedures involve: a woman lying on her back, legs open, with a little piece of paper covering her dignity, while instruments are inserted into her body, often while she’s told to “just relax” it will only hurt for a minute or two “ For an MST survivor, this isn’t just a medical procedure. The lack of adequate anaesthesia isn’t just poor practice,
The outdated justification that women’s pain is an inconvenience, that their symptoms are an overreaction, is rooted in the same misogyny that allowed MST to flourish unchecked for decades.
For neurodivergent women veterans, those with autism, ADHD, dyslexia, or other neurological differences, accessing gynaecological care presents yet another layer of exclusion. Women have consistently told us they are not given the opportunity to talk to someone about what is going to happen during their appointment. This communication gap, challenging for all women, becomes an insurmountable barrier for neurodivergent patients.
The Pre-Appointment Information Void
Neurodivergent women often need detailed, explicit information to prepare for medical appointments. They need to know:
Exactly what will happen during the examination
What instruments will be used and how they’ll feel
How long each part of the procedure will take
What position they’ll need to be in
Whether they can ask for breaks
What sensory experiences to expect (lights, sounds, touch, temperature)
Yet NHS gynaecology services rarely provide this information proactively. Appointment letters arrive with a time, date, and location nothing more. Phone lines are overwhelmed. Receptionists can’t answer clinical questions. The first time a neurodivergent woman learns what will happen is often when she’s already undressed and on the examination table.
For neurodivergent women veterans, this information void is particularly devastating. Military service often taught them to mask their neurodivergent traits to appear “normal,” to follow orders without question, to never admit confusion or need for accommodation. The gynaecology clinic becomes a space where they’re expected to advocate for themselves in ways their military conditioning actively suppressed.
One neurodivergent veteran described the experience: “I need to know what’s going to happen so I can prepare myself mentally. But asking feels like admitting weakness. So I don’t ask. And then I have a meltdown on the examination table because I wasn’t prepared for the speculum or the sudden cold gel or the student observer no one mentioned. And then they write in my notes that I’m ‘anxious’ or ‘difficult,’ and next time it’s even harder to get the care I need.”
Gynaecological examinations are inherently sensory-challenging: bright lights, cold rooms, paper gowns that crinkle, the smell of latex, unexpected touch, instruments with uncomfortable textures and temperatures.
Without pre-appointment communication, neurodivergent women can’t:
Request reasonable adjustments (dimmer lighting, warning before touch, time to process instructions)
Bring appropriate sensory supports (fidget tools, noise-cancelling headphones for waiting rooms)
Prepare coping strategies for specific sensory experiences
Mentally rehearse the sequence of events
The lack of information doesn’t just cause discomfort it causes trauma. And for neurodivergent veterans with MST history, the combination of sensory overload, lack of control, and body vulnerability can trigger severe traumatic responses.
The instruction becomes another layer of shame. The neurodivergent veteran, already fighting decades of military conditioning to suppress her needs, interprets “just relax” as proof she’s failing—that her neurodivergence makes her broken, difficult, undeserving of care.
What Neurodivergent Women Veterans Need
Neurodivergent women veterans need pre-appointment communication as a standard of care:
Detailed procedure information sent at time of booking: written explanations with visual diagrams showing exactly what will happen, in what order, and why
Pre-appointment phone calls from clinic staff to discuss the procedure, answer questions, and arrange reasonable adjustments
Social stories or video walkthroughs showing the clinic layout, equipment, and procedure steps
Sensory profiles included in medical records, noting specific sensitivities and effective accommodations
Extended appointment times to allow for processing, questions, and breaks without rushing
Clear language without euphemisms—saying “I’m going to insert the speculum now” rather than “you might feel some pressure”
Routine offering of communication supports: written instructions, visual schedules, AAC devices if needed
Training for staff on neurodivergence and the specific intersection with military trauma
Conditions like endometriosis take an average of nearly a decade to diagnose in the UK. For women veterans, this timeline often spans their transition from active duty to civilian life, creating gaps in care and lost medical records. The lack of specialist knowledge and under-resourced NHS services affects all women, but veterans face additional barriers: inconsistent care quality between NHS trusts, limited availability of gender-specific services within military healthcare, and the challenge of coordinating between MOD medical services and NHS care.
One veteran noted the stark difference in care quality between locations: “My care at one hospital was so, so wildly different from the care I received when I moved to a different trust.” When you’re already navigating a decade-long diagnostic journey, having to restart with each move or provider change is devastating.
Women are routinely bounced between GPs, gynaecologists, pain clinics, and mental health services without coordinated care. For women veterans, add to this list: the system’s fragmentation means that no one sees the whole picture; the pelvic pain might be endometriosis, but it’s also exacerbated by PTSD. The heavy menstrual bleeding might be fibroids, but the panic attacks during pelvic exams are MST-related.
Without integrated, trauma-informed care, women veterans fall through the cracks between specialities, each provider addressing one symptom while missing the interconnected whole.
Many women resort to private treatment due to NHS delays, cost barriers, or traumatic past experiences. For women veterans, this decision often comes after experiencing inadequate care within NHS settings, or after being pushed toward unnecessary procedures. One veteran reported being “aggressively pushed for an unnecessary hysterectomy” and accidentally overheard her doctor talking about her in a derogatory way to a student, revealing an agenda to prevent her from accessing IVF.
Women veterans from deprived areas or ethnically diverse communities face compounded disadvantages. They experience worse outcomes and poorer access to services in both civilian healthcare and NHS settings. The economic impact of untreated gynaecological conditions absenteeism, reduced productivity, inability to work- hits hardest those who can least afford it.
And yet, these conditions are not treated with urgency. A woman veteran with debilitating endometriosis, PTSD from MST, and limited access to childcare or transportation is expected to navigate a system that was designed for men and has only grudgingly made space for women.
Women veterans don’t need a separate-but-inferior system. They need the same high‑quality, trauma‑informed healthcare every woman deserves, delivered by services that understand their experiences and meet their needs.
Trauma-informed gynaecological services where NHS providers understand MST and its impact on reproductive healthcare
Adequate pain management for all procedures, with recognition that some patients require additional support due to trauma history
Coordinated care that integrates mental health, trauma support, and gynaecological services
Timely access with extended clinic hours, childcare support, and telehealth options
Specialist training for NHS providers on both women’s reproductive health and military culture
Zero tolerance for harassment within healthcare settings
Proactive communication before appointments, particularly for neurodivergent patients, detailing exactly what will happen
Belief and validation of symptoms from the first appointment, not after a decade of dismissal
What Safe, Modern, Trauma-Informed Gynaecology Should Look Like
If we want women to stop feeling terrified, ashamed, or retraumatised in gynaecology appointments, then the system needs to change not the women. The solutions aren’t complicated. They’re humane, evidence-based, and long overdue.
Here is what women have asked for
Make pain relief automatic, not optional
No woman should have to beg for pain relief.
No woman should be told “you’ll just feel a little discomfort” when the reality is often severe pain.
Pain relief should be standard, not a special request.
Offer sedation as a routine option for procedures like hysteroscopy
Hysteroscopy is one of the most painful procedures women undergo, yet sedation is treated like a luxury.
Sedation should be offered automatically, especially for women with trauma histories, neurodivergence, or previous bad experiences.
Ask every woman about sensory needs
A simple question “Is there any sensory support that would help you feel safer?” could change everything.
Options could include:
lights dimmed
sunglasses (like dentists offer)
quieter rooms
warm instruments
weighted blankets
predictable step-by-step explanations
None of these changes are extreme.
None require reinventing the NHS.
They simply require seeing women, believing women, and treating women with dignity, And above all, women deserve to walk into a gynaecology appointment without feeling like they’re walking into a battlefield.