Elephant in the Bedroom: Sexual Functioning in Military Populations

Military personnel, including service members and veterans, have a high risk for experiencing sexual functioning (SF) problems. During the recent conflicts in Iraq and Afghanistan in support of the Overseas Contingency Operations (OCO), more than a third of military personnel have returned home with a psychological injury. Many of these injuries, including PTSD and depression, have strong links to SF problems, including erectile dysfunction (ED). Despite high rates of SF problems in military populations and the strong link to psychological injuries, it has not been considered as a national priority. This gap can be largely attributed to policies governing insurance coverage for SF problems and limited access to comprehensive care. Behavioral health providers also lack a clear, standardized method of assessing SF problems. Accurate rates of SF problems are often difficult to ascertain, as available data has relied on a variety of assessment methods (i.e., patient self-reports, medication prescriptions, and diagnostic codes). Additionally, behavioral health professionals are not adequately prepared to address these problems, thus are not effectively engaging military populations in treatment. This presentation will provide a brief overview of the problem, discuss challenges associated with assessment, present available treatment options, and provide policy recommendations for applying the key findings within both military and civilian health care systems. More work is needed in this area. Researchers, clinicians, educators, military populations, and policy makers need to work together to create and share new best practices in an effort to provide appropriate and comprehensive care for military personnel and their families.