ST. PETERSBURG, Fla. — Every morning for more than two years, retired Army Sgt. Brenda Reed had the infuriating chore of screwing on what she calls her “man foot.” The prosthetic was given to her by the Department of Veterans Affairs after her left leg was amputated below the knee in 2013, but the replacement was so bulky and ill-fitting that it kept falling off in public. She pleaded with VA officials for “a foot that fits, a female foot,” only to be told repeatedly that the agency doesn’t carry that kind of customized prosthetic, which is available on the private market.
Reed tried to have a sense of humor about it. So she put bright red press-on nails on the wide “man” toes. “I just wanted to get this man’s foot off of me,” she said.” Does it really have to be this hard for female veterans to get the right kind of care?”
VA slow to help
Women are streaming home from war and through VA doors in record numbers. But a health care system that for generations catered almost exclusively to men has been slow to recognize that the 2.3 million female veterans represent the fastest-growing population turning to the agency. In myriad ways, the VA is struggling to address the urgent needs of these women for medical and mental health services.
VA hospitals and clinics don’t offer prenatal care; instead they outsource it. And they don’t deliver babies. Dozens of VA facilities don’t have full-time gynecologists, and some don’t have any gynecological staff. Even for basic female wellness services, such as mammograms, some facilities have to refer women elsewhere.
There is also a severe shortage of VA mental health therapists who are women, an especially pressing problem for female veterans trying to come to terms with sexual assaults suffered in the military.
While some VA hospitals have premier women’s clinics, others offer women little privacy, forcing them to share rooms with men and separating them at most with a curtain. Even recently, as VA Secretary Robert McDonald has acknowledged, some hospitals didn’t have separate restrooms for women.
“Look, the VA is great if you are a 65-year-old guy with a prostate problem. But if you are pregnant or a woman with breast cancer, I would run the other way,” said retired Air Force Col. Kimberly Olson, former president of the women’s veterans group Grace After Fire.
Skyrocketing need
The number of female veterans using the VA health service increased by 80 percent between 2003 and 2012, the agency says. And that demand is certain to skyrocket over the next five years as the total number of female veterans is projected to double, reaching about 4.5 million, according to the agency.
Reed says she has been fighting for respect her entire military career, ever since she was in the first class of Army recruits to go through coed basic training 30 years ago. But no struggle has filled her with such rage as her campaign for a foot that fits properly.
Last year, a VA specialist cut off the toes on Reed’s prosthetic and shaved off the sides in an effort to make it fit into her shoes. Reed said not only didn’t it fit, but she also found that she couldn’t walk on it. She was given another prosthetic and told to make do.
She didn’t. She “nearly went ballistic” and took her case to the VA secretary’s office, calling and e-mailing McDonald repeatedly.
Finally, this summer, the VA hospital in Tampa notified Reed that the agency had located a foot that it could customize for her. Of an estimated 2,100 female veterans with amputated limbs, now at least one has a VA-issued prosthetic tailored for a woman.
Reed remains unsatisfied, resentful that she had to go to “absurd lengths to get what male veterans receive within days.”
Patricia Hayes, VA’s top official for women’s health-care issues, stressed that the agency is committed to improving its services but acknowledged that there’s much more to do.
Hayes said agency officials are working hard to reeducate staff and change the male-dominated culture, with campaigns that include posters and videos that say, “This is not your father’s VA,” and pictures of women in combat gear with the slogan, “Not every GI is a Jane.”
“It’s not your father’s VA — it really isn’t,” Hayes said in an interview. She added, “We have geared up and are gearing up. But we have a lot of catching up to do.”
Man boot
Reed’s troubles with the “man foot” began with a man’s boot.
As a 22-year-old Army private serving in Germany, Reed, like all female soldiers, was issued combat boots made for men. Not long after, she badly injured her foot while running on cobblestone streets. But a health care provider on base told her to “shake it off,” she said, recounting how she was “lectured, ignored and then made fun of.”
In excruciating pain, she went back three months later and demanded an X-ray. It revealed that her foot was broken in four places.
“That was the beginning of recurring injuries for decades due to existing damage that would years later end in amputation,” she said.
(It was only four months ago, after multiple studies showing that female service members are more susceptible to stress fractures because they are put into male boots, that Congress asked the armed forces to design a special line of women’s combat boots.)
Over the years, VA officials and doctors have given Reed various excuses. Some said there was no money for customized prosthetics while others said they didn’t know they existed.
VA officials said in interviews that they are aware of the problem facing female amputees and are working to bring customized prosthetics into the agency rehabilitation centers. The VA says it is also working on artificial limbs that can be adjusted over the course of a pregnancy.
But Reed and other female veterans said while they welcomed the news, the deeper issue is giving women timely access to equal treatment. “It’s been two and a half years of tripping over feet that were too large,” Reed said. “Women served their country, too. We shouldn’t have to fight this hard.”
