Female Service Members Need Different PTSD Care, Military Leaders Say

Military experts are calling for specialized mental health support for female service members, saying women experience and process combat trauma differently than men. With over 65,000 women serving in frontline Israeli forces, advocates argue current treatment programs don't address their unique needs.

Aviv Shapira received a PTSD diagnosis in early 2023 following challenging military service that concluded before the October 7 attacks and subsequent conflict.

Watching their daughter struggle with inadequate support, her parents Avital and Moti Shapira recognized that numerous women dealing with military-related trauma weren’t receiving appropriate assistance.

This realization prompted them to take action and establish change.

The family created Arim Roshi (meaning “I shall rise”), a community support network for women with combat PTSD, originally scheduled to begin operations in 2024. However, following the October 7 massacre, the Shapiras moved up their timeline and launched the organization ahead of schedule, establishing a dedicated healing environment for women.

During Sunday’s ICAR (Israel’s Collective Action for Resilience) Summit presentation, Avital Shapira explained that her daughter rejected all available support programs. Initially puzzled by this response, she later understood that existing programs failed to address her daughter’s specific requirements.

“We realized women’s needs are very different from men’s,” Shapira said. “Just like physical health is different for men and women, so is mental health.”

Following decades of fighting for equal treatment in the Israel Defense Forces (IDF), women now serve in combat and police positions alongside their male colleagues. However, while receiving identical field treatment, military approaches to PTSD prevention and care frequently overlook gender-based differences.

Recent Ynet statistics reveal that women comprised approximately 20% of IDF combat personnel during the latest conflict, totaling over 65,000 female service members. These women participated in border protection, counterintelligence, and additional frontline operations. Similar to their male colleagues, many now face post-traumatic challenges.

Latest data from the Ministry of Defense rehabilitation department indicates that among more than 82,000 wounded personnel under their supervision, 31,000 are managing psychological wounds and post-trauma conditions.

Arim Roshi operates on four foundational elements: community support, therapeutic workshops, individual guidance, and research initiatives.

“Many women think they’re the only ones dealing with this,” Shapira explained. Arim Roshi creates a safe space where members can connect, share their experiences, and support one another.

The group conducts workshops incorporating movement, artistic expression, aquatic therapy, and horse-assisted treatment to help women work through trauma using methods beyond conventional talk therapy.

Additionally, Arim Roshi offers individual assistance to help women handle bureaucratic processes, manage family relationships, and complete Ministry of Defense recognition procedures.

The organization also monitors results and collects information about effective methods, aiming to support broader research efforts and enhance care for women with military-related PTSD.

Shapira joined other speakers addressing women and warfare issues during a panel led by Israel’s special envoy for trade and innovation, Fleur Hassan-Nahoum. The discussion examined distinctive wartime challenges facing women and institutional improvements needed to better serve them.

“The health of women is not just related to gynecology,” said Dr. Michal Sela of NOGAFem, a center for health innovation and policy. “We are different in every way.”

Despite this awareness, Sela noted that research and information about female fighters’ wartime experiences remains insufficient.

“The information is lacking,” Sela said.

The consequences reach well beyond frontline female personnel.

Dr. Inbal Shlomi from the Merhavim Medical Center for Brain and Mind Care described nationwide trauma levels as “unbelievable.”

“Even though most of us were not in Gaza or on the frontline, we all experienced unbelievable levels of trauma,” Shlomi explained. Social media exposure and constant interaction with people directly affected by the attacks contributed to widespread secondary trauma.

Furthermore, hundreds of Israeli women suffered sexual assault and abuse by Hamas terrorists on October 7 and during captivity. Shlomi explained that women with previous sexual abuse experiences might have experienced intensified symptoms, renewed flashbacks, or worsening PTSD after learning about their peers’ experiences that day.

She shared details about one patient who explained that before October 7, she considered the world evil but thought she might be wrong and attempted to challenge that viewpoint. Following October 7, she stated that nobody could persuade her otherwise.

Mothers also experienced profound trauma.

Agamit Gelb, who founded Inner Forces, described becoming a mother, sister, and aunt to fighters on October 7. While sending family members into combat, she realized she was experiencing complex emotions that seemed unrecognized by others.

Initially, few anticipated the conflict would continue for nearly two years, keeping loved ones on frontlines for extended durations. However, prolonged conflicts aren’t unprecedented for Israel. Gelb observed that her 70-year-old mother has served as a fighter’s mother, grandmother, and aunt throughout her life, yet remained overlooked in national discussions.

Gelb understood that mothers and other female relatives required support and clear information. However, the State failed to recognize their need for these resources.

She responded by establishing Inner Forces, a program designed for female family members of fighters. Working with Ruppin Academic Center, she researched 400 mothers. Results demonstrated that many women dismissed as simply anxious or concerned were actually experiencing trauma. About 20% of survey participants lost employment due to wartime challenges of being a soldier’s mother.

“The family is what provides resilience,” Gelb said, noting that keeping these women strong was essential.

Gelb reported that when asking mothers about their coping strategies, many would start crying. However, they frequently felt guilty about expressing distress because their sons hadn’t been killed or kidnapped.

“I was just a mom of someone in the field,” Gelb said, describing how she felt lost because she viewed her own trauma as less significant than others’.

Through Inner Forces, she established a community providing resilience programming, psychoeducation, and crucially, a gathering place for mothers to connect and support each other throughout the war.

As increasing numbers of women assume combat responsibilities and serve in critical IDF positions, understanding mental health protection becomes increasingly vital, Shapira emphasized. She noted that many women work in frontline positions not officially designated as combat roles, yet potentially expose them to equivalent trauma levels.

Nevertheless, she expressed optimism.

Her own daughter, who had suffered significantly, recently delivered her second child. She observed that many women who experienced early war trauma are now contributing to what she called a “baby boom.”

“There is hope,” she told the room. “You can live with PTSD,” she added, “and it can even be transformed into post-traumatic growth. That is our hope.”