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By Sabrina Tullo
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Women are now the fastest-growing segment of the US veteran population, yet many continue to navigate a system that was never fully designed to recognize their service. More than two million female veterans live across the country, and their numbers are projected to keep rising in the decades to come. Every year, more women raise their hands to serve. Every year, the systems built to receive them afterward fall further behind.
Public perception forms an alarming gap that follows women veterans long after their service ends, showing up in disproportionately higher rates of homelessness, cardiovascular disease and mental health disorders. Women veterans are more than twice as likely to become homeless as women who never served, and even as overall veteran homelessness has declined, homelessness among women veterans has moved in the wrong direction in recent years.
It is most stark in military sexual trauma (MST). When VA (United States Department of Veterans Affairs) clinicians screen incoming patients, roughly one in three women disclose an MST experience, compared with about one in 50 men. The consequences can be fatal. Among recent women veterans using VA care, those who screened positive for MST had a suicide rate roughly 45 percent higher than those who did not.
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But those numbers only describe veterans the system already knows about. Roughly three-quarters of veterans receive some or all of their care outside the VA, in civilian hospitals and clinics where no one is required to ask whether a patient ever served. That absence of data is itself the point. We cannot measure what we refuse to ask, and each unasked question keeps a woman’s service and its cost invisible in her medical chart.
Women veterans often encounter another obstacle before those conversations even begin: the assumption that they could not have served at all. Dr. Evelyn Lewis, a retired Navy officer and President and Chair of the Veterans Health and Wellness Foundation (VHWF), believes that those misconceptions carry consequences that entirely invalidate recognition. In her view, it echoes how women veterans are heard, how their health concerns are evaluated and whether their experiences are treated with the urgency they deserve.
“The top issue is that women are still not necessarily recognized or appreciated for their service. People don’t acknowledge them, they don’t hear them and they don’t listen to the issues that primarily affect them,” she says.
Recognition is not symbolic but an important facet that directly influences health care outcomes. Dr. Lewis recalls scheduling a medical test when a health care representative asked for her husband’s Social Security number because she assumed he was the military sponsor. “I served for 25 years, and yet the assumption was that I couldn’t possibly have been the veteran,” Dr. Lewis says.
It was a small moment. It was also, she believes, a symptom of a health care system and a country still struggling to see the more than two million women who have worn the uniform.
Dr. Lewis has spent years pushing for one deceptively simple fix: every health care provider, VA or civilian, should ask every patient, including children, whether they or a family member has ever served in the military. Too often, a woman’s health concerns are dismissed or minimized before anyone thinks to ask whether her service might be relevant. “They don’t always stop to ask whether something deserves further investigation,” she says.
Those missed conversations become even more significant when military service may have contributed to later health conditions. “If that question isn’t asked, the clinician has no reason to consider toxic exposures, military sexual trauma or other service-related factors,” she explains. “Once you know someone served, it changes the questions you ask and potentially the care they receive.”
The cost of not asking, she adds, can be vicious. A 29-year-old Iraq and Afghanistan veteran, exposed for years to burn pits during his deployments, went to a Baltimore urgent care believing he had strep throat. No one asked about his service. Days later, he passed away from myocarditis, inflammation of the heart muscle that may have been tied directly to that exposure. Dr. Lewis says, “His widow has since given voice to the question that haunts her: ‘What a simple question. What if they had asked it? What would’ve changed if they did?’”
That grief became law. Maryland Senate Bill 740 (2025), known as the SFC Matthew Fast Act, came into effect in October 2025. It authorizes health care facilities across the state to screen for and document patients’ military service status—the first legislation of its kind in the nation. Virginia followed closely behind, with House Bill 1504 taking effect on July 1, 2026.
Both laws, Dr. Lewis explains, define the population broadly, not just veterans, but the spouses, children and stepchildren of service members. VHWF worked alongside military families to build support for both measures. “We’re building this from every direction. Education matters, policy matters and health care outcomes matter. If we don’t approach it from all sides, progress stays much slower than it needs to be,” she states.
Still, neither law requires the question; both stop at authorizing it. Dr. Lewis views that as a floor rather than a ceiling. She notes that she will keep pressing for screening to be required as more states follow. The obligation, in her view, already exists regardless of statute. Clinicians take an oath to do no harm, which means asking whether a patient has served should never truly be optional.
That conviction is what brought VHWF to Bethesda, Maryland, this past March for A Serenade for Strength: Honoring Her Service | Healing Her Journey, an evening of music, storytelling and recognition held during Women’s History Month and built entirely around women veterans. Images of women who have served throughout American history filled the venue, a deliberate reminder that military service has never belonged to one gender.
“The title itself reflected exactly what women veterans experience,” Dr. Lewis explains. “‘Honoring Her Service’ speaks to recognition that often doesn’t happen. ‘Healing Her Journey’ acknowledges that many women continue living with health issues that have been ignored or minimized, sometimes for decades, until a name finally gets attached to what they’ve been carrying.”
For one night, women who had spent careers being second-guessed were the center of the room. But Dr. Lewis is candid that a single evening, however moving, is not a solution. She says, “You have to keep these stories visible because if people don’t hear them, they assume everything is fine.”
She believes listening has to become a national habit. Health care providers should routinely ask about military service. Policymakers should strengthen the legislation that supports veterans’ care, and the public should reconsider what comes to mind when they hear the word “veteran”.
“We have to raise these voices. Once people truly hear the stories, they begin to understand these aren't isolated experiences. There are issues that deserve attention,” she states.
Recognition is often framed as a matter of respect. Dr. Lewis argues it should also be viewed as a public health issue. Every woman veteran whose service goes unrecognized represents a missed opportunity for earlier care, better policy and more informed clinical decisions.
One question, asked at the right moment, can save a life. It shouldn’t take an act of law or an act of grief to make that question routine. But that shift will not happen on its own. Laws do not enforce themselves, screening programs do not appear spontaneously, and lasting change depends on health care systems, legislatures and individuals willing to do more than nod in agreement. With the number of women in uniform continuing to grow, she believes the next challenge is ensuring institutions evolve as quickly as the military itself.
She says, “It’s a choice available to every clinic, every hospital, every urgent care and every person reading this—starting now.”
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