Of the nearly 3,500 Medal of Honor recipients, Dr. Mary Edwards Walker is the only female recipient ever to have been awarded the honor, despite the fact that nearly 77% of female veterans have served during wartime. She is neither a Post-9/11 veteran nor a World War II veteran: She was the first female U.S. Army surgeon, a prisoner of war, and a suspected spy during the Civil War. Major Generals Sherman and Thomas both personally recommended her for the medal in 1865. President Andrew Johnson readily acquiesced. 

American women have been fighting and dying for the U.S. military, officially and unofficially, for just about as long as it has existed. During the Revolutionary War, women served unofficially as seamstresses, water-bearers, nurses, and cooks—and sometimes disguised themselves as men to do actual fighting on the frontlines. This they repeated during the Civil War, in addition to providing valuable service as spies. It wasn’t until 1901 that Congress established the Army Nurse Corps, allowing women a formal way to serve in the military. By WWII, more than 350,000 women were serving in uniform across a wide variety of capacities. Eighty-four of these would be held as prisoners of war; 543 would eventually die in the line of duty. The Women’s Armed Services Integration Act of 1948 granted women permanent status in the Air Force, Army, Marine Corps, and Navy, but it imposed a 2% cap on female enlistment that wasn’t lifted until 1967. And while legislation enacted in 1975 allowed women to enroll at U.S. military academies for the first time, it took until the 1980s for women to be granted official “veteran” status. 

Women could not hold official combat positions until December 3, 2015, when Defense Secretary Ashton Carter announced that the Pentagon would open the roughly 220,000 combat-designated jobs to women (to understand how elastic the term “combat” is used in this regard, here is a quick guide). However, that does not mean that prior to that moment, women hadn’t found themselves serving under fire. 

Today, women veterans make up the fastest-growing segment of the veteran population, now amounting to about 10% of the total veteran population—though the Department of Veterans Affairs (VA) projects them to make up nearly 20% of that total in the next thirty years. Women make up around 20% of new recruits, 15% of the active duty military, and 18% of the guard and reserve forces, serving in every branch and holding numerous officer positions. Of the more than 280,000 women sent to Iraq and Afghanistan over the last twenty years, 44% of those enlisted and 13% of those who were officers deployed two or more times. As of 2020, 173 Post-9/11 women in uniform gave the ultimate sacrifice for their country. But research has found, despite an ongoing public debate about the role of women in combat, that women dying in combat in fact does not decrease public support for America’s wars. Nor does it necessarily increase their fellow male soldiers’ respect or estimation of female leadership potential. This does not hold true for women—women serving and dying for their country appears to increase women’s own estimation of their leadership potential, causing an “aspirational” effect. 

But when these 3.8 million Post-9/11 women who’ve served in the military return to their civilian lives, they often struggle to be recognized as military veterans within the broader public. And they struggle with the VA health system, since that system was built with the male, non-childbearing soldier body in mind. Because for years these women had to wear body armor and other equipment designed for men, they also bear the physical effects on their necks, backs, and hips that are not easily corrected. Research by the Wounded Warrior Project (WWP) has found that female veterans experience military sexual trauma, anxiety, and depression at higher rates than male warriors and that the lack of privacy at many VA health and treatment centers exacerbates this and informs their decisions not to seek the care for which they are legally eligible. 

Since 2010, the VA has published updated guidelines for women’s health care, but it is an ongoing struggle for the agency. But that struggle is subsumed within the larger struggle of women veterans for recognition of their post-service needs, and it will only become more pressing as more women choose to join, and then exit, military service.