Female service members bear a disproportionate burden of sexual and reproductive health care responsibility within the Military Health System, receiving more counseling than males but rating their healthcare experiences lower and feeling less comfortable in those interactions.
Key Findings
Results
Approximately 40% of male service members reported never having discussed a variety of sexual and reproductive health topics with Military Health System healthcare providers.
Study included 263 active duty service members (43% female, 57% male)
Participants identified whether they had discussed various SRH topics with a healthcare provider ever or in the past 12 months
This represents a substantial gap in SRH engagement for male service members
Topics assessed included STI testing and pregnancy prevention, among others
Results
Female service members were significantly more likely than males to have discussed STI testing and pregnancy prevention with a healthcare provider.
The difference was statistically significant between male and female service members
The sample included 43% female and 57% male active duty service members (n=263)
This differential was interpreted as reflecting a disproportionate SRH burden on female service members
The study characterized SRH as 'a total force responsibility' despite the observed gender disparity in counseling
Results
Among service members who had not discussed SRH topics with a provider, female service members were more likely than males to desire to do so.
This finding applied specifically to STI testing and pregnancy prevention topics
This suggests unmet need is higher among female service members even after accounting for higher rates of discussion
The pattern indicates females have both greater engagement with and greater unmet desire for SRH counseling compared to males
Results
Female service members rated their perceptions of general health encounters within the Military Health System lower than male service members.
Participants rated their perceptions of the military health system on dimensions including quality and wait times
Participants also rated their perceptions of communication with MHS providers
Female service members reported feeling less comfortable in healthcare interactions compared to males
This lower satisfaction occurred despite females receiving more regular SRH counseling than males
Results
Many female service members still did not report receiving critical sexual and reproductive health care despite receiving more regular counseling on SRH topics than males.
The study recruited participants as part of a broader study on SRH in the U.S. military
The finding indicates that higher rates of counseling among females do not translate to comprehensive SRH care coverage
Authors noted that 'some differential counseling on these topics between males and females is appropriate' but called for 'a more holistic approach'
Gaps in SRH care were framed as a readiness issue for the force overall
What This Means
This research suggests that there is a significant gender imbalance in how sexual and reproductive health (SRH) care is delivered to U.S. military service members within the Military Health System (MHS). In a study of 263 active duty service members, roughly 40% of male service members had never talked with a military healthcare provider about topics like STI testing or pregnancy prevention. Female service members were much more likely to have had these conversations and more likely to want them if they hadn't occurred — but they also rated their overall healthcare experiences more negatively and reported feeling less comfortable during those interactions.
This research suggests that while some difference in SRH counseling between males and females is medically appropriate (for example, around contraception), the current system places a disproportionate burden on female service members to manage what the authors call a 'total force' issue. Even with higher rates of counseling, many female service members still reported not receiving the SRH care they needed, pointing to gaps that affect both individual wellbeing and military readiness.
The practical implication of these findings is that military healthcare systems may benefit from more proactive and equitable approaches to SRH conversations with all service members regardless of gender. Improving male service members' engagement with SRH topics and addressing female service members' lower satisfaction with healthcare interactions could contribute to better health outcomes and overall force readiness.
Landoll R, Ryan S, Iwuagwu R, Clark M, Vargas S. (2025). Perceptions of the Military Health System: Differences in Sexual and Reproductive Health Burden Among Males and Females.. Military medicine. https://doi.org/10.1093/milmed/usaf298