Comment

The #MeToo movement: an opportunity in public health?

Approximately 1 in 3 women veterans endorse military sexual trauma (MST) during Veterans Health Administration (VHA) screening. Higher rates have been reported in anonymous surveys.

We compared MST identified by VHA screening to survey-reported MST within the same sample and identified participant characteristics associated with discordant responses.

Cross-sectional data were drawn from an observational study of women veterans aged 45–64 enrolled in VHA care in Northern California, with data from mail- and web-based surveys linked to VHA electronic health records (EHRs). Between March 2019 and May 2020, participants reported sociodemographic characteristics, current depressive (Patient Health Questionnaire-9) and posttraumatic stress (PTSD checklist for DSM-5) symptoms, and MST (using standard VHA screening questions) in a survey; depression and posttraumatic stress disorder diagnoses (ICD-10 codes) and documented MST were identified from EHRs. Associations between sociodemographic characteristics, mental health symptoms and diagnoses, and discordant MST reports (EHR-documented MST vs. MST reported on survey, not in EHR) were examined with multivariable logistic regression.

In this sample of midlife women veterans (n = 202; mean age 56, SD = 5), 40% had EHR-documented MST, and 74% reported MST on the survey. Sociodemographic characteristics, mental health symptoms, and diagnosed depression were not associated with discordant MST responses. Women with an EHR-documented PTSD diagnosis had fivefold higher odds of having EHR-documented MST (vs. survey only; odds ratio 5.2; 95% confidence interval 2.3–11.9).

VHA screening may not capture more than half of women who reported MST on the survey. VHA screening may underestimate true rates of MST, which could lead to a gap in recognition and care for women veterans.

Victims of many types of transgressions may delay voicing accusations of wrongdoing. Across seven studies and a within-paper meta-analysis, we examine whether these victims pay a social cost and, if so, how they can reduce it. We find that people perceive victims who delay (vs. do not delay) voicing accusations to have less psychological standing to accuse their transgressors. People therefore perceive such victims as lacking in integrity-based trustworthiness and, often, in benevolence-based trustworthiness as well. People consequently report greater intentions to avoid such victims, trust them less in an economic game with money at stake, and are less willing to hire them. The findings collectively highlight the difficulty that victims face in moving from silence to voice. We further draw on the triangle model of excuses (e.g., Schlenker, 1997) to identify attributions that attenuate the social cost of victims’ delayed accusations.