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What Should Healthcare Providers Working with National Guard or Reservists Know About TBI and Issues with Sexual Health?

What Should Healthcare Providers Working with National Guard or Reservists Know About TBI and Issues with Sexual Health?


What should healthcare providers working with National Guard or Reservists know about TBI and issues with sexual health?

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[Glenn Parkinson] The National Guard and Reserve populations within the military are a very special population—our citizen soldiers as we call them. It's a very complex population because they sort of have one boot as it were in two different worlds in the civilian world, as well as the military world, and there are very different cultures they're in. While they have all of the same experiences when activated as full active duty service members to include whether they're deployed, whether they're in the rear detachment, whatever it is, and yet the vast majority of their social lives really reside within the civilian setting. So often times there's a lot of internal conflict that Guard and Reserve service members feel about that. It's kind of a sense of displacement sometimes. So for providers that are working with that population or even newly medically discharged service members who are kind of thrust into more of a civilian setting, there can be a sense of a cultural schism that they feel— a feeling like so much of them is circumscribed by their training, by their culture, by their identity as a member of the military, and yet they're living in a world in which that's often not known very much about. So when someone has a history of traumatic brain injury and military service, I think it's really important to be sensitive to a variety of issues. To begin with just to have an awareness that there is something really different about someone who served in the military and also really different about someone who has had a traumatic brain injury and been in the military medical setting. The cultural differences are vast. When it comes to issues around sexuality related to that, I think a lot of times someone's military identity is a big part of their sense of their gender identity. For a Marine, "I'm a Marine." You know? "I'm a man, but I'm a Marine." For women too. I think one of the things that is—it's difficult to articulate, and it's not very well understood by people outside of the system, is the extent to which someone's compulsion to serve is really part of the fiber of their being. It's very meaningful to them, and it's something that I think is not as understood. It's not that it's not respected, I think it's just not really understood outside of the system, and I think that when someone has that as a part of their identity, and then their identity is altered, their sense of their perspective about themselves is altered either by an injury or by combat service. That's a really important part of their identity that gets altered as well. So for anyone that's working with newly medically retired service members or Guard and Reserve who are deactivated, it's important to understand that because when you think about someone's sense of themselves sexually and their sense of self-esteem and how they identify themselves and how a potential physical injury impacts them, it's really important to understand all those moving pieces.

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Produced by Victoria Tilney McDonough and Erica Queen, BrainLine.

Glenn W. Parkinson, MSW, MAGlenn W. Parkinson, MSW, MA, Glenn Parkinson, MSW, MA works as the psychotherapist on the Traumatic Brain Injury service at Walter Reed National Military Medical Center. She works with active duty and retired military personnel and their families specializing in combat-related injuries.

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