Thank you for the opportunity to speak to all of you today. This is a very important subject area for me, so I'm very grateful.
I'll be speaking to you today as a researcher and a civilian who supports members of the Canadian Armed Forces, our first responders and veterans.
My research focus at this time is how biological sex, reproductive health and occupation are related to musculoskeletal injuries. I will likely be referring to musculoskeletal injuries as “MSKI”, because it's a lot easier to say.
Women have been serving in Canada for over a hundred years in both military and RCMP contexts. Research, training, infrastructure, equipment and resources for both serving and retired female members do not reflect this. In fact, when I conducted my first literature review in 2018 to build evidence-based rehabilitation and physical training programs for the CAF members I was supporting, there wasn't a single study published on the common injuries among Canadian servicewomen. As a world leader for the integration of women into careers that are historically open only to men, we need to do better.
What do I mean by “do better”? I'm now going to share, with permission from the sources, some examples and quotes from female members.
One says, “The sexism that is systematically built into our medical care also makes it so that any female-specific medical issues aren't taken seriously. I also hear that's health care in general though, so I guess it doesn't matter if it's documented. It won't really help.”
Another says, “I had my breasts basically removed to fit my kit. Yes. Having a surgically modified chest designed specifically to be flatter has helped me better fit my kit and that is super messed up because women shouldn't have to cut their boobs off to be able to do basic military tasks without the injury risks by just wearing their kit they're forced to wear.”
This is another: “I went in with bad cramping and asked to have my IUD removed. They wouldn't look at me because I was being posted out soon and they said just to do it when I get to my next posting. When I got there, it took eight months before someone would take out my IUD and they just gave me naproxen. They offered me more drugs, but I just wanted the thing out because I'm pretty sure it wasn't put in right in the first place. This experience has stopped me from going to the MIR when needed, I would rather pay out of pocket to be taken seriously.”
This one says, “I am avoiding putting my claims in through VAC because they're notoriously horrible to deal with and I don't have the bandwidth to do that on top of everything else.”
Finally, this says, “No woman I know wears the front plate. I end up just wearing two back plates on my frag vest because at least it kind of fits.”
I'm now going to speak to the research that I've been a part of at the Adamo Lab at the University of Ottawa.
Females serving in the CAF experience higher rates of pelvic floor dysfunction when compared to the civilian population. Female CAF members experience higher rates of overuse injuries when compared to their male colleagues. Female members experience higher rates of injuries during their annual physical force test compared to their male colleagues. Female members who have given birth are more likely to sustain overuse injuries than their nulliparous peers and also males. Only 6.7% of CAF members who have been pregnant while serving received specialized physical training support—that's 6.7%.
To conclude, Canada has taken a gender-neutral and female-inclusive approach. Unfortunately, evidence-based “gender-neutral” means “man”, because of the lack of women representation in research. Until the physiology, biomechanics and anatomy of females are included in the CAF health services training courses, prioritized in research and required to be supported by the defence team, the needs of female CAF members and veterans will not be understood, and they will continue to be invisible.