At least 765 of them have been killed or wounded since 2001, mostly in Iraq. Some are household names, such as Jessica Lynch, who was a 19-year-old Army supply clerk when she was captured in Iraq in March 2003. Lynch's subsequent rescue received widespread media coverage.
Most of the women marched home quietly and are trying to remake their lives, battle scars and all. The wounds are physical, mental and emotional.
Marine Sgt. Shannon Evans, a military policewoman, still deals with traumatic memories after being injured by a roadside bomb in Iraq.
Navy Cmdr. Lenora Langlais, a surgical nurse wounded when bombs hit her base in Iraq, has tried to remain stoic despite grappling with her own wartime horrors.
These women are among four San Diego County residents profiled in a new book about the battlefield and homecoming experiences of female warriors.
“I can say, without a doubt, that everything I did there was with every part of me,” said Evans, 28, who served seven months in the Middle East. “Every mission I went on, every woman and child that I searched over there, I can still see their faces.”
Female veterans who have seen combat face many of the same challenges as their male counterparts and deserve help in overcoming them, said Kirsten Holmstedt of Wilmington, N.C., who profiled Evans and Langlais in “The Girls Come Marching Home.” Holmstedt visited San Diego County last week for book signings.
“We're used to men coming home from war wounded and with (post-traumatic stress disorder), and they don't have to explain anything to anyone because this is how it's been forever,” said Holmstedt, who interviewed about 50 women for her book, which focuses on 18 veterans from all branches.
“Women come home and they have to explain why they are the way they are — why they don't want to be with the kids, why they want to go back to the battlefield.”
Male and female service members can experience different stresses while serving overseas, said Natara Garovoy, director of the women's prevention, outreach and education center for the Department of Veterans Affairs health system in Palo Alto.
There's pressure for women to take care of their children despite the geographic distance. There's the possibility of sexual assault, which the Pentagon continues to identify as a concern.
And there's the worry that women's sacrifices aren't viewed in the same light because they serve in combat “support” jobs — such as mechanic, helicopter pilot, medic and bomb squad technician — not outright ground combat.
The dynamic is slowly changing as the nation's armed services widen the definition of what women are allowed to do. The United States officially bans women from direct fighting, but the guerrilla nature of the wars in Iraq and Afghanistan means noncombat service members suddenly can find themselves in the middle of a shootout.
“How her role in the military is viewed and how she is responded to can be different than for a man, and that can affect her experience of a combat stressor — if it's not seen as valid,” Garovoy said.
Garovoy's program was established two years ago to meet the growing mental health needs of women who served in Iraq and Afghanistan. The facility offers outpatient counseling for PTSD, depression and substance abuse. It also has an inpatient residential program with 10 beds.
The Department of Veterans Affairs runs 232 counseling centers nationwide for male and female veterans, including sites in San Diego and San Marcos.
Female veterans don't always agree on the nature of their problems, but Evans and Langlais concur that the military's stigma surrounding mental health care remains.
Evans, who has been stationed at Miramar Marine Corps Air Station, said she believes women form an emotional connection to what they see on the battlefield.
She said her male compatriots seem to have on-off switches for their feelings. Evans said hers is more of a “dimmer” switch that has been hard to shut down since she returned to the United States in 2006.
Evans still has nightmares about Iraq, yet she often wants to return to the theater of war.
“Even though we're fewer than the men and sometimes we're not held to the same light as them, we take home our work just like they do,” she said.
Evans backs the idea of making more counseling available for all combat veterans, and possibly creating programs and support groups that encourage military women to seek mental health treatment whenever they need it.
“A lot of things are catered just to everybody,” Evans said. “But sometimes it has to be broken down because you have different issues between men and women.”
Between the time Evans prepared to leave Iraq and before she went back to work in San Diego, she received two “briefs” — military parlance for a group meeting with a speaker. The talks covered domestic violence, intimacy issues and other problems that veterans might face on the homefront.
Evans can check off several items on that list: the nightmares, a rocky time getting reacquainted with her now-husband, the nagging sense that she can never again be the person who hadn't witnessed warfare.
She has not sought counseling because, she said, things seem all right. But she's also well-aware that Marines in her unit scoff at seeking mental health services, calling it “going to see the wizard.”
“I guess I'm not afraid of it, but I guess I just keep kind of pushing it back,” Evans said.
Langlais, a senior Navy nurse, has a slightly different perspective, saying women aren't necessarily more emotional.
She stayed in Iraq and continued to work in her surgical trauma center despite suffering severe wounds to her face and neck when bombs hit her base. When Langlais asked to leave in 2006, she said, she was misdiagnosed with PTSD instead of combat stress, a less serious condition. She hasn't undergone counseling or other treatment.
After a long fight to eliminate the PTSD notation from her record, Langlais is now training personnel at the San Diego Naval Medical Center in Balboa Park.
“Women are expected to be emotional and are expected to act out and cry. When you don't respond that way, it's sort of, ‘She has a problem, she's hiding her problems,’?” said Langlais, 48. “When you are over there, you learn to deal with some of the most horrific things you can possibly ever imagine. Tears are part of the package of dealing with it, but eventually you need to learn to internalize it because you have junior people looking at you.”
Like Evans, Langlais supports efforts to erase the taboo of seeking mental health care. Although Pentagon officials encourage service members to actively ask for treatment, Langlais said it's still “the kiss of death” for a military career if a person receives counseling.
Langlais and Evans agree that women have earned their place in and around the front lines.
“To me, it's a no-brainer,” said Evans, who feels she was essential for interactions with Iraqi women. “We need to have that presence, (to show) it's not just a male-dominant world.”