Gender Role Stress Mediates Depression Among Veteran Men With Military Sexual Trauma

Compared with survivors of other types of trauma, survivors of sexual trauma, particularly military sexual trauma (MST), are at greater risk for posttraumatic distress. Although traditionally masculine aspects of gender identity may mitigate the deleterious effects of trauma (Valdez & Lilly, 2014), it may, in some cases, exacerbate negative outcomes. Sexual victimization may undermine traditional gender expectations of power among male survivors, potentially explaining the added risk associated with this type of trauma. These dynamics may be even more pronounced for veteran men, given their involvement in a military culture that highly values masculinity. Accordingly, we hypothesized that masculine gender role stress (i.e., stress from not upholding masculine gender norms; Eisler & Skidmore, 1987) would be greater among veteran men with MST than those with other interpersonal trauma and would mediate the relationship between MST and posttraumatic distress (i.e., posttraumatic stress disorder [PTSD] and depressive symptoms). We found that while veteran men with MST (n = 52) reported greater PTSD and depressive symptom severity compared to men without MST (n = 52), there was no significant difference in overall gender role stress. Ad hoc analyses exploring specific aspects of gender role stress found that men with MST reported greater gender role stress related to emotionality and intellectual inferiority. Additionally, gender role stress related to emotionality fully mediated the relationship between MST and depression but not PTSD. The vulnerability and intense emotions that accompany MST are discussed in the context of gender role expectations and in terms of clinical implications.