Female veterans face the same post-war mental health issues as male soldiers, but also have to deal with gender discrimination and sexual assault.

In the rough-and-ready, male-dominated world of military pilots, Olivia Chavez held her ground.

Chavez was 5 feet tall and 140 pounds when she became one of the first women, and first Latinas, to fly an CH-47D Chinook helicopter in a combat situation.

In fact, for more than two decades, in three separate branches of the military, Chavez was a pioneer and served among her mostly male counterparts with great distinction and pride.

But her unbreakable loyalty to the military almost destroyed her.

Chavez told Healthline that she was sexually assaulted multiple times by several different men while on active duty.

“The idea that we as women endure so much to fight for our country saddens me,” said Chavez.

She developed a thick skin and learned to live with every unwanted sexual advance, grope, and comment.

“I developed a wall thicker than the walls of the USS Tunny in order to go on with my days,” she said. “I stood my ground. I developed a vocabulary that would astonish Chesty Puller in order to show my strength. I drank as hard as the guys to show how strong I was and that I could hang.”

Little did she know the strategy she developed to protect herself would cause great personal trauma.

“Unfortunately, I do feel shame that a former commanding officer encouraged and convinced me not to press charges against a sergeant first class for groping me and discussing what he thought my sexual preferences were,” said Chavez.

She said she also had a command sergeant major kiss her on the mouth upon leaving her commissioning party, and had an executive officer who wanted to discuss her progress in flight school over beer and pizza in his hotel room.

“Our leaders are the ones entrusted to keep us safe, not create unhealthy environments,” said Chavez.

The decorated aviator says that berating and belittling female service members is still commonplace in the military.

Chavez had a mentor in the Marine Corps who would tell her regularly not to let things get under her skin, to just excel in her work and her duties so no matter what was said or thought of her, the results would speak for themselves.

“In 21 years of service, more often than not I found myself one of a few and sometimes the only female,” she said. “With every new duty station, it was like starting over, proving you are more than a target.”

Chavez is making the tough transition now from active duty to veteran. She’s dealing with mental and physical wounds. She has post-traumatic stress disorder (PTSD) as well as military sexual trauma (MST).

But she’s a survivor and an eternal optimist.

She’s working in a management position, is engaged to be married, and continues to help her fellow veterans — women and men — who are making that long and often arduous journey home.

“Women have been serving our country in one official capacity or another since World War II and even before,” she said. “But we are still the afterthought.”

Read more: Female marine breaks silence on PTSD »

While Chavez’s experience may seem shocking, it is not uncommon.

Many American women who honorably serve their country find themselves with disabling mental health issues when they leave active duty.

It was described by the more than a dozen women veterans interviewed for this story, along with physicians, therapists, veteran advocates, and pols, as nothing less than an American crisis.

Most of this anguish is service connected. America’s female veteran population is collectively dealing with everything from PTSD, MST, anxiety, depression, unemployment, homelessness, and suicide.

There are 21 million veterans in the United States, and 2.2 million of them are women.

Many face enormous emotional challenges that are not widely known to the general public. And some of them fall between the cracks.

While 2 in 5 female veterans report that they have experienced sexual abuse or harassment, sexual assault of men in the military is an enormous and underreported problem, too.

The Department of Defense noted last year that about 10,800 men are sexually assaulted every year in the military, and that about 8,000 women are sexually assaulted, but that few of these men report being victims of sexual assault.

That treatment often leads to PTSD, potential homelessness, and even suicide.

Among the 15 women military veterans randomly selected to comment for this story, more than half said they had been sexually assaulted or harassed while on active duty.

Several have attempted suicide.

But while the underreported crisis of military sexual assault and harassment still plague every branch of the service, the treatment isn’t the only reason why women are struggling when they come home.

Many are experiencing the effects of something equally damaging: Being relentlessly dismissed, overlooked, or degraded by peers and those in charge.

Others are still coping with the separation anxiety they felt when leaving their children behind during long deployments.

While men come home from war with serious mental and physical challenges, women have many of the same issues and these are compounded by multiple factors.

One of the most serious is the fact the military, Department of Veterans Affairs, and most of the veteran service organizations are still largely male dominated environments that often degrade or disrespect women.

Multiple sources for this story insist that the American people are simply not ready to see women return from war with the same physical and emotional issues that men have been bringing home since war began.

Read more: Vietnam veterans still have PTSD 40 years after the war »

Women join the military for many of the same reasons men do.

They want to defend their country’s freedoms, carry on their proud family tradition of military service, and find greater opportunities than are available in their local communities.

But statistics show that far fewer women volunteer their veteran status, either because they’re made to believe they don’t fit the definition of “veteran,” or, more commonly, they don’t want to invite the social stigma attached with being a woman who chose to serve in the military and make the ultimate sacrifice.

Katrina Eagle, an attorney who has advocated for veterans on a wide array of issues, said thestigma attached to a woman who pursues a military career path, one that repeatedly tells her that she is in a man’s world and has no business being there, follows her throughout her post-military life.

“There’s an even greater steel a woman must employ to stand shoulder-to-shoulder with her male active duty counterparts, and the negative, judgmental comments and attitudes come fast and furious if she even shows a hint of weakness, pain, or fatigue,” Eagle told Healthline.

“Our women veterans are facing a mental health crisis because the VA has failed to provide a consistently safe haven to turn for help. The VA is suffering its own shortage of competent, qualified medical professionals, which then also leaves a lasting mark on women veterans.”

For example, if a woman suffered military sexual trauma during her service, she may be unable to psychologically tolerate a male OB-GYN examining her during pregnancy or even for annual gynecological exams.

“Thus, she foregoes VA healthcare completely, which is neither good for her or her family, and the cyclical downward spiral that this country now recognizes as a crisis pervades multiple generations of that woman’s family,” Katrina Eagle, an attorney who has advocated for veterans on a wide array of issues, told Healthline.

Read more: Gulf War veterans still fighting serious health problems »

Approximately 40,000 veterans are homeless on any given night in America, according to the National Coalition for Homeless Veterans.

In a 2014 study, Disabled American Veterans (DAV) found that 8 percent of those homeless veterans are women.

A woman who’s served in the military is three times more likely to become homeless than a woman who hasn’t served in the military.

Darlene Mathews had big dreams and no history of mental health issues when she joined the Women’s Army Corp (WAC) just after the Vietnam War.

But during basic training at Fort McClellan in Anniston, Alabama, Mathews says she was sexually harassed by officers and then was viciously retaliated against for defending her enlisted female colleagues who had been sexually assaulted.

“They gave me the option of staying, but I knew they were going to make life difficult for me,” said Mathews, 59, who’s been homeless since November 2013.

She currently sleeps in her car, a 1984 Volvo, in a Southern California business parking lot.

“They let me sleep there. They know I’m a veteran,” said Mathews, who on an unusually muggy autumn morning talked to Healthline while planting peas in her well-manicured vegetable garden at the University of California Irvine’s community garden.

She waited two years for a slot to open up at this coveted, 11 feet by 16 feet on-campus cooperative, and she said it’s been a lifesaver for her.

“The garden helps me a lot, physically and emotionally,” said Mathews, who’s disabled and has battled physical and psychological issues since she left the Army with an honorable discharge in 1976.

Last year, nearly 40 years after she left active duty, Mathews was awarded disability benefits by the VA for her service-connected PTSD. She doesn’t smoke, drink, or take illegal drugs, but she has attempted suicide.

“I was naive when I joined the military,” she said “I always thought the military and our government did the right thing. I wanted to serve my country.”

Read more: Painful headaches plaguing many U.S. war veterans »

Perhaps the biggest problem women face when they leave the military is what many describe as a simple lack of public awareness that women serve in combat zones and have for a long time.

And they are bringing home all the attending emotional and physical issues.

Anyone who doubts that women are in the line of fire need only speak with Marissa Strock, who joined the Army in 2004 as a military police officer. She worked with Iraqi police and the Iraqi army doing patrols in an area south of Baghdad known as “The Triangle of Death.”

In November 2005, she and her team were asked to investigate a mass grave of Iraqi casualties. As they made their way to that site, an improvised explosive device (IED) detonated beneath their Humvee, a blast that killed her team leader, her driver, and an Iraqi police colonel.

Strock was thrown from the Humvee, landed on her head, then slid into the bushes. She lost both her legs in the explosion and spent a year and a half in the hospital. She also suffered from traumatic brain injury (TBI).

But Strock, who was profiled twice in Newsweek in 2007, has since become an outspoken and compassionate advocate for veterans.

She currently lives in Michigan, where she works for Final Salute Inc., and is studying to become a physical trainer who specializes in working with others who are disabled.

She’s also a fashion model and was a contestant in, and then host of, the Ms. Veteran America competition.

“Ms. Veteran America showcases women veterans beyond the uniform,” Strock explained. “It highlights women veterans’ beauty, grace, and poise. Women are serving our country. We are soldiers, airmen, Marines, but we are also women. We are mothers, sisters, daughters.”

Strock, who’s dedicated her life to the memory of her team leader, Steven Reynolds, and driver, Marc Delgado, said that while she’s had mostly good experiences with the VA, it took six months for the Ann Arbor, Michigan division to fix her wheelchair. It took even longer for VA doctors to give her the proper neurological exam she desperately needed.

Strock said that when she walks in to the Ann Arbor VA, many staffers assume she is there as the wife of someone in the military.

“People in this country still aren’t ready to see women come back from war broken and bloodied,” she said. “I didn’t lose my legs baking cookies. It wasn’t an oven explosion.”

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Sevrine Banks, an Army medic, served in the military for 20 years.

Her first stint was in war-torn Bosnia, where she saw children and families in unthinkable living conditions.

“When I talked to the children suffering on the streets in Bosnia with no food or water, I could not help but think of my own kids,” said Banks, the mother of two.

She spent nearly a year in northern Iraq, where her unit was mortared almost every night.

Her final deployment was in southern Afghanistan, where she led a group of more than 60 women as the female engagement team and first sergeant — the only one in the Army.

She said the women would go out on dangerous daily patrols with the men and initiate dialogues with the women and children of the community in an effort to create bonds and trust.

She was in Afghanistan seven and a half months, during which she went out to the village close to her post.

“Soldiers had never gone there,” she said. “One time, this baby was crying, and I reached out to the baby to comfort him. You never stop being a mom. I didn’t know, but a soldier took a picture, my daughter saw the picture, and then my dad’s Pentagon friend got the picture and it went viral at the Pentagon.”

Being in Afghanistan was humbling for Banks.

“There were people there who were so poor, yet they would give you their last meal,” she said. “In that village, they made us meals. There were no chairs. We sat on the floor, cooking dinner. They were asking about my kids, and I was asking about theirs.”

Despite all the horrific things she saw in the trenches of warfare, Banks didn’t realize she had PTSD and other serious emotional issues until after she retired and came home in 2015.

“My mom knew it,” said Banks, who left the military last February. “But it took me a while before I realized I really needed help.”

Banks, who’s now in counseling, works full time as a manager for a state agency in Sacramento, California. She also works with the Women Veterans Alliance, whose mission is to empower women soldiers and veterans through networking, career development, and mentorship.

Banks is on the right path, she said, but being a woman in the military took its toll. She has a hard time with loud noises, such as a car backfiring. And the 4th of July is no longer one of her favorite holidays.

“I’m dealing with a lot, but I am still alive,” Banks said. “I have my kids. Things could be worse.”

Read More: Depression and military families »

On average, 20 American veterans take their lives every day, according to the VA.

And the suicide rate among women who served is even higher per capita than it is among men — especially among younger women veterans.

A report released last year showed that for women veterans between 18 and 29 years of age, the risk of suicide is 12 times the rate of nonveteran women.

Valerie Whelton,the mother of three and an Army veteran who spent 14 months in a combat situation in Iraq, saw several close friends and colleagues killed by bombs.

Whelton worked in security at her outpost at the top of a tower. She carried a machine gun and scoured the surrounding area eight hours a day, keeping it protected. The outpost was regularly threatened by insurgents.

Whelton, who is now disabled, has attempted suicide three times. But she remains proud of her service.

She told Healthline that the last attempt to take her life, which took place just a few months ago when she took a handful of pills she had been prescribed, was her last.

“I just can’t do that anymore, ever. I have to put my children first and stay healthy,” she said. “I need to be here for them.”

Glenn Towery, a Vietnam War combat veteran, and founder and chairman of the Veterans Suicide Prevention Channel, is working to increase public awareness of the suicide epidemic among veterans.

“For so many years as a nation we have paid little attention to the women who serve as soldiers, airmen, and sailors,” he said. “There is real risk for anyone willing to put themselves into harm’s way for country, honor, and duty, but to see the enormous toll that military service is having on women who serve in terms of suicide is particularly alarming.”

Towery noted that while women only became recognized as official combatants in war in 2013, the suicide problem predates that recognition.

“We must address this issue with programs that are designed specifically for women,” he said. “There are many instances of PTSD among veterans but the mix of MST, PTSD, the pressures of family, military duty, and possibly prevalent military misogynistic attitudes may be playing a lethal role when it comes to escalating and continuing this deadly problem of female veteran suicide.”

Read more: Where the presidential candidates stand on veterans’ health issues »

While President-elect Donald Trump has expressed a desire to address the problems of veterans at the VA, he does not seem to be especially sympathetic to the plight of women in the military.

Trump has repeatedly blamed sexual assault in the military on the fact that men and women serve together.

In 2013, when the Pentagon announced the sharp rise in reports of sexual assault, Trump tweeted, “26,000 unreported sexual assaults [sic] in the military-only 238 convictions. What did these geniuses expect when they put men & women together?”

In 2015, Trump said to CBS News about women in combat situations, “You’re in there and you’re fighting and you’re sitting next to a woman … Now they want to be politically correct. They want to do it but there are major problems. And, as you know, there are many people that think this shouldn’t be done, at a high level. I can say this, the numbers of rapes in the military are through the roof. Through the roof.”

Trump did say during the primaries that he would fix the broken VA system.

“The current state of the Department of Veterans Affairs is absolutely unacceptable,” Trump said at a rally a year ago in front of the battleship USS Wisconsin. “Over 300,000 — and this is hard to believe, and it’s actually much more than that now — over 300,000 veterans died waiting for care.”

Rep. Jeff Miller, chairman of the House Veterans’ Affairs Committee, told Healthline, “As women become a larger part of our military, the Department of Veterans Affairs must become more accessible to female veterans and do a better job of addressing their needs. To that end, the House has passed the Ruth Moore Act and the Female Veteran Suicide Prevention Act to improve the benefits process for both male and female survivors of sexual assault, and require VA to adapt its mental healthcare programs to the needs of female veterans, respectively. Now is the time for the Senate to consider these important bills.”

During this congressional session, the committee held a hearing entitled Examining Access And Quality Of Care And Services For Women Veterans. At the hearing, Miller requested that the Government Accountability Office conduct an assessment of VA’s ability to improve the healthcare quality and access for female veterans. The report is expected to be released this fall.

H.R.2915, the Female Veteran Suicide Prevention Act, would direct the secretary of VA to identify mental healthcare and suicide prevention programs and metrics that are effective in treating women veterans as part of the evaluation of such programs. It passed the House on Feb. 9, 2016, and is currently pending in the Senate.

H.R.1607, the Ruth Moore Act of 2015, would allow a statement from a person who had been sexually assaulted to serve as sufficient proof that the assault occurred in the disability benefits claims process. It passed the House on July 27, 2015, and is currently pending in the Senate.

More reading:

VA Medical Centers Not Equipped to Handle Female Veterans

Desert Storm Soldiers Paved The Way for Female Veterans