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The first day Kristine Wise returned from eight months military service in Iraq, she knew something was wrong. Driving from San Diego to Bakersfield to see her brother, the road signs triggered flashbacks.

"One said 'railroad,' but instead I saw 'roadside' and in my mind a roadside bomb," said Wise, who supplied parts to combat vehicles in the first wave of the war. "I would see 'beware' and my mind would see 'Baghdad.' I couldn't explain it."


The depression and panic attacks began long before her honorable discharge in 2004, but the battle to get the Department of Veterans Affairs (VA) to take her symptoms seriously was just as difficult.

"They had a hard time comprehending I was a combat vet and didn't treat me with the same respect," said Wise, now 40 and rated 10 percent disabled for post traumatic stress disorder.

Wise is one of more than 230,000 women -- about 11 percent of the U.S. military -- who have served in Iraq and Afghanistan.

As of the third quarter in 2009, the VA reported that 11,713 of the women evaluated received a diagnosis of post traumatic stress disorder (PTSD).

Women have experienced the same psychological and emotional trauma as their male counterparts, but the VA has only begun to pay attention to their gender-specific needs, according to to "Combat to Community," a 2009 report conducted the veterans' advocacy group, Swords to Plowshares.

The number of women in all branches of the military has doubled in the last 30 years, and is expected to double again in the next decade, the VA estimates.

Women are enrolling in VA healthcare at "historical rates," about 44 percent of all Iraq and Afghanistan war veterans, but say they face roadblocks to good care.

"In case after case, Jack and Jill were both deployed and were in the same fire fight," said Tia Christopher, a Navy veteran from Washington state, who is being treated for PTSD caused by sexual assault.

"He's decorated and she's not because she's in support instead of in combat," she said.

These veterans are also plagued with problems unique to their gender -- sexual harassment, guilt over leaving children behind and a more difficult time transitioning back to civilian life, according to Christopher, an associate for the Iraq Veterans Project.

They are younger than their male peers -- more than 66 percent of all females seeking care are under 30, according to the VA. And some say that exposure to war conditions can also compromise their reproductive health.

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Two nightmares haunt Robin Milonas.

While serving in Afghanistan in 2004 as an Army Reserve civil affairs officer, the former lieutenant colonel got lost in a minefield while leading a small convoy delivering school supplies to civilians. Even more troubling is the memory of a man who arrived at the main gate of Bagram Air Base carrying a young boy whose leg had been blown off by a land mine.

"I was an outgoing, energetic, determined good soldier who wanted to make the Army a career," said Milonas, of Puyallup, Wash., who just turned 50. "Now I am broken."

Milonas is one of roughly 180,000 women who've been deployed to Afghanistan and Iraq. While they don't officially serve in combat, they have experienced life in a war zone where there are no front lines.

And as they return home, they're increasingly turning to an already overtaxed Department of Veterans Affairs for help. Last year, the VA treated more than 255,000 female veterans. The number is expected to double within five years.

VA officials say they're better prepared to handle female patients than they were several years ago. But they acknowledge "continual challenges" as they move to open the door to a man's world, where pap smears and mammograms could become as common as prostate exams.

And where "military sexual trauma" would be treated as a serious and growing mental health problem, rather than as a subject to be avoided.

"It's not your father's VA — it really isn't," said Patricia Hayes, the VA's national director of women's health care issues. "We have geared up and are gearing up. But there are places that may have gaps."

They aren't ready," said Sen. Patty Murray, D-Wash., said of VA officials. "Absent a proactive, concerted effort and knowing their limited resources, they (VA officials) are struggling with so much this might get lost."

Murray, perhaps the leading VA critic on Capitol Hill, has introduced legislation that requires studying how serving in Iraq and Afghanistan has affected the physical, mental and reproductive health of women, and how the VA is dealing with their problems.

The legislation also would require the VA to start caring for newborn children of female veterans who are receiving maternity care. Currently the VA doesn't cover newborn costs. In addition, it would require increased training for VA personnel dealing with military sexual trauma and post-traumatic stress disorder, or PTSD, in women.

The Senate Veterans Affairs Committee will hold a hearing on Murray's bill on Wednesday.

"It's a hard issue, and pouring a huge light on this is a risk, as some will say women just shouldn't be in the military," Murray said. "But as more women transition home from the physical and mental wounds of war and step back into lives as mothers, wives and citizens, the VA must be there for them."

Robin Milonas says she's been stopped three times by police for erratic driving. When she sees a dark spot in the road, she thinks it's a landmine and swerves. Except for her job teaching special education, she stays home. She constantly checks to see whether the doors and windows are locked.

Milonas has been diagnosed with PTSD and receives therapy at the veterans center in Tacoma, Wash. But three times she's been denied a disability rating from the VA, which says Milonas hasn't proved her problems are related to her service in Afghanistan.

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