Women Veterans Face Persistent Gaps in Health Care as Report Calls for Urgent Reform

Lucas Tremblay

11/12/20267 min read

For Wanda Motard, some of the health problems that would follow her for decades began with something as basic as a pair of boots.

Motard wears a women’s size five-and-a-half. But when she began basic training at Saint-Jean Garrison in Quebec in 2002, she says the only military boots available to her were designed for men and were far too large.

In the August heat, she doubled up on heavy wool socks and tried to make them work.

She remembers repeatedly tripping over her own feet and rolling her ankles. Eventually, she suffered a sprain.

Then came the forced marches.

Once she added a rucksack that also did not fit properly, the physical strain became even greater.

“I was constantly tripping over my feet, had rolled my ankle a few times, [which] led to a sprain,” Motard said. “With the forced marches, it became really, really difficult once I had my rucksack on.”

She tried to cope with store-bought insoles, anti-inflammatory medication and nightly icing.

Halfway through basic training, Motard finally received boots that fit.

But by then, the experience had become an early example of a much broader problem: military systems and equipment that historically were not designed around women’s bodies.

More than two decades later, Motard, now 47, is living with complex physical and emotional health problems that include chronic pain.

And experts say her experience is far from unique.

Chronic Pain Disproportionately Affects Women Veterans

Roughly half of Canadian veterans live with chronic pain, according to a joint report from the Chronic Pain Centre of Excellence for Canadian Veterans and the Canadian Pain Society.

Among women veterans, the prevalence is more than twice that seen among women in Canada’s general population.

The report, released in June, called for “urgent, co-ordinated action” to close gaps in treatment and care.

Alice Aiken, founder of the Canadian Institute for Military and Veteran Health and a professor of physiotherapy at Dalhousie University, says the differences in health outcomes between women veterans and civilian women deserve much greater attention.

“We know that women veterans have different health outcomes from women civilians,” Aiken said.

While the chronic-pain report did not establish all of the reasons behind that difference, Aiken said chronic pain is particularly important because it can become a gateway to long-term disability.

Military service itself can involve highly physical work, repeated strain and greater opportunities for injury.

For women, those risks have historically been compounded by equipment and uniforms that were designed primarily around male bodies.

Equipment Was Often Not Designed for Women

Aiken says Motard’s experience with badly fitting boots and equipment reflects something many women in the military have encountered.

“A lot of the uniforms were not and are not designed specifically for women,” Aiken said. “They don’t fit properly.”

Equipment that does not fit can affect posture, movement and the way weight is distributed across the body.

Over time, those issues may increase the risk of musculoskeletal injuries and contribute to chronic pain.

For Motard, the oversized boots and poorly fitted rucksack were not simply uncomfortable. They changed how she walked and carried weight during physically demanding training.

Her description of the culture at the time was simple: “one man, one kit.”

Major Gaps Remain in Research

Despite growing awareness of women veterans’ health issues, experts say there is still relatively little research focused specifically on their experiences.

Aiken says less than 10 per cent of publicly funded health research dollars go toward research specifically focused on women.

Research concentrating on women veterans represents an even smaller field.

That lack of evidence makes it more difficult to identify how military service affects women differently and to design health-care systems around those needs.

The House of Commons Standing Committee on Veterans Affairs highlighted the problem in its 2024 report, Invisible No More.

The first of the report’s 41 recommendations called for the establishment of a comprehensive research program focused on women veterans.

For Aiken, improving the evidence base is essential to understanding everything from chronic pain and reproductive health to mental health, occupational injuries and the long-term effects of military sexual trauma.

Leaving the Military Can Mean Leaving an Integrated Health System

Another major problem can emerge when military members leave the Forces.

While serving, Canadian Armed Forces members receive care through a separate military health system.

Aiken describes that system as highly integrated and multidisciplinary.

Clinicians can refer members directly to other health professionals, allowing different aspects of a patient’s condition to be treated together.

But once members leave the military, they generally enter the civilian health-care system of their province or territory.

That transition can be difficult.

Canada’s publicly funded health-care system offers broad access to medical services, Aiken said, but it does not necessarily recognize the distinct medical experiences of people who served in the military.

Those gaps can be even more pronounced for women veterans.

A patient may have chronic pain, trauma, mobility problems and mental health concerns that all developed through interconnected experiences during service, while civilian care can be fragmented between different providers.

Private Clinic Attempts to Fill the Gap

Some veterans have turned to specialized private clinics for more integrated treatment.

Dr. Markus Besemann opened Beechwood Physical Medicine in Ottawa in 2022 with chiropractor Dr. Geoff Outerbridge.

Besemann is a physiatrist specializing in rehabilitation medicine and spent 37 years in the Canadian Armed Forces.

From 2008 until 2023, he served as chief of the military’s rehabilitation program.

When he retired, he wanted to continue treating people with pain, with a particular focus on veterans and chronic conditions.

Beechwood brings together a range of practitioners, including physicians, physiotherapists, psychologists, chiropractors and acupuncturists.

Some services may be eligible for funding through Veterans Affairs Canada, while others require patients to pay privately or seek reimbursement through their own health benefits.

Motard Found Care Outside the Public System

Motard eventually became a patient at Beechwood.

After leaving the military, she says she was placed on a waiting list to see a physiatrist through the public health-care system.

While waiting, she began looking for alternatives.

Motard lives in the Gatineau, Que., region, across the river from Ottawa, and her search led her back to Besemann, who had treated her for five years while both were still connected to the military.

What attracted her to the clinic was its integrated approach.

Instead of visiting separate providers who may have little communication with one another, she could receive treatment addressing different dimensions of her condition under one roof.

For Besemann, that includes recognizing that chronic pain cannot always be separated from psychological trauma.

He describes the distinction through two questions.

Traditional medicine often asks: “What’s wrong with you? What’s the diagnosis?”

Trauma-informed care, he said, asks something different: “What happened to you?”

Sexual Harassment Can Be Part of the Health Picture

For some women veterans, experiences of sexual harassment or assault during military service can form part of that answer.

Aiken says Canadian-specific research remains limited, but studies involving U.S. veterans suggest military sexual trauma can contribute to chronic pain.

Motard says sexual harassment was also part of her own military experience.

She described behaviour ranging from inappropriate and unwanted comments to touching, pressure to enter sexual relationships, threats and stalking.

At Beechwood, her treatment has included psychotherapy to address those experiences alongside her physical health problems.

Motard was also a member of a class-action lawsuit against the Department of National Defence over sexual misconduct.

The lawsuit was settled in 2019, with the federal government agreeing to compensate eligible people and implement measures intended to create a safer and more respectful military environment.

In 2021, the Canadian Armed Forces, Department of National Defence and federal government issued a public apology to people affected by sexual misconduct.

Military Says Cultural Change Is Underway

A 2025 report examining the military’s response to sexual misconduct found significant progress had been made but warned that continued work was necessary to ensure cultural changes became permanent.

The Department of National Defence says it is continuing efforts aimed at sustained culture change.

Changes are also being made to military equipment.

DND says a contoured combat uniform designed around female body shapes is scheduled to begin entering service in 2027.

Updated body armour designed with similar considerations is expected to follow in 2028.

The changes address a problem women in the Forces have raised for years: equipment designed around male bodies can create both operational and health consequences.

For veterans such as Motard, however, those reforms come decades after their own injuries and experiences occurred.

Veterans Affairs Says Supports Are Available

Veterans Affairs Canada says it recognizes the complex needs of veterans living with chronic pain and provides coverage for a range of physical and mental health services.

The department also says it is working to close gaps in care and improve research into the health of women veterans.

But experts say solving the problem will require more than individual programs.

The chronic-pain report’s call for co-ordinated action reflects the interconnected nature of the issues women veterans may face.

An injury sustained during training can become chronic pain.

Chronic pain can affect employment, sleep and mental health.

Sexual trauma may complicate both physical and psychological symptoms.

Then, after leaving military service, veterans may encounter a civilian medical system that has little familiarity with how those experiences fit together.

A System Historically Built Around Men

The underlying problem, experts say, begins with a military institution that for generations was overwhelmingly designed around men.

That influence could be seen in equipment, uniforms, medical research and assumptions about what a typical service member looked like.

As the number and roles of women in the Canadian Armed Forces expanded, systems did not always evolve at the same pace.

Those shortcomings can continue affecting women years after their military careers end.

Motard’s story began with oversized boots, an ill-fitting pack and the expectation that she adapt.

But the consequences have extended far beyond basic training.

Her experience now sits within a much larger discussion about what Canada owes women after they serve — and whether health-care systems are adequately prepared for the injuries, pain and trauma they may bring home with them.

For researchers and advocates, the answer is increasingly clear: women veterans have distinct health needs, and addressing them will require better evidence, better equipment, more integrated treatment and a smoother transition from military to civilian care.

The latest report warns that those changes cannot remain fragmented.

After years of documented gaps, it says the response now needs to be urgent and co-ordinated.

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