Mental health outcomes associated with military sexual trauma in serving and ex-servicewomen: A systematic review

Abstract Military sexual trauma (MST) (sexual harassment or sexual assault experienced during military service) is associated with adverse mental health outcomes. This systematic review assessed international, published, peer-reviewed academic literature and aimed to (1) identify the mental health outcomes of MST for serving and ex-servicewomen, (2) understand whether sexual harassment and sexual assault impact mental health differently, and (3) identify individual differences that may influence mental health outcomes. Included sources were peer reviewed, primary research, which investigated MST as a predictor of mental health outcome(s) in women. Database searches (June 2023, May 2024, and March 2025) yielded 63 studies, most of which (n = 58) were conducted in the United States and used quantitative methods (n = 60). A narrative synthesis approach facilitated data synthesis. Quantitative studies identified associations between MST and adverse mental health outcomes, with qualitative studies providing further context to these associations. Military sexual assault appeared to have a stronger relationship with adverse mental health than other MST experiences. Posttraumatic stress disorder and depression symptoms were associated with further outcomes, such as suicidality, disordered eating, and substance use. Some additional trauma exposures exacerbated the impacts of MST on mental health, whilst social support mitigated negative mental health outcomes. This review identifies significant mental health impacts of MST and highlights the importance of formal and informal support for serving and ex-servicewomen with MST experiences.