By Andrea Plate, LCSW
The following is an excerpt from the acclaimed book, Madness in the Trenches of America’s Troubled Department of Veteran’s Affairs. For fifteen years, Andrea Plate served as a social worker at the Veteran’s Administration in Los Angeles counseling soldiers returning from Viet Nam and Iraq—men and women dealing with multiple addictions, depression, PTSD, and homelessness. Below is a portrait of the day-to-day problems at the residential rehab facility known as Domiciliary or the Dom.
Plate paints a portrait of a dysfunctional system–one so rule-bound that patients have died in Rehab Facilities and those seeking help have routinely fallen through the cracks. And she raises the disturbing question, Why do we expect our young people to fight for American values and then leave them high and dry when they return?
As of 2018, there were about 18 million veterans in the United states, or 7.1 percent of the adult population. More than 5 million have at least one disability, 1.2 million were living in poverty and nearly 40,000 were homeless. About 1.64 million women now serve in the U.S Military.
In the early years of the Iraq War, female veterans slowly trickled in. They, too, were thrust into the general patient pool. Sometimes we had fifty-seven male residents and three females on the same floor. Of course, the women complained that they were “hit on.” And they were scared—because their doors had no locks. The open-door policy had been in place for decades, to ensure staff access to all rooms in case of emergency.
Women have served in all of America’s wars, but the Veterans Administration did not serve them until the 1980s. Accordingly, when they first arrived at the Dom, we were not prepared. All UAs (urinalysis tests for drugs) for veterans, both male and female, were observed by males on staff. Men observed male patients standing close by, inside the bathroom; they observed female patients from the doorway, facing away, in the direction of the hall.
This practice was not questioned. In fact, once, needing a man on staff to monitor a urinalysis test for a patient who seemed under the influence, the Assistant Chief—Jean, or Ms. Carter, or Sergeant—barked at me: “You can do it yourself! We don’t discriminate!” Fortunately, an administrator pulled the tough-talking sergeant aside to explain the ethical and therapeutic ramifications of that:
(1) A female social worker or psychologist cannot watch a man urinate into a cup if she engages him in individual therapy, listens to his deepest confessions, and, as is often the case in individual therapy, becomes the object of his intimate fantasies;
(2) Some of these men have been sexually victimized by women, including their mothers; and
(3) Observations by the opposite sex would open the door to allegations of sexual abuse.
Fortunately, visiting higher-ups issued an immediate ban on the practice of male staffers observing female patients. From then on, only female Domiciliary Assistants (of which there were few) had permission to observe female patients (not too many of those, either, thankfully).
In time, women got their own locks, their own rooms, their own floor at the Domiciliary and their own (female-specific) treatment program. Sexual trauma is a well-known hazard of military service. It had been making news since the Tailhook scandal of 1991, when more than a hundred Navy and Marine officers assaulted or harassed female officers at the Las Vegas Hilton Hotel. Now, with an all-volunteer military and increasing opportunities for women, staff was directed to trainings on the topic of MST (military sexual trauma) as well as other female-specific treatment needs.
There were a lot of wrongs to be righted, and the VA tried to do so all at once, with ferocity. Patient Mary J, for example, came to the program before the implementation of a separate women’s track. The vets nicknamed her “Janis Joplin” for her long, straggly blonde hair, ripped jeans and roughhouse ways.
One day, she voiced several complaints about “Mr. B”—a thirty-something, African American veteran who happened to be on my substance abuse treatment team. She said he was “looking at me funny,” and she objected to his tone and manner when he said, “You look nice.”
This single perceived offense, which Mary mentioned to several on staff, launched a cannonade of phone calls my way: from the women’s outpatient clinic at the main hospital; the woman’s Domiciliary psychologist; and the Chief of the Dom, who summoned me to her office to ask, “Did you speak to the victim first?”
No, I explained, defending my decision: “I spoke to my patient (Mr. B), first. He’s the one with whom I have a therapeutic rapport. I’m not even sure she was a ‘victim.’”
This approach was unacceptable, she said. “Always go to the accuser first!” (Would that apply if the accuser were male?)
From then on I advised my male patients: “Stay away from the women. Don’t talk to them. Don’t say hi.”
One male veteran asked: “When a female smokes a cigarette in the quad, braless, in a sheer blouse, in the freezing cold, am I not supposed to look?” He argued that some of these women, already “messed up” by their military trauma, were actually trolling for sex (then cried foul, maybe to get attention).
Nevertheless, I advised: Don’t look.
It was not an egalitarian culture. It was not a gender-neutral culture. When the laundry machines on the women’s hall broke down, female veterans were permitted to use those on the men’s floor, anytime, unannounced; but when the second-floor washers on the men’s floor broke down, male veterans were denied entry to the women’s floor without staff escort. The men complained, so I told the Chief of the Domiciliary. Her answer: “You can tell them that’s because of thousands of years of oppression!”
Another example: Women, but not men, were routinely granted weekend passes to go off grounds. When questioned, the Chief said, “They have children!”
And men don’t??
Now the male veterans’ rights were at risk.
Something was wrong. I could sense it, and see it, the moment I returned to work Monday morning when a group of veterans seemed very upset. How was their weekend?
“Lousy!” Something wrong? “You bet!”
Unbeknownst to me, a directive had been issued Friday afternoon that all male veterans were to be “educated” on the topic of sexual harassment. Audrey was assigned to speak to the guys on my floor. She was a “lifer”—the term for those whose only employer was the VA. She had in fact started there more than twenty years before, in a low-level clerical job. Now she was supervisor of the Dom Assistants. Audrey cut an imposing figure. At 5 ́11 ̋, not counting the four-inch stilettoes, the vets described her as “ghetto chic,” “hard-ass” or “the African queen.” This Monday morning, they vented at what she had “taught” them:
(1) Never look a woman directly in the eyes, because that’s intrusive; focus instead on her forehead; and
(2) Never let a woman know you’re staring at her from behind. (Audrey told them, “I know when I walk out of this room you’re all staring at my ass.”)
What did I think, the guys asked? On the contrary, I said, the eyes are the windows to the soul, so look deeply within. When asked if I, too, felt the heat of their eyes “from behind,” I made fun of myself, as I knew they saw me—a skinny uptown girl with a boney butt.
Caution: Transgender Veterans Crossing
In the early Obama years, the rights of transgender persons to serve in the military wasn’t even a hot topic on cable news, or in classrooms and living rooms.
Thus, we were not prepared for Ella Love, a forty-something veteran transitioning from male to female. She was flighty and outwardly girlie, with peroxided hair, a heavily pancaked face and a penchant for floral print, diaphanous dresses. A free spirit, she was prone to cartwheeling down the hall and blowing bubbles during groups on stress management. Anatomically, however, she remained male; her surgery was not yet complete.
Where to house her? First, she was placed on a men’s floor, but soon after she complained that the men were “coming onto me.” And yet, they couldn’t place her on a women’s floor. This had been tried a year earlier, with another male-to-female transgender veteran, and resulted in a legal judgment against the VA. In that case, a female roommate, a survivor of military sexual trauma (MST), claimed she was re-traumatized one night upon awakening to see her transgender roommate in the bathroom, genitalia exposed.
Administrators were so desperate, they considered housing Emily on the “cancer” floor. Emily did not have cancer but the unspoken assumption, or hope, was that these ill veterans wouldn’t have the wherewithal to bother her. Then a nurse practitioner strongly objected: “Those cancer patients need peace and quiet, not the belle of the ball!”
Eventually, Emily got a single room. Problem solved.
I didn’t know Emily, but I loved Feyonce, also a male-to-female transgender veteran. Her birth name was distinctly masculine— something like Bill Hughes—which was still the name on her patient record. Three times she came to the Domiciliary, tired of homelessness and turning tricks.
The first time she looked predominantly male, dressed in black leather pants, a colorful print bandana and two over-sized silver hoops dangling from her ears. I remember seeing her for the first time, in a heated argument, snarling and stomping away from some macho guys. A short time later, she tested positive for crack and left the Domiciliary program.
I saw her again about a half-year later, waiting to be interviewed for Domiciliary admission. This time she wore a shoulder-length, blonde wig and a baby-blue spaghetti-strap dress, despite the chill of winter. Again, she left the program shortly after coming in.
The third time was the charm—for me, and for Feyonce. She got her own room on a men’s floor (mine). This time, her appearance was far more feminine. She wore dresses every day, wigs in a variety of styles (tousled red tresses; a chic, black bob), and always a velvet ribbon choker, she explained, “to hide my Adam’s apple.” But her sexual reassignment surgery had been stopped. With an enlarged heart from abusing crack, she was prohibited from further surgeries until she stayed sober, which is what brought her back for treatment.
This girl had moxie. Three mornings a week she strode proudly, if not defiantly, through the sixty men assembled for morning community meetings, always sitting up front. She appreciated not being bothered by the male vets (this time they stayed away, not certain where she stood on the gender spectrum). But at the same time, she was lonely. “I’m the only one of my kind,” she once remarked.
Feyonce and I built a strong therapeutic tie. She had a history of clashes with staff, and was the butt of jokes by those who had previously worked with her. I defended “my girl.” I taunted them:
“Hey, aren’t we supposed to be an empathic therapeutic community?” That stopped them.
To me, this veteran was fun. “I have nothing to wear!” she would say, rolling her eyes in mock exasperation. She gloried in girlish clothes, and they were very flamboyant—one day, a Scottish plaid micro mini from a thrift shop called Out of the Closet; the next, a neon-yellow spandex cat-suit and four-inch strappy stilettoes in which she teetered around managing, somehow, not to fall. “Looks like a pineapple!” whispered a woman on staff when she whisked by. Feyonce heard that remark. I could tell, by how force- fully she whipped her head away, but at heart she was undeterred.
Feyonce was through with suffering. She wanted fun, and she pursued it with a vengeance. She wasn’t one to slouch on a bench smoking cigarettes, waiting for the bus with the guys. She was the one beside them, grinding her hips and mouthing the words to a song blasting through headphones. This girl wasn’t going to waste a minute!
And she never took herself too seriously. She laughed in fact, telling me about the drug-sniffing German Shepherd that stuck its cold, wet nose up her towel as she stepped out of the shower, still dancing to a Supremes song. It was 7:00 p.m. and the dogs were part of a surprise drug raid underway. Said Feyonce, hand clasped over her heart with melodramatic flair, “What a shock!” Then she sang a few bars: “Stop! In the name of love!”
Unlike other vets, she was fearlessly honest, at least with me. She talked about the stepfather who beat her for “acting feminine,” and how she had been “born with a flick of the wrist.” She explained that in her teens she thought, “I’m just not sexual”, and in her twenties “tried” to be heterosexual but “didn’t like it.” She spoke about the deep personal isolation she felt at having to hide her sexual orientation while in the Service, long before “Don’t ask, don’t tell.”
Despite all this, she was not embittered. Winsome, yes—“I’ll never have the jaw… or the hands and feet [of a woman],” she said. Enraged, yes, when decrying the traumas of life as a “trannie” (her term): “It’s all about how you look, your face, your body, who looks better than who!” She said it was worse than competition between heterosexual women, “because of all that testosterone and violence.” But embittered, no.
Unfortunately, Feyonce tested positive for cocaine, as she had twice before, and went AWOL one night. No note, no phone call— typical relapse behavior. I missed her, especially that first day, when I revisited her room, wigs still nailed to the wall, glittery, strappy stilettoes and velvet chokers strewn over the floor.
About a year later, I ran into her at OPCC, the Ocean Park Community Center, a hub of homeless services and temporary housing in Santa Monica, near the beach. She seemed happy, with new therapeutic ties and a sense of acceptance. Heading down the hallway with a laundry basket, she cheerfully greeted residents and staff. But a year after that, she telephoned to ask me about returning to the Dom. “I need help,” she said. “I need a connection.”
When Feyonce came to my office she did not look well. Her hair was matted and tucked beneath a baseball cap. She was hunched inside the folds of an old, faded pea coat. I explained that the Dom had changed, and that all patients now faced a thirty-day restriction to VA grounds. She declined, obviously still on crack and unwilling to stop.
I haven’t seen Feyonce in years. I hope she’s alive, but when high-risk patients stop showing up, I always wonder. In recent years, the VA has made some advancements in caring for transgender veterans. They not only get their own rooms, but are respected members of the gay—or, to be politically correct, non-normative gender—community. Feyonce would have had an easier time.
I am grateful to Feyonce for some measure of enlightenment. She showed me, with far more specificity and candor than any academic or clinical course, that gender can often be a state of mind. She had the clothes, the mannerisms, and more joie de vivre in being female than many of us who were born that way.
Andrea Plate was a Senior Social Worker at the West Los Angeles branch of the U.S. Department of Veterans Affairs, within the Veterans Health Administration (VHA), for almost fifteen years. She now teaches “Gender and the Military” at Loyola Marymount University in Los Angeles. As a child actress (Andrea Darvi), she appeared on many television shows during the Golden Era of Television, including Combat! and I Spy.