Love After War: Saving Love, Saving Lives

Veterans with service-connected injuries that affect their sexual health are often left with little to no information or support in the services they receive in healthcare and behavioral healthcare settings (Tepper, 2021). Although programs providing services for active duty military and veterans are beginning to address sexual health and sexuality more comprehensively, beyond just functionality to relationships, many barriers exist for people who have experienced injuries in their military service that affect their sexual lives (Shepardson et al., 2021). According to US Department of Defense, 4.9 million veterans have service-connected injuries in the United States (US Bureau of Labor Statistics, 2023). In a recent study with veterans about sexual health utilizing a sexual experiences scale, 62% of women and 32% of men screened positive for sexual dysfunction (Shepardson et al., 2021). Veterans also have a difficult time discussing sexuality with their partners and healthcare providers (Shepardson et al., 2021). The documentary Love After War: Saving Love, Saving Lives (Tepper, 2021), calls attention to the need for further education and advocacy to address sexual health in the military and veteran community.

The filmmaker, Dr. Mitchell Tepper, provides a context throughout the film for the impact of these injuries, advocacy, and strategies for veterans, partners, and healthcare providers to include these issues in treating military and veteran populations. Love After War (Tepper, 2021) includes the experiences of five couples. Four of the couples include one disabled military member or veteran, and for a fifth couple, both are military veterans. The film also educates and explores the ways medical and mental health professionals, as well as veterans and their partners, can reduce stigma in discussing issues of sexuality, injury, and disability in healthcare settings.

The film opens with each veteran discussing the ways they sustained injuries, both combat and noncombat injuries, which are later described as catastrophic physical injuries, to the less visible injuries of posttraumatic stress (PTS) and concussive injuries related to combat and military sexual trauma (MST). The stories are impactful in the depth and scope of the veterans’ experiences, and move towards the impact on their sexuality and sexual functioning post-injury. The audience is also introduced to the filmmaker, Dr. Mitchell Tepper, a sexologist who himself lives with a spinal cord injury, and his work with injured and disabled veterans.

An interesting narrative arc of the film is how the viewers also meet the partners of the veterans individually, and then later connect them to the veterans in the film as couples. The film explores and identifies the struggles of veterans in the systems of care for their injuries regarding sexuality and intimacy in their personal lives and intimate relationships. It also provides information on what veterans can do to advocate for themselves in these systems and how healthcare providers can focus on asking questions about sexual functioning in treating veterans. In the film, certified sex therapists, psychiatrists, and other doctors also educate the audience on ways to develop and include sexuality in the healthcare of military service members and veterans.

One strength of the documentary is the depth and scope of the personal experiences and information it provides in just under an hour. The veterans’ narratives of their visible and invisible injuries are particularly impactful in reducing the stigma of talking about these issues and opening the door to address sexual health in the context of their healthcare and relationships. Communication is also identified as a key aspect of addressing these issues.

Dr. Tepper also provides an important connection between being able to feel anger and the disconnect from emotions other than anger that veterans who experience PTS often experience. By feeling anger and opening communication pathways about anger with others, various feelings can surface to expand one’s emotional life and connections, which can lead to more intimate relationships. Veterans in the film express the impacts of developing communication about their sexual lives, shifting their perspectives from judgments about themselves to working with what they can do (versus what they may no longer be able to do): Their exploration and openness has allowed them to gain satisfaction in this area of their lives and intimate relationships. As the film concludes, several veterans also speak of how intimacy, instead of focusing on the sexual act itself, has strengthened their relationships and improved their sexual lives.

Another important aspect of the film is the message that help is available, from medical and physical interventions and online information that individuals and couples can find to assist them in developing a sexual life that works for them as a couple. It stresses that no one approach will work for all veterans or couples. Also, it highlights the importance of healthcare providers asking questions about sexuality and treating sexual issues like any other healthcare issue people experience.

While the film is expansive in the issues it addresses regarding injuries and sexuality in the veteran community, it is also limited in significant ways. The film only focuses on what appear to be heterosexual people and couples. This gap for a film focused on sexuality ignores and excludes the spectrum of sexuality, including LGBTQ+ veterans who are already marginalized and experience bias and discrimination in many areas of the healthcare they receive (Grozdanic et al., 2022). Love After War misses an opportunity to include diverse narratives and people addressing the experiences of sexuality and disabilities with nonheterosexual veterans. The film also has a bit of a “stand by your man” feel at times; unfortunately, this trope supports the longstanding narrative of combat veterans only being male and heterosexual, which is often the only example portrayed in the media.

A woman in the film, Tosombra Kimes, who is a veteran, is introduced as a military sexual assault survivor and later reveals she is the partner of a combat veteran, Casey Kimes, also in the film, who was seen earlier describing his concussive injuries. While emotional and difficult to see and hear as a viewer, Tosombra discusses the difficulties of living with a person experiencing combat-related PTS, including child abuse. She later describes sticking with the relationship through hard times.

The context presented in the film for working through abuse in a relationship, was to “walk through the fire to get to the other side.” While this cliché used in the film appears to have worked for one couple in the film, that example alone simplifies the complexity of the issues with women and violent relationships and the history of violence against women in the military, particularly regarding physical abuse and sexual violence. The film fails to provide a context or examples of when it can be dangerous for women and children to stay in abusive relationships, which is important to share when raising awareness about healthy families, disabilities and sexuality.

The film also centers on the male veteran’s experience within the couple’s relationship, with Tosombra discussing the impact of her injury and living with Casey’s injury. Still, it fails to provide the same context for Casey’s experience living with his partner, an injured veteran. Even though the film is about sexual health and she experienced a sexual assault, there is little about how Casey, as Tosombra’s partner, supports her and instead focuses on her support of him. This would be an important perspective for many viewers: (a) the numerous partners living with veterans who experienced sexual assault, (b) couples that are both veterans, and (c) healthcare providers to support veterans in their care.

With that being said, Tosombra’s dual role as a military veteran and partner of a veteran is invaluable in the film. Also, relating MST to being an injury and how the filmmaker chose to include it as such is supportive in changing the dismissive culture of the impact of MST on individuals. Her partner, Casey, who later in the film discusses his experiences post-deployment, the change process he went through, and how he is now in a different relationship with his children and family, also provides a moving example of how change and healing can occur with support.

Even with the limitations of only one type of sexuality discussed in the film, and the gender disparities it does not identify well, the film does an excellent job of bringing to light the often taboo topics of the impact of military injuries on sexuality, and sexual health in the military and veteran communities. The veterans in the film share their experiences from a deep place of authenticity and vulnerability that provides an example of how veterans can talk about injury and sexuality, which educates the viewer on many issues for veterans related to sexual health. The information and context for the film partially fill an identified gap in veterans’ experiences and healthcare services for sexual health. With a more inclusive lens, the film could have an even greater impact on a larger audience and help expand the veteran narrative of sexuality and sexual health.