INTRODUCTION Women have served as combatants in the U.S. Armed Forces since the Revolutionary War, when they avoided being detected as females by disguising their appearance and changing their names. Likewise, hundreds of women presented themselves as men to fight in the Civil War. More than 12,000 women enlisted in the U.S. Navy and Marine Corps during World War I, and some 400 died. Approximately 350,000 women served in the U.S. Armed Forces in World War II, assigned to every theater of combat, many in positions that had been newly created to meet emerging military scientific and technological needs. Some women were taken prisoners of war, some earned the highest honors, and many died in service to their country. However, women (other than nurses) were only permitted to serve in temporary, emergency capacities; they were then discharged without benefits. The military changed after World War II, when General Dwight Eisenhower and other military leaders supported integration of women as regular service members. General Eisenhower told Congress that although he had originally opposed women’s military service (“I was violently against it.”), “Every phase of the record they compiled during the war convinced me of the error of my first reaction.” Interestingly, Eisenhower also believed that few women would remain members long enough to earn retirement benefits. He believed that “after an enlistment or 2 enlistments they will ordinarily – and thank God – they will get married.” Today, women comprise more than 200,000 members (about 15%) of the U.S. active duty military. As of 2014, 2 million of the nation’s military veterans were women, approximately one-third of whom were enrolled in Veterans Health Administration health care. In 1948, President Harry S. Truman signed the Women’s Armed Services Integration Act, officially allowing women to serve as full and permanent members of the Army, Navy, Marine Corps, and Air Force. However, the law capped women’s total military membership at 2%. It also limited promotions, prohibited service in combat positions, and allowed for involuntary discharge because of pregnancy or parenthood. Despite marked sociocultural changes and legal efforts to expand women’s access to military service opportunities, these conditions applied to female members of the U.S. military until 1991, when Congress modified exclusions of women from Navy and Marine Corps assignments and repealed prohibitions that had prevented women being assigned to combat aircraft. In 1994, the Department of Defense (DoD) adopted the Direct Ground Combat Definition and Assignment Rule, which specifically excluded women from assignments to or co-location with units or organizations whose primary mission was to engage in direct combat on the ground. This policy prevented women from serving in infantry, artillery, armor, combat engineer, and special operation units below the level of brigade. However, this was difficult to apply in the Afghanistan and Iraq wars, where enemy tactics obscured the traditional distinction between combat and noncombat environments and where, to achieve mission critical objectives, female military members were instead “attached” (not assigned) to combat units. Whereas among post-1990 female veterans 24% report having been exposed to combat, a 2009 study by the Defense Advisory Committee on Women in the Services found that most military women deployed to Afghanistan and Iraq were involved in combat functions and/or exposed to hostile fire. In January 2013, in response to recommendations of the Joint Chiefs of Staff (JCS), the Secretary of Defense rescinded the ground combat exclusion rule. This action opened the door for women to serve in more than 14,000 additional occupations and assignments involving exposure to direct ground combat. The JCS directed the Services to develop integration plans—with full implementation to occur no later than January 1, 2016 (unless SECDEF approved an exception to keep certain positions closed)—in keeping with JCS guidelines and objectives as follows: