Why health care for Canadian women veterans is falling short

Wanda Motard is a size five-and-a-half in women's footwear. But when she was in basic training at Saint-Jean Garrison in Quebec in 2002, the only options were men's boots that didn't even begin to fit.

So despite the August heat, Motard says she would double up on thick wool socks and try to make do.

"I was constantly tripping over my feet, had rolled my ankle a few times, [which] led to a sprain," she told Dr. Brian Goldman, host of White Coat, Black Art. "With the forced marches, it became really, really difficult once I had my rucksack on."

The ill-fitting backpack left Mortard hunched over, compounding her struggles.

"But you know, the military is: one man, one kit."

Motard says she coped by getting off-the-shelf insoles, loading up on anti-inflammatory meds and icing her feet every night.

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Halfway through her basic training, Motard got boots that fit. But those early experiences were just the beginning of a series of problems that — more than two decades after she first joined Canada's Armed Forces (CAF) — have left the 47-year-old veteran with complex physical and emotional health problems, including chronic pain. 

She's not alone. Roughly half of all veterans live with chronic pain, which for women veterans is more than double the number among Canada's general population, according to a joint report from the Chronic Pain Centre of Excellence for Canadian Veterans and the Canadian Pain Society.

The report, which came out in June, called for "urgent, co-ordinated action" to address gaps in care.

"We know that women veterans have different health outcomes from women civilians," said Alice Aiken, founder of the Canadian Institute for Military and Veteran Health, and professor of physiotherapy at Dalhousie University in Halifax.

While the report on chronic pain didn't explain the causes, said Aiken, it's important to monitor "because it can be a gateway for disability."

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Aiken, who has a PhD in health policy and is herself a veteran, said military jobs can be "very physically demanding" and come with more opportunities for injury and other sources of physical pain.

And she says many female members of the Forces have experiences similar to what Motard went through with ill-fitting equipment.

"A lot of the uniforms were not and are not designed specifically for women. They don't fit properly," said Aiken. "And so they're also then subject to potentially more injury and more reasons for chronic pain."

Not enough research

But there's a gap in research about women's experiences. Aiken says less than 10 per cent of publicly funded research dollars go to health research specific to women and research on women veterans is even more sparse.

When the House of Commons standing committee on veterans affairs released its 2024 report Invisible No More about the plight of women veterans, the first of its 41 recommendations was to launch a comprehensive research program, notes Aiken.

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Additionally, there can be a tough transition in terms of where veterans find care.

While they're in the Forces, people receive their health care from a separate military system, which Aiken describes as "probably one of the best health systems in Canada."

Soldiers board a CC-150 Polaris aircraft at CFB Greenwood in Nova Scotia in October 2014. (LS Eduardo Jorge/Combat Camera/Canadian Forces)

In that system there's a more interdisciplinary approach, in which any clinician can refer a patient to other health professions, says Aiken.

Once they leave the military, though, veterans are left navigating the health-care system in their province or territory. 

Aiken praises publicly funded health care but says it "doesn't recognize, necessarily, the unique health needs of veterans and in particular women veterans."

Help from a private clinic

Into that gap has sprung at least one private clinic where a longtime military doctor, Dr. Markus Besemann, opened Beechwood Physical Medicine in Ottawa in 2022. 

Besemann is a physiatrist, an expert in rehabilitation medicine. His 37-year career in the Forces included being chief of its rehabilitation program from 2008 to 2023.

When Besemann retired from the military, he and chiropractor Dr. Geoff Outerbridge founded Beechwood "to look after many people in pain but, amongst others, to focus on veterans and chronic pain," he said.

Dr. Markus Besemann, a longtime military doctor, opened Beechwood Physical Medicine in Ottawa in 2022, along with chiropractor Dr. Geoff Outerbridge. (Brian Goldman/CBC)

For some services the clinic offers, patients may be able to seek funding from Veterans Affairs Canada (VAC), but for others they'll need to pay out of pocket or seek reimbursement through any group health benefit programs they have access to.

Motard is one of their patients. She says she was put on a waitlist for a physiatrist in the public system after she left the military, but started searching online for other options during her wait. 

Motard, who lives in the region of Gatineau, Que., across the river from Ottawa, says that search led her to Besemann, whose patient she'd been for five years when they were both in the military.

She says she was drawn to the integrated care Beechwood offered, where clinicians ranging from physicians to physiotherapists to psychologists and acupuncturists are together under one roof.  

The mental health side of what they do is important, says Besemann.

"The simple sentence, I think, that says everything is, medicine is all about 'What's wrong with you? What's the diagnosis?' And trauma-informed care, I think, is 'What happened to you?'"

Sexual harassment a factor for many

Aiken said that while there isn't research on Canadian veterans specific to this topic, research on U.S. veterans suggests "military sexual trauma can also be a contributor to chronic pain."

To that end, Motard says the support she's had from Beechwood clinic includes seeing psychotherapist Mary Marcolin to address problems that include sexual harassment.

While in the Forces, Motard says the harassment she experienced "ranged anywhere from inappropriate comments, unwelcome comments, to inappropriate touching, pressure to enter into sexual relationships, right up to threats and stalking, essentially," Motard said.

She was a member of a class-action lawsuit against the Department of National Defence (DND) for sexual misconduct, which was settled in 2019, with the federal government agreeing to compensate those affected and take steps to make the military a safer and more respectful workplace.

In 2021, the Forces, the federal government and the DND issued a public apology. 

A 2025 report found the military made significant progress in changing the culture around sexual misconduct, though it said more work is needed to make those changes last.  

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DND said in an email to CBC News that it is "addressing sexual misconduct through a sustained culture change effort." 

It also said, among other things, that "a contoured combat uniform designed around female morphology" will begin to go into service in 2027, with similarly updated body armour to follow in 2028.

A spokesperson for Veterans Affairs says the department recognizes the complex needs of veterans living with chronic pain, and offers coverage for a range of physical and mental health services. 

The spokesperson also said VAC is working to address gaps in care and in research on the health of women veterans.