Barriers and facilitators to successful transition to civilian life for ex-servicewomen: the perspective of service providers and policymakers.

The role of women in the UK Armed Forces has changed considerably in the last decade. With drives to increase the number of women serving in the military, research must consider the impact of both service and transition into civilian life on the health and wellbeing of service and ex-servicewomen (female veterans). This paper adds to the field by providing the perspective of service providers supporting ex-service personnel with their mental health, employment, housing and other needs in addition to those working in policy affecting ex-servicewomen. This study aimed to explore their understanding of what constitutes a successful transition into civilian life, the barriers and facilitators to achieving this and how transition might be impacted by the gender of the individual transitioning. Interviews and roundtable discussions were held with stakeholders (n=28) and analysed using framework analysis. Four overarching themes were identified: Successful transition is individual and all-encompassing, The conflicting identities of servicewomen, Sexism: women don't belong in service and The needs of servicewomen. The first theme describes how the process and result of successful transition is individual to each ex-servicewoman, whilst the remaining themes outline common challenges faced by ex-servicewomen on this journey. There was no singular definition of successful transition, but stakeholders described barriers to a successful transition. They identified prominent gender-specific barriers rooted in misogyny and inequality during military service that permeated into civilian life and impacted support use and workplace experiences. Ex-servicewomen were often required to juggle multiple responsibilities, mother and partner, and identities, women and warrior, simultaneously. Policies should look to address elements of military culture that may reinforce gender inequality and ensure veteran services are inclusive and welcoming to women and cater for gender-specific needs such as gynaecological health. Whilst in-service and veteran-focused interventions are needed, entrenched sexism in general society should not be ignored. ### Competing Interest Statement BC, AS, RK and NG have no conflicting interests. MLS salary is partly funded by a research grant from the Office for Veterans Affairs, UK Government. SAMS is supported by the National Institute for Health and Care Research (NIHR), Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and the National Institute for Health and Care Research NIHR Advanced Fellowship (Dr Sharon Stevelink NIHR300592). NTF is a trustee (non-paid) of a charity supporting the health and wellbeing of the UK Armed Forces Community and is part funded by a grant from the UK Ministry of Defence. ### Funding Statement This project was supported by a grant from the Forces in Mind Trust (FiMT) (FiMT/2202). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This research received full ethical clearance from the Health Faculties Research Ethics Subcommittee, King's College London (HR/DP-22/23-33303). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data not available due to ethical restrictions.