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March 20, 2025

Soldiering and Silences: Witnessing Child Sexual Abuse in Afghanistan

Caroline Kennedy-Pipe and Martin Thorp
©2025 Caroline Kennedy-Pipe and Martin Thorp

ABSTRACT: Based on interviews with United Kingdom veterans, this special commentary offers a new interpretation of war trauma. Few studies investigate the emotions soldiers experience when witnessing child sexual assault. During the Afghan campaign, personnel witnessed acts of rape by allies in the Afghan security services on boys—usually excused as the local practice of bacha bazi—and were directed not to intervene. This special commentary examines the effects of these actions on soldiers and the mission, highlighting how soldiers were impacted by what they witnessed but could not stop.

Keywords: bacha bazi, Helmand, trauma, UK troops, veterans

 

There are silences in war: some are deliberately cultivated by the state to deny the horror of war. There are intimate silences such as those invoked by people who experience sexual violence in and after conflict but are too ashamed to articulate their experience or seek redress for the assaults on their minds and bodies. Often, no one is listening. Historically, those who have perpetrated violence in uniform and those we may describe as unbadged have, across the record, been notably absent from narrations of war. Silences abound. Some are justified by institutions, politicians, and groups reluctant to acknowledge the consequences of war or, as in our case study, by those unwilling to recognize the character of chosen allies.1

To date, no psychology or physiatry literature has discussed the associations between UK forces witnessing abuse and rape in Afghanistan with post-traumatic stress disorder (PTSD) or moral injury. Our findings introduce unexplored causes of war trauma not typically associated with combat experiences. Nonetheless, the literature on moral injury resonates with veterans’ thoughts and feelings.

There are different interpretations of what constitutes moral injury, but there is consensus that moral injury refers to the intense psychological stress certain situations provoke that transgress an individual’s ethical values. It is important to note that moral injury is not yet a clinical diagnosis. Research shows, however, that it may lead to mental illness, including depression and PTSD, and these conditions can even lead to suicide. It might have profound effects on a person’s emotional, psychological, behavioral, social, and spiritual functioning. Moral injury is caused in three ways: acts of commission (doing something), acts of omission (not doing something), and feeling betrayed. These causes may be related to moral dilemmas that soldiers face, including instances when they may witness intense human suffering and cruelty that undermines their core beliefs. These situations associated with moral injury are known as potentially morally injurious events (PMIEs). Several risk factors increase the possibility of suffering moral injury. These may include events involving vulnerable people such as children, feeling unprepared for the situation, or believing there is a lack of support during or after experiencing traumatic events.2

Moral injury, PTSD, or the long list of medical and emotional issues experienced after military service now receive scholarly investigation. We extend this literature by adding a study highlighting what soldiers say or cannot bring themselves to say about the experience of being ordered not to intervene and to stand as silent witnesses to human rights violations. Drawing on interviews and reports with personnel who witnessed, and were ordered not to intervene in, the rape of boys and young men in Afghanistan as part of bacha bazi (boy play), we examine how this moral injury contributes to PTSD. Moral injuries caused by witnessing a child’s suffering and pain can be as traumatizing to the witness as the trauma which may be experienced during combat. Acknowledging those silences around this issue may allow us to understand existing trauma better and prepare for future deployments.

Bacha Bazi

Bacha bazi is a practice in which pubescent boys are hired to dance and entertain older men. Their masters dress the boys as women and, in addition to dancing, the boys submit to their masters’ sexual whims. After the boys grow beards, they are undesirable and no longer fulfill the function of sex and servitude.3

Many explanations account for how the practice of bacha bazi developed in Afghanistan, Pakistan, and across Central Asia. The origins of bacha bazi could theoretically stretch back to the invasion of Alexander the Great in 330 BCE due to the well-documented practice of pederasty in ancient Greece. Scholars, however, theorize that Afghanistan’s more recent and turbulent history rendered boys vulnerable to the vagaries of war, endemic conflict, and widespread poverty and enabled the emergence and ongoing practice of bacha bazi. In destitution, boys (usually illiterate) found themselves unprotected by their families and forced into any employment they could find, including sexual services. Sometimes, boys were given to men of influence, such as warlords or government officials, by their fathers in return for money; many boys were trafficked by pimps. Sexual abuse was a reality plotted and acknowledged by everyone involved.4

Social theories can account for these male relationships. Scholars point to the consequences of a society in which women are excluded from public life. Displays of affection are forbidden between males and females; women are prized for their chastity, so open demonstrations of affection between males was tolerated and regarded as commonplace. In the absence of females, powerful men pursued alternative sexual opportunities.5

The Taliban publicly condemned the practice. In 1994, the founder of the Taliban, Mullah Mohammad Omar, famously rescued a young boy who was about to be raped by two military commanders. Opposition to bacha bazi facilitated his popularity throughout the 1990s. When the Taliban came to power in 1996, they made bacha bazi illegal as a violation of Islamic law. After the Taliban seized Kandahar, Mullah Omar issued a fatwa that made sodomy (which included consensual relationships and the rape of children) a capital offense.6

After the 2001 US invasion which, with the help of the Northern Alliance, a loose coalition of militias in Afghanistan who opposed the first Taliban regime, removed the Taliban, bacha bazi reappeared across Pashtun customs. Boys were kidnapped and raped without the pretense of entertainment that had previously denoted bacha bazi. Powerful men in the Northern Alliance, many of whom became figures of considerable influence (such as governors or police chiefs), used a bacha boy to reflect their status and authority.7

Through interactions with the police and military, International Security Assistance Forces (ISAF) became familiar with bacha bazi across the Afghan security services. Troops deployed to mentor and build Afghan forces learned of the sexual relationships between men and boys on military bases. Incidents and confrontations with Afghan allies occurred over this abuse. Travis Schouten, a corporal in the Canadian Armed Forces, reported the 2006 rape of a boy by members of the Afghan National Security Forces (ANSF) on Canada’s Forward Operating Base Wilson, just outside of Kandahar. The Ottawa Citizen and other press outlets reported the incident, and Schouten demanded clear guidelines as to how Western troops should and could protect these children. Schouten also revealed that he had been driven to the brink of mental collapse after witnessing the brutal sexual assaults. Alongside Schouten, other military personnel and chaplains objected to the sexual abuse but were, on a routine basis, told that these sexual relationships were a matter of local cultural norms and lay within the jurisdiction of Afghan law.8

In 2010, in Helmand, Major Jason Brezler, a US Marine, identified a local police chief, Sarwar Jan, as a threat to children and his contingent. Jan had arrived at Forward Operating Base Delhi with an entourage of boys and moved into the barracks one floor below the Marines. Aware of the obvious abuse, Brezler expelled Jan from the base and returned to the United States. Two years later, when a colleague informed him that Jan had reappeared at the same base in the Garmsir District, Brezler sent an e-mail to a fellow Marine stationed at the base detailing previous sexual abuse by Jan. In August 2012, four marines were shot in the base gym by a boy who had been a “bacha” for the Afghan National Police (ANP) commander. During the trial of the perpetrator, there was little mention of bacha bazi, and the boy was referred to as a radicalized individual.9

Concern over the practice prompted the US Department of Defense to investigate bacha bazi. One measure the department took was to charge social scientist Anna Maria Cardinalli to produce a report on Pashtun sexuality. Cardinalli served with a Human Terrain Team and identified widespread sexual abuse and the related risks of radicalization among the victims of boy sexual abuse. Members of the US government criticized Cardinalli’s work, claiming that she lacked expertise on Pashtun customs.10

The abuse of boys became public in 2015 when The New York Times published “US Soldiers Told to Ignore Sexual Abuse of Boys by Afghan Allies.” The coverage shocked the US public and drew attention to Congress’ 2014 authorization of a special waiver to the Leahy law. The Leahy law explicitly bans US assistance to units of foreign security forces when there was credible evidence that gross human rights violations had been committed. The waiver, the so-called “notwithstanding clause” was invoked to ensure Afghan security partners continued to receive funding.11

In January 2018, the Special Inspector General for Afghanistan Reconstruction (SIGAR) published a report instigated by the Obama administration. It was entitled “Investigation into Child Sexual Abuse by Afghan Security Forces and US Military Inaction.” The report was heavily redacted and initially embargoed until 2024, highlighting how institutions can enforce silence. The report found that Afghan security forces had participated in at least 75 gross violations of human rights from 2010–16, including murder and child sexual assault.12

This controversy included several important features. The first was the proposition that the persistence of child sexual abuse by Afghan allies rested solely in local politics. Regardless of Article 3 of the UN Convention on the Rights of the Child, the coalition governments presented the plight of boys as an issue of cultural practices and preference that had to be respected. This position was instituted despite the duty of all agencies and organizations to uphold the existing international and national laws to protect children in Afghanistan. At the time, Afghan President Hamid Karzai argued that there were more important issues than bacha bazi and that the boys were a secondary concern to ensuring that the Afghan Army and the police could continue the war against the Taliban.13

That position remained the priority despite evidence that bacha bazi damaged popular support for the Afghan security services. Catherine Norman’s 2012 report about the Afghan National Police in Helmand provided evidence that families complained and lacked trust in local police because of the threat posed to their sons by the widespread practice of bacha bazi. While acting as the guardians of women and their virtue, the Taliban also claimed a protective role for boys abused by the Northern Alliance while using boys as a way of infiltrating and disrupting security forces, including so-called “honey trap” bachas to ensnare police. These boys, who sometimes were the bacha of commanders on remote bases or at checkpoints across the Uruzgan Province (where American, Australian, and Dutch forces were deployed), were used as suicide bombers or to allow Taliban into bases to attack police. In one case, a bacha went on a shooting spree, killing seven police officers, including his abuser—the commander. These insider attacks facilitated or undertaken by these boys were also reported in Helmand and Kandahar.14

Insider attacks proved disruptive, but the Taliban also used bacha rape as a recruitment tool, highlighting how the police abused boys—some police demanded the presence of a bacha as a condition of taking the position. Practically all of the 370 local and national checkpoints in the Uruzgan Province had boy slaves. Indeed, jealousy over the boys could occasionally produce deadly encounters between members of the Afghan police, with reports of public gunfights over bachas.15

Despite the weaknesses that bacha boys in tandem with the Taliban introduced into security arrangements, Coalition leaders ordered ISAF troops to ignore the ongoing sexual abuse. Canada, the United Kingdom, and other European partners, such as Norway and the Netherlands, were aware of the issue, with bacha bazi raised in debate in the UK Parliament. Nonetheless, Western allies did not wish to condemn a vital security partner and instigate investigations, which could have deepened mistrust, undermined cohesion, and potentially derailed the fragile process of building Afghan security structures.16

Significant scholarship on the strategies and mistakes that led the Afghan police and military forces to fail and PTSD research focused on the lasting effects of fighting the Taliban insurgency already exists. At the intersection of these two subjects resides a silence regarding the emotional trauma experienced by soldiers who witnessed the rape of children and whose leaders ordered them not to intervene. To that end, the rest of this special commentary draws on a case from the United Kingdom that shows soldiers were, and continue to be, emotionally affected by witnessing the systemic rape of boys by their Afghan allies.17

Evidence

Our evidence emerges from a UK study centered on understanding how commanders psychologically impacted British soldiers exposed to combat and trauma during the Afghan and Iraqi campaigns. Researchers collected data by interviewing veterans who served between 2006 and 2014 and by interviewing psychologists, psychiatrists, and therapists who treated veterans. The project examined the effects of command, both good and bad, on these individuals. Nonetheless, throughout the interviews with British veterans (who had served in the Helmand Province), accounts of bacha bazi in the Afghan National Security Forces and its consequences emerged. It was striking during these conversations how veterans recalled the plight of and narrated the everyday abuse of children. Although this study originally focused on PTSD relating to combat experience during the interviews, a majority of the respondents shared a set of emotional responses to the witnessing of child rape.18

Building on that material, our research examines how witnessing the abuse of children engendered a range of feelings. It illustrates how witnessing the practice of bacha bazi emotionally affected military men during and after their tours of duty in the Helmand Province. In that period, statistically, male soldiers primarily encountered such practices, so the sample draws mainly from male veterans in frontline positions and the mentoring teams formed by Ground Close Combat (GCC) troops. During the study, 37 veterans were interviewed and 14 therapists. We were interested in how, when mentoring Afghan colleagues, commanders and their subordinates became aware and then distressed by the abuse.19

British Experiences (2006–14)

The United Kingdom played a significant role in the ISAF mission. By October 2006, approximately 5,845 British personnel were in the country. Soldiers operated alongside ANSF personnel, often at isolated patrol bases. The UK forces, with other coalition partners, were heavily involved with training and mentoring the Afghan National Security Forces. Often, these teams were embedded within ANSF units. The UK forces coordinated training and operated alongside various Afghan National Army, police, and specialized units. Building the ANSF capacity to provide its own security eventually became a vital component in the ISAF strategy.20

The Operational Mentor and Liaison Teams (OMLT), an expansion of the American led Embedded Training Teams (ETTS) and Police Operational Mentor and Liaison Teams (POMLTS), conducted much of the training. The Afghan government and its Western allies established the Afghan Local Police (ALP) in August 2010 to complement the national police and to relieve the unsustainability of a heavy footprint counterinsurgency force by increasing local responsibility for security. This move formed part of a broader strategy to engage with the population. These units were recruited locally and received minimal training; some units successfully delivered security, while others did not. Discipline could be poor, and some members of the local police behaved in a predatory fashion by intimidating, extorting, and taxing villagers in ways that reinforced support for the Taliban. The Afghan Local Police disbanded in 2020 due to a change of strategy directed by the Obama administration. The controversial termination of funding created repercussions for local defense and, indeed, security nationally.21

Before our study, there had been some descriptions of how UK troops responded to witnessing child sexual abuse in Afghanistan. In his book Unwinnable, Theo Farrell refers to this issue. He recounts how a British Battle Group was sent to secure Sangin District Center in 2006. Part of that mission entailed protecting the District Police Chief, whom locals wanted to lynch for abducting and raping children. After hearing the accusations, soldiers questioned why they had been sent to protect a child rapist. One of the platoon commanders recalled the emotions expressed by soldiers, “Why the hell are we going to support this guy? We should go and kill him, and then we would get the locals on our side straight away.” Interestingly, the platoon commanders showed a clear appreciation of the strength of local feeling about the topic and the concerns over the local police, who soldiers described as lacking discipline and “going feral.” It was reported that there was abuse of “little boys off the street,” behavior which the soldiers found both abhorrent and distressing. Farrell’s work provided some useful background to our study. Of the veterans interviewed for this project, most said they became aware of the sexual abuse of children in Helmand Province. Abuse, however, was also reported in Faryab Province, where ALP members were accused of raping teenage boys.22

One concern was whether troops were adequately prepared for what they would witness once stationed in the country. Before deployment, training included cultural awareness training, which consisted of basic language skills presentations. Some service personnel learned to speak Dari or Pashtun. Yet, none of the veterans interviewed remembered receiving information on the prevalence of sexual misconduct and child rape as a feature of Afghan society, though other sources recalled lectures by military lawyers on male sexuality and male friendship, which was described as a result of local cultural preferences and was not to be interfered with or mocked.23

When deployed, the soldiers interviewed for this project became aware of the abuse, initially through rumors such as in the following recollection: Within the Afghan platoon, that were attached to our company, I observed several very young members of their platoon wearing makeup and looking very feminine. Although I did not personally witness any sexual assaults, it was rumored that these young soldiers were being used for the sexual pleasure of the rest of the platoon on a Thursday night.24

Veterans remembered being taken aback when they had noticed older men constantly accompanied by much younger men or boys. So, witnessing was a matter of discovery, as over time the man-boy relationships became obvious. For instance, one explosive ordnance disposal (EOD) commander recalled that he found it disturbing when he saw an older man on policing duties accompanied by a very young man.25

While several avenues of discussion arise from our data, including the nature of pre-deployment information provided to the soldiers, we are interested in the emotional impact that being forced to stand by and witness sexual abuse and misconduct has had on veterans. (We do not discuss the consensual male-on-male relationships within the society here). Instead, we analyze the operational and human impact, but we acknowledge that other factors could have impacted operations in addition to the emotional effect of witnessing abuse. Coalition forces began to question the loyalty of their Afghan partners. Mentoring or working alongside Afghan security forces posed considerable risks to ISAF personal safety. Along with the obvious threats from Taliban attacks, mentoring teams were at risk from the Afghan “insider threat,” also called green-on-blue attacks.26

In 2007, ISAF personnel recorded two green-on-blue attacks; the number surged to 37 in 2012, with more than 60 NATO soldiers and civilian contractors killed. To place that figure in perspective, in 2012, green-on-blue attacks accounted for 15 percent of coalition casualties. The UK newspaper The Daily Telegraph reported that 24 UK service personnel were killed by an “insider attack.” As of June 2014, roughly 87 insider attacks had occurred on US bases after 2008. The political impact of green-on-blue deaths became significant and provoked considerable media attention. These attacks led to questions in the UK Parliament over Afghan competence to assume security duties from NATO troops in the future and calls for a clear exit strategy intensified.27

In March 2012, a tactical directive issued in response to the growing concern about insider attacks included provisions for improvement in force protection, close-quarter combat, and active-shooter training for personnel working closely with the Afghan National Security Forces. Individual ISAF soldiers were assigned to ANSF advisers from within units to be “guardian angels” standing by to protect against a would-be attacker. The guardian angels protected military advisers on their way to and from meetings and during meetings with Afghan personnel. The necessity for guardian angels highlighted the need to increase troop numbers.28

In a 2012 CBS News interview, General John Allen, who led ISAF Afghanistan from July 2011 to February 2013, emphasized “We are willing to sacrifice a lot for this campaign, but we are not willing to be murdered for it.” Allen made these comments in response to insider threats, highlighting concerns over trust between coalition forces and the competence of Afghan allies.29

Our interviews reveal veterans experienced considerable disquiet about mentoring ANSF personnel, including reflections on purpose, safety, and losses. For instance, the veterans questioned the purpose of the mission in Afghanistan, asking, “Why are we here? Why are we doing this? Why am I sending a patrol out every day where people could [get], and are getting, killed and maimed and injured for these people?” One referred to corrosion in the sense of mission.30

When asked about his experiences mentoring the police, a medical sergeant who was part of the Police Operational Mentor and Liaison Teams responded, “I wouldn’t call it mentoring; I would call it watching them get high on drugs. And, put it this way, the Thursday night thing is true.” An officer argued that, in his view, mentoring the ANP in 2010 was a “fool’s errand . . . as . . . tactically, operationally, and strategically, we had minimal effect mentoring the police on that tour.” The war was already lost, and he revealed that ensuring everyone stayed alive became the most important thing—not the mission. The same officer claimed he believed that in 2012, NATO policy had changed. He interpreted policy to mean, “if you see young boys at a checkpoint on a Thursday night, do nothing.”31

“Thursday night” was an important occasion; it was the day before the religious day and regarded as an excuse to celebrate. It was reported that boys were brought into camp to entertain the officers and were on occasion openly picked from a line waiting outside the base. While this Thursday night ritual was an open secret tolerated by Western allies, it often caused tension because of the blatant sexual abuse. One platoon commander working alongside an Afghan National Army (ANA) unit in 2010 remembers having to “calm” his soldiers, as they were aware of that abuse. He believed the abuse was inherently wrong, but he could not intervene. Nonetheless, while determining who to include on his mentoring team, the same platoon commander became so concerned about the behavior of Afghan personnel that he refused to have a female medic on his team, fearing for her safety.32

While mentoring ANSF officers, British commanders arranged meetings with their Afghan counterparts. In 2013, one commander regularly met with the local chief of police. On many occasions, he observed a clean, well-dressed young boy in the room (a chi boy / bacha). He recalls that the boy was there while he drank tea. He knew the boy had been sexually abused, but he tried to ignore it even though he found such behavior disgusting. He went on to explain that “the average soldier will find it very difficult to reconcile this. Telling them that there’s nothing we can do and that’s just the way they are. That’s their way of life, it’s like boys are for fun and women are for babies. That’s just how they see the world.”33

It is important not to underestimate the potential psychological impact seeing or hearing abuse can have on a witness. One Army welfare officer who supported wounded, injured, or sick service personnel between 2012 and 2015 stressed the profound psychological impact on soldiers witnessing or even knowing of such abuse. During our interviews, we found that witnessing children undergoing harm was particularly traumatic for these soldiers. It was common; therapists pointed out that harm to civilians, especially injured children, caused soldiers extreme distress, especially if the children were killed. One psychologist noted that if soldiers had children of their own, witnessing a child being killed or severely injured during operations was especially traumatic. Another psychiatrist argued that if soldiers witnessed harm to children the same age as their children, the psychological impact could be deepened.34

After witnessing harm to children, soldiers experienced an initial reluctance to recall incidents that was further compounded by a reluctance to discuss the incidents. One therapist recalled, based on his experiences treating veterans, that soldiers seemed resistant to revisiting the trauma. This finding contrasted starkly with the attitude of torture victims he had also treated. The therapist had no answer for why this resistance was the case or why soldiers were inclined to suppress these feelings.35

One therapist described a veteran’s account of witnessing an Afghan police officer taking a boy (around 6 or 7 years old) into a cave and raping him. The veteran said he “couldn’t process that in his head.” Another disturbing eyewitness account came from a reserve soldier who witnessed the gang rape of a local child by an Afghan civilian and two ANA soldiers. He recognized the child from an innocent interaction the day before when he had blown up a surgical glove to make a balloon for the child to play with it and given him sweets. He then saw a farmer, who he believed to be the owner of the compound, drag the same screaming child into the compound, throw him over the table, and start to rape him. He thought the ANA soldiers would stop the rape, but they joined in. A third soldier walked over and pulled across a makeshift curtain. He, too, raped the child. Throughout the ordeal, the child screamed. The soldier recalled that the platoon commander was concerned about the insider threat and reprisals if they had tried to stop the attacks, so he instructed his team not to intervene. The soldier, though, felt like he was protecting the men as they raped a child.36

Understandably, the reserve soldier was distressed by the event. He was instructed by his commander “to forget about it.” In the interview for this project, he expressed feelings of betrayal and guilt. After that tour, he said he tried to “bury” the trauma. He recalled feeling disgusted, yet he wrestled with why his commander had let it happen and why he did nothing. The soldier now suffers from PTSD and has attempted suicide; he relates that he feels socially isolated and is unable to cope with the sound of children crying because it reminds him of the rape. During the interview, the veteran mentioned another soldier who had witnessed the same rape. He was 18 years old, and he said that he was “in a bad way” and had also attempted suicide. Interestingly, this incident triggered memories of a previous 2009 Afghanistan tour, where he witnessed a close friend blown to pieces by an improvised explosive device (IED), thus compounding his trauma.37

Soldiers who knew or witnessed sexual abuse of either children or young men experienced a range of emotions, including anger, disgust, frustration, and feelings of powerlessness. These emotions later, from our interview sample, seemed to develop into guilt, shame, and regret. In certain cases, soldiers believed they were complicit, as in the case of the soldier who witnessed the gang rape.

Reflections

The Taliban’s return to power following the United States and allied withdrawal has driven bacha bazi back underground: unacknowledged and silent, but still present. Although British authorities now recognize that condoning bacha bazi constituted a failure to protect the children of Afghanistan adequately, the abused remain marginalized in the histories of the campaign. That attention is welcome, but we wish to highlight, as we have throughout the commentary, that deployed soldiers drawn from a variety of countries, not just the United Kingdom, have suffered trauma because of what they witnessed.38

According to The New York Times:

the stress of knowing the boys are sexually abused is taking a toll on certain US military members. They are returning to America conflicted and confused, struggling with the fact that they did not or could not save young boys from being exploited or molested.39

While the existing literature on trauma acknowledges how soldiers suffer after combat, after killing, and after injury, it does not address the trauma caused by moral injury. Our UK-based submission substantiates the claims made in The New York Times and extends the literature on war trauma by considering the trauma originating from being forced to stand witness to the sexual assault of children and unable to intervene.40

This project is novel, and avenues for further research exist. We may add to masculinities studies, deepening the understanding of traditional masculinist ideology within Western thought, which has emphasized achievement and prohibited what may be regarded as “weakness,” including expressions of vulnerability. An endorsement of traditional masculinist values creates a culture in which experiencing a traumatic event may be emasculating, creating psychological distress when a man fails to meet role expectations. Our data demonstrates that witnessing and not intervening to stop child abuse engendered feelings of trauma and helplessness over many years. We acknowledge that it is not easy to disentangle “witnessing” from other effects of deployment in a combat zone.41

Questions about how the military prepares troops for deployment into societies alien to Western norms, expectations, and traditions are important. The absence of guidelines for military personnel entering the complex society of a deeply conservative, religious, and tribal environment meant that the responsibility for how to act in response to bacha bazi fell to the soldiers in the field, leading to confusion about the values that should govern the mission, a point raised in the reported US cases. Coalition partner nations failed to provide a framework for dealing with the abuse of boys. This neglect ran from direct instructions not to intervene to a “don’t look, don’t tell” attitude and a convenient moral relativism that the sexual abuse of boys was a cultural matter. Beneath this moral relativism lay the view that vital partners in the war against the Taliban should not be provoked.42

Some militaries deployed during the Afghan War recognized that ignoring, if not condoning, this abuse was harmful for the mission and the soldiers. The Dutch military, for example, has reflected on its own failure to comply with the responsibilities of the responsibility to protect (R2P) and the core principles of human rights embedded in the international mandate for intervention in Afghanistan.43

One avenue that may be of future benefit is for militaries to learn from the best practices of other actors. Nongovernmental organizations (NGOs) are not militaries, have a different status, and a particular mission. As a starting point, scholars can draw valuable information on the impact of witnessing on NGO personnel in conflict-torn areas. The organization openDemocracy, for example, has found evidence of trauma—with levels of distress comparable to the veteran population—in human rights advocates working in war zones.44

There is a wider recognition that training on sexual violence needs improvement and that military ethics should be taught more effectively and systematically. In the case of Norway, there was and is a lively debate about the roles of respect and responsibility as core values guiding deployed soldiers. The suggestion is that respect would and should effectively trump any form of moral relativism. There has also been debate in the United Kingdom about moral relativism and its application in war zones, with one scholar commenting that “ethical relativism does not require us to stand back and watch acts that are abhorrent to us.”45

Witnessing and Coping

Military commanders and scholars have worked in partnership to develop ways to limit the psychological costs of conflict, including psychological decompression, psycho-education, and screening. At a national level, the United Kingdom introduced Trauma Risk Management (TRiM), which is a peer-led occupational mental health support process that identifies and supports anyone exposed to traumatic events. The United States has implemented Combat and Operational Stress Control (COSC) interventions. These strategies and interventions mitigate common or expected combat stresses that soldiers have experienced. The subject of our commentary, witnessing the sexual abuse of children and feeling powerless to intervene, likely falls outside these frameworks. It is possible many of the stress controls in place are or may be beneficial. Nonetheless, because of the unique nature of witnessing, we suggest military leadership afford more attention to how soldiers may cope after witnessing such events.

Williamson et al. assert that there is an increased risk of experiencing trauma in response to PMIE if an individual feels unprepared and lacks social support. Our research indicates that veterans who witnessed the abuse of children demonstrate a response consistent with those suffering the effects of a potentially morally injurious event. Strong leadership, cohesion, and social support can help individuals, so too can considering what tools were provided to soldiers before deployment. Notably, individual and team interventions have been associated with reduced PTSD and moral injury. It can be challenging treating those who suffer mental health problems that are caused by potentially morally injurious events. Existing standard treatments such as cognitive behavioral therapy may not be effective. Interventions might require a co-design approach. Considering the possible causes of moral injury, spiritual care may also be beneficial.46

The data from our research—in the form of anxiety and trauma surrounding the act of witnessing the sexual abuse of children—indicates that moral injury could play a significant and unacknowledged role in the study and treatment of PTSD in veterans. This recognition is important because the soldiers interviewed (and those who spoke out in the United States) believed that there had been a transgression of their values in tolerating the abuse of boys. The effects of this transgression are demonstrated by our research and the voices of the veterans who now experience distress, guilt, and trauma because of what they have witnessed.47

Military practitioners and scholars need not remain silent and should widen the scope of understanding trauma to include witnessing. Sadly, the sexual abuse of children, women, and men—on and off battlefields—remains woven into contemporary warfare.48

 
 

Caroline Kennedy-Pipe
Caroline Kennedy-Pipe is a professor of war studies at Loughborough University. She is the author of several books and many articles about war, including on the women of Afghanistan. She is the founding editor of the journal Civil Wars and is currently working on a manuscript examining the impact of IEDs in warfare. She is a former chair of the British International Studies Association (BISA).

Martin Thorp
Martin Thorp, a PhD student at Loughborough University, is a former British Army parachute regiment soldier who commanded operations in Afghanistan, the Balkans, Iraq, and Northern Ireland. On his third deployment to Afghanistan, he served as a command sergeant major within the NATO Training Mission-Afghanistan. In 2014, he was awarded the Member of the Order of the British Empire (MBE) for his service and command. After leaving the military, he qualified as an organizational psychologist. His PhD research topic investigates command, combat, and trauma.

 
 

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Endnotes

  1. Lars Mehlum and Lars Weisæth, “Predictors of Posttraumatic Stress Reactions in Norwegian U.N. Peacekeepers 7 Years After Service,” Journal of Traumatic Stress 15, no. 1 (February 2002), https://doi.org/10.1023/A:1014375026332; Elisabeth Schweiger, “Fighting Silence Covert Warfare and the Uphill Battle Against the Unsaid,” European Journal of International Relations 28, no. 1 (March 2022), https://doi.org/10.1177/13540661211053830; Emily Prey and Kinsey Spears, “What About the Boys: A Gendered Analysis of the U.S. Withdrawal and Bacha Bazi in Afghanistan,” New Lines Institute, June 24, 2021, https://newlinesinstitute.org/gender/gender-as-an-analytical-tool-for-foreign-policy/what-about-the-boys-a-gendered-analysis-of-the-u-s-withdrawal-and-bacha-bazi-in-afghanistan/. Return to text.
  2. Haleigh A. Barnes et al. “Moral Injury and PTSD: Often Co-Occurring yet Mechanistically Different,” Journal of Neuropsychiatry and Clinical Neurosciences 31, no. 2 (April 2019): A4-103, https://doi.org/10.1176/appi.neuropsych.19020036; Brett T. Litz et al., “Moral Injury and Moral Repair in War Veterans: A Preliminary Model and Intervention Strategy,” Clinical Psychology Review 29, no. 8 (December 2009), https://doi.org/10.1016/j.cpr.2009.07.003; and Victoria Williamson et al., “Moral Injury: The Effect on Mental Health and Implications for Treatment,” The Lancet Psychiatry 8, no. 6 (June 2021): 453–55, https://doi.org/10.1016/S2215-0366(21)00113-9. Return to text.
  3. Ghaith Abdul-Ahad, “The Dancing Boys of Afghanistan,” The Guardian, September 12, 2009, https://www.theguardian.com/world/2009/sep/12/dancing-boys-afghanistan; and Mohammad Hossein Saramad et al., “Causes and Consequences of Bachabazi in Afghanistan: National Inquiry Report,” Afghanistan Human Rights Commission August 18, 2014, https://www.loc.gov/item/2016349056/. Return to text.
  4. Andrew Lear, “Ancient Pederasty: an Introduction,” A Companion to Greek and Roman Sexualities (Wiley, 2013); F. W. Walbank, “Alexander the Great,” Encyclopædia Britannica, n.d., accessed February 3, 2025, https://www.britannica.com/biography/Alexander-the-Great; and Chris Mondloch, “Bacha Bazi: An Afghan Tragedy,” Foreign Policy, October 28, 2013, https://foreignpolicy.com/2013/10/28/bacha-bazi-an-afghan-tragedy/; Saramad et al., “Causes and Consequences”; and Simone Borile, “Bacha Bazi: Cultural Norms and Violence Against Poor Children in Afghanistan,” International Review of Sociology 29, no. 3 (September 2, 2019): 498–507, https://doi.org/10.1080/03906701.2019.1672346. Return to text.
  5. Joseph Goldstein, “U.S. Soldiers Told to Ignore Sexual Abuse of Boys by Afghan Allies,” The New York Times, September 21, 2015, https://www.nytimes.com/2015/09/21/world/asia/us-soldiers-told-to-ignore-afghan-allies-abuse-of-boys.html; Hafizullah Emadi, “The Politics of Homosexuality: Perseverance of Lesbian, Gay, Bisexual and Transgender (LGBT) Community in a Repressive Social Milieu in Afghanistan,” International Journal on Minority and Group Rights 26, no. 2 (February 2, 2019), https://www.jstor.org/stable/26727213; and Amalendu Misra, “Men on Top: Sexual Economy of Bacha Bazi in Afghanistan,” International Politics 60, no. 2 (April 11, 2023): 350–70, https://doi.org/10.1057/s41311-022-00401-z. Return to text.
  6. Peter McKnight, “How Abuse of Boys Played a Role in the Taliban’s Eventual Triumph,” Vancouver Sun, October 6, 2022, https://vancouversun.com/opinion/peter-mcknight-how-abuse-of-boys-played-a-role-in-the-talibans-eventual-triumph. Return to text.
  7. Abdul-Ahad, “Dancing Boys of Afghanistan.” Return to text.
  8. UK Parliament Hansard, “UK Armed Forces in Afghanistan, Volume 515 Debated,” UK Parliament, September 9, 2010, https://hansard.parliament.uk/commons/2010-09-09/debates/10090911000001/UKArmedForcesInAfghanistan; David Pugliese, “Former Soldier Still Fights to Protect Afghan Boys from Abuse,” Ottawa Citizen, September 19, 2009, https://ottawacitizen.com/news/former-soldier-still-fights-to-protect-afghan-boys-from-abuse; Rick Westhead, “Don’t Look, Don’t Tell, Troops Told,” The Toronto Star, June 16, 2008, https://www.thestar.com/news/dont-look-dont-tell-troops-told/article_35750605-f64f-5ba2-ab0e-181a9bbf9475.html; and Goldstein, “U.S. Soldiers.” Return to text.
  9. Jeff Schogol, “Marine Major Who Warned of Danger Before Insider Attack Wins Court Case,” Marine Corps Times, December 6, 2016, https://www.marinecorpstimes.com/news/your-marine-corps/2016/12/06/marine-major-who-warned-of-danger-before-insider-attack-wins-court-case/. Return to text.
  10. AnnaMaria Cardinalli, Crossing the Wire: One Woman’s Journey into the Hidden Dangers of the Afghan War (Casemate Publishers, 2013); and Nivi Manchanda, “What We Talked About At ISA: ‘Afghan Masculinities’: The Construction of the Taliban as Sexually Deviant,” The Disorder of Things, April 19, 2013, https://thedisorderofthings.com/2013/04/19/what-we-talked-about-at-isa-afghan-masculinities-the-construction-of-the-taliban-as-sexually-deviant/. Return to text.
  11. Goldstein, “U.S. Soliders”; Lauren McNally and David Adesnik, “FPI Bulletin: It’s Time to Rethink U.S. Policy Towards Child Sex Abuse in Afghanistan” (The Foreign Policy Initiative, 2015), http://www.jstor.org/stable/resrep07458. Return to text.
  12. Special Inspector General for Afghanistan Reconstruction, “Sexual Abuse of Boys by Afghan Allies,” January 18, 2017. Return to text.
  13. “Convention on the Rights of the Child,” United Nations, September 2, 1990, https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-child; Carlos Bertha, “The Difficult Case of ‘Bacha Bazi,’ ” Journal of Military Ethics 17, no. 1 (2018); Samuel V. Jones, “Ending Bacha Bazi: Boy Sex Slavery and the Responsibility to Protect Doctrine,” Indiana International & Comparative Law Review 25, no. 1 (April 25, 2015): 63, https://doi.org/10.18060/7909.0005; and Antonio Giustozzi, “Re-building the Afghan Army” (paper presented at The London School of Economics and Political Science and University of Bonn symposium on State Reconstruction and International Engagement in Afghanistan, June 1, 2003), https://eprints.lse.ac.uk/28363/1/giustozzi_LSERO_version.pdf. Return to text.
  14. Catherine Norman, “What Do Afghans Want from the Police? Views from Helmand Province,” CNA, January 2012, https://www.cna.org/archive/CNA_Files/pdf/d0026181.a2.pdf; and Anuj Chopra, “Their Silent Screams,” The India Times, August 3, 2016, https://correspondent.afp.com/their-silent-screams. Return to text.
  15. Chopra, “Silent Screams”; Anuj Chopra, “Taliban Use ‘Honey Trap’ Boys to Kill Afghan Police,” Arab News, June 16, 2016, https://www.arabnews.com/node/940346/amp; and Tarin Kot, “Honey Trap: Taliban Sending ‘Beautiful Boys’ to Kill Afghan Policeman,” Hindustan Times, June 17, 2016, https://www.hindustantimes.com/world-news/honey-trap-taliban-sending-beautiful-boys-to-kill-afghan-policemen/story-Ljf8vaKq8jPeVwQBfDOosN.html. Return to text.
  16. House of Commons, List of MPs Involved in the Debate on Afghanistan, UK Parliament Hansard. The debate included contributions from James Arbuthnot, John Baron, Rehman Chrishti, Kary Clark, Damian Collins, Oliver Colville, Jeremy Corbyn, Richard Drax, Natasha Engel, Paul Flynn, John Glen, Richard Graham, John Hemming, Kate Hoey, Kevan Jones, Mark Lazarowicz, Julien Lewis, Jack Lopresti, Michael Meacher, John McDonnell, Madeleine Moon, Sarah Newton, Christopher Pincher, Simon Reevell, Geoffrey Robinson, and Sarah Wollaston. Return to text.
  17. Eva van Baarle and Michell Schut, “Dancing Boys and the Moral Dilemmas of Military Mission: The Practice of Baca Bazi in Afghanistan,” in International Security and Peacebuilding: Africa, the Middle East, and Europe, ed. Abu Bakarr Bah (Indiana University Press, 2017); Craig Whitlock, The Afghanistan Papers: A Secret History of the War (Simon & Schuster, 2021); Elin Gustavsen, “The Construction of Meaning Among Norwegian Afghanistan Veterans,” International Sociology 31, no. 1; UK Parliament Hansard, “UK Armed Forces in Afghanistan, Volume 515: Debated on Thursday 9 September 2010,” September 9, 2010, https://hansard.parliament.uk/commons/2010-09-09/debates/10090911000001/UKArmedForcesInAfghanistan; and Prey and Spears, “What About the Boys.” Return to text.
  18. Martin Thorp, “Command and Psychological Trauma in Combat” (doctoral thesis, Loughborough University, 2024). Return to text.
  19. Randolf Fitriani et al., “Women in Ground Close Combat,” RUSI Journal 161, no. 1 ( January 2, 2016): 14–24, https://doi.org/10.1080/03071847.2016.1152117; Bertha, “Difficult Case”; and Cornelia Vikan, “Soldiers and ‘Respect’ in Complex Conflicts: An Afghan Case,” Etikk i Praksis 12, no. 1 (May 15, 2018): 3–21, https://doi.org/10.5324/EIP.V12I1.2258.” Return to text.
  20. Claire Mills and Nigel Walker, Proposal for an Inquiry into the UK’s Involvement in the NATO-Led Mission to Afghanistan (November 2, 2021), https://researchbriefings.files.parliament.uk/documents/CDP-2021-0174/CDP-2021-0174.pdf; and Ministry of Defence, “British Forces Bridge Language Divide in Establishing Stability in Afghanistan,” Gov.UK, July 8, 2010, https://www.gov.uk/government/news/british-forces-bridge-language-divide-in-establishing-stability-in-afghanistan. Return to text.
  21. Andrew Burtch, “At the Limit of Acceptable Risk: The Canadian Operational Mentor and Liaison Team, 2006–2011,” International Journal 68, no. 2 (June 2013), https://doi.org/10.1177/0020702013493611; Headquarters, Department of the Army (HQDA), Tactics in Counterinsurgency, Field Manual (FM) 3-24.2 (HQDA, April 2009); Ben Barry, Blood, Metal and Dust: How Victory Turned into Defeat in Afghanistan and Iraq (Osprey Publishing, 2020), 458; Kate Clark, “Disbanding the ALP: A Dangerous Final Chapter for a Force with a Chequered History,” Afghanistan Analysts Network, October 6, 2020, https://www.afghanistan-analysts.org/en/reports/war-and-peace/disbanding-the-alp-a-dangerous-final-chapter-for-a-force-with-a-chequered-history/; and Howard Altman, “Why Dissolving the Afghan Local Police Program Troubles Its American Architects,” Military Times, May 27, 2020, https://www.militarytimes.com/news/your-military/2020/05/27/why-dissolving-the-afghan-local-police-program-troubles-its-american-architects/. Return to text.
  22. Theo Farrell, Unwinnable: Britain’s War in Afghanistan (Vintage Digital, 2017), 174, 180, 380. Return to text.
  23. House of Commons Defence Committee, “The UK Deployment to Afghanistan: Government Response to the Committee’s Fifth Report of Session 2005–06 Report,” HC 1211 (London, March 28, 2006), https://publications.parliament.uk/pa/cm200506/cmselect/cmdfence/1211/1211.pdf; and Ministry of Defence, “British Forces Bridge Language Divide.” Return to text.
  24. Command Sergeant Major (E-9) Martin Thorp, 2008 eyewitness account. Return to text.
  25. Anonymized (V32/Sergeant, EOD), interview by Martin Thorp, December 18, 2023. Return to text.
  26. Burtch, “At the Limit”; The “insider threat” is that of insider attacks by insurgents posing as Afghan police or ANDSF members turning on NATO forces in so-called green-on-blue attacks. Return to text.
  27. US Department of Defense (DoD), “Report on Progress Toward Security and Stability in Afghanistan,” Report to Congress (DoD, November 2013); Bill Roggio, “Green-on-Blue Attacks in Afghanistan: The Data,” Foundation for Defense of Democracies, October 16, 2012, https://www.fdd.org/analysis/op-eds/2012/08/24/green-on-blue-attacks-in-afghanistan-the-data; Ben Bryant, “The 24 British Soldiers Killed by Rogue Afghan Forces in ‘Green on Blue’ Attacks,” The Telegraph, January 8, 2012, https://www.telegraph.co.uk/news/worldnews/asia/afghanistan/9550916/The-24-British-soldiers-killed-by-rogue-Afghan-forces-in-green-on-blue-attacks.html; Anthony H Cordesman et al., “Insider Attacks: ‘Green-on-Blue’ and ‘Green-on-Green,’ ” 2013; and James Kirkup and Gordon Rayner, “Betrayed: Murder of Five British Soldiers Casts Doubt on Afghanistan Strategy,” The Telegraph, November 5, 2009, https://www.telegraph.co.uk/news/worldnews/asia/afghanistan/6504721/Betrayed-Murder-of-five-British-soldiers-casts-doubt-on-Afghanistan-strategy.html. Return to text.
  28. Louisa Brooke-Holland, “In Brief: Afghanistan – Insider Attacks,” Standard Note SNO6423, International Affairs and Defence Section Research Briefing (UK Parliament, September 18, 2012), https://commonslibrary.parliament.uk/research-briefings/sn06423/; and Josh Smith, “ ‘Guardian Angel’ Need for Advisers in Afghanistan Drives Call for More Troops,” Afghanistan Analysts Network, August 18, 2017, https://www.afghanistan-analysts.org/en/recommended-reading/guardian-angel-need-for-advisers-in-afghanistan-drives-call-for-more-troops/. Return to text.
  29. “Gen. Allen: Mad as Hell over Insider Attacks,” 60 Minutes, CBS News, September 28, 2012, https://www.cbsnews.com/news/gen-allen-mad-as-hell-over-insider-attacks/. Return to text.
  30. Anonymized (V29/major, welfare), interview by Martin Thorp, November 7, 2023. Return to text.
  31. Anonymized (V17/sergeant, medic), interview by Martin Thorp, July 17, 2023; Anonymized (V17/sergeant, medic), interview by Martin Thorp, July 17, 2023; and anonymized (V10/captain, infantry), interview by Martin Thorp, June 29, 2023. Return to text.
  32. Anonymized (V08/lieutenant, infantry), interview by Martin Thorp, June 12, 2023. Return to text.
  33. Anonymized (V10/captain, infantry), interview by Martin Thorp, June 29, 2023. Return to text.
  34. Anonymized (V29/major, welfare), interview by Martin Thorp, November 7, 2023; Anonymized (T10/Stacy, therapist), interview by Martin Thorp, September 6, 2023; Anonymized (T12 / doctor, psychologist), interview by Martin Thorp, September 28, 2023; and Anonymized (T14 / professional psychiatrist and researcher), interview by Martin Thorp, June 18, 2024. Return to text.
  35. Anonymized (T04/Isabella, therapist), interview by Martin Thorp, July 11, 2023; and Anonymized (T02/Felix, therapist), interview by Martin Thorp, June 15, 2023. Return to text.
  36. Anonymized (T07/Lisa, therapist), interview by Martin Thorp, August 7, 2023; and Anonymized (V01 / lance corporal, infantry), interview by Martin Thorp, May 16, 2023. Return to text.
  37. Anonymized (V01 / lance corporal, infantry), interview by Martin Thorp, May 16, 2023. Return to text.
  38. UK Parliament, House of Commons, “Afghanistan Strategy: Volume 502,” Hansard, December 8, 2009, https://hansard.parliament.uk/commons/2009-12-08/debates/09120856000001/AfghanistanStrategy; and All Survivors Project, “Submission to the UN Committee on the Rights of the Child on Afghanistan, 85th Session” August 8, 2020, https://allsurvivorsproject.org/submission-to-the-un-committee-on-the-rights-of-the-child-on-afghanistan/. Return to text.
  39. Emphasis added, Goldstein, “U.S. Soldiers.” Return to text.
  40. War Child, Being “a Force for Good”: How the UK’s Military Partnerships Can Better Protect Children in Conflict (The Joseph Rowan Tree Charitable Trust, October 2021), https://www.warchild.org.uk/sites/default/files/2022-02/War-Child-UK-Being-A-Force-for-Good-2021-Report.pdf; and Valorie K. Vojdik, “Sexual Violence Against Men and Women in War: A Masculinities Approach,” Nevada Law Journal 14, no. 923 (Summer 2014), https://scholars.law.unlv.edu/nlj/vol14/iss3/15/. Return to text.
  41. Ramon Hinojosa, “Doing Hegemony: Military, Men, and Constructing a Hegemonic Masculinity,” The Journal of Men’s Studies 18, no. 2 (April 1, 2010), https://doi.org/10.3149/jms.1802.179. Return to text.
  42. E. M. van Baarle, “Ethics Education in the Military: Fostering Reflective Practice and Moral Competence” (PhD thesis, Vrije Universiteit Amsterdam, 2018); and Charu Lata Hogg and Barbara Buckinx, “Conflict-Related Sexual Violence Against Boys: From Recognition to Response,” All Survivors Project, May 22, 2023, https://allsurvivorsproject.org/conflict-related-sexual-violence-against-boys-from-recognition-to-response/. Return to text.
  43. Van Baarle, “Ethics Education.” Return to text.
  44. Janice H. Laurence, “Military Leadership and the Complexity of Combat and Culture,” Military Psychology 23, no. 5 (2011): 489–501. https://www.tandfonline.com/doi/full/10.1080/08995605.2011.600143 ; R. Charli Carpenter, “Recognizing Gender-Based Violence Against Civilian Men and Boys in Conflict Situations,” Security Dialogue 37, no. 1 (March 2006): 83–103, https://doi.org/10.1177/0967010606064139; Charlotte Pfeffer et al., “Moral Injury in Human Rights Advocates,” Psychological Trauma: Theory, Research, Practice, and Policy 15, no. S2 (December 1, 2022): S268–74, https://doi.org/10.1037/tra0001404; and Meg Satterthwaite, “Evidence of Trauma: The Impact of Human Rights Work on Advocates,” openDemocracy, April 7, 2017, https://www.opendemocracy.net/en/openglobalrights-openpage/evidence-of-trauma-impact-of-human-rights-work-on-advocates/. Return to text.
  45. Vikan, “Soldiers and ‘Respect’ in Complex Conflicts”; and David Whetham, “The Challenge of Ethical Relativism in a Coalition Environment,” Journal of Military Ethics 7, no. 4 (December 2008): 302–16, https://doi.org/10.1080/15027570802509983. Return to text.
  46. Victoria Williamson et al., “Moral Injury: The Effect on Mental Health and Implications for Treatment,” The Lancet Psychiatry 8, no. 6 (June 2021): 453–55, https://doi.org/10.1016/S2215-0366(21)00113-9; Amanda Bonson et al., “Veterans’ Experiences of Moral Injury, Treatment and Recommendations for Future Support,” BMJ Military Health170, no. e002332, December 16, 2023, https://doi.org/10.1136/military-2022-002332; and Lindsay B. Carey and Timothy J. Hodgson, “Chaplaincy, Spiritual Care and Moral Injury: Considerations Regarding Screening and Treatment,” Frontiers in Psychiatry 9 (2018), https://doi.org/10.3389/fpsyt.2018.00619. Return to text.
  47. Victoria Williamson et al., Experiences of Moral Injury in UK Military Veterans (King’s Centre for Military Health Research, and King’s College London, October 9, 2020,) https://s31949.pcdn.co/wp-content/uploads/20200826-Experiences-of-Moral-Injury-report-2020-v2b-1.pdf; and Brandon J. Griffin et al., “Moral Injury: An Integrative Review,” Journal of Traumatic Stress 32, no. 3 (June 28, 2019): 350–62, https://doi.org/10.1002/jts.22362. Return to text.
  48. Schweiger, “Fighting Silence.” Return to text.