Some women in the military are still receiving inadequate care for sexual assault, a Government Accountability Office (GAO) report published Tuesday found. The report found that "not all first responders had completed the required training," even after a 2005 Department of Defense directive mandated "a comprehensive policy for the prevention of and response to sexual assault." One servicewoman even reported an inability to gain access to yeast infection treatment.

Though GAO found that the military "has not established guidance for the treatment of injuries stemming from sexual assault -- a crime that requires a specialized level of care." Often, officers assigned to be "victim advocates" for those who had suffered sexual assault "are not always aware of the specific health care services available to sexual assault victims."

GAO investigated three military installations in the United States and seven Afganistan installations, as well as looking at eight Navy ships. The investigators talked to 92 servicewomen, 60 of whom said they believed they were receiving "generally" adequate care, but 8 reported deficiencies in female-specific health care.

"At one location we visited in Afghanistan," the report said, "a female airman told us that she believed the military was trying to meet the health needs of women, but still had work to do—noting, for example, that a medication she was prescribed had given her yeast infections."

The biggest barrier seems to be confidentiality. As Wired reported, "Sexual assault cases can be reported in the military using two ways: unrestricted reports and restricted reports. For an unrestricted report, a survivor reports an assault to superiors and military law enforcement, who — in theory — begin an investigation, and provide medical care and counseling. A restricted report, on the other hand, allows a survivor to confidentially inform superiors about the assault without sparking a criminal investigation. The survivor, according to military policy, should still receive medical care, but personally identifying information will be kept anonymous."

But the GAO found that policies on the ground are inconsistent and often contradict the ability of servicewomen to file a confidential report of sexual assault. In at least one facility, "the policy was silent on the issue of sexual assault." At another, "a command’s medical policy contained requirements for health care personnel that conflicted with their responsibilities under restricted reporting."

This is problematic, because, as the report said, "As a consequence, sexual assault victims who want to keep their case confidential may be reluctant to seek medical care." The report concluded that "such factors can undermine DOD’s efforts to address the problem of sexual assault."

Update: Protect Our Defenders responds to the GAO report

"The GAO report indicates that military leadership has failed for over 25 years to fundamentally address this crisis of sexual assault in our military, half measures regularly put forward by Congress and DoD are not answers," said Nancy Parrish, President of Protect Our Defenders in an email statement to Raw Story. "Every aspect, from prevention and victim care, to investigation, prosecution, and adjudication is fundamentally dysfunctional and there has been no coherent effort to fix the deficiencies."

"The Department of Defense is responsible for failing to effectively govern its personnel," she continued. "The problems are so long standing and pervasive that, at a minimum, they constitute gross negligence on the part of the leadership and actually reflect, albeit informal, countenancing of the violation of the rights of women in the service and of victims of assault, men and women."

"This crisis cannot be effectively addressed incrementally. Regardless of the reason, the chain of command is not making the right calls with these cases," Parrish said. "Continued lack of efficacy validates the standing up of an impartial, expert office to determine effective investigation and appropriate adjudication of sexual assault cases."

Rep. Jackie Speier (D-CA) introduced the Sexual Assault Training Oversight and Prevention Act (STOP Act), which would create such an impartial office in November 2011. She plans to reintroduce it in this congressional session.

Photo: Capt. Patel, a doctor with 1st Brigade Combat Team, 10th Mountain Division conducts an exam on a young girl at the Ghormach Clinic Oct. 3. (Flickr user isafmedia)