WASHINGTON -- For the growing number of soldiers and Marines whose genitals are damaged or destroyed by blasts from improvised explosive devices while in combat, the Pentagon has decided it will not provide some critical reproductive health benefits.
To put it bluntly, if you are sent to war and an IED blast blows off your testicles, the U.S. government will not pay for your wife to have in vitro fertilization or artificial insemination using donated sperm.
The new policy, quietly adopted without announcement by the Defense Department, responds to the growing demands of the more than 1,800 veterans with genital wounds that the government that sent them to war now help them return to normal life, including raising a family.
The policy authorizes payment for some reproductive procedures for the first time, including limited in vitro fertilization and artificial insemination. But it also specifically excludes covering males who cannot produce sperm. "Third-party donations and surrogacy are not covered benefits," the policy states firmly.
The Pentagon decision dashes the hopes of a growing number of young Americans wounded in combat and unable to produce sperm who had wanted to start a family. In one recent U.S. military study, the average age of those with genital wounds was 24 years. The majority of those in military service -- 56 percent -- are married.
Pentagon officials were not immediately available to explain their decision to deny benefits to couples like Heather and Mark Litynski, a Marine who lost both legs and his left arm, along with his testicles, to an IED blast in Afghanistan almost two years ago.
Heather, 27, and Mark, 26, had decided to use donor sperm to begin their long-planned dream of raising a family. But the cost of in vitro fertilization can be dauntingly high: at the Walter Reed National Military Medical Center in Bethesda., Md., where Mark was a patient, it costs $4,800 to $7,000 for each procedure. They were hoping the military would cover the cost.
When The Huffington Post contacted Heather Litynski about the new policy, she expressed deep disappointment. Given all the other benefits that combat veterans are given, including medical care, housing and educational support, she was shocked that the government would refuse to support procedures using donor sperm.
"This is one ugly hole in the system," she said. "The only thing I can think of, and to me it's not an excuse, is that it might involve some ethical issue. I'm thinking, if a guy loses both testicles, why would ethics get involved in a family's decision to use donor sperm?"
Extending other assisted reproductive benefits to families in which the male can produce sperm, she said "is a huge weight off a lot of peoples' shoulders, which is good. I do appreciate that even this is being done. But I don't think it's fair for all the families it doesn't help."
Since 2005, at least 1,875 American troops have suffered genital wounds, including 51 so far this year. They are among the 34,440 American battle casualties caused by roadside bombs in Iraq and Afghanistan, a grim toll that includes over 3,000 dead and 31,394 wounded through May, according to the most recent Defense Department data.
Most of those who suffer genital wounds also lose one or more limbs to IED blast, so the devastating loss of sexual function is compounded by the difficulties of adapting to life as an amputee with prosthetic limbs or a wheelchair.
For these wounded warriors, the compensation policies of the Pentagon and the Department of Veterans Affairs can be infuriating. For instance, the VA pays up to $100,000 to the severely wounded like Mark Litynski to compensate for loss of income and to help finance adapting their home to wheelchairs and other needs. Late last year, the VA also agreed to pay up to $50,000 for damage to or loss of genitals in combat.
But the VA's $100,000 lifetime cap on such compensation does not account for veterans who have been wounded as catastrophically as Mark Litynski. He received the $100,000 for his amputations -- but nothing for his genital wounds that might have helped finance fertilization procedures or adoption, since he'd already reached the lifetime cap.
For wounded warriors and their spouses, many of whom are unemployed and without significant income, the issue of financing a family adds to the other issues they struggle with.
Heather and Mark agonized over the issue of using donor sperm, the only option that would allow Heather Litynski to experience childbirth. Mark was okay with the idea, but Heather said she "spent months going back and forth before I felt comfortable with my decision. Nobody," she said, referring to the Pentagon, "should frown on that decision."
She and Mark had decided to pay for their own artificial insemination procedure, and later to adopt a child. They are working to save the $40,000 they believe adoption will cost. They are at home now in Minnesota, where Mark -- now getting around on his prosthetic legs -- plans to go back to school.
In an effort to prevent more such genital wounds as Mark experienced, the Pentagon last fall rushed 165,000 pairs of Kevlar-reinforced briefs to Afghanistan along with 45,000 sets of armored over-garments designed to blunt the impact of shrapnel and blast on the lower torso.
The measure had limited effect, according to a preliminary study completed in Afghanistan this spring for Task Force Paladin, which is responsible for all counter-IED training and operations in Afghanistan.
The unpublished study found that for those injured by IEDs, 33 percent of those wearing the protective garments suffered partial or complete destruction of the testicles, compared to 46 percent of those who were not wearing protection.