A program helps Ukraine's veterans find sexual healing after the trauma of war

KYIV, Ukraine — When Russia first launched its war against Ukraine in 2014, Rodion Trystan was 23 years old, a soldier in a front-line battalion in the eastern Donbas region. A Russian sniper bullet nearly took his life.

"It was high-caliber explosive round, my right eye was totally destroyed," Trystan said, speaking in accented English. "I was having a hole in my head."

Trystan said it was a miracle he survived. His skull is scarred now. He wears an eye patch. His left eye was also severely damaged, leaving him with partial vision.

After leaving the hospital, Trystan struggled to make peace with his new appearance, his changed face and the rejection he experienced with many women.

"When you came to a date, she looks at you and not says nothing and just turns around and goes away," he recalls. "It was kind of problem to find sexual partner, because people say, 'You're handicapped, no, it's not going to work.'"

Experts in Ukraine say this is a fast-growing problem since Russia's full-scale invasion began last year. By some estimates, more than 120,000 Ukrainian soldiers have been wounded defending their country.

One of the most complicated parts of their recovery can involve sexuality and intimacy. Trystan says other soldiers have asked him, "How you struggle [with this], how you stand it?"

Veterans Hub, a support group headquartered in Kyiv, has launched a project called ReSex aimed at helping veterans — and healthcare providers — grapple with those questions.

"It's not easy for them sometimes to ask, or for medical workers to answer this," says Kateryna Skorokhod, head of ReSex.

The group's message to soldiers who've experienced physical and mental trauma is one of hope, she says.

"It's not the end of your life, you can be happy, you can have relationships, you can have sex, it could be great, playful," she says. "It's not only about sadness and dark and toughness, it can be bright."

A multimedia effort is used to heal veterans

ReSex has released two books in Ukrainian, one for male veterans, one for female veterans, offering support and guidance.

The texts offer a mix of practical advice, such as how to have sex in a wheelchair, as well as ideas for rethinking body image and desire.

"It's not only about physical contact. It's also about relationships. It's about how to perceive yourself after the injury," Skorokhod says.

Her group is also reaching out on social media, trying find a wider audience while destigmatizing discussions of sexuality in the military.

A video posted by Veterans Hub and ReSex on YouTube shows Ukrainian veterans, men and women, with severe war injuries, getting playful with partners.

"Sex after a combat injury can be serious and uncomfortable," the narrator of the video says. "Or it can be fun and playful, hot and exciting. The main thing — make love!"

The tone is flirty and sexy by design. Trystan is one of the veterans featured, shown in a moment of intimacy with his eye patch removed. He looks handsome, confident.

"The video's looking very provocative, yeah, but it's a way to make them interesting," he says, laughing. "They're definitely getting people's attention. My friends were calling me after this video."

Healing for Ukrainians, influenced by the U.S. war in Afghanistan

Dr. Kseniia Vosnitsyna, head of the Institute of Veteran Mental Health and Rehabilitation run by Ukraine's Ministry of Health, says the government decided to support the ReSex program in an effort to counter poor medical information about sexuality circulating online.

Although it's not clear how many veterans have received support for intimacy issues through the program, "We hope it will have an impact, because people often have very little information," Vosnitsyna says. "When they receive high-quality, good information from trusted specialists, we hope it helps."

Vosnitsyna says it's also difficult to assess how many veterans experience sexual dysfunction due to wartime injury or trauma.

"It is difficult to say in percentages, but in fact there are a lot of complaints about this problem," she says.

The books, the Youtube video and the effort to normalize discussions of body positivity and sexuality after war are based on the work of Kathryn Ellis, an American therapist who started her career treating U.S. veterans.

"There were tons of service members coming back at that time from Afghanistan and they had questions about sex and intimacy," Ellis tells NPR. "Often the providers were not prepared to address those questions."

Ellis wrote a book — Sex and Intimacy for Wounded Veterans — that provided much of the material, with her permission, in the manuals now being used in Ukraine.

Military cultures tend to be conservative, she says. Sex and self-image are areas where many soldiers can feel extra-vulnerable after an injury. Many wounded veterans also experience low libido, according to Ellis.

"It can feel really shameful to bring that up," Ellis says. "Body image plays such a role."

With help and guidance, she says, many veterans recover, learning to feel good again about their bodies. She believes sexual healing can also help with other parts of mental and physical recovery after war.

"There are a lot of hopeful outcomes. Just helping people unpack and work through what they are expecting sex to be like," she says. "They can really be focusing on the pleasure they're feeling in their bodies. That can be extremely empowering in the healing process."

Trystan says with a lot of therapy and work, he's doing well these days — dating, finding romance and getting comfortable seeing himself in the mirror.

"Yeah, OK, I lost my eye, I have some problems with my face, OK, but some people [are] born much more uglier," he jokes.

Despite the war that drags on, Trystan says he's hopeful he will eventually meet a long-term partner who accepts him and the scars that came defending Ukraine.

"At some point, yeah, definitely, my life is not yet ended, at least for now," he says, adding that most of the women he meets these days are more understanding: "If conversation begins, I have chances."

Veterans working on this sexuality project say this kind of hope is essential. They're not just fighting for survival against Russia. They're fighting for the joy and life they believe will come after the war.

Polina Litvinova contributed to this story in Kyiv.

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