-Additional funding was provided by... -I was wounded in a firefight in Afghanistan where I was shot four times.

One of the bullets paralyzed me from just above the belly button down.

-I was an explosive ordnance disposal tech, which means I was military bomb squad.

I lost both my legs above the knee.

I have traumatic brain injury, as well as I lost my right testicle and one-third of my left testicle.

-A sniper shot me in the head, where the bullet penetrated my left temple and exited out my right eye, causing blindness instantaneously.

-I received some injuries, mostly concussive stuff, things exploding close by.

The violence that was going on, you know, it was a constant, and it kind of came home with me after that deployment.

-My NCO, he called and he said, "Hey, I need you to come over to my house."

So I show up to his house and walk in.

It's smoky.

He was smoking -- he was smoking weed in the house.

And I was like, "What did you call me over here for?"

Like, why am I here?

Like, I don't -- I'm not doing this, you know?

And... you know, he kept me there.

-So, I'm in the ambulance with another fellow Marine, and one of the Navy Corpsmen.

And luckily, the Marine, he used to be an EMT before he joined the Marine Corps.

So he was telling the corpsman, you know, "We need to do this and this."

So him and I were joking around, and all of a sudden I had -- I started getting this burning sensation in between my legs.

And at that moment, everything came crashing down because I'm like, "Oh, my God, did I get burned down there?"

-Upward to one million men and women who have served since 9/11 have experienced either traumatic brain injury, or post-traumatic stress or depression.

And furthermore, we have thousands of people, tens of thousands of people who have incurred catastrophic physical disabilities.

-You go through this traumatic event and now you have this disability, you have this issue that is, you know, affecting you every single day and affecting such an important part and such a big part of life that, unfortunately, a lot of the healthcare system has failed to even address, the shortcomings of sexual health and anything related to that.

-We had absolutely no support for our sexual health.

The intimacy of our relationship, it was not addressed in his recovery at any point.

Nobody ever asked us about it.

-Research shows that when people return from deployment with a serious mental or physical disability, they experience more marital stress and divorce than their non-disabled peers.

Failed intimate relationships continue to be the leading contributor to suicide in service members and veterans.

♪♪ ♪♪ -I always knew that I was gonna serve in the military.

My main motivation was I come from a family of individuals who have served our country.

-I joined the military when I was 18 years old.

And you know, I was a single guy, straight outta high school and not a lot of people leave from where I'm from.

So I wanted to join the Army and serve my country, and that was the easiest way for me to get out.

-I grew up taking the Junior ROTC and I loved it.

I was so gung ho about everything.

I was the only girl on the rifle team, and I just -- I had a love of, you know, the military.

-When I signed up, I was 18 years old and I was single.

I kind of went into it with the mindset I wanted to stay single and focus on my job and everything I needed to do 'cause I knew, you know, as time passed and serving in my unit, so many guys had relationship issues and marital problems and such, especially once you're deployed.

-On top of what everyone else faces, there's long periods of separation, you know, so people have to deal with that.

And one partner is, you know, deployed and under a lot of stress.

The other one's at home, maybe taking care of the house and finances, kids.

So there's stress on both sides, and then people come back together.

They have to get reacquainted.

For folks who are in the military, a bomb going off, an IED, a sniper -- everything can change with the blink of the eye, especially when it comes to their sexual health.

-Someone yelled, "Gas, gas, gas!"

And that's the command for everybody to drop what they're doing and put on their gas masks.

So as I'm putting on my gas mask, I hear someone yell, "Fire!"

What had happened was we were training in dry brush, and California in the middle of the summer, everything's dead.

So, unfortunately, it ignited the brush on fire.

A number of us tried putting it out.

It was very small, but spreading quickly.

I saw another Marine about 20 yards away at the base of the hill, on the ground, and you never leave a fellow Marine behind.

And without even hesitation, I decided, you know what?

I'm going back for him.

-I was wounded on May 3, 2005, in the Zabul Province in the Arghandab River Valley.

I caught a round underneath my left arm in between my armor plates.

Right then and there, it was as if a light switch had been flipped, and I couldn't feel anything from about the belly button down.

That's when another volley of bullets came in, and I was hit three more times.

I was hit through the left knee, through the chest again, which went through my left lung and lacerated my liver.

The bullet is still there in my liver to this day.

-I was in Afghanistan, Southwest of Kandahar, around a little area called Pashmul.

I was called out to an IED in a culvert.

I showed up, identified the IED as a hoax, which is a fake IED.

Went back downrange to find what I knew was there somewhere, was the real stuff, and I stepped right on it.

They told me at the time, with my injuries, the chances of me having a child ever again was pretty much never going to happen.

-As a female soldier in the Army, I was told by leadership that I had to learn how to play the military game.

My NCO, he called and he said, "Hey, I need you to come over to my house."

This was like seven o'clock at night, and I'm like, "Why?

What do you need me to come over to your house for?"

He goes, "Well, you know, you're gonna go to the board.

You're gonna do training.

I need you to come over.

You know, you need to be over here."

-Well, I tend to view military sexual trauma as along the same lines as those invisible injuries of war.

So, when we think about PTSD, when we think about even some of the mild traumatic brain injury where you have symptoms that aren't necessarily visible to the naked eye by others.

Military sexual trauma is similar to that in that we do need to focus on the issues that we can see as well as the issues that we can't see.

And it's a trauma with unique features unto itself.

-That played a lot on... you know, on me personally, you know, emotionally.

And there are certain times where, you know, even now, you know, with Casey and I -- you know, I mean, and it's sweet -- you know, he might grab my butt or something, and you know, it's just like... "Don't touch me."

You know, I just -- I cringe, you know?

But it's my husband, you know.

I shouldn't feel that way.

But there are, were occasions where I just, you know, I-I don't... you know, I don't want him to touch me.

I just, you know... Because it gives me, you know, a little flashback of just that feeling, you know?

And I'm not even... You'd think that it's gone, you know, but it stays with you.

-Unfortunately, thousands of men and women experience military sexual assault.

90% of the time, the assailant is another service member, often a superior.

Junior enlisted women are at the highest risk of sexual assault, but thousands of men are also victims of military sexual assault.

And we don't talk about it, and they don't talk about it.

They're afraid of repercussions.

They know other people who reported it and it went nowhere.

But it's still important to step up and reach out for help.

-I was blinded while in combat operations in Iraq while conducting a raid with the Iraqi National Guard on a mosque where I was performing the external perimeter security.

-I deployed to Iraq with the First Cav Division in 2003.

It was a real violent deployment -- the wear and tear on the body just from constantly being in places and doing things that people shouldn't have to do.

Some bad guys show up and start beating kids and women and stuff like that.

And when we started to go after those guys to get 'em out of there, they started grabbing kids to use them as shields.

You know, there were casualties that there didn't need to be.

-Military injuries run the gamut from loss of limbs to other serious physical disabilities, to invisible disabilities such as traumatic brain injury or post-traumatic stress, or otherwise known as PTSD.

And all of these can affect your sexual health.

People who serve also experience something we refer to as moral injury, or you could think about that as a spiritual injury.

And these happen when somebody experiences an event and then feels, you know, very badly about it.

So they might feel shameful or guilty about witnessing an atrocity that they maybe could have prevented, or seeing something or doing something that ran counter to what their values would be in civilian life.

So, this happens, and then they walk around -- people have said they felt like they have a dark spot on their soul.

These feelings haunt them.

-He was a monster when he came back.

And I knew it was because of everything that he had dealt with, but he was refusing to talk about it or to even acknowledge that it had happened.

After his first deployment, he wasn't the same, really, with my son.

I remember one time... coming in the house [voice breaking] and seeing my son... Wow.

♪♪ [ Crying ] Sorry, I didn't expect that to happen.

♪♪ [ Sighs ] Um...

So, my son was... he was hog-tied.

His hands were tied and his feet were tied.

And he was just... Casey was just... [ Breathing shakily ] He was yelling at him and he was just like, demean-- you know, just belittling him, telling him, you know, how much of a piece of [bleep] he was and just, I mean, horrible stuff.

And so immediately I came in and I'm like, "What the hell's going on," you know?

So, I go to my son, you know, and...

I know this isn't my husband.

I know that something is wrong.

And I'm trying to protect my son, and I'm trying to keep myself married, you know.

I'm trying to be there for my husband.

And that was -- that was really hard, you know.

-A lot of times nowadays, I feel like I'm compensating for it, for how I was when he was a lot younger.

But back then, it was a lot of my wife protecting our son.

And it just had to do with how violent I was all the time -- how aggressive, you know, how, you know, cock-of-the-walk type sort of deal.

I had to be in charge.

I had to let everybody know that, you know, I was the man of the house, if you will, and stuff like that.

But it was really just -- it was over the top, and wrong.

-PTSD and TBI and depression, other psychological injuries of the war affect intimacy and sexual health in several ways.

First of all, post-traumatic stress disorder usually causes a feeling of disconnectedness, numbing or avoidance with especially people who haven't been there -- by "been there," been in the theater of war with you -- and that's often your spouse, your wife, husband, partner.

-During the three- to five-year period when I was having a huge internal struggle with myself, with anger against myself, resentment against myself, it severely impacted the relationship between Kate and I.

-Anger is a significant component in how those patients are impacted from an intimacy perspective in their relationships.

Often with traumatic brain injury, we see insomnia and issues with sleep that impact our frustration tolerance and our ability to manage anger and irritability.

And often that comes out in those relationships.

-A lot of them, before they went out to combat, you know, they had...

Some had sexual experience -- many didn't.

And these traumas to the lower extremities and to the genital areas, well, they caused a lot of not just physical injuries, but psychological injuries, emotional injuries, spiritual injuries, because at this point, they feel that they cannot go on and have families.

They can't experience what the average person at 18, 19, 20 years old in their group have experienced.

-At 20, you're in your prime.

You know, sex is a very, very important thing in life for a 20-year-old.

And you essentially just have that ripped away and this whole new life thrown in front of you that you essentially have to learn through on a crash course.

-Many veterans tell me that they're confused because they can't share their feelings 'cause they have a sense of emotional numbness.

They say they're not feeling, and I point out to them that you feel anger, and that anger is an emotion.

And if we feel anger, then we have the ability to feel better emotions too.

So, it's important for folks to be able to kind of express that anger and move it out of the way so that some of the more positive emotions can come to the surface.

So, it's very important to be able to start to talk about your issues and communicate them with your health professionals, with your partners, because we can't fix what we don't know about.

-Before Casey's first deployment, and like right after I met him, I was just head over heels, madly in love with him.

You know, I felt like God showed me, you know, how he sees him.

And that's who I fell in love with.

-After my time as an inpatient in the hospital, recovering with a spinal cord injury, you know, there was a lot of unknowns.

You know, what was life gonna look like?

What was dating gonna look like?

-I was married to Aaron 18 months when he was injured.

He had been deployed for six of that.

So we were only married a year before he left for Afghanistan.

So we've spent considerable time on his needs in a really unnatural way.

So, most of our marriage has focused on one half of it, and the other half is trying to serve that person.

And I feel like it's possibly created some feelings and some habits that will not serve us very well, you know, in the future.

-My entire role changed from being a therapist to being someone's significant other.

When you're working with them, that your time ends.

The fact that you work for an hour, half a day, a day, a week, whatever it may be with this person, to help them overcome their barriers, reach their goals.

But then when you're in a relationship with someone, that time doesn't end.

It's 24/7.

And the barriers that are placed in front of you every day are no longer just placed in front of you.

They're placed in front of us and our entire family.

-The physical aspect of me recovering was easy.

The therapy, not a problem.

But relationships...

It was tough because I was my biggest enemy.

I would defeat myself before I even would initiate any type of relationship with anybody.

I don't see myself being burned because it's just who I am.

I'm still an outgoing person.

But then I'd be like, "Well, she's not gonna wanna be with me because I'm burned, I'm scarred."

I'm not what the -- you know, fits the "norm," what you see on TV.

-Often when we're talking about sexuality, we automatically think of the couple.

But so many people, when they're injured, they are single and they think that their disabilities are the end of their sexual life.

But that isn't the case.

It's important to remember that you're not your disability, and you're not your scars.

You have value and you bring something important to every relationship.

-People always tell me, you know, "It's so great that you were able to see beyond Manny's scars and see who he really was and to look past those scars."

And that always takes me back.

You know, I'm always like, I don't look past the scars -- the scars are part of who he is.

What first attracted me to him probably was his persistence.

He...

I was not actually looking for anything or anything.

As I said, I was just recently divorced and was just getting on my own two feet on my own.

So... you know, but we just connected.

-The first time I made love after my injury was... an incredible moment.

For me, so many emotions and feelings overcame me.

Um...

It's hard to put into words, you know?

I mean, how do you describe that?

Um... For me, it was like, you know what?

This overwhelming feeling of acceptance, that here's someone who loves me for who I am, not who, you know, is judging me by my appearance in any way.

Um... And... you know, it was a little emotional for me because I'd just... been thinking about that time, you know, all those years.

And finally here I was with someone that loved me for who I was and was willing to take that step with me.

You know... start an incredible journey together.

-The first time we were intimate was in the hospital, about...

I wanna say about three or four days maybe before I went outpatient.

Pretty much, it was a wink-wink, nod-nod, "Nurse, like, leave us alone," and during the busy morning in a hospital.

And it was interesting.

It was definitely fun.

-I was just excited... ...to give our relationship that opportunity.

He was still pretty heavily bandaged.

His legs were still healing, so definitely I was very concerned about hurting him.

I tried to go slowly and be very gentle, because, you know, more than anything, I didn't want this to be a negative experience for him.

So, I was excited to have intimacy with him, but I was also really excited to give him that, to reassure him that I was still sexually attracted to him and I was still very interested in maintaining our marriage in all aspects.

-So, the first time that we had sex after I returned from Iraq, while I was still receiving treatment at Walter Reed, it was within the confines of my room over at Walter Reed as an inpatient, on inpatient status.

And it was one that, it was kind of mutual in how it started.

And it was also extremely short and fast, as you can imagine -- a guy that's walking around hooked up to a couple of IVs of not just fluids, but some pain relievers, just trying to have sex.

It was one of those, okay, down and dirty, nothing attractive, nothing you're gonna see in any type of Hollywood type movie or anything.

That's what it was.

But what did it mean to us?

A whole lot more than that.

It was just kind of this first piece of us putting back some sense of normalcy within our lives, within our relationships.

-The first time I got intimate was with the first serious girlfriend I had, you know, post-injury, and... you know, I had looked into it a little bit and been prescribed some medication -- you know, pills -- that definitely helped some.

But it was... you know, without the lack of sensation and everything, you know, I personally didn't have any, you know, personal pleasure and feedback, you know, from things because I didn't -- I couldn't feel anything.

-One of the things Tyler's always said is, every single one of his past relationships post-injury has ended because of the chair.

And with me, I think definitely working with people with disabilities helped that initial fear.

But it also helped with the fact that I saw Tyler as a person, Tyler as an individual, Tyler as a man, someone who had a lot to offer.

-The biggest barrier was the medications -- what would work, what wouldn't -- 'cause, you know, there's a number of different options out there, and it's just trial and error.

You know, you try this -- oh, it doesn't work.

Oh, you try this -- oh, it doesn't work.

Oh, you try this -- oh, it works okay.

But you know, it's just, you gotta see what works for you.

And everyone's different.

And you know, for me, I have to do injections.

-So, men who are struggling with erectile dysfunction, or ED, feel like it's the end of the world.

But that is one of the issues that is relatively simple to fix.

We have oral medications, like the little blue pill.

We have injections of medication into the penis, which may seem scary, but works very effectively.

We have vacuum devices, which people know as the pump, that we could use in conjunction with constriction devices or rings to keep the blood flow in the penis.

And if all else fails, we have prosthetics.

We have implants that we can put into the penis, that you could have a reliable erection anytime you want.

These solutions might not sound like anything you imagined, but they may be a great part of your new life, so don't rule them out.

-Not a comfortable idea.

You know, when you're sticking a needle anywhere down there... Just the idea of it, it's...

It's not a pleasant thing to experience.

[ Laughs ] But you get over that.

And even, you know, without the sensation, you know, it's... just a mental block you have to get over.

-The spinal injury had taken a big chunk of the physical relationship out, because I was having issues with ED real bad.

There were some days that I just couldn't do anything.

You know, and even once they had diagnosed that stuff, the sexual portion of it was never addressed whatsoever till right at the end of my active duty status, after we got here.

I finally just went to the doctor and we talked about it and they tried a few things, and it's slowly gotten better.

And then once they finally installed the internal stimulator into my spine and got those pain levels down and took some of the pressure off the nerve endings, as far as things working properly, at that point, that's when things got better for me.

-There have been some advances in the field of healing the pelvic trauma and the genital injuries at Walter Reed.

We are very aggressive of taking care of their wounds surgically.

Also, if there's testicular injury, of course, we'll do testosterone supplementation if necessary.

And by giving a man testosterone therapy, his libido and sex drive will return.

-He'll never pick me up and throw me over his shoulder again.

Being more assertive is a little different.

And that's something that we had enjoyed before.

And I don't like to lament that too much because I don't want to waste too much time on it.

But I also don't want him to feel like there's something he can't do for me, 'cause that's not true.

Like, he does plenty, just as much as he did before, you know.

So, it's just -- there are certain things that we just won't do again.

And there's just no point in going there.

As someone once suggested that maybe we talk out that kind of fantasy, and I haven't been interested in that.

-Communication is just essential for dealing with your sexual health issues.

You know, it's amazing how people can really just get naked and have sex, but they can't talk about it.

And it's something that we have to dig deep, we have to kind of be courageous, be brave, and talk about these things that we may feel ashamed about.

We know that most of these injuries affect sexual health, but the person with the injury is not bringing it up because they're waiting for the doctor to ask the question.

And the doctor, they're not bringing it up 'cause they're waiting for the patient to bring it up.

And then this most important core issue goes unaddressed.

Having a sexual problem is like having any other medical problem, and it's something that we need to talk about.

We don't need to feel ashamed just because we can't function like we thought we should.

So, you know, if you can't walk, then you're going to want to get a wheelchair.

If you're in pain, you're gonna want relief for your pain.

And if you're suffering because of a problem with sexual function or response, then unfortunately it's gonna be up to you to tell your health professional that you have a need.

-People oftentimes, they'll label intimacy as just sex.

And it's so much more, especially in the case of somebody with a physical disability or barriers placed in front of them to maintaining a traditional relationship.

And one of the things that Tyler and I work really well together with is the fact that we face all of those things head-on together.

-I'm definitely more of a giver than a taker when it comes to that.

And, you know, you kinda learn ways around those barriers with essentially taking pleasure in your partner's pleasure.

And that was kind of the first step as far as regaining any of my sexual health.

-Well, many people I work with who've experienced trauma in the past often tell me that it takes a drink or two, or three, for them to get into a place where they can experience sexuality in a pleasurable way.

-Oh, my God, it was really hard to be sexually intimate with Casey after, you know, the incident with my son.

It was really hard because I was kind of starting to hate him, you know, for that... ...and for who he was, but I still battled with, "But I know this isn't him."

And I still loved who I knew he was inside, and I knew my son loved that.

As far as, you know, getting intimate, I just...

I don't know, I did drink a lot, you know?

I would, you know, have more than a drink or two if I needed to.

And that was plenty enough to just help me focus on just being in the moment, and it worked.

-There's nothing wrong with a drink or two to help, you know, as a bridge to sexual activity.

However, I encourage folks who are doing that to really seek some more help for their trauma histories so that they're not dependent upon that in order to have a positive experience.

-I don't think sexual activity ever triggered my PTSD.

I think the after of it -- like afterwards, for some reason I always had kind of almost a guilt.

Like I took advantage of my wife or something, you know?

And then lost in thought, feeling guilty about everything that I should probably feel guilty about.

And then that would kind of trigger it a little bit.

-Sexual arousal can trigger PTSD in many folks because of the increase in the heart rate and respiration and blood pressure.

And these things that are arousing in a normal sexual situation, for someone who has PTSD, can be a trigger.

So, if sexual activity is triggering a PTSD event for you, it's important for you to first acknowledge that and then to share that with your partner and seek help.

When you don't share this information, often the sex becomes very aggressive, and their partner is on the receiving end of this, wondering what's going on.

You may think you're hiding this event from your partner, but often the partner has a sense that you're somewhere else and they have a sense of disconnection, and that's not gonna serve you well in the long run in your relationship.

-My wife had talked me into first speaking to our pastor at the time.

We went and talked to our pastor, and I was telling him about the issues I was having.

He -- He helped a lot.

He didn't stick with the...

He was our pastor, you know, a very godly man, but he... he kind of put things into perspective for me.

You know, he changed my perception.

Instead of having sex, you know, every single chance we could at that point, it became more of a once a week, once every couple of weeks, sometimes once or twice a month and that's it, sort of deal.

But it was intimate at this point.

That's when things really started to change for us.

It was more of an experience than just the sex at that point.

And our communication got better at that point.

-A sense of humor.

A lot of laughs in a bed where you're experimenting.

We've gained appreciation for what intimacy we do have.

Also, having intimacy without intercourse -- that's really important to us, and that's carried us through a lot of rougher moments.

-Many couples have learned that intimacy is not just sexual intercourse.

So, when we rely on a goal-orientated idea of sex, that sex requires intercourse and orgasm, when one of those two things can't happen, so many couples just give up.

There are so many more avenues to pleasure.

So, if we are pleasure-focused, then we put value in touching, in kissing, caressing, biting, whatever, you know.

So, there are a lot of things that people find sexually stimulating, and it doesn't require intercourse in order to experience pleasure and even orgasm.

So, I have a particular formula that I speak to people about as far as in adapting to changes after illness or injury.

And it starts with trust, safety, and connectiveness.

When we have a sense of safety and when we feel like we trust our partner, then we develop a sense of connectiveness.

And that sense of trust, safety, and connectiveness has the ability to transcend any physical loss.

Stop, focus, and connect is the second part of the formula.

And what I mean by that is to slow things down.

You know, people are rushing and moving too fast.

So we have to slow things down.

We have to slow the negative chatter in our brain.

We have to focus.

It means we have to set a positive intention for pleasure, and we have to pay attention to what's going on internally, physiologically, and what's going on with our partner, and we have to connect with our partner.

So we have to be there with them.

-Probably the one thing that would help a lot is if... we knew what assistive devices were out there for us.

We get curious and look things up and wonder if they're gonna work.

There needs to be more of this out there, this kind of work to where I can go to a reference point and see a double amputee who has tried this piece of furniture or this assistive device and seen that it works for them.

-As for positioning aids and positioning devices, sometimes people that might have limited mobility, they will report feeling not as close to their partners depending on the position they're using.

So, perhaps if someone with paralysis or with limb loss was on bottom, they might feel far away from their partner.

Using positioning items like a wedge beneath their back or a pillow can help them feel closer to their partner.

-Unfortunately, there's not really, you know, a cookie-cutter way to do any of this stuff.

It's just find what works and just, you know, you gotta keep at it.

And you know, that drive and that will, because you love each other and, you know, you care about each other and you both understand each other at that level, you know, is the most important thing.

-The fact that you're limited doesn't mean that there aren't other options and you can't adapt things.

But it's something that we're constantly trying to overcome and trying to look for solutions and find ways that work for us.

-When a veteran experiences a physical disability, such as limb loss or paralysis secondary to spinal cord injury, that's when they have to really call on their creativity and their adaptability.

We're talking about adaptive toys, changing positions, maybe facilitated sex -- which means having a helper if we're with somebody else who also has a disability -- and our ability to communicate and to laugh, all to contribute to a really pleasurable sexual experience.

-Because my injury did not involve any injury or damage that would impede my sexual function, you know, it wasn't too much of a concern.

What was a greater concern, which I think is a little bit more shared within the overall blindness community related to sex, is we're missing a very important stimuli related to attraction.

Meaning we can't see, we don't have that ability to go and say, "Oh, you're looking good.

You're giving off these signs.

You're giving off this physical presence."

So, not having that piece has been my primary concern.

And, you know, that was something that was never brought up with case managers, social workers, psychologists -- no one.

No one ever brought that up as a way of saying, "So, have you guys talked about sex lately?"

-The closest thing we got to support was when urology pulled his Foley and they basically okayed sex after, you know, a certain rest period of him having a Foley catheter.

And then we had a couple really understanding nurses who realized that this is a part of life and a part of your marriage and it's important, but there is no introduction of toys, of devices.

I don't think anybody ever talked to him about masturbating.

I know with some injuries, urology will want them to masturbate, but it's all kind of from a medical standpoint.

No one talks about how it plays into here.

So, there was nothing out there at the time for us.

-It is critically important for medical professionals to ask the question.

And the question can be as simple as, "How is their sexual health?

How is your relationship?

Are you in a sexual relationship?"

And we tend to focus on sexually transmitted diseases when we ask about sexual behavior, but it's so much of a bigger question than that.

-We have 1.1 million people who are providing care -- family members, partners -- to injured veterans.

We have a tendency to identify veterans' partners as the caregiver.

And when we do that, when we label someone as a caregiver, we set up a dynamic of caregiver and patient.

And it's important to remember that caregivers are still lovers, and that people receiving care can still care for their partners in different ways.

But when caregiving really becomes something that blinds you to seeing your partner as a sexual person, then maybe you should seek some alternative way or some kind of other support, if possibly you could bring in a helper for some tasks, or if your loved one can learn to do maybe some more for themselves, that would help.

-Caregivers who are tending to the needs of an individual that they were in a romantic relationship with, tend to be spending more time in their caregiving roles.

And those that spend more time in their caregiving roles are at higher risk for experiencing depression and other social impacts of that caregiving role.

-One of my strategies for separating caregiving and taking care of him medically -- which sometimes includes very intimate, personal things you don't usually do for another adult -- and keeping our relationship alive and remaining his spouse is you have to draw a line and know when to tap out of a certain thing.

So, if there's any way that your person can learn to do something for themselves or someone else can help them, or you just find a different way to do it.

-As caregivers, you need time to yourself, you know, whether it's 30 minutes alone, you know, where you lock the bathroom door and you can actually enjoy a nice, hot bath without interruptions, or you actually get to get away.

You know, I think that's important because then you're refilled and you can come back and you can give.

-For veterans with a disability or illness, parenting can be a real challenge, from infertility treatments if you don't have children yet and you want them, to those who are parents and need to get their kids to kindergarten on time.

Every step of the way, it's going to affect the sexual relationship of the couple.

-Throughout my life, I had always wanted a child, yes, but, you know, I was always like, you know, "If it happens, it happens.

If it doesn't, that's not a problem."

-When we had first met, I had told him, I said, "You know what, I have two kids.

They're both older."

I said, "You know, you need to know going into this," when we started getting serious, I said, "I really don't want any more kids."

It's not that I don't want kids, but my kids are grown up and I can't imagine having kids 12, 14 years apart from another one.

I love kids.

I would've had, you know, eight kids if I could have.

But I said -- you know, we just sat down and we were talking, and I'm like, "Alright, well, you know what?

Let's just -- let's see what happens."

[ Laughs ] Let's see what happens.

We'll give it a few months, see if something happens, and it was meant to be, and it, you know -- and it happens.

So, we ended up with our little Johnny.

-Oh, you see Mommy?

-One of the things Tyler and I talked about very early on, because we had an existing relationship and we didn't have to go through that whole get-to-know-you stage -- we already knew each other pretty well -- was we jumped right into those hard conversations.

We jumped right into, "Look, I want a family.

I want to get married.

I want to have kids.

This is pretty much what I want.

And if you're not on the same page, then you're awesome and you're great and I like you, but it's not gonna work out, so let's not either one of us waste our time."

And luckily, he wanted exactly the same thing.

Because of Tyler's injury, we knew that we were gonna have to find an alternate way of having a family of our own, whether it's through assistive reproductive technology or through adoption, whatever it may be.

And we figured out or found out that IVF was our only option to have a biological child.

So we decided that we wanted to try for that first.

Every day for multiple months, doctor's appointments, pokes, prods, blood draws, ultrasounds, multiple surgeries for both of us, and lots and lots and lots of money.

Lots and lots and lots of time.

And the fact that now we can say we have a baby boy on the way, all of those "lots and lots and lots" don't matter.

-So much of our life right now revolves around our 7-year-old daughter, and that is the center of our life.

She was an absolute -- I wanna say blessing, miracle for us.

We did not think that we would have kids.

I mean, we were married for roughly seven years before we had her.

We had several miscarriages.

We didn't know if it was possible to even sustain a pregnancy.

This entire parenting with a disability, especially with, in my case, blindness -- it's very challenging.

So, positive -- I get to bring along an adorably cute dog wherever I go, that my daughter absolutely loves.

And she loves to talk about him to other kids that come up and say, "Hi, can I pet your dog or see your dog?"

And she loves being able to talk about that.

And some minuses also with being blind is I cannot just drive her to where she needs to go.

So our parenting style really becomes almost a single parent at times because I just can't pick up and say, "Okay, Abs, time to go to soccer, time to go to piano, time to go to swim."

I don't have that ability to just drive her there, take her there by myself.

She's not exactly at the age where I could just pop her in an Uber car without a booster seat.

So, I just don't have that full ability to be a full parent, in my view, to her because I can't exactly take her to all these places.

And then I'm not able to fully see and engage with her in what she is doing.

And she does try her best to explain what she's doing, just like everyone around me tries their best, but it's still not quite the same.

So I do feel like I'm missing out on parts of the parenting thing, which makes me wonder, it's like, "Okay, how is she gonna remember me?"

-When I realized how extensive Aaron's injuries were, the first thing that came into play was his fertility, because that's what we addressed medically.

I value him so much as our daughter's father and the way that he parents her when I'm not present, the way he interacts with her -- like, I just feel like that's just a really great gift.

I know a lot of my friends, injury or no, their husbands don't do things the way that they would like, or even worse, in this world of injury and combat injury, some husbands can't be alone with their children.

So, that's awesome.

At the end of the day, our daughter has a great parent.

I never want him to feel emasculated or that he's not good enough for me because of this.

We all have marital problems, of course, but I don't ever want him to look at his body and think this is why.

And it's like, I just -- you know, that would just hurt me, you know, that I did that to him.

And I'm sorry if I have.

-Never.

-Communication is paramount to any successful relationship, but also knowing that if it's something that you can't handle, then find resources that you know you could use to your benefit, yeah, whether it's peer counseling or therapy.

But working together and communicating, more than likely, will be able to help out whatever issues are being dealt with.

-She's amazing, like I say, she saved my life, you know, and my sanity, and kept me out of prison, probably.

You know, she held our marriage together even when I was unknowingly doing everything I could to end it, and kept our family together.

And I'm forever grateful for her for that, you know, and I'll spend every minute I got left on this Earth proving, trying to prove that she made the right decision to do that.

I had to look in the mirror and be honest with what I saw to make that change.

And it wasn't easy.

I mean, it really wasn't.

I don't like feeling like less of a man, I don't...

But at the same time...

I had to change my perspective.

You know, the problem wasn't the problem, my perspective of it was, so I had to change my perspective.

And once I did that, everything really, really... And my wife and I are stronger now, intimately and in any other way, than we have ever been.

-I would tell another veteran with a disability, that first thing to do to assist not only yourself, but the people around you -- really look at yourself.

Really take a deep, hard look at how do you view yourself with your disability.

Because the first thing that you need to do is be able to acknowledge that you have a disability.

And I really like using the term disability rather than some of the more positive or strength-based words, because we, especially within the veteran population, military population, we have such this negative view.

I'd rather stick with that, using that more negative, charged word and say, accept that negative part of you, because that's only an ability -- that's not you.

-My advice to anyone who's, you know, dealing with these struggles is, you know just to remember the love that you had before it all started.

And I mean, to pray.

For me, praying worked.

And just be willing to stick it out.

Be willing to go through, you know, the hell and fire.

Because when you come out on the other side, it is a beautiful thing.

-He medically has no reason to be living right now, but there were so many things that fell just into place and allowed us to be married and this baby to be born.

I love him more than I could ever, ever say.

And I am so grateful for every single person that helped him make it out of that battlefield that day, and for him choosing to fight and continue fighting.

-Looking back, you know, almost 12 years ago now, you know, I never thought it was gonna be possible, you know, to have these opportunities of being married with a baby on the way.

You know, it was just the furthest, you know... Like, oh, that's probably not gonna be me.

I don't ever foresee me getting the chance to do that again.

And I'm glad I was as wrong as I could possibly be on that.

-Walter Reed Military Medical Center in Bethesda has developed a sexual health and intimacy program, which will begin to address sexual health issues for the more seriously injured folks who make it to Walter Reed.

The VA, which is a separate healthcare system, is also beginning to address these issues.

Over the last several years, they began to hire marriage and family therapists.

They've trained mental health professionals to provide couples counseling, and they've instituted retreats, relationship retreats that people can go to, you know, at no charge.

-So, at Walter Reed Bethesda, we offer a variety of sexual health and intimacy services that are embedded in various departments throughout the medical center.

So, you would find it within Warrior Clinic, and addressing a lot of the needs around battle-injured service members, post-traumatic stress disorder, and traumatic brain injury.

-Don't give up.

If you ask for help and you feel like your health professional is dodging the issue, then ask again.

Ask for a referral.

You have to be your own sexual health advocate.

There's also information available online.

I know often it feels like your sex life is over, but it's not.

I mean, I could hold out example out of example of people with disabilities or illnesses that are in happy, healthy, pleasurable sexual relationships, and that's possible for you too.

-I'm living proof that sometimes it takes a while, but eventually, you just have to open up and take that leap of faith.

And it was a leap of faith with Laura, and... no regrets.

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