At least once a day, on average, Atlanta’s Veterans Administration Medical Center is alerted to another case of a woman in mental and emotional pain because she was raped, groped or sexually harassed by someone else in the military.

Some call or walk through the doors seeking help. Others are referred by outside doctors or therapists but never show up. Altogether, their numbers are almost double what the VA saw in 2011 — mirroring a surge in both the number of cases nationwide and public discussion of a problem long consigned to the shadows.

BriGette McCoy, a victim who lives in Atlanta and works to bring attention to the issue, thinks the numbers represent an actual increase in sexual assaults and harassment in the ranks.

“More people are being raped,” McCoy said, and Georgia, with its many military bases, will inevitably feel the fallout.

Atlanta VA officials, meanwhile, attribute the increase to more victims coming forward, rather than more attacks. The truth is unknowable, because, as in the civilian world, evidence suggests that only a fraction of victims file formal complaints.

Whatever is causing the number of reported cases to swell, scrutiny from Congress as well as the media has Pentagon officials vowing meaningful reform. At the same time, though, top brass in a Senate hearing Tuesday resisted proposals such as one that would take away commanding officers’ discretion to prosecute or not prosecute accused attackers.

“Making commanders less responsible and less accountable will not work,” said Gen. Ray Odierno, the Army chief of staff.

Such responses are disheartening to many victims, who say they’re accustomed to false promises of reform. They say the military must do far more to punish attackers, make victims feel comfortable coming forward, and improve treatment.

And they point to recent wolf-in-sheep’s-clothing incidents, including the arrest of the Air Force officer in charge of sexual assault prevention. His alleged crime: groping a woman in a parking lot.

Fundamentally, the root of the problem is simple, said one northeast Georgia woman who said she was both raped and sexually harassed in the Navy.

Her male colleagues “thought our bodies — women — belonged to them,” she said. The woman requested anonymity, and The Atlanta Journal-Constitution’s policy is not to name victims of sexual assault unless they choose to go public.

Like many women, the Navy veteran did not report the incidents. She said she was afraid to report the rape because the attacker was her supervisor — the person she would report it to.

Afterwards, she had to return to work with him. That, she said, deepened the emotional damage.

“I went into freeze mode,” said the woman. “I had no feelings.”

She felt betrayed by the military, since she had believed she joined an organization where people watch out for and protect one another.

“It was the ultimate betrayal,” said the woman, who is now 50. “You think they are people who are going to help you, but it seems like they’re just watching you and planning.”

She waited almost 20 years to seek help. For many of those years she did not even know what was driving her to depression and sometimes thoughts of suicide. She dreaded leaving the house, and was angry much of the time. She purposely gained weight to become less attractive to men, but that led to health problems.

McCoy, who testified before a Senate subcommittee in March, also did not report being raped — in her case, twice. The first attack, by a superior non-commissioned officer in the Army, came two weeks before her 19th birthday in 1988. The second was later that year, by a soldier in her unit in Germany.

Finally, in 1991, she filed a formal complaint after a non-commissioned officer sexually harassed her with inappropriate talk and touching.

“Then it got crazy,” she said.

People in her unit stopped talking to her, she said, and she was given extra duty. A superior pressured her to leave the service. No action was taken against the person she complained about; actually, she said, he was promoted.

“It was like everybody stepped away,” she said. “I felt bad all the time.”

McCoy did leave the service, obtaining an honorable discharge in 1991. For years afterward, she struggled with depression and suicidal thoughts. She hid in her house, afraid that if she went out her attackers would somehow find her and hurt her. For a time she was homeless in Atlanta.

Military officials say they’ve made many changes to prevent assaults and make victims’ lives easier: training and education programs, expedited transfers for victims, trained responders and victim advocates in brigades, a 24/7 sexual assault hotline.

At the Atlanta VA, about 20 percent of the women who come for medical treatment say they suffered some form of military sexual trauma, or MST, as the therapists call it. The VA defines military sexual trauma as any sexual activity where a person is involved against their will, ranging from sexual harassment to rape.

The local data align with the national average for women in the military, said Meghna Patel, a clinical psychologist and leader of the MST team at the Atlanta VA.

In 2011, the unit got 201 referrals for sexual trauma; in 2012 the number was 323. In the first five months of this year, the unit got 167 referrals for MST, putting it on course to have 400 this year.

“It is kind of straining on the staff,” Patel said. Nevertheless, she said, “I don’t think it’s decreasing the quality of care.”

As politicians, advocates and military officials wrangle over causes and solutions, therapists and researchers are working to tailor treatments for MST patients, said Ursula Kelly, an assistant professor at Emory’s nursing school.

Most are treated with techniques developed to help civilian women who were raped and male combat veterans suffering from Post Traumatic Stress Disorder. It’s not yet clear how effective that treatment is for people with MST, Kelly said.

“A lot more research needs to be done,” she said.

So painful are the memories that many victims find it impossible to revisit them, said Kelly, who also works at the VA medical center. Many victims also suffer from high anxiety and a constant sense of being threatened, she said.

She recently got a $100,000 grant from the VA to explore a therapy that uses yoga “on a physical level to calm that down.” She has begun testing the therapy with small groups at the VA.

McCoy, who is 43, said she received little help for her emotional problems at the Atlanta VA. She sought help elsewhere, eventually creating her own support group.

“I do not use the VA (for mental health issues.) We’re like oil and water,” she said. “You’re either too well for them to help you, or too screwed up.”

In contrast, the Navy veteran praised the VA program, saying it “gave me back my life.”

“Now I’m where I can talk about what happened,” she said. “I know I’ll never be 100 percent, but now I can mingle with others.”

Cynthia Barren, an independent training consultant in Fairburn, is on the front lines of change in the military. For the past 18 months, she has been teaching two-week classes to Army soldiers in bases around the country, including Fort Benning and Fort Gordon in Georgia.

Barren teaches the soldiers about the difference between playful flirtation and sexual harassment. She instructs them on why sexually explicit language is inappropriate for the work place, and when one soldier should intervene when another has stepped over the line.

But she knows she is bucking an ingrained culture of machismo, and she sees resistance to change.

“People want to hold on to the old culture,” she said.

She sees signs of trouble in the way some soldiers talk about women’s role in the military. When they assert that women can’t handle combat conditions, she hears an underlying message that women have less worth.

“It draws a wedge between the genders,” said Barren, herself an Army veteran. “The soldier thinks, ‘She’s not like me, so it’s OK for me to treat her like this.’”

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Sexual crimes in the military

* The Pentagon tracks “unwanted sexual conduct,” which includes physical acts such as rape or groping.

** The VA tracks “military sexual trauma,” which can arise from harassment as well as physical acts.

Sources: U.S. Department of Defense; Atlanta Veterans Administration Medical Center