By Jessica K. Spicer, MPH, and Dr. Derrick Edwards
On any given shift, a firefighter, EMT or paramedic plays a figurative game of Russian roulette dictated by the unpredictable “EMS/Fire Gods.” Violence, overdoses, car wrecks — in a single shift, emergency responders may witness more tragedy than most people see in a lifetime. The calls stack up, and with them comes a quiet, heavy toll.
Over the last decade, suicide, post-traumatic stress disorder (PTSD) and burnout among emergency responders have risen to alarming levels, outpacing those seen in the general population. But trauma does not always end in despair. For some, an experience that once seemed unbearable can lead to resilience, strength and even a new sense of meaning. This phenomenon is called post-traumatic growth (PTG) — the idea that hardship can spark personal development. Today, PTG is being studied alongside PTSD as researchers try to better understand responder mental health.
| STAY INFORMED: 2025 AHA CPR guideline changes — mechanical CPR, choking, single chain of survival
With this in mind, I set out to explore a simple but important question: Do male and female emergency responder experience trauma differently?
Resilience in focus
I surveyed 111 firefighters, EMTs and paramedics from several fire and EMS agencies. The breakdown of participants was 77% male and 22% female.
Participants completed a questionnaire with three validated tools:
- The Life Event Checklist to capture trauma exposure;
- The PTSD checklist to measure symptoms; and
- The Post-Traumatic Growth Inventory to assess how much growth they reported after trauma.
For reference, the PTSD Checklist (PCL-5) has a score range from 0-80, higher scores reflecting more severe PTSD symptoms.
The results from this checklist were eye-opening. Female responders reported significantly higher PTSD symptoms than their male peers. On average, women scored nearly 40 on the PTSD scale compared to 25 for men. This pattern is consistent with broader research indicating higher PTSD vulnerability among women in both the general population and emergency services. While the current study does not address the underlying reasons for the increased vulnerability, prior literature has found limited female peer support models, exposure to harassment and exclusion, and broader psychosocial differences all contribute.
Even more intriguing was that when examining the results associated with post-traumatic growth, there was no difference between men and women. Both groups reported similar levels of growth, meaning female responders are every bit as capable as their male counterparts of finding strength, resilience and new meaning after hardship.
The connection between the two was even more telling: Higher PTSD was modestly linked with higher PTG. In short, those who struggled also found room to grow.
Key takeaways
These results carry important lessons for the fire and EMS community. First, women face greater PTSD risk. Agencies need to provide behavioral health supports that are accessible and sensitive to the needs of female responders. Just as importantly, the findings reinforce that women are just as resilient, just as capable of healing, and are just as able to achieve post-traumatic growth as their male peers.
Here’s how fire/EMS agencies can take action:
- Normalize mental health conversations for all.
- Build strong peer and leadership support systems.
- Highlight PTG as part of the healing process. Growth is not limited by gender, and it is part of the shared human response to trauma.
Bottom line
Emergency responders will always face trauma. But growth is possible for every responder. By embracing this truth and supporting both men and women in their healing journeys, departments can foster resilience, strengthen camaraderie, and ensure that all who wear the uniform know they are valued, capable and not alone.
ABOUT THE AUTHORS
Jessica K. Spicer, MPH, is a former psychology researcher at Tennessee Tech University. Her work focuses on the mental health of emergency responders, with a focus on post-traumatic growth and resilience.
Dr. Derrick Edwards is an associate professor of psychology at Tennessee Tech University.
