Worldwide developments in the conceptualisation of trauma over the twentieth century have largely guided clinical practice in Australia. However, domestic political and military imperatives have ensured that understandings of war-related trauma also follow what Fassin and Rechtman (The empire of trauma: An inquiry into the condition of victimhood. Princeton University Press, 2009) label a ‘moral genealogy’. In ensuring that the process of diagnosis adheres to gendered constructions of the Australian, predominantly male, citizen, medical personnel have assessed and categorised trauma both clinically and according to the perceived ‘status’ or ‘social usefulness’ of victims. Military-medical authorities thus minimised the link between combat and trauma among archetypal Australian soldiers, instead pointing to personal attributes or family histories in determining the aetiology of traumatic symptoms. Ideas about heredity and degeneracy that dominated the management of military mental health were supposedly challenged by the inclusion of post-traumatic stress disorder in the 1980 Diagnostic and Statistical Manual of Mental Disorders (DSM-III). This new categorisation moved away from victims’ personal histories and revived nineteenth-century conceptions of the violent event and traumatic memory. Despite this shift, the findings of the Royal Commission into Defence and Veteran Suicide (2021–2024) suggest that the ‘moral genealogy’ of war trauma still guides everyday practice. This chapter explores these shifts and continuities using political and military archives alongside historical and social perspectives on mental health.