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March/April 2011 Issue

Male Survivors of Childhood Sexual Abuse — Looking Through a Gendered Lens
By Lindsey Getz
Social Work Today
Vol. 11 No. 2 P. 20

Social workers must be prepared to look at the adult male survivor’s experience in a different light from that of a female survivor.

When working with sexual abuse survivors, it’s important to remember that no two cases are exactly alike. Although there are some similarities that can help social workers prepare and train to work with these clients, it’s still a mistake to lump male and female experience together, as they are unique in their own right.

Over the years, sexual victimization has often become characterized as a “women’s issue,” and many social workers aren’t adequately prepared to work with adult male survivors as more emerge from their silence and struggle to overcome sexual abuse from their past.

“Most clinicians are trained to work with women and children—it’s just always been the focus of sexual abuse,” says Anthony D. Rodriguez, MSW, LISW, LCSW, BCSA, a certified sexual addiction therapist and clinical director of The Men’s Center based in Rock Island, IL. “We might be educated on how to help the boy, but we’re not trained to work with the boy who becomes a man.”

“When we talk about sexual violence, we know that trauma is fairly universal, regardless of one’s culture or gender,” adds Rick Goodwin, MSW, RSW, executive director of The Men’s Project based in Ottawa, Ontario, Canada. “But because our gender defines much of who we are and roots us in our upbringing, we do require a gendered lens to engage with male survivors.” In other words, social workers must be prepared to look at the male experience in a different light from that in which they view the female experience.

For example, there are some notable differences that must be addressed when dealing with male clients. One involves masculine gender socialization.

“We’re all socialized to believe that men are resilient and self-sufficient,” says Richard Gartner, PhD, a training and supervising analyst at the William Alanson White Institute in New York City where he is faculty and founding director of the Sexual Abuse Program. He is also a founder and past president of MaleSurvivor, the National Organization on Male Sexual Victimization. “We’re led to believe that men are not victims and they don’t turn down sex—they’re in charge of sex. All of these things make it difficult for a man to acknowledge he’s been victimized. Often men will even rewrite the history and say they were the one who was in charge of the situation or they’ll say it didn’t bother or affect them.”

Gartner, who is the author of several books on sexual abuse, including Beyond Betrayal: Taking Charge of Your Life After Boyhood Sexual Abuse and Betrayed as Boys: Psychodynamic Treatment of Sexually Abused Men, says these factors make it difficult for men to open up about their experiences in the first place. Coupled with the fact that men are socialized to not verbalize emotions, it can be a challenge to get them to talk about what happened to them. In addition, if the perpetrator was a woman, which is more common than once thought, the victim may be even less willing to admit he was negatively affected by the experience.

“It’s hard to admit that contact with a woman was victimization,” explains Gartner. “Let’s say it was a teacher or a babysitter. The victim’s friends are likely to say he was a ‘lucky guy,’ so he has nowhere to go with those feelings. In these cases, male victims often close up and decide to never talk about it again or to say it didn’t affect them.”

Frequently, men may start treatment because of another, though often related, issue, such as struggling with the sexual relationship in their marriage. It may take multiple sessions for the true history to unfold, but from the start, the client will likely be gauging whether he feels comfortable about opening up.

“When men come in for treatment, they’re not just going to come out and talk about their abuse,” says Rodriguez. “For me, the clinician, I need to read between the lines and evaluate what’s really going on.”

Rodriguez says doing this can put a lot of pressure on a social worker, especially because sexual abuse victims often already have “great radar,” meaning they’re often quite in tune to how the other person is reacting to them. “If the clinician is not handling it well in any way—maybe presenting his or her own biases about gender or sexual issues—it can shut the conversation down immediately,” says Rodriguez. “If social workers want to work with these clients, they should have a good understanding of their own sexual biases toward various issues and how they’re reacting to information the client is sharing.”

Key Differences
Another key difference between the male and female experience comes down to confusion over sexual orientation. Because of the physical makeup and anatomy of the male species, the victim may have become aroused (had an erection) during the experience, even if he was an uncomfortable or unwilling participant.

“Some perpetrators may use it against their victim, making them think that because they were aroused it was their fault,” says Ken Singer, MSW, LCSW, executive director of New Jersey’s Association for the Treatment of Sexual Abusers and past president of MaleSurvivor, “or say, ‘You’re gay—look, you have an erection.’” Singer, who is the author of Evicting the Perpetrator: A Male Survivor’s Guide to Recovery From Child Sexual Abuse, says this often makes young men unwilling to “tell” on the person who abused them.

In addition, Singer says male-male abuse can make sexual orientation incredibly confusing for a young victim. “If the abuse was not painful or perhaps not even perceived totally negatively because the boy experiences sexual arousal, pleasure, or even orgasm, maybe even before they’re old enough to ejaculate, then it can be very confusing,” he explains. “The victim is overwhelmed by these strange and scary but also pleasurable feelings.”

The idea that young men abused by men are or will become homosexual is just one myth that MaleSurvivor hopes to overcome. Another big myth is “vampire syndrome,” or the idea that boys who are sexually abused will go on to sexually abuse others, just like in the myth that those bitten by a vampire are destined to become vampires themselves. This has proven untrue, yet society continues to perpetuate the myth.

Gartner adds that this is another issue men often must tackle, as opposed to female survivors, making it more challenging for men to come forward. Society isn’t so worried about sexually abused women becoming future pedophiles, but they generally embrace this belief with male victims.

“It’s simply not true,” Gartner says. “The overwhelming majority of young male victims will not grow up to become sexually abusive men. Still, they are often very afraid they will be, even if they don’t have any fantasies. Or they may think that their flashbacks of their own abuse are proof that they’ll be abusive or are having fantasies. All of this makes these victims afraid to tell anyone since they think they’ll be perceived as a potential abuser and not be allowed to be around children. I once spoke with a client that was afraid to tell his sons and daughters-in-law about a past abuse because he worried he’d be denied access to his grandchildren.”

While society continues to hang on to this belief, Rodriguez says he believes some clinicians can perpetuate it as well. “It does irritate me that some clinicians attempt to ‘catastrophize’ the situation,” he says. “They jump to the worst-case scenario: ‘You’ve been sexually abused, so you’ll be traumatized your whole life’ or ‘You’ll sexually abuse others.’ I have friends that have gone on to be doctors, lawyers, and presidents of universities that have been sexually abused as children. Male survivors need to have role models, not be subjected to these worst-case scenarios.”

Though it’s a myth that all abused men will go down the wrong path themselves, certainly some do respond to their trauma with rage and/or violence, even if not becoming sexually abusive themselves, says Goodwin. This is another difference between male and female survivors.

“In some cases, we need to understand that what we’d consider an example of men’s dominating or violent behavior could actually be an expression of victimization,” Goodwin continues. “That’s a tough one for even some social workers to understand because if we picture a bike gang, our first thought is not that they are guys who were victims. These guys aren’t ‘good clients’ in terms of the social work business, and I don’t think as a field we’ve done a very good job at working with clients who we decide are not ‘good clients.’ Men may fit that preponderance for rage and dominance, and sometimes social workers, though they wouldn’t necessarily admit it, will simply feel they are not people they want in their waiting rooms. That can be unfortunate for the victims who sometimes have nowhere to turn.”

Treatment and Recovery
Unfortunately, there are not many training opportunities for social workers who want to work with adult male victims, and nationwide there are few organizations like MaleSurvivor, The Men’s Project, or The Men’s Center that really focus on men as these groups do. The experts say that while these programs are just starting to emerge, there are already many opportunities for social workers to educate themselves specifically on male victims. Gartner’s book Betrayed as Boys was written for therapists who are working with or plan to work with these clients. “That’s important because most of the books out there were written for sexually abused men, not for their therapists,” says Gartner.

It’s also important for social workers to read books written specifically for abuse survivors to determine whether patients can benefit from reading them as well “Just be sure to tell the client not to read the book all at once,” says Gartner. “And that’s true for therapists too. My book is a difficult read. I tell both clients and therapists to put it down if they start to feel overwhelmed.”

There’s no question that working with male survivors can require a delicate approach. Reading about survivors’ experiences will help social workers better understand what a victim is going through. Treatment often comes down to walking a fine line, according to Gartner. “On one hand, it’s very important not to give the impression that you’re interested in the details of the experience,” he says. That can make the patient feel pressured, and it can easily make them close down.

Still, survivors do need to open up eventually to make treatment effective. Take a slow approach and don’t make the client feel pressured, says Gartner. “You obviously need to get the person talking because it’s important to know the details so they can start working it out. I always tell a client not to go faster than they can. You do not want to traumatize someone into sharing more details than they’re ready to share,” he says.

Singer stresses the importance of allowing the survivor to maintain control during the treatment process because the loss of control during the abuse was part of the trauma. “Anything that smacks of ‘You need to work on this’ or anything else that comes off as an order is going to feel like control to the victim,” Singer explains. “The process needs to be client centered and within their control. The therapist is almost more of a guide to these clients.”

And wording is critical as well. “Don’t come out and ask, ‘Have you been sexually abused?’ because that makes the patient feel like a victim, like less of a man,” says Gartner. “Ask in a neutral way by inquiring about early sexual experiences. Research has shown that when you ask a man if he’s been sexually abused, he’ll often say, ‘No,’ but if you start asking about sexual situations the man didn’t like, he may start to share details.”

In terms of a social worker’s gender, Goodwin says that’s a highly individualized issue that may or may not come into play. At The Men’s Project, there are both male and female therapists available as it’s an issue for some clients, while others may have no preference.

“Sometimes a preference for gender by the survivor may be based on who the perpetrator was,” says Goodwin. “If it was a female, they may prefer to see a male. That’s certainly a variable that needs to be considered.”

And while many social workers simply won’t have the experience of having worked with actual victims, the more they educate themselves through reading and online resources such as MaleSurivor.org, the better they can relate to their clients.

“The better educated you can be as a therapist and the more you know, the more commonality you’ll have with your client, even if you’re not a personal survivor yourself,” says Singer. “And I don’t believe you have to be [a survivor] to be able to successfully work with these clients. This advice goes with experience of any area: The more you educate yourself, the better you’ll be able to relate.”

— Lindsey Getz is a freelance writer based in Royersford, PA.