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Behavioral and Physical Health Effects on Male Sexual Assault Survivors — What Professionals Need to Know

By Sue Coyle, MSW

Over the past several years, sexual assault—its prevalence, varying forms and impacts—have come to the forefront of societal conversation. This is in part due to high-profile cases, media attention, and the willingness of survivors to share their stories.

However, the discussion stemming from this movement has revolved largely around the assault of women. And while it is true that the majority of juvenile and adult survivors of rape are female, narrowing the conversation excludes other victims, such as adult males. According to the Rape, Abuse & Incest National Network (commonly known as RAINN), “1 out of every 10 rape victims are male.” Also, according to the 2011 The National Intimate Partner and Sexual Violence Survey, “one in 71 men will be raped at some point in their lives.”

Not including male victims of sexual violence in the increased awareness risks limiting the support available to them—not just from the general public and the survivors’ individual support systems but also from the professionals tasked with understanding and addressing the short- and long-term effects of sexual assault.

Fortunately, researchers and service providers are paying attention to this need, and in doing so they will be better able to determine how to deliver services to male survivors.

Identifying as Survivors
There are a number of reasons why male sexual assault survivors have been less seen, and it is not simply because their numbers are less than those of female survivors.

For a long time, the definition of rape only acknowledged the assault of a woman by a man. According to the United States Department of Justice, ‘Forcible rape’ had been defined by the Uniform Crime Report Summary Reporting System as “the carnal knowledge of a female, forcibly and against her will.”

The Department of Justice continues, “That definition, unchanged since 1927, was outdated and narrow. It only included forcible male penile penetration of a female vagina.”

The definition has since been changed and expanded to include any gender of victim or perpetrator. It now also acknowledges that penetration may occur with an object and that rape has occurred when a victim is unable to consent due to incapacitation, age, or other factors.

Further, it is important to note that the understanding of sexual violence has expanded beyond rape as well. There are multiple forms of sexual violence, explains R. Lane Forsman, LMSW, a doctoral candidate at the College of Social Work and research technician at the Institute for Justice Research and Development, both at Florida State University. These include but are not limited to unwanted sexual touching, attempted penetration, and completed penetration.

Even with a broader definition of sexual violence, there can be some hesitation and confusion about identifying sexual assault against a male survivor.

“Men may not know that they’ve experienced sexual violence,” Forsman says, “because of the discourse around sex. It can take a while for men to realize, ‘Wow, I didn’t want that to happen.’”

Additionally, Forsman says, male survivors can have a difficult time separating a physical reaction during the assault from their psychological willingness to be there. There is a prevailing misassumption that if a man is able to engage in a sexual act and/or experiences an orgasm, it cannot be assault. This can lead to fewer men coming forward and seeking assistance.

What’s more, “Women are perpetrators, but statistically speaking, it is more likely that perpetrators would be male,” Forsman says. “[Thus, as a male victim,] you’re more likely to have a perpetrator the same gender as you. Men will run into the concept of their sexual identity when seeking help. If they are straight, they may fear being categorized. And if they are not straight and not open about their identity, they may fear being outed.”

All of these factors have led to less-consistent reporting and less awareness of male survivors of sexual violence.

Behavioral and Physical Health Effects
Despite these barriers, researchers such as Forsman are working to better understand how sexual assault impacts male survivors. It is known that males, in some ways, experience the effects differently from female survivors.

For example, “Men may have more aggression,” Forsman says. “They are possibly more likely to experience aggressive tendencies after an assault.” Their initial reaction and response are based in anger more often than a female survivor’s response may be.

Men are also more likely to struggle with substance use, specifically alcohol, after an assault. This is not surprising, as studies have found that, generally speaking, men are more likely to be consumers of alcohol, marijuana, and other illicit substances. Additionally, sexual assault survivors regardless of gender are more likely to use substances. According to a report issued by the Pennsylvania Coalition Against Rape, “When compared with nonvictims, rape victims are 3.4 times more likely to use marijuana, 5.3 times more likely than nonsurvivors to use prescription drugs for nonmedical purposes, 6.4 times more likely to use cocaine, and 10 times more likely to use hard drugs other than cocaine.”

There can also be changes in sexual functioning after a sexual assault, Forsman says. “It can go one of two ways,” he explains. “[The survivor] may either have trouble engaging in sex in the future or may engage in riskier behaviors.”

Physically, male sexual assault survivors are at risk of sexually transmitted infections, as well as physical damage to the body depending on how the violence occurred. In fact, “Sexual assault directed against gay men is more likely to involve higher levels of violence, use of weapons, and multiple assailants. Statistically, male survivors are at higher risk of suicide. And while they don’t become pregnant, male survivors of anal rape are at a high risk of internal damage, which leads to a greater possibility of HIV infection,” according to the Association of Alberta Sexual Assault Services.

Forsman adds that overall poor health and sleep disruptions are other common symptoms that can stem from PTSD and other behavioral health concerns resulting from the assault.

Making Services More Inclusive
While many of the effects male survivors experience are similar to those experienced by female survivors, there are—as noted above—differences, and as such, the services that males receive should not be identical to those offered to females. Providers appear to be aware of this but in a way that is not necessarily helpful to the men seeking assistance.

Forsman says that he has seen firsthand service providers welcome men but with significant hesitance. “[They] said, ‘We’re willing to help, but we don’t know if what we have really works for you.’”

And it would seem that the males have a similar reluctance. In the research that Forsman has been doing, he has noted that most college students view the sexual assault resources available on campus as women’s centers. Such an understanding would likely deter a male survivor from seeking help there.

Does this mean that there need to be specific centers for male sexual assault survivors? Not necessarily, Forsman says. Rather, there needs to be an evaluation of the services available currently and how they suit (or do not suit) male survivors. It is possible that services simply need to be tweaked. It is also possible that new interventions and prevention plans need to be put into place. Ultimately, it is up to the researchers and the service providers to work together to better serve this population of survivors.

Furthermore, Forsman adds, as the professionals begin to better serve male survivors of sexual assault, there must also be recognition that cisgender male and cisgender female are not the only gender populations affected by sexual violence. Forsman’s research has also examined the effects of sexual assault on transgender females and transgender males—two additional populations that, again, do not encompass all.

Appropriate, quality, and prepared services need to be available to all individuals, because all individuals are at risk and are impacted by sexual violence.

— Sue Coyle, MSW, is a freelance writer and social worker in the Philadelphia suburbs.