According to a Center for Disease Control (CDC) National Intimate Partner and Sexual Violence Survey, one in six U.S. men have experienced sexual violence, and 17% of those men develop symptoms of post-traumatic stress disorder (PTSD). In my years practicing therapy, I’ve found male survivors face unique challenges to recovery, yet hesitate to get the help they need.
The question is why.
For one, we don’t hear much about male sexual assault survivors, although one study found sexual assault history was common among both women and men, reported by 25% of women and 16% of men surveyed. The research participants also faced similar long-term problems, regardless of gender.
This same study found both male and female victims faced increased risk for substance abuse, relationship problems, and suicide attempts. In addition to PTSD symptoms, the aforementioned CDC report also found male and female survivors experience physical problems such as headaches, chronic pain, or gastrointestinal symptoms.
The Gender Gap
In my clinical experience, I’ve seen that males and females each bring distinct concerns to therapy. Unfortunately, there remains a significant gender gap in research on sexual victimization — and that keeps the conversations about sexual violence often limited to female survivors.
Of course, this gap also affects mental health and general medical care. In fact, according to a 2014 study, doctors treating male survivors of sexual assault have far fewer guidelines available to them than physicians treating females do.
Simply put, male survivors have more trouble than female survivors finding knowledgeable providers when they seek help.
Stereotypes and Power
In my work with male survivors, I’ve found abuse brings up challenges to the conditioning we’ve all received about gender identity — specifically, what it means to “be a man.”
Because common male stereotypes value toughness, males must contend with society’s expectations that they remain strong and silent.
Stereotypes suggest men enjoy heterosexual experiences of any kind, so some feel unmasculine if a sexual interaction makes them uncomfortable. For example, boys abused by women sometimes wonder if there’s something wrong with them for reporting it.
On the other hand, the majority of people who commit sexual assault are male. In the case of a male perpetrator and heterosexual victim, survivors may struggle with questions about gender identity and sexual orientation.
Sexual assault often revolves more around power than gender. Male survivors also face feelings of powerlessness, wondering why they weren’t “man enough” to stop abuse.
Coping Mechanisms and Treatment Barriers
Men who have experienced sexual assault are more likely to engage in risky behaviors or substance abuse to cope with complex feelings. These problems may bring men into treatment, but they mask the underlying issues. When men feel uncomfortable disclosing assault, therapy can be less effective.
Because many male survivors experienced assault at the hands of an authority figure (think coach or youth leader), they having trouble trusting other authorities — even doctors. These men avoid medical care, even though the sexual assault also makes them more likely to have health problems.
Even with these unique challenges, therapy and other medical interventions can reduce the impact of assault history on overall health and well-being. If you decide to get help for yourself or a loved one, consider the following guidelines.
Ask Questions First
When you’re calling new therapists, ask about their experience working with male survivors of sexual assault. If you need a doctor for a physical problem, ask for an appointment to talk about your history and concerns first, even before you go in for a physical exam.
Communicate Your Needs
Let providers know how they can make you more comfortable. You can request they move at a slower pace, explain treatments thoroughly, and ask permission before any new intervention.
Plan for Setbacks
Feelings of powerlessness and other triggers in treatment can send your coping mechanisms flying out the window. Develop a plan with your provider for how you’ll handle distress, perhaps by taking a break to regain composure or briefly changing topics.
Look for Signs of a Good Match
Does the provider respond to your assault story with close attention and a supportive tone? Does the provider explain interventions, answer questions, and seek your input?
The Therapeutic Relationship
Most therapists, myself included, welcome feedback to make you more comfortable through a difficult process. Therapy is hard work, but it’s a collaborative relationship. Being open with your therapist about your feelings in the here and now, within that relationship, brings about the best care.
Although male survivors of sexual assault face distinct challenges receiving the treatment they need, it is possible to find knowledgeable, sensitive providers who can help you face those challenges.
What’s more, coming forward with your experiences not only helps you feel better, but helps the medical community better understand the needs of this too-often silent group.