The Treatment Needs of Sexually Abused Men

THE TREATMENT NEEDS OF SEXUALLY ABUSED MEN

The Role of Sexism and Homophobia in Denial
BY KALI MUNRO, M.Ed., Psychotherapist, 2000

Men who have been sexually abused as children often feel a great sense of isolation. That isolation is worsened by a society that has difficulty acknowledging the sexual abuse of boys.

The sexist belief that men, even as children, are invulnerable to sexual victimization stops many people from believing male survivors of sexual abuse, or from taking the abuse seriously. Homophobia is at the root of the widespread view of male-to-male sexual abuse as sex, and the victim as a “faggot.”

Both of these oppressive belief systems are routinely communicated to children. They leave male sexual abuse survivors confused and ashamed about the abuse, their gender, and sexuality. These belief systems effectively silence abused boys, and stop them from being believed. Even psychotherapists, can overlook the possibility of sexual abuse and incest in male clients reserving that possibility only for female clients.

The widespread myth that women are incapable of sexual abuse also serves to silence boys and men who are sexually abused by women.

THE RAISING OF BOYS AND MEN
In Western culture, men are raised to deny and mask their emotions. They are expected to be “strong,” productive, physically active, and concerned with making money. There is little room for them to feel scared, vulnerable, or sad. Anger is often the only outlet offered to men. Abused men who act out of their anger often end up in the criminal justice system.

Other men numb themselves to the pain of their abuse, telling themselves that it wasn’t so bad, or hoping it will just go away. They may end up in psychiatric institutions, or in drug and alcohol treatment programs. Either way, they are invisible as sexual abuse and incest survivors, leaving them alone, depressed, angry, and without appropriate support and treatment.

Boys grow up learning that they are not like girls; they will become men. If they are viewed as being “like a girl,” they are labelled “sissies,” “pussies,” “girls,” or “faggots.” Boys learn that they will not be victims of sexual abuse: only girls can be. They learn that it’s not possible for them to be victims of women, afterall women don’t do those kind of things and any sexual activity between a woman and a boy is always wanted by the boy. Popular culture reinforces this myth.

Sex between boys is considered sick, bad, and it is what “faggots” do?real men are not “fucked.” Add these messages and myths to the common but mistaken belief that males cannot achieve an erection or ejaculate unless they are aroused, and we have a powerful and pervasive belief system that sets boys up to blame themselves, deny their pain, feel ashamed, and keeps them silent for fear of being viewed as less than a man or worse as a “faggot.”

TREATMENT ISSUES
Some men, despite these numerous obstacles are able to disclose and are believed. Often they tell a lover or a therapist. However, there are very few resources that are specifically designed for sexually abused men. Ones that do exist often fail to address homophobia and sexism, which have a direct impact on all men, including straight men. Services also often fail to challenge stereotypical notions of the male gender role which perpetuate shame, feelings of inadequacy, and non-disclosure. Rarely, do services extend themselves and respond to the specific needs of abused gay men.

There are a number of treatment issues specific to men who have been sexually abused.
Among them are:

Self-blame

Feelings of inadequacy and shame about their gender

Confusion, inner conflict, fear and shame about their sexuality

Mistaking male-to-male sexual abuse for gay sex

Fear that having been abused by a man means that they must be gay, or that it caused them to be gay, and for many gay men: the inner conflict arising from the fact their introduction to the possibility of male-to-male sex was abuse

Feelings of inadequacy for continuing to be affected by the abuse

Minimization of the abuse and its effects

Problems with relationships and sex that stem from inner conflict about their gender and sexual identification

On the whole, men make few, if any, disclosures of the abuse to others; receive little or no support and understanding from others; and have profound feelings of being different, stigmatized and alone.

TREATMENT
In my experience, while individual therapy may be best suited to the initial stages of treatment, it is the group experience that is the most powerful tool for healing and change. Men in our society are generally isolated from each other, but this isolation is even more intense when they have been sexually abused. They have an profound need to connect with each other, and to explore how they have been effected both by the abuse and the larger context of denial, blame and shame. The following are some of the themes that I include, in the form of exercises or facilitated discussion, in groups for men who have been sexually abused:

The different forms of abuse: Many men focus on the sexual aspect of the abuse and not the totality. They may overlook: coercion, the nature of the relationship with the perpetrator, power differences, emotional abuse, and any other abuse they experienced as a child. Broadening their understanding of abuse helps to reduce their self-blame.

Effects of the abuse and coping strategies: Many men have not looked at the whole picture of how the abuse has and continues to effect their lives. They may have viewed their coping strategies as “weaknesses” rather than self-protection. Focusing on this theme helps to reduce their tendency to minimize and to feel badly about themselves.

The larger context: It is important to examine the messages they received at home, and from their community, about themselves and what it means to be male. It can help to explore how these messages left them vulnerable to: being abused, feeling ashamed, and staying silent. This work can be very empowering for men and helps them to feel angry about not being protected.
Permission to feel: Many men have never let themselves cry, feel sad, or grieve the abuse, particularly in the company of other men. Encouraging and supporting men to express their feelings and to be vulnerable with one another is important work.

Permission to have needs: As children, many men’s emotional needs were rebuffed, particularly by their fathers. Sexual abuse reinforces this: it tells them that their needs are not important, and that men are not supportive; they reject and abuse. Men need to have opportunities to give to and receive support from other men, in order to break these patterns and to affirm their male identity.
Sexuality: It is important to encourage men to explore their beliefs about and problems with their sexuality, particularly as it relates to sexual abuse. An openness about gay, bi and straight sexuality is essential and encourages a thorough exploration of their true feelings. Ambivalence and confusion may be an important part of the process for both gay and straight men.

While there are many overlaps in the treatment needs of men and women, there are important differences too. Until we address those differences, men are not going to receive the support that they deserve. In listening and responding to male survivors, all of us will benefit.