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Home , Rape of males, Rectum

INTRODUCTION

 The forgotten victim WHEN MEN ARE  They don ’t fit our standard profile of a sexual VICTIMS assault victim  Average population of male assault victims is Kate Espy RN, BSN, SANE -P usually 5 -10% Harrison ’s 10 -15%  Many legal jurisdiction are only just recognizing the crime of against a male victim.

INTRODUCTION HISTORY

 Male assaults occur more frequently than ever  goes back to the beginning of thought time  If assaults that occur in prisons are included in  Greek mythology king, Zeus,who was the king the statistics, as many or more men are assaulted of gods abducted other males for sexual in the U.S. on any given day than women purposes against their will  One study suggested that on average 1 in 10  In some societies the rape of a defeated male men will be sexually assaulted in their adulthood. enemy was considered the prerogative to the victor of the battle

HISTORY MYTHS

 To loose your manhood equals no longer being  Male rape is rare. able to be a warrior or ruler.  Real men do not get raped.  Lawrence of Arabia was captured by the Turks  Male rape only occurs in prisons/institutions. and raped. The subsequent disruption of his life  Only get raped can now be recognized as rape trauma  Males are less traumatized than females syndrome. Males are less traumatized than females  If the male experiences or  is considered an ultimate form of from the abuse, this means he is a willing punishment and other countries use rape of a from the abuse, this means he is a willing participant or enjoyed it male for adultery and other violations. participant or enjoyed it

1 FACTS FACTS

 Men get raped by other men  Sexual arousal or orgasmic response does not  Rapist who rape men are heterosexual in 98% of mean that positive emotions or consent were the cases. involved. It simply means that the body reacted. The act of abuse assumes or disregards a  It happens in all parts of society. victim ’s feelings. A male can have an or  Men are less likely to report rape an orgasm even when he is afraid. If a male  Males may be more traumatized by the abuse victim became sexually aroused, had an erection, than females because societal views often cause or ejaculated during the , he may them to deny there victimization and deal with it not believe that he was raped. on their own.

Prison Sexual Assaults Prison Sexual Assaults

 One in four prisoners will be raped in their first Who is targeted more? year in prison.  White  Only 1 -5% will be offered medical and/or  Small/weak counseling. Small/weak  feminine characteristics/gay  Most victims are too scared to report, due to feminine characteristics/gay knowing that more harm will occur and guards  Less aggressive will ignore  Young  Many officials polled stated that SA rarely  Good looks happens in their prisons

WHAT ARE SOME OF THE FEELINGS Prison Sexual Assaults THAT MAY BE EXPERIENCED ?

Who is doing these assaults:  Any survivor of sexual assault may experience the following feelings, but male survivors may  Gangs experience these feelings in a different way:  Long term inmates  Inmates in “high official status ”  Guilt -- as though he is somehow at fault for not preventing the assault because our society  Inmates who don ’t want to be assaulted promotes the misconception that men should be themselves able to protect themselves at all times.

2 WHAT ARE SOME OF THE FEELINGS WHAT ARE SOME OF THE FEELINGS THAT MAY BE EXPERIENCED ? THAT MAY BE EXPERIENCED ?

 Fear -- that he may be blamed, judged, laughed  Shame -- as though being assaulted makes him at, or not believed . "dirty," "weak," or less of a "real ."

 Denial -- because it is upsetting, he may try not  Sadness -- feeling depressed, worthless, to think about it or talk about it; he may try to powerless; withdrawing from friends, family, and hide from his feelings behind alcohol, , and usual activities; some victims even consider other self -destructive habits. suicide

REASONS FOR LOW REASONS FOR LOW REPORTING REPORTING  Unbelieved  Most men disclose after seeking medical services  Thought of as gay for STD issues, mental health issues, and/or legal problems  Not a real man  Not wanting to be revictimized by agencies/society  Be hurt worse in prison

SIMILARIITES TO FEMALE DIFFERENCE TO FEMALE VICTIMS VICTIMS  Know assailant  Rarely seen acutely  Experience  Teenage boys are more likely to be abused by  Request female examiners authority figures like church leader, coaches, and scout leaders.  Forensic exam similar except for a differences  Greater  More use of weapons  More non -genital .  More severe anal injures

3 DIFFERENCES TO FEMALE FORENSIC EXAM VICTIMS  More types of sexual acts being demanded.  Detailed history  In the prison system, men are bought and sold  Use quotes through out the prison or even is transferred to  Head to toe assessment with written and photo another facility. documentation of injuries.  Greater chance of violent behavior from the  Use clock to document injuries. victims due to no follow -through with law  If uncircumcised, must retract the foreskin to enforcement/support systems/prosecutions enforcement/support systems/prosecutions inspect for .  Obtain swabs from shaft, corona, and glans.

FORENSIC EXAM Glans penis, corona, shaft

 Lift up scrotal sac and exam the area thoroughly.  Due to men having denser pubic hair patterns, closely inspect for injury.  Rectal exam -- usually more injury  Knee chest very embarrassing, similar to assault.  Need sphincter relaxed, 2 -3 minutes.

Glans penis Urethral orifice and glans penis

4 Penile Shaft Penile shaft, corona, and shaft

Scrotal Sac FORENSIC EXAM

 Look for rectal injury, photo documentation, and forensic swabs.  Consider T -blue.  If unable to locate source of , an needs to be used either by yourself or the ED .  Offer STD medication, greater chance of through rectal mucosa.

LEGAL SYSTEM CONCLUSION

 Laws are the same for both sexes.  Rape of males is a wide -spread problem across  Reality is that juries don ’t convict the same. the country.  It has escaped the attention of society because of deep taboos springing from the popular misconception that to be raped is to forfeit one ’s .  Remember that women have pushed most of the rape movements across this country.

5 CONCLUSION CONCLUSION

 We continue to see rape as a women ’s issue  Don ’t change because your victim is a male. only.  Be prepared for male victims, so that the first  Need to see emphasis placed on adolescent and time you have a male victim you don ’t feel adult male rape issues. unprepared.  Remember: Don ’t re -victimize!  Examine your own attitudes regarding male victims of sexual assault.  Ensure patient ’s follow through with support systems. If possible, see them in follow up.  Work through your issues.  Find out about resources that are sensitive to  Be supportive and caring. male victims.

CONCLUSION CONCLUSION

 Work with local agencies regarding male victims.  We want to foster an environment that  Offer male victim sexual assault training to encourages male victims feel like they will get agencies that interact with sexual assault victims. help and not be re -victimized again.  Just as with female victims, we want reporting  We have been able to do it for female victims. numbers of male victims to rise. Not more We can do it for male victims as well , but more reporting.  Need to work with prison officials to take the accusation of rape seriously.

Case Study

Age: 15 year old male

History of Assault: Ran away from foster home CASE STUDIES and took the ferry to Bremerton. Picked up by a stranger and assaulted multiple times.

Injuries: Redness, soreness, and positive T -blue dye around .

6 Case Study Case Study

Age: 36 year old male Age: 17 year old male History of assault: Assaulted in the back seat of his best History of assault: Held captive for a week at his friend ’s car. Assailant was best friend ’s mother. Victim home by is significant other. Held physically stated that he had been during the night of the with restraints. Multiple assaults over the week. assault. He was brought into the ED for a mental health evaluation after becoming violent at home. Injuries: Denied any pain or discomfort. No injuries Injuries: Multiple bruises from beating with first noted except for a bruise on his hand from hitting the and a belt. Redness, soreness, and positive T - wall at home blue dye around rectum.

Case Study Case Study

Age: 18 year old male Age: 20 year male History of assault: A man called the victim and wanted to meet him at a local restaurant. Victim thought he might be from the Crisis clinic, since he had just called History of assault: Victim had been partying at a them. He was picked up outside the restaurant and friend ’s home. Woke up during the night to driven to a wooded area. The man began touching the victim and attempted to anally assaulted the victim. find an acquaintance on top of him rectally Injuries: Had bruising on forearms from assailant trying assaulting him. to put handcuffs on the victim. Complained of Injuries: Complained of discomfort to his rectum, soreness to the head of his penis due to the assailant but no injury noted. sucking on his penis.

Quote from a survivor

Questions “If ever there was a crime hidden by a Thoughts curtain of silence, it is male rape ” Concerns

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