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 rape against a male victim. INTRODUCTION HISTORY Male assaults occur more frequently than ever Rape of males 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 gay men 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 sexual arousal or orgasm Gang rape 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 erection 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 sexual assault, 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 man." 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, drugs, 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 rape trauma syndrome 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 anatomy differences Greater violence More use of weapons More non -genital injuries. 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 injury. 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 rectal bleeding, an anoscopy needs to be used either by yourself or the ED physician. Offer STD medication, greater chance of transmission 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 masculinity. 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 rapes, 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 rectum. 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 drinking 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 7.