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 don’t recognize a 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. WHAT ARE SOME OF THE FEELINGS WHAT ARE SOME OF THE FEELINGS THAT MAY BE EXPERIENCED? THAT MAY BE EXPERIENCED? Any survivor of sexual assault may experience the following feelings, but male survivors may Fear -- that he may be blamed, judged, laughed experience these feelings in a different way: at, or not believed. Guilt -- as though he is somehow at fault for not Denial -- because it is upsetting, he may try not preventing the assault because our society to think about it or talk about it; he may try to promotes the misconception that men should be hide from his feelings behind alcohol, drugs, and able to protect themselves at all times. other self-destructive habits. WHAT ARE SOME OF THE FEELINGS REASONS FOR LOW THAT MAY BE EXPERIENCED? REPORTING Unbelieved Shame -- as though being assaulted makes him Thought of as gay "dirty," "weak," or less of a "real man." Not a real man Not wanting to be revictimized by Sadness -- feeling depressed, worthless, Not wanting to be revictimized by powerless; withdrawing from friends, family, and agencies/society usual activities; some victims even consider suicide 2 REASONS FOR LOW SIMILARIITES TO FEMALE REPORTING VICTIMS Most men disclose after seeking medical services Know assailant for STD issues, mental health issues, and/or Experience rape trauma syndrome legal problems Request female examiners Forensic exam similar except for a anatomy differences DIFFERENCE TO FEMALE DIFFERENCES TO FEMALE VICTIMS VICTIMS Rarely seen acutely More types of sexual acts being demanded. More likely abused by authority figures like Greater chance of violent behavior from the church leader, coaches, and scout leaders. victims due to no follow-through with law Greater violence enforcement/support systems/prosecutions More use of weapons More non-genital injuries. More severe anal injures FORENSIC EXAM FORENSIC EXAM Detailed history Lift up scrotal sac and exam the area thoroughly. Use quotes Due to men having denser pubic hair patterns, Head to toe assessment with written and photo closely inspect for injury. documentation of injuries. Rectal exam--usually more injury Use clock to document injuries. Knee chest very embarrassingembarrassing,, similar to assault. If uncircumcised, must retract the foreskin to Need sphincter relaxed, 2-3 minutes. inspect for injury. Obtain swabs from shaft, corona, and glans. 3 FORENSIC EXAM LEGAL SYSTEM Look for rectal injury, photo documentation, Laws are the same for both sexes. and forensic swabs. Reality is that juries don’t convict the same. 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. CONCLUSION CONCLUSION Rape of males is a wide-spread problem across We continue to see rape as a women’s issue the country. only. It has escaped the attention of society because Need to see emphasis placed on adolescent and of deep taboos springing from the popular adult male rape issues. misconception that to be raped is to forfeit Examine your own attitudesattitudes regarding male one’s masculinity. victims of sexual assault. Remember that women have pushed most of Work through your issues. the rape movements across this country. Be supportive and caring. CONCLUSION CONCLUSION Don’t change because your victim is a male. Work with local agencies regarding male victims. Be prepared for male victims, so that the first Offer male victim sexual assault training to time you have a male victim you don’t feel agencies that interact with sexual assault victims. unprepared. Just as with female victims, we want reporting Remember: Don’t re-victimize! numbers of male victims to rise. Not more Ensure patient’s follow through with support rapes, but more reporting. systems. If possible, see them in follow up. Find out about resources that are sensitive to male victims. 4 CONCLUSION We want to foster an environment that encourages male victims feel like they will get help and not be re-victimized again. We have been able to do it for female victims. CASE STUDIES We can do it for male victims as well Case Study Case Study Age: 15 year old male Age: 36 year old male History of Assault: Ran away from foster home History of assault: Held captive for a week at his and took the ferry to Bremerton. Picked up by a home by is significant otother.her. Held physically with restraints. Multiple assaults over the week. stranger and assaulted multiple times. Injuries: Multiple bruises from beating with first Injuries: Redness, soreness, and positive T-blue and a belt. Redness, soreness, and positive T- dye around rectum. blue dye around rectum. Case Study Case Study Age: 17 year old male Age: 18 year old male History of assault: Assaulted in the back seat of his best History of assault: A man called the victim and wanted to friend’s car. Assailant was best friend’s mother. Victim meet him at a local restaurant. Victim thought he stated that he had been drinking during the night of the might be from the Crisis clinic, since he had just called them. He was picked up outside the restaurant and assault. He was brought into the ED for a mental assault. He was brought into the ED for a mental driven to a wooded area. The man began touching the health evaluation after becoming violent at home. victim and attempted to anally assaulted the victim. Injuries: Denied any pain or discomfort. No injuries Injuries: Had bruising on forearms from assailant trying noted except for a bruise on his hand from hitting the to put handcuffs on the victim. Complained of wall at home soreness to the head of his penis due to the assailant sucking on his penis. 5 Case Study Age: 20 year male Questions History of assault: Victim had been partying at a friend’s home. Woke up during the night to Thoughts find an acquaintance on top of him rectally assaulting him. Concerns Injuries: Complained of discomfort to his rectum, but no injury noted. 6.