A major difficulty in the study of child sexual abuse and adult survivors is accurately assessing occurrence. Incidence — the number of cases occurring in a given time frame (usually years) — is expressed as a number or rate (e.g.,100,000 per year or 1.5 per 1,000 children). Prevalence — the proportion of a population — is usually expressed as percentage (such as 20% of all boys).
Incidence numbers of sexual abuse of males rely on cases actually reported to authorities. However, all researchers agree that only a small percentage of cases are reported. Therefore, incidence vastly underestimates the numbers (Peters, Wyatt and Finkelhor, 1986).
Prevalence rates of sexual abuse of males are affected by a wide range of factors, including method of data collection, type of sample (e.g., clinical, probability or non-probability, college students, general populations, etc.), and definition used for sexual abuse (such as age limits, victim/perpetrator relationship and age difference, and type of abuse — contact vs. non-contact). Thus, it is not surprising that prevalence rates for at least one sexually abusive incident prior to age 18 range from six to 62% for females, and three to 31% for males (Wyatt and Powell, 1988). Furthermore, the general caveat is that even in anonymous prevalence studies males are usually under-represented due to factors working against acknowledgment. The number of persons affected is large, even at the lowest prevalence rates. If the more common numbers of one in three women and one in five men are accepted, the occurrence rate is staggering.
Why are men significantly under-represented in both incidence and prevalence? David Finkelhor (1984) suggests three reasons. 1) Boys grow up with the male ethic of self-reliance. They are supposed to be able to take care of themselves. Abuse violates this ethic. 2) The stigma of homosexuality and society’s anxiety about it creates fear in boys of being labeled homosexual since most perpetrators are male. Parents may collude in this by not reporting to authorities if a son discloses abuse to them. 3) Boys have more to lose by reporting. They generally are allowed more independence, unsupervised activity, and range of movement than girls. They fear reporting would curtail this.
The Virginia Bureau of Child Protective Services Report (1989) adds other reasons. Among them are: 1) males in our culture are taught that men are not victims; 2) boys fear being punished or held responsible for the abuse; and 3) in many cases boys do not perceive the activity as abusive. Many male survivors who eventually self-identify as gay believe that they wanted the sexual activity to happen and see themselves as the seducer of the adult. They feel responsible no matter how negative the outcome.
Self-identified heterosexual men often harbor fears that something in them triggered the abuse and lingering doubts about their sexuality haunt them. If the abuse was by a woman, this may be seen as sexual initiation, even though clinically we see negative effects.
The long-term negative effects of abuse are not disputed. Browne and Finkelhor’s (1986) review of the literature on females identified depression, self-destructive behaviour, anxiety, self distrust, isolation, sexual maladjustment, substance abuse and poor self-esteem as major problems.
Briere et. al. (1988) compared 40 men and 40 women. Each group consisted of 20 abused persons. Men and women did not differ on negative outcome measures. Abused individuals were always significantly more negative on measures than the non-abused. Swett et. al. (1990) studied 125 consecutive male patients and found 48% acknowledged a history of sexual and/or physical abuse. The highest negative scores on outcome measures were always for those with histories of sexual abuse only or with both physical and sexual abuse. Both of these studies used treatment populations only.
Freeman-Longo (1986) used a prison population of sex offenders who themselves admitted abuse. They reported anger, hurt, frustration, fear of intimacy, and re-enactment of their own abuse as major outcomes. Bruckner and Johnson (1987) found that anger, sexual confusion, fear of intimacy and trust issues were among the concerns that abuse survivors commonly introduced in group therapy. Additionally, men acted out more externally through acts of aggression; women survivors tended to internalize their responses via depression and self-punishment.
Mike Lew‘s list (1988), put together by his clients, is a two-page single line listing of after effects. In addition, Mary Beth Williams (1990) reported that almost all of her 61 male respondents had full patterns of Post-Traumatic Stress Disorder symptoms on her multiple measures of PTSD. The existing body of literature on the negative effects of sexual abuse on adult male survivors is small, but it is growing.
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David 0. McCall, M.Div., is a pastoral counselor and doctoral candidate of
Catholic University in Washington, D.C.