Chapter 6 Men and boys who are raped experience many of the same difficulties that women regularly encountered 20 years ago when they reported rape. Furthermore, men are traditionally regarded as perpetrators rather than targets of rape and this stereotype is hard to break. However, since rape of men was legally recognised in England and Wales in the enactment of the Public Order and Criminal Justice Act 1994 and with subsequent changes in the Sexual Offences Act 2003, attitudes have changed. Rape is now defined in law as an act wherein a man intentionally penetrates the vagina, anus or mouth of another person with his penis; when that person does not consent to the penetration; and when the man does not reasonably believe that the person consents. When penetration is with something other than a penis, the offence is assault by penetration. A woman can be charged with, or convicted of, rape as a secondary party, for example when she has helped a man who has raped another person. Other forms of male sexual assault by women are described by terms such as ‘indecent assault’. Since the introduction of these wider legal definitions of rape, the police and medical services have become more familiar with how men who are raped should be assessed and managed. At the outset, it is important to be aware of the many myths about sexual assault of men (see Box 6.1 and Figures 6.1 and 6.2). The first is that men cannot be forced to have sex against their will. It is assumed that men can defend themselves when threatened. In fact, research has shown that people of either gender often feel helpless and submit to an assault due to panic and an overwhelming sense of disbelief. This ‘freezing’ is experienced by many men and women threatened with assault and may be a form of self-preservation in the face of a severe threat. Figure 6.1 ‘Real Men Get Raped’: education poster from self-help group SurvivorsUK. Source: www.survivorsuk.org (last accessed 12 February 2014). Reproduced with permission of Survivors UK. Figure 6.2 ‘You Don’t Owe Sex to Anyone’ Source: NHS image. A second misunderstanding is that men who are sexually assaulted must be gay. This echoes earlier misconceptions that women who were raped wanted it or were in some way ‘asking for it’. A closely related myth is that men who sexually assault other men must be gay. In fact, evidence shows that stranger rape is more likely to be by heterosexual than homosexual men and that two-thirds of gang rapes are perpetrated by heterosexual men. A fourth myth is that if a man experiences an erection or ejaculates during an assault then he must have been complicit in some way. However, research has shown that extreme fear or anxiety in any situation can lead to erection and even ejaculation in men. Furthermore, erection and ejaculation are often involuntary responses to intimate sexual touching, particularly in a younger man, and are not an indication that he is sexually aroused. In fact, a perpetrator may intentionally stimulate the victim in order to arouse him, and this may make it seem that he wanted the assault. Another assumption is that rape takes away a man’s masculinity. An assailant may actually play on this possibility, given that rape is often an expression of power and control. For example, in war zones and other conflict situations, defeated soldiers may be raped primarily to humiliate and emasculate them. A further myth is that rape makes heterosexual men homosexual. Although confusion about sexual orientation is not uncommon in men following male-on-male sexual assault, there is no evidence that sexual assault affects a man’s fundamental sexual orientation. Finally, although it is commonly assumed that a woman cannot sexually assault a man, there is evidence that female perpetrators are involved in almost half of sexual assaults against men and boys. However, men’s reactions to sexual molestation by women may be even more negative, because they feel strongly that they should have been able to defend themselves and resist the assault. While people who are sexually assaulted are always distressed by their experiences, their responses do not necessarily mean that they need immediate or specialist psychological treatment. Many men will come to terms with the assault by talking about the experience with someone who is empathetic, nonjudgemental and supportive. Some men may have longer-term problems of anger, despair and anxiety and only disclose much later, to a sympathetic clinician who takes the time to explore sensitively what is troubling them. In some cases, they may develop post-traumatic stress disorder (PTSD; see Chapter 4). The approach to a man who has been sexually assaulted follows the process outlined in Chapters 18 and 19, and is summarised in Box 6.2.
Sexual Assault of Men and Boys
OVERVIEW
Definitions of rape and sexual assault
Myths about male rape
Box 6.1 Myth busters concerning sexual assault of men and boys
Response to the assault
Assessment of recent sexual assault of a man
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