Abstract

Sexual assault is an on-going epidemic issue with no end in sight.  Healthcare providers are in constant search for opportunities to improve prevention through education and response to sexual assault.  The classic victim has always been female; however, in recent years men have been coming forward to report abuse and assault.  A societal norm since the beginning of time has always placed a man in the role of being strong and emotionless. A male reporting sexual assault is still viewed as an emotion displaying weakness; but for those that have the strength to be able to speak out is trailblazing a path to improve preventive measures for everyone.  One population that has gathered increased concern is men in the military.  In addition to the trauma of wartime environments leaving scars on men in uniform, Black’s survey from the Centers for Disease Control and Prevention (CDC) reported 35% of men report significant short-term or long-term impacts such as Post-Traumatic Stress Disorder (PTSD) because of sexual assault (NIPSVS; Black et al., 2011).  It is of the utmost importance to provide education and support to these victims of such a violent act.

Strategies and Approaches to Provide Education to Male Victims of Sexual Violence

Men have always been held to a level of being the foundation of the family.  Blackstone (2003) stated, “A common gender stereotype about males is that they are not emotional” (p. 337).  Therefore, according to societal norms, men need to be emotionless or be viewed as weak.  This has always been an acceptable and supported practiced trait to be passed from generation to generation.  In our society the male gender has always been expected to be strong.  They are the hunters, gathers and protectors of others.  For generations these traits have been passed on to pressure males to conform to traditionally learned gender roles and behaviors.  Barker advises demonstrating how our traditional version of masculinity may not actually be worth the fight. “Men who have more rigid views of what it means to be men are more likely to suicidal thoughts, more likely to be depressed, less likely to report they’re happy with life overall, less likely to take care of their health, more likely to own guns, the list goes on,” he said. “There is something toxic about this version of masculinity out there” (Weingarten, 2015).

The topic of sexual assault has gained more attention in reference to the problem of sexual violence in the military.  The effects of sexual trauma on victims in uniform are coming to the forefront of research as the military provides a unique opportunity for a controlled group.  The research could afford a way to improve education as well as prevention.  Over the past decade there has been increased concern among leadership and the American public regarding the incidence of sexual violence in the military (Draper, 2014) (Secretary of Defense Memo).

Sexual violence is not solely isolated to one gender, it can happen to anyone at any time.  Males are not excluded just because they are males.  How healthcare providers respond to male victims could impact the recovery process from his sexual assault.  As most male rape cases involve males assaulting other males, the victim has already been shamed and humiliated by society norms.  One must understand the term rape is not about sex; it is a violent crime.  The perpetrator is demonstrating power, control and domination often terrorizing their victims with threats of extreme bodily harm or even death.  Put simply, rape is life-altering for any victim.  It is most important to help the victim know that he can recover.  For purposes of this research, sexual assault is defined by the military as: “…intentional sexual contact, characterized by use of force, threats, intimidation, abuse of authority, or when the victim does not or cannot consent; including rape, forcible sodomy (oral or anal sex) and other unwanted sexual contact that is aggravated, abusive, or wrongful (to include unwanted and inappropriate sexual contact) or other attempts to commit these acts” (Stander, 2016).

The Department of Defense (DoD) labels victimization as a broad category as military sexual trauma (MST).  Defined as: “Psychological trauma, which in the judgment of a mental health professional employed by the Department, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty or active duty for training” (Stander, 2016).  A common theme in the military that is true, is the use of authority to coerce a subordinate into sexual contact.  Such action is viewed as force or a threat and usually involves military law (courts martials) if reported.  With the focus on sexual violence in the military, measures are being taken to implement programs and policies to educate individuals on the reporting process, but most importantly the care of the victims.

Method

Prevalence of sexual violence in the military is based on a screening done by a healthcare professional asking two questions: (1) did you receive uninvited and unwanted sexual attention, such as touching, cornering, pressure for sexual favors, or verbal remarks? And (2) did someone ever use force or threat of force to have sexual contact with you against your will? (Stander, 2016).  Within the DoD, official epidemiological surveillance of sexual harassment and assault historically has been conducted via periodic administrations of the Workplace and Gender Relations Survey (WGRS). Sexual assault was assessed using one or two questions developed for the WGRS. Based on data from the WGRS over the approximate period of the War on Terror (2002–2012), annual sexual assault prevalence rates ranged from 4% to 7% for women and from 1% to 2% for men (DMDC, 2013).  There have been multiple attempts to compare the prevalence of sexual victimization in military versus civilian populations, and some have concluded that military rates are comparatively high (Stander, 2016).

Participants

Why are rates of sexual trauma considered higher within the military populations? A possible explanation suggests risk factors for sexual aggression may be unique aspects of military demographics (e.g., preponderance of young, single, male, and lower-ranking personnel), lifestyle (e.g., combat deployment, high mobility, heavy drinking, and barracks where sexual activity is common), culture (e.g., hostile attitudes, rape myth acceptance, hypermasculinity, and an organizational climate condoning sexual aggression), structure and policy (e.g., prevention and response policies that make reporting and prosecution difficult; top-down hierarchical structure) that may heighten risk (Stander, 2016).

Research Design

Given the military’s emphasis on group cohesion and loyalty, the bystander approach seems to be a good cultural fit for the military (Shanker, 2013).  “Leave no man behind,” one of the most popular and well-known sayings in the military.  As in a was zone situation, the same holds true for any person being sexually victimized.  They should not be left alone to deal with the issues that follow.  Of all military sexual assault victims, approximately half are men (Matthews, Farris, Tankard & Dunbar, 2018).  To be able to improve people’s knowledge and hopefully correct misperceptions about male victims of sexual violence is key in providing a road for recovery.  Among service providers, opinions are mixed about whether the general military population has an adequate understanding that men can be victims of sexual assault (Turchik & Edwards, 2012).  Aside from having a supportive battle-buddy, educational material should be made available that dispels myths regarding male sexual assault.  Researchers O’Brien, Keith and Shoemaker have suggested including examples of male sexual assault survivors in educational material (2015).  Additionally, pamphlets and other material should provide accurate statistical information supported by research to counteract the mythical beliefs that real mean cannot be sexual assault victims.

Measures

Male victims will need to know that when they report an incident, they will be treated with the same respect and consideration as female victims.  Rebuilding a level of trust that has been destroyed is crucial.  To promote reporting, male sexual assault victims must know that the professional to whomthey disclose will not express negative attitudes toward them or disbelief in the account of the assault (Matthews, Farris, Tankard & Dunbar, 2018).  The Sexual Harassment/Assault Response & Prevention (SHARP) programs, by the pressure of DoD surveys, are ensuring all military personnel are taught about sexual assault myths and facts, fostering a preventive culture, ensuring a safe reporting environment, and ensuring appropriate accountability (SHARP, 2019).  Simple to remember, military personnel are taught a mnemonic, I AM to better understand, identify and fight sexual violence.  I = INTERVENE:  I will have the personal courage to intervene and prevent sexual violence.  A = ACT:  It is my duty to stand up for you, no matter the time or place; I will act.  M = MOTIVATE:  We are motivated to keep our fellow military members safe; denounce sexual misconduct (SAPR, 2013).

When sexual violence occurs, it affects everyone.  Military personnel are trained to function as one unit.  They are responsible for each other and support each other.  Sexual violence is no longer just considered “a women’s issue.”  Though the percentage of women reporting sexual violence is higher, statistics have found actual violence toward men, which usually goes unreported is greater.  According to the CDC Adverse Childhood Experience Survey, one in six men report being sexually abused during childhood (Sheats et al, 2018).  In the 2017 annual report by the DoD, it was stated that more men experience sexual violence than women; estimating 6,300 men experienced sexual violence in fiscal year 2016 (DoD).

It is important that men to understand facts from myths.  Educate the facts so that trust can begin to be reestablished in the first step to help fight sexual violence.  Some key facts to include in screening to reassure a male victim would be:  arousal or ejaculation does not equal consent; men can be just as traumatized as women; and having been sexually assaulted does not make you any less of a man (SHARP, 2019).

Conclusion

All individual should be fully committed to support all members of the military who have experienced any form of sexual violence.  Develop a plan to reach out to male victims to encourage them to seek support and report sexual violent events.  Improve service members understanding of sexual assault toward men, debunking any misconceptions, myths and stigma associated with sexual violence.  Ensure existing services meet the needs of male victims.  Take steps needed to improve existing services as needed.

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