An Intersectional Look at Male Sexual Assault Survivors in the LGBT Community
Author: Caleb Byers
At this point in time, there is an enormous gap in the existing knowledge base concerning male sexual assault (SA). This lack of research is even more evident regarding male sexual assault survivors who identify as gay, bisexual, or transgender (GBT). This vulnerable population faces a unique set of circumstances within the paradigms of socioeconomic status (SES), ethnic identity, and gender roles and identity. Furthermore, GBT males are confronted by an overall lack of resources as sexual assault survivors, and face a plethora of negative social stereotypes, and beliefs. Thus, it is important to examine the intersectionality of the aforementioned demographic and social factors to better understand the rather unique experience of a GBT male sexual assault survivor. This review of the existing literature will attempt to provide a comprehensive account of the many risk factors, barriers, and struggles that male, GBT, survivors face in the aftermath of their sexual assault.
This topic is of particular importance to study because Kalichman, Benotsch, Rompa, Gore‐Felton, Austin, Luke, and Simpson (2001) report that gay, and bisexual men are at greater risk of developing substance use disorders, borderline personality symptoms, and engaging in negative coping techniques, such as self-injury. Furthermore, King, Coxell, & Mezey (2002) report that male sexual assault survivors are at greater risk of developing clinical depression, and to suffer from anxiety. The negative impact that mental health issues and substance use disorders have on both the individual and society are enormous when one considers the costs of health care services, lost wages, and overall quality of life. Thus, further study of this at-risk population is warranted in order to educate mental health practitioners and the general public of factors affecting the experience of sexual assault that are unique to GBT male sexual assault survivors.
Risks of SA among GBT males
Balsam, Lehavot, and Beadnell (2011) conducted a study that looked at perpetrators of SA in addition to the chances of sexual re-victimization of gay men compared to heterosexual women. Their results indicate that childhood sexual assault (CSA) is associated with increased rates of adult sexual assault (ASA) for all three groups that were examined throughout the course of this study. In addition, they found that perpetrators (perps) may be male, female, friends, intimate partners, or even strangers. Results showed that gay, and bisexual men in particular, appear to have a higher risk of experiencing ASA throughout their lifetimes.
Prevalence of SA among GBT males
According to the Office for Victims of Crime, one in two transgender individuals (one in three transgender women, and one in six transgender men) will either be sexually abused or sexually assaulted in their lifetime and most at risk within the transgender community are trans-youth, and trans-people of color (Transgender Rates of Violence, 2012; Transgender Victims of Sexual Assault, 2014). Grant, Mottet, Tanis, Harrison and Keisling (2011) support this statistic with their findings that 12% of transgender youth were sexually assaulted in grades K–12 by peers or staff and that 13% of African-American transgender people experienced sexual assault (SA) in the workplace.
Several studies have been conducted on the prevalence of sexual assault among gay and bisexual men, with prevalence statistics varying by study. Two studies reported findings ranging from 14%-20%, and 40%-47% in gay, and bisexual men respectively (Kalichman et al., 2001; Walters, Chen & Breiding, 2013). It is evident that considerable variability exists in the current literature concerning the prevalence of SA among GBT men.
Rothman, Exner, & Baughman, (2010) note this disparity in research, and attempted to consolidate the current findings by conducting a meta-analysis of 75 studies concerning SA prevalence of lesbian, gay, and bisexual (LGB) men and women. In their review of the 46 studies that looked at gay and bisexual males they report that prevalence of (1) CSA range from 4.1% - 59.2%, with a median of 22.7%; (2) ASA range from 10.8% - 44.7%, with a median of 14.7%; (3) lifetime sexual assault (LSA) range from 11.8% - 54%, with a median of 30.4%; (4) intimate partner SA (IP) range from 9.5% - 57%, with a median of 12.1%; and (5) hate crime-related sexual assault (HC) range from 3% - 19.8%, with a median of 14%. Rothman et al., (2010) attribute this variation to methodological differences, participant sampling and conceptual definitions of SA. Additionally, they highlight the need for researchers to improve current research procedures.
Post-Traumatic Stress Disorder (PTSD)
Prior to the publication of the 5th version of the Diagnostic Statistical Manual (DSM-V) by the American Psychological Association (APA) in 2013, sexual assault was not specifically included as a potential cause of PTSD. Roberts, Austin, Corliss, Vandermorris and Koenen (2010) found that LGBT survivors are twice as likely to develop PTSD following SA compared to heterosexual survivors, and note that this is likely caused by (1) lower levels of social support; (2) reduced access to mental health care; and (3) internalized stressors resulting from the discrimination and stigma that this community faces in our society.
The DSM-V contains four diagnostic clusters; re-experiencing, avoidance, negative cognitions and mood, and arousal. Re-experiencing occurs in different forms, such as nightmares, spontaneous memories, or flashbacks (reliving the traumatic situation after it has occurred). Symptoms of avoidance include avoiding activities, places, thoughts or feelings that remind you of the trauma. Negative cognitions and mood symptoms include self-blame, depression, anger, and the inability to remember aspects of your trauma. Finally, symptoms of arousal include sleep disturbances; hypervigilance; and aggressive, reckless, or self-destructive behavior such as self-harm (“PTSD Fact Sheet”, 2013).
Currently, very little research exists on the prevalence of PTSD occurrence in male, GBT sexual assault survivors. This lack of research may be attributed to social myths such as “men are affected less by sexual assault” and “men cannot be forced to have sex against their will” as noted by (Stermac, Bove, & Addison 2004). One study that investigated the occurrence of PTSD in male SA survivors found that 41% of men in the study met the criteria for a diagnosis of PTSD (Rogers, 1997). However, due to the small sample size used, it is difficult to draw any empirical conclusions concerning the prevalence of PTSD in GBT male SA survivors from the existing research.
Survivors of SA often resort to self-destructive behavior because they lack healthy coping strategies to deal with the immense amount of cognitive dissonance that they are faced with. Kalichman et al., (2001) asserts that survivors experience increased substance abuse, more borderline personality symptoms and internalizing behaviors such as self-harm. Furthermore, King et al., (2002) found that those who reported surviving childhood sexual assault (CSA) were (1) 2.4 times more likely to experience psychological disturbances such as anxiety, depression and insomnia; and (2) were 3.7 times more likely to engage in self-harm. Additionally, results showed that participants who experienced adult sexual assault had an increased likelihood of experiencing various psychological disturbances.
Hequembourg, Parks, Collins, and Hughes (2015) conducted a study of the sexual assault of gay and bisexual men that focused on maladaptive coping behaviors such as having unprotected intercourse with multiple sexual partners, excessive drinking and internalized homophobia (IH). Internalized homophobia is defined as adopting negative societal messages and incorporating them into the perception of one’s self (“Internalized Homophobia”, 2011). Gold, Marx, and Lexington (2015) also report that higher levels of IH are associated with both increased depression and PTSD symptom severity.
Additionally, (Hequembourg et al., 2015) found high rates of hazardous drinking and possible alcohol dependence among their participants. In regards to the perpetrators of the assault, an extremely high amount (83.9%) were also under the influence of alcohol when the assault took place. Differences between gay and bisexual men were also found, such that bisexual men had higher alcohol severity scores, more female perpetrators, higher IH scores and fewer male sexual partners than gay men.
Socio-Economic Status (SES)
Research has shown that a correlation exists between SES and rates of sexual violence. Both men and women who live in lower SES communities, are more likely to experience sexual violence (Rodgers & McGuire, 2012). Rodgers and McGuire (2012) assert that those living in poverty face (1) increased risk of alcohol and drug use (AOD); (2) increased risk of SA as young adults; and (3) having multiple sexual partners. The researchers note the significant impact of adolescent perceptions regarding parental warmth and involvement. Specifically, perceptions of low parental warmth and involvement were correlated with higher rates of sexual violence and note the intersectionality of the three aforementioned factors. Such that, adolescents who experience SA may self-medicate with AOD and seek intimacy through multiple sexual partners (Rodgers & McGuire, 2012).
Moreover, research has shown an interconnection between poverty and homelessness (Schmitz, Wagner, & Wenke, 2001). Homelessness for young individuals and those with PTSD in particular, can create and further exacerbate existing problems. Specifically, homeless youth experience higher rates of depression, anxiety and poor health, in addition to facing an increased risk of experiencing physical and sexual assault (Breslau et al., 1991; Kilpatrick & Saunders, 1999). Keuroghalin, Shtasel and Bassuk (2014) note that LGBT youth are at greater risk of being homeless and (Durso, Gates, & Gary, 2012) attribute the high levels of homelessness in this population to the family of the youth not accepting their sexual orientation.
Minimal research exists in terms of racial/ethnic differences of male sexual assault survivors. Tewskbury (2007) using data from the National Crime Victimization Survey (NCVS) reports that an estimated 3 million U.S. men experience sexual assault each year, with higher rates among white and non-Hispanic males. Similarly, (Cloudhary, Gunzler, Tu, & Bossarte, 2012) using data provided by the National Incident Based Reporting System (NIBRS), from 2001 to 2005, found that the majority of survivors were under the age of 19 (~80%) and white (ranging from 80%-83.9%). Although data concerning ethnicity was missing for about 40% of men, it was found that most survivors were not from the Latino community.
Another significant finding from (Cloudhary et al., 2012) was that African American males showed the highest rates of SA (50 per 100,000 persons). The high rates of sexual assault found among African Americans may be attributed to the high rates of poverty found among this racial minority. According to a 2014 report from the CDC, African Americans earn 65% as much as whites, are unemployed in greater numbers and are almost 3 times more likely to have incomes below the poverty line (CDC, African American, 2014).
Society, as a whole believes in the prescribed gender roles of the “masculine male” and “feminine female.” Groth and Burgess (1980) report that the male gender role simultaneously creates and perpetuates male rape myths. Examples of male rape myths include, “being raped by a male means losing your masculinity” and “a man should defend himself from being sexual assaulted.” The male gender role teaches men from an early age that they should always be strong, dominant, assertive and aggressive. To be submissive, or even worse, to be taken advantage of sexually is the equivalent of social castration and the subsequent loss of your masculinity. In essence, it completely emasculates any male that has survived a sexual assault.
This prevailing social belief in the “masculine male”, and the subsequent expectation that “a real man never lets himself be taken advantage of” makes reporting the crime to the authorities a humiliating and debilitating ordeal for any male, regardless of their sexual orientation. Sable, Danis, Mauzy, & Gallagher (2006) explore the barriers to SA disclosure among college aged students. They found that the barriers that were rated as most important were (1) shame, guilt, embarrassment and not wanting family/friends to find out; (2) concerns about confidentiality; and (3) the fear of not being believed. In addition, both male and female participants perceived the fear of being judged as gay as an important barrier for male sexual assault survivors.
Disclosure Factors for LGBT Individuals
Wakelin & Long (2003) conducted a study where participants were given hypothetical rape scenarios of both homosexual and heterosexual men and women to determine if a survivor's’ sexual orientation affected the way that people viewed the sexual assault. Their results showed that participants attributed greater blame to the survivor in the hypothetical scenarios if their sexual orientation implied potential attraction to the perpetrator. In addition, their sexual orientation was seen as a stronger contributing factor of the assault than it was for other survivors.
These findings indicate that it may be more difficult for the LGBT population to disclose their SA due to the stigma surrounding sexual minorities. In addition to dealing with their perceived failure of not living up to the social ideal of the “masculine male,” GBT males face the possibility of encountering homophobic attitudes in reporting their SA to the authorities and face the possibility that the severity of their assault will be minimized because of their sexual orientation.
In a discussion concerning male physiological responses (Bullock & Beckson, 2011) note that it is quite common for the male being assaulted to experience an erection and may even be stimulated to the point of orgasm during sexual assault. Similarly, research has shown that experiencing an erection and/or experiencing an orgasm are only partially under voluntary control and in times of extreme stress or pressure, both erection and orgasm may occur, regardless of the fact that the sexual contact is unwanted (Mezey & King, 1989).
Despite the aforementioned research, a myriad of misconceptions regarding male physiological responses still exist. This lack of education results in several adverse repercussions, most notably within the criminal justice system. Specifically, experiencing an erection or achieving orgasm are often misconstrued as signs of consent from the male survivor and may serve as a barrier to the disclosure of SA (Bullock & Beckson, 2011). Donnelly and Kenyon (1996) report that law enforcement agencies in particular, tend to believe that male sexual assault survivors are gay and discount the assault in the belief that “they actually wanted it”.
Unfortunately, sexual violence towards male GBT individuals by law enforcement professionals does occur. Forge (2009) report that 15% of transgender individuals, (32% of which were African American) were sexually assaulted while in police custody, with 5-9% of transgender individuals being sexually assaulted by police officers. Current research findings indicate the need for greater education in the criminal justice system concerning sexual minorities and the male physiological responses that occur during SA.
Mental Health Services
A severe lack of mental health services exists for male SA survivors. Donnelly and Kenyon (1996) highlight this fact in their study of 30 agencies in Georgia. They found that 11 agencies did not offer services to male survivors, 10 were capable of serving male survivors, but never had, 5 had provided services for at least one male survivor in the past, and 19 were agreeable to providing services for male survivors, but in the past year only 4 agencies had done so. The authors found an abundance of negative stereotypes among the agencies regarding male SA survivors. Furthermore, agencies that were least likely to offer services to male sexual assault survivors were law enforcement agencies, or feminist based call centers. Donnelly and Kenyon believe these results are the result of the false belief that “men cannot be sexually assaulted.” This lack of mental health services is even more noticeable for members of the LGBT community. Todhal, Linville, Bustin, Wheeler, & Gau (2009) attribute this lack of available services to low community awareness and support for survivors in the LGBT community.
Research shows that male SA survivors face an increased risk of developing mental health issues such as depression, anxiety, deliberate self-harm and PTSD following SA. Furthermore, those that identify as LGBT appear to face an increased risk of SA and re-victimization. LGBT persons appear to be at an increased risk for the development of PTSD following SA and this may be attributed to the stigma that sexual minorities face in our society. LGBT youth are more likely to be homeless and of a low SES and therefore face an increased risk of experiencing SA. Furthermore, research show an increase in risky coping behaviors among LGBT survivors, such as having unprotected sexual intercourse with multiple partners and substance use/dependence disorders.
Male survivors are more likely to be Caucasian or African American, and less likely to be from the Hispanic/Latino community. Transgendered individuals in particular appear to have a much higher chance of facing sexual violence throughout their lifetime, in addition to facing an increased risk of SA at work or school. Furthermore, GBT, male SA survivors are less likely to disclose their SA to the authorities, and may face minimization as a result of their sexual orientation. In regards to mental health services, a survivor may find that no services exist or that existing services consider them “ineligible” because of their gender.
Future research should focus on (1) closing the gap in research concerning transgendered individuals; and (2) developing more standardized research procedures to gain a clearer picture of SA prevalence in the LGBT community. Similarly, it is necessary to place a greater emphasis on the collection of demographic information, so that more accessible mental health services and outreach programs can be implemented for the LGBT community. Likewise, further research concerning mental health issues such as depression and PTSD among male GBT survivors is necessary to address the lack of mental health services available for this population.
Furthermore, increased education among the general public concerning the occurrence of male SA is a crucial step towards ending the stigma that male survivors face following their SA. Likewise, greater education concerning the male physiological responses that occur in periods of intense stress is critical to address the negative impact that this lack of education has on a male survivor within the criminal justice system. Lastly, national educational programs of the LGBT community should be implemented to dissolve the many myths and stereotypes that exist regarding this marginalized group.
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