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Male Rape in Young Adulthood: History, Etiology & Effects Across the Lifespan

 

Introduction

            Rape is an act that is used to dehumanize, and strip an individual of their power and control. It is arguably the most extreme and traumatic violation of a person's identity. Although, it is stereotypically viewed as an act committed by a male perpetrator and female victim; both males and females have been raped by individuals of both the same and opposite sex throughout the course of history.

            However, male rape has been largely ignored due to a variety of sociocultural factors such as; ideas of masculinity, patriarchal values, and gender roles. As a result, the developmental effects of male rape have been largely overlooked in academia. Therefore, this review will discuss the: (1) history; (2) prevalence and incidence; (3) costs to society; (4) bio-psycho-social impact; (5) developmental effects of male rape throughout the lifespan using Erikson’s Stages of Development theory; (6) macro and micro interventions and; (7) Social Work Ethics.

History

            Male on male rape has an extensive history. It has been discussed in ancient Greek mythology, and the gang rape of a male was used as punishment for adultery in the height of the Roman civilization. Additionally, in some societies, the rape of males defeated in battle was a right of the victor, due to the widespread belief that sexual penetration was the equivalent of “losing your manhood”. Lastly, up until the 1970’s, modern Western civilization often viewed male rape as something that only occurred while incarcerated (Donaldson, 1990).

Prevalence, Incidence and Risk Factors

            It is important to note that current statistics likely underreport the true prevalence of male rape. This fact can be attributed to a variety of reasons including social stigma, shame, guilt, and the fear of retaliation, ridicule or not being believed. Furthermore, prevalence statistics appear to be contextually skewed, such that, higher rates of male rape have been reported among incarcerated and active war zone populations (Stemple & Meyer, 2014; Knapp & Footitt, 2013).

            It is estimated that 1 in 6 men will experience rape in their lifetime (Connecticut Alliance to End Sexual Violence, n.d.). Moreover, the Rape, Abuse, and Incest National Network (RAINN) reports that in the year 1998, 2.78 million, or 3% of men experienced an attempted or completed rape (Victims of Sexual Violence: Statistics, n.d.). Additionally, they report that males ages 18-24 who attend college are 5 times more likely to experience sexual violence. In a 2011 report, the National Intimate Partner and Sexual Violence Survey (NISVS) estimates the lifetime prevalence of adult male rape to be 1.7%, and that 23.4% of males are subjected to other forms of sexual violence. In addition, the NISVS states that young adulthood (ages 18-25) appears to be a high-risk period for this population (NISVS, 2011).

            Sexual orientation also appears to increase the risk of a male experiencing sexual violence. The Office for Victims of Crime reports that while the rates of sexual violence among heterosexual males sits at 21%, the rates for gay and bisexual men sit at 40% and 47% respectively (Office for Victims of Crime (OVS), 2017). This finding is alarming, as gay, bisexual and transgender males are faced with a double dose of stigma. Specifically, the stigma surrounding LGBTQIA+ individuals in our society, and the stigma that surrounds males and sexual assault.

            Ethnicity also appears to be a risk factor for males and sexual violence. The Office for Victims of Crime reports that 40% of multi-racial men have experienced other forms of sexual violence besides rape (Office for Victims of Crime (OVS), 2017).  Similarly, The Centers for Disease Control and Prevention report that 26.6% of Hispanic men, 24.5% of American Indian or Alaska Native men, 24.4% of black men, and 15.8% of Asian or Pacific Islander have experienced sexual violence at least once in their lifetime (The Centers for Disease Control and Prevention, 2014).

            Cloudhary, Gunzler, Tu, & Bossarte, (2012) report that African American males face a significantly higher risk of sexual violence across the lifespan when compared to Caucasian and Hispanic males. Most notably, the authors report an increased risk of 197% for African American males. However, the authors note that Hispanic males may fail to report their crime because of the cultural emphasis on machismo, or masculinity (Cloudhary, et al., 2012).

            Finally, (Andrews & Veroenen, 1993) report that sexual assault among people with disabilities, is as common, if not more so than able-bodied individuals. Further, it is estimated that 83% of women and 32% of men with a developmental disability will be sexually assaulted in their lifetime (National Council on Domestic and Sexual Violence, n.d.). Lastly, (Andrews & Veroenen, 1993) assert that further use of both risk assessments, and safety planning are needed among this population.

Cost to Society

            Rape is an enormously costly crime when both the short and long-term costs are considered. Peterson, Degue, Florence, & Lokey, (2017) estimate that each rape costs each male victim $122,461 over the course of their lifetime. Furthermore, the authors estimate that all rapes costs society $3.1 trillion: (1) $1.2 trillion in medical costs; (2) $1.6 trillion in lost work productivity; (3) $234 billion in criminal justice costs and; (4) $36 billion in other costs such as property damage or loss. Lastly, the authors note that the costs of pain and suffering for (1) the survivor and; (2) the victim and perpetrator’s friends and family members were excluded from this estimate.

Bio-Psycho-Social Impact

            Because rape is such a traumatic experience, it may have numerous negative impacts on an individual’s bio-psycho-social well-being. Walker, Archer, & Davies, (2005) looked at the negative effects caused by male rape and note that most of their subjects reported symptoms of depression (97.5%), anger (95%) and anxiety (92,5%) in the weeks and months following their rape. Moreover, most participants reported a loss of self-esteem, (90%) an increased sense of vulnerability (90%), emotionally distancing themselves from their friends and family (85%), fear (82.5%), guilt (82.5%), self-blame (82.5%) and symptoms of Post-Traumatic Stress Disorder (PTSD) (92.5%).

            Furthermore, subjects reported experiencing decreased work performance (70%) following their assault. Participants also reported experiencing crisis with their sexual identity (70%), damages to their masculine identity (68%), changes in their sexual behavior, such as promiscuity decreased libido, and engaging in sex with other men despite identifying as heterosexual. Moreover, 27.5% of the male survivors developed an eating disorder following their assault, and reported an increase in tobacco (67.5%), alcohol (62.5%), and drug abuse (52.5%). Finally, 55% of subjects disclosed having suicidal ideations, 50% engaged in self-harming behaviors, and 47.5% noted that they had attempted suicide. (Walker et al., 2005)

            Clearly, male rape has a profoundly negative impact in virtually every aspect of a survivor’s identity and/or well-being. Thus, it is critical that male survivors receive the necessary medical, and mental health treatment to begin their recovery process. It is arguably even more important for young adult males, as they are still developing their male identity. If a young adult male does not receive the services necessary for recovery, he may be negatively affected by his experience for the rest of his life.

Erikson’s Stages of Development

            Erikson’s Stages of Development assets that every individual must through a series of eight interrelated stages from birth to death (Zastrow, & Kirst-Ashman, 2013). Each stage has a unique age range, and successfully passing through the stage will grant an individual a virtue. The stages are as follows: (1) Basic Trust vs. Mistrust, - Hope, birth-18 months; (2) Autonomy vs. Shame – Will, 18 months-3 years; (3) Initiative vs. Guilt – Purpose, 3-5 years; (4) Industry vs. Inferiority – Competence, 6-12 years; (5) Identity vs. Role Confusion – Fidelity, 12-18 years; (6) Intimacy and Solidarity vs. Isolation – Love, 18-35 years; (7) Generativity vs. Self-absorption or Stagnation – Care, 35-65 years and; (8) Integrity vs. Despair – Wisdom, ages 65-death.

Identity vs. Role Confusion – Fidelity

            For this paper, we will focus on stages 5-8, as the end of Identity vs. Role Confusion stage is the beginning of young adulthood. In this stage, Erikson asserts that that an adolescent must struggle to find their emerging identity in adulthood, while simultaneously balancing the pressures of social interactions, discovering their morality and their sense of right and wrong. Clearly, this is a sensitive and tumultuous time of life for any individual regardless of experiencing any sort of trauma.

            Therefore, if an 18-year-old male were to be sexually assaulted before he has solidified his identity, the sexual trauma could have disastrous effects on his emergence into adulthood. If he identifies as heterosexual, he may question his sexuality. Or, his trauma may negatively affect his ability to develop and maintain romantic relationships, and may even alter his intimacy template (Mills & Turnbull, 2004). Thus, directly impacting Erikson’s next stage, Intimacy & Solidarity vs. Isolation.

Intimacy & Solidarity vs. Isolation – Love

            Erikson reports that this stage is characterized by the need and search for companionship and love. However, according to Erikson, if an individual is unable to find a healthy intimate relationship, isolation may occur. For a male survivor, the feelings of isolation are overwhelming at best, and feeling as though no person may understand what you have been through takes an enormous toll on a person’s physical, mental, and emotional health (Holt-Lunstad, Smith, & Layton, 2015; Cacioppo, & Cacioppo, 2014).

            Post-Traumatic Stress Disorder (PTSD) following trauma has been associated with the adoption socially isolating behaviors (Teodorescu, Siqveland, Heir, Hauff, Wentzel-Larsen, & Lien, 2012). At this point in time, minimal research exists concerning the prevalence of male PTSD following rape. However, one study found that 41% of males qualified for a diagnosis of PTSD following their sexual assault (Rogers, 1997).

            This is concerning because, (Teo, 2013) reports that: (1) isolation appears to increase an individual’s risk of developing a mental illness and; (2) social isolation may exacerbate the severity of an existing mental health issue. Considering these findings, it is evident that strong social support is vital to minimize the negative impact that isolation may have on a male survivor in this stage.

            Similarly, the development of PTSD may also have negative implications for a male survivor to successfully develop and maintain a healthy intimate partner relationship. Specifically, the use of socially isolating behaviors over a period of time, may cause the male survivor to unintentionally block or ignore the advances of a potential intimate partner candidate. If this does happen, the male survivor has inadvertently sabotaged his chances of successfully completing this stage of Erikson’s development.

Generativity vs. Self-Absorption or Stagnation – Care

            This stage of Erikson’s theory of development is marked by “settling down” in different ways, such as, becoming established in a career, entering a long-term relationship, or starting a family. Developing intimate social relationships is a critical factor for the development of generativity. Unfortunately, male survivors may face greater difficulties in successfully completing this stage of development for several reasons.

            First, male survivors often report withdrawing from their friends and family following their assault (Walker et al., 2005). Secondly, a high percentage of male’s report experiencing difficulties in being intimate with their partner, and successfully maintaining a long-term relationship (Singer, n.d.). Lastly, males who lack a strong social support system are less likely to be successful in their careers (Nabi, 2001). In other words, research indicates that a male survivor may face significant barriers in nearly every aspect in completing this stage.

Integrity vs. Despair – Wisdom

            The eighth and final stage of Erikson’s theory is a period of reflection on the successes or failures of the previous stages of development. Some adults, can look back on their lives with integrity, or a sense of fulfillment. Conversely, other adults may reflect on their lives with despair, and wonder “what was the purpose of my life?”

            Obviously, the more successful completions an individual has, the more satisfied they can be with their impact on the world. Alternatively, if an individual has more failures, they may experience a sense of despair or hopelessness when reflecting on their life. If the second occurs, that individual may be more susceptible to negative mental health outcomes.

            Sadly, considering the number of barriers that a male survivor faces to the successful completion of Erikson’s stages of development, a disproportionate number of males may reach this stage and look back on their lives with despair. Because Erikson’s stages are focused on the social development of individuals and interconnect with one another, it is vital for a male survivor to receive strong social support following their trauma. In doing so, a survivor may be more likely to navigate Erikson’s stages successfully, thereby enabling them to reach the eighth and final stage of development and reflect upon their lives with integrity.

Social Work Ethics

            The NASW code of ethics asserts that social work practitioners should be knowledgeable in the many factors that contribute to the oppression and discrimination of a certain population. Examples of these include; “ableism”, “sexism”, and “racism”. Unfortunately, male survivors may face more than one of these factors following their trauma (B. Mass, personal communication, April 8th, 2017).

            First, and foremost, male survivors are confronted with sexism. The existence of sexism can be attributed to the socially constructed gender roles in our society (Groth & Burgess, 1980). Additionally, these gender roles contribute to the existence of rape culture, or a culture in which the victim of a sexual crime is blamed for its occurrence (Zaleski, Gundersen, Baes, Estupinian, & Vergara, 2016).

            According to society, men should be strong, masculine, assertive, and willing to fight back in the event of an assault. Therefore, if a male fails to defend himself from a sexual assault, he is viewed as feminine and subsequently stripped of his masculine identity. This reality creates a hostile and stigmatized environment and may serve as a barrier to disclosure or seeking the medical, legal, and mental health services necessary for recovery.

            Race and racism appears to have two separate, yet interrelated effects on a male survivor. Specifically, some ethnic minorities, such as African American and Hispanic males face an increased risk of experiencing sexual violence. Despite this, they are also significantly less likely to disclose and/or seek treatment following their trauma (Choudhary, Gunzler, Tu, & Bossarte, 2011; B. Mass, personal communication, April 8th, 2017).

            Lastly, disability may have a negative impact on the disclosure and recovery process for a male survivor. If a male who has been raped cannot verbally disclose their trauma to members of the Criminal Justice system, they may not be believed and therefore never receive the justice they deserve. Similarly, a disability may serve as a barrier to obtaining mental health services. If a male is unable to leave his residence due to a disability, he can (1) not seek mental health therapy or; (2) receive in-home therapy from a practitioner that may not be properly trained or educated to provide services to a disabled individual (B. Mass, personal communication, April 8th, 2017). Clearly, neither of these options are in the survivor’s best interest for recovery.

Conclusion

            In conclusion, male rape is a social issue that has been largely ignored until very recently. Nevertheless, male rape has an extensive history in many different cultures, and has been used as punishment for criminal acts. Lastly, it has been used in war as an act of demasculinization.

            Although the current prevalence statistics are likely skewed due to underreporting, estimates range from 1.7% to almost 25%. This number is alarming, and shows the need for further advocacy and educational efforts in our society to reduce the stigma that surrounds male sexual assault. However, research has shown that young adult males who attend college face an increased risk of sexual violence, and are most at risk between the ages of 18-25.

            Rape is extremely costly to our society. Research has shown that all rapes cost the United States a staggering $3.1 trillion. For males, it is estimated that a rape or sexual assault will cost that individual over $120,000 over the course of their lifetime. Thus, a social emphasis on eradicating sexual violence would save the US trillions of dollars that could be used for more productive means, while simultaneously improving the quality of life of millions of its citizens.

            Sexual trauma carries an immense toll on a person’s well-being. A survivor may experience negative emotions such as, shame, and guilt, and are at increased risk of experiencing a mental health disorder, such as depression. Other concerns include questioning one’s sexual identity, engaging in self-harming behaviors, and suicidal ideations or attempts.

            Moreover, because Erickson's stages of development are interconnected, the negative effects of experiencing sexual violence in young adulthood may hinder a survivor's ability to successfully navigate their way from one stage to the next. Unfortunately, this may cause a "domino" effect, in which the trauma impact from one stage carries over into the following stages, causing the overall impact to be exponentially more harmful over the course of time. Therefore, it is vital for a male survivor to receive the mental and medical health services shortly after their trauma to mitigate potential harm as much as possible.   

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