The Evaluation and Treatment of Adult Male Survivors of Sexual Abuse

In the wake of Penn State’s sexual abuse scandal, I interviewed Dr. Matthew Mendel of Raleigh, who specializes in the evaluation and treatment of adult male survivors of sexual abuse.

NCPA Interview: Impact of Sexual Abuse Upon Men

Download: interview-ncpa

Your 1995 book, The Male Survivor: The Impact of Sexual Abuse (Thousand Oaks, CA: Sage), broke new ground on a difficult subject. What led you to write this book?

The idea for the book grew out of my dissertation research at the University of Michigan where I was involved in the Inter-disciplinary Training Program on
Child Abuse and Neglect, which included M.D.s, social workers, clinical psychologists, epidemiologists, doctoral students, and medical students. When I began reading what little there was on the topic of sexual abuse of males (hereinafter, “male sexual abuse”), it was clear that the literature was based almost entirely on the experience of female sexual-abuse victims and survivors.I could find Little in print about what was unique and different about the experience of male sexual abuse. I attended conferences and workshops and talked with those who had worked with male survivors. Eventually I organized a study based on 124 male survivors of childhood sexual abuse and then interviewed 10 of the men in person.

Can you discuss your forensic expertise in the area of male survivors?

I was not intending to pursue forensic work at all, however after the book came out in 1995 I was approached by legal professionals to present my work at conferences, which then led to my work as an evaluator in capital offenses. This is a very specific area. Most of my cases are in the trial phase, in which the men are facing first-degree, capital-murder charges, and the possibility of a death penalty. Others are already on Death Row and in various stages of  the appeal process. My evaluations are used to possibly reduce the potential level of punishment.

My work is not about identifying guilt or innocence and not about culpability for the crime. The outcome for these prisoners is either death or life without parole. I have evaluated men in several states and in the military judicial system. Spending an afternoon in a jail or prison and seeing the humanity of these men is not something I ever thought I would experience in my life. I have learned that these men who have done these despicable things are still human beings that one can talk to and get to know. Sometimes the crimes they have committed are directly related to what they experienced in childhood; the clearest connection is when they kill their abuser. In other crimes, these prisoners had gone on to perpetrate abuse parallel to what had been done to them. Their crimes went even further and ended in murder; unbelievably painful to talk about and almost equally painful to bear witness to their story of the abuse that had been done to them a generation earlier.

It may seem strange for me to both help victims of abuse and to work on behalf of the offenders and their defense team. I believe this is still the same kind of work; dealing with the long-term effects of childhood abuse and trauma and the sequelae of everything that can happen when men do not get help and support in the form of treatment.

In the past several months, there have been a series of reports of high profile alleged male sexual abuse. What is the likely effect of this reporting?

This is certainly not the first time time there has been male sexual abuse reported. Reporting does have a big impact. When male sexual abuse is underreported and not talked about, it sets up a vicious cycle. When male sexual abuse is secretive and believed to be unusual or rare, this perpetuates the victim’s sense that he is the only one abused, which creates a climate in which it is more difficult to come forward and report The silver lining of the widespread awareness of the high-profile cases is that public recognition has been shown to make it easier for boys and men to come forward.

Download NCPA Interview: The Evaluation and Treatment of Adult Male Survivors of Sexual Abuse

Fifteen years ago a professional hockey player, Sheldon Kennedy, publicly disclosed having been abused. He had an enormous impact partly because it is hard to think of a more tough, gritty, masculine profession than hockey. For this player, who had a reputation as a hard hitter, to come forward, gave implicit permission to the public to view abuse differently, and formale victims to see themselves differently.

Oprah Winfrey aired a series on male sexual abuse that also is thought to have had a significant impact on public awareness. I think and hope that the recent cases will have a similar impact. Public awareness doesn’t take away from the tragedy, but my hope is that this will allow other male victims to come forward and get help. It makes such a difference when people realize they have to be aware and report abuse, whether male or female and no matter how important the people involved in the offense happen to be or who they are. Anywhere there is a situation where someone has a great deal of solitary unsupervised contact, there is the potential for abuse, because ultimately sexual abuse is an abuse of power.

What are the teaching points you may have for colleagues interested in deepening their understanding of this population?

Due to male socialization and roles, we are expected to be competent, capable, and self-reliant. To be a victim means to be helpless and powerless, which is particularly abhorrent, terrifying, and intole-rable for males. Men who have been abused ask me, “Does this mean I am weak, powerless, or effeminate? Did my abuser think of me as girlish or feminine, and did they see a weakness in me?” Recovery involves helping these men come to terms with what happened in the past when they were a child and were, in fact, powerless and dependent. This abuse history doesn’t determine anything about their strength, power, effectiveness, or masculinity in their adult lives. It is such a hard lesson to learn, but it is at the core of recovery. Public awareness and family support makes it easier for those who have been abused to come forward and report.

Is there a particular myth about male sexual abuse that you would like to address for our NCPA colleagues?

It is a myth that sexual abusers are always men. Historically, sexual abuse was not acknowledged for many years. And then, the collective mental model was that of the stranger in the trench coat, and that only little girls were at risk. Research then emerged to show that the vast majority of offenders are known to the victim and the family and often are members of the family. Increasingly, the public is learning that sexual abuse can happen to boys as well, not at as high of a rate as we see among female victims, but closer than many would estimate. There is a surprising proportion of female offenders.There is a unique shame about being abused by a female which is, in some ways, even greater because we are socialized as males to believe that we should be indiscriminately sexually interested as long as the other person is a female. Consider how many movies portray early pubescent initiation into sex where the boy is lucky and fortunate, as though he were living the dream of every boy.

Although it may be a fantasy of some, in reality early sexual activity for a boy with an older woman is traumatizing. Research  shows that males may not experience these encounters as abusive, which explains a portion of the under-reporting. When males are asked, “Were you sexually abused?” a very low percentage will say yes. However, if the question is asked, ‘Did you experience sexual activity below a certain age, with somebody a specific number of years older,’ there is a much higher level of disclosure.

Legally, these encounters are defined as sexual abuse, and the research shows that their level of trauma, social and occupational impairment is comparable to those individuals who identify as having been sexually abused by a male perpetrator. We see effects associated with early trauma such as substance abuse, and poor adjustment overall. Additionally, when a boy does not enjoy the sexual initiation with an older woman, which that socialization has taught him that he ought to, he may internalize questions such as, “What does it say about me that I didn’t enjoy this. Is something wrong with me?”

Do you offer workshops or individual consulting for professionals in the area of treating male sexual abuse?

I have presented for NCPA as well as other professional organizations. I am available for public speaking, and for consultation.