When working with men who have been subjected to sexual abuse or assault, thinking in depth about disclosure is necessary in order to comprehend the difficulties these men can face when seeking assistance or attempting to talk about this trauma.
Disclosure is a highly significant event in men's recognition of the traumatic impact of sexual abuse. This can include their historical experience of disclosure, if they attempted to do so as a child, as well as their efforts to disclose or discuss the issue as an adult.
Vulnerability is often present in decisions to disclose, whether it is a child speaking for the first time, or an adult disclosing abuse many years after its occurrence. There are many barriers to disclosure for boys and men that can add to their sense of vulnerability and fear of being judged.
The responses that these boys and men then get to disclosure are influential in their healing and well being. Research indicates that a negative response to disclosure can exacerbate the mental health effects of sexual abuse. This means that where responses have been damaging or inadequate it is important to pay attention to the impact of this experience.
This training module focuses on the act of disclosure, and the discussion of sexual abuse that follows. Information is provided about what can influence men's disclosure of sexual abuse or sexual assault. These factors should be considered in practice responses to working with men. There is also information on the ways to work with men to understand both the difficulties of disclosure, and the context and impact of damaging or inadequate responses to disclosure.
The module is presented in two parts. Part one is focused on research evidence regarding boys and men's disclosure of child sexual abuse. This examines past experiences of disclosing or not disclosing, and the personal and socio-cultural barriers faced by boys and men. Part two has an orientation to the present time — decisions faced, both by practitioners and men, regarding disclosure. This is looked at in the context of help seeking, as well as men's decisions about whether (and how) to tell partners, family, and friends. There are important links to other topics, such as Masculinity and Effects, when considering disclosure of sexual abuse.
Men's decision to disclose to police or child protection authorities, which is called 'justice reporting', will soon be discussed in a separate module. However, reference is made in this module to conditions where it may be appropriate as part of a duty of care to report any risks of harm. This is briefly discussed in terms of the importance of managing expectations regarding limits on confidentiality in response to disclosure.
Contents of module
Part one: Research evidence about boys and men's experiences of disclosure of sexual abuse
- Disclosure – a process, not a static event.
- Gender differences in disclosure of sexual abuse.
- Men's experiences of disclosure – as boys; as men.
- Barriers to disclosure.
- Factors impacting men's disclosure.
- Dispelling unhelpful myths about the sexual assault and rape of men.
Part two: Responses and decisions regarding disclosure
- Responding to men's disclosures in different practice contexts.
- Men's experiences of past responses of professionals.
- Events that may trigger or promote disclosure.
- The importance of the response received to disclosures.
- Asking the question.
- Initial responses to disclosure.
- Choosing whether and how to tell partner, family, friends?
- Disclosure is not a one-off static event but a process.
- Each time a man discloses there are opportunities for responses that serve to either a) support and validate him, or b) add to his trauma and silence him from speaking further.
- Research literature presents a clear picture that patterns of disclosure are different for men than they are for women. Boys and men disclose less often and much later than girls and women.
- Barriers to disclosure for men are influenced by gender and socio-cultural factors, which make it more difficult to acknowledge that men can be sexually victimised.
- Men's disclosure of sexual abuse or associated information can occur in a range of social and practice contexts. Disclosure can be direct, inadvertent, incomplete, or via a third party. Therefore, responses need to be context specific.
Indicators of possible abuse
There are psychological and behavioural indicators of possible sexual abuse for boys and men. These can include generalised factors, such as anxiety, or can be more specific, such as fear and distrust of males. Indicators differ across age groups and contexts. If working with boys or men in other contexts, and these indicators are observed, it could be worthwhile considering that he may have been sexually abused. Men can demonstrate distress through a range of behaviours, without ever directly acknowledging or disclosing that their distress may be linked to sexual abuse. Caution is needed as indicators are guides only, and may easily be indicative of another issue altogether. At the same time, some boys and men may have become quite attuned to keeping silent about their abuse, and therefore indicators might not be easily observed.
There are complexities across the life course for the manifestation of indicators of sexual abuse. For example, sexualised behaviour for boys might manifest as behaviour that demonstrates sexual knowledge beyond their developmental stage. Sexualised behaviour of adolescents and men might include obsessive or risk taking behaviour, such as compulsive masturbation, sexual confusion, or dysfunction. All of these behaviours can also occur without a history of sexual abuse.
Some men who have experienced sexual abuse have reflected back on the lack of action by adults around them; adults who did not understand, or who were unable to discern the signs. For those caring for or providing services to boys and men, this highlights how important it is to be able to recognise possible indicators. For example, imagine a boy who demonstrates changes in behaviour, from being relatively cooperative, to becoming disruptive or disengaged. To an experienced worker, this might prompt further inquiry into the boy's well-being, rather than relying on a reflexive response that the child is 'going through a stage' or 'being naughty for attention'. When reflecting on childhood, men might recount times when their behaviour was problematic, yet no one recognised that this may have been attempt to seek help.
Men may be cryptic in identifying behaviours or challenges that are associated with their history of sexual abuse. Careful and sensitive questioning might spark a conversation to make disclosure possible, without directly asking the man about being sexually abused. Direct questioning can be experienced as confronting, and males may quickly retract from feeling able to disclose. Being cognisant that boys and men will often feel silenced by the perpetrator, but may express their trauma with other behaviours, should prompt further examination. However, it is important not to simply assume that there was or was not abuse in such cases. A balanced approach is required to support the boys and men to participate in their own protection.
Crome’s (2006, p. 5) review of a number of research studies provides examples of effects and possible indicators of sexual abuse. These range from those which have a greater propensity in younger children, through to adolescents and adults. However, there is often crossover across the developmental stages.
|Intense sexualised behaviour.
Urination and defecation problems.
Hyperactivity and aggression.
Fantasy and withdrawal.
Distrust of males.
Disrupted self-identity development.
Drug and alcohol abuse.
Disproportionately high percentage of the population in care and correctional facilities.
Often experiencing cyclical victimisation and continue to be abused, sexually or otherwise in their key relationships.
Psychiatric diagnoses – mood (e.g. depression), anxiety (e.g.post traumatic stress disorder), and personality disorders (e.g. borderline personality).
Divorce, infidelity, isolation.
Sexual orientation conflict, homophobia, male specific sexual dysfunction and compulsions.
Masculine identity confusion and fear of women.
It is important to note that these 'indicators' are not exclusive to a history of sexual abuse, and could just as easily be indicative of other issues. The key understanding here is that indicators are complex and can be part of accumulation of trauma effects and life circumstances.
Strong adherence to male norms can also form part of men's reticence to disclose (Easton, Saltzman, & Willis, 2014). There is research that identifies screening questions that show a good reliability in identifying men who have been sexually abused in childhood (O'Leary, Easton, & Gould, in press).
Relevance for practice
There is evidence to suggest that men present to a range of services for a number of reasons without ever disclosing sexual abuse (ASCA, 2012). Therefore it is important that workers, informed by their knowledge of the effects of sexual abuse, become attuned to the possible indicators of sexual abuse amongst boys and men. Further discussion of how to 'ask the question' about sexual abuse is discussed in this module.