U. study investigates sexual abuse of males

The research found that eight to 16 percent of the general male population have been sexually abused. While the issue of sexual abuse has risen to the forefront of public consciousness, psychologists and the media have mainly focused on cases where young girls are the victims. But the common perception that boys are rarely sexually abused stands to change with today's publication of a study conducted by University researchers about the treatment of sexually abused boys and the consequences of this abuse. The study, published in today's Journal of the American Medical Association, concludes that sexual abuse of boys happens more often than the medical community previously believed and asks for more recognition and treatment of the problem. The project, led by Internal Medicine Professor William Holmes, involved a review of 166 previously published articles that examined sexual abuse. "Sexual abuse of boys is happening, and we need to address it more aggressively as a society," said Holmes, the lead author of the study. The researchers found that eight to 16 percent of the general male population has a history of sexual abuse. Holmes said this statistic -- which comes out to one in every six to eight men -- is a higher rate than the much more widely known incidence of breast cancer in women, which occurs in one out of every eight to nine women. Holmes, who teaches at Penn's Medical School, found that studies on male sexual abuse are sparse compared to those on female abuse. He added that while people have become more comfortable dealing with abuse of girls, they still have a hard time coming to grips with the reality that boys are also abused. A number of factors contribute to this disparity, he said. Physicians generally ask patients if they have been abused only if there is some suspicion of abuse. Since doctors are more likely to consider the possibility of sexual abuse in females, Holmes said, they often miss the signs on males. Also, Holmes said people are uncomfortable asking boys if they were abused because most cases of male abuse is homosexual behavior, which remains somewhat taboo in our culture. "These things work together to conspire silence and discomfort" for males and their physicians, Holmes said. But Holmes said he hopes his study will raise awareness of the issue in the general and medical communities. In addition to finding a higher prevalence of abuse than was previously known, the researchers also discovered that the boys at the highest risk for abuse are under 13 years old, non-white, of low socioeconomic status and not living with their fathers. The perpetrators, many of whom were female, tended to be friends or acquittances of the victims. Holmes also said that he found an "interesting trend" among the male victims -- that those who are sexually abused by older females at a young age often tend to change their views of the incident as they get older, ultimately coming to see the abuse as "normative." "Boys probably have sexual abuse experiences with older women that subsequently become redefined as normative," said Holmes, who is also a senior scholar at Penn's Center for Clinical Epidemiology and Biostatistics. Randy Fitzgerald, president of the three-year-old National Organization on Male Sexual Victimization, also said sexual abuse by a woman is often misinterpreted as sexual initiation. "We see [men] only as oppressors, and we need to get over that," to include them as victims, he added. "There is an ingrained cultural understanding? [that] expects men to be able to care for themselves and protect themselves." The Penn study also found that there are extensive consequences of childhood abuse, ranging from psychological distress -- including depression, anxiety and suicide attempts -- to sexual problems. Former victims also tend to be younger and more frequent drug users, Holmes said, perhaps because "for these men, substance abuse is a way of self-medicating." And they are also more likely to become sexual abusers as adults in an attempt to rid themselves of the "victimhood" that they held inside for so long, Holmes said. He called upon parents to be concerned with where their sons are and who they are with and to encourage them to talk about any abuse. "We must become as vigilant with our boys as we are with our girls," he said. Darlene Pessein, director of outpatient services at Philadelphia's Joseph J. Peters Institute for victims and perpetrators of sexual assault, said this study is "great" because it will raise awareness that boys can be victims too. She also encouraged victims to speak out about their abuse and realize that therapy can help them get on with their lives. "The myth of 'don't talk about it' really is a myth," she said.