The magazine, Harper's Weekly, carried an item from the American Bar Association Journal declaring that few rapists are punished for their crime: only one in five rapes is reported and only one out of eight reported rapes ends in conviction. In a dialogue to demonstrate why most rape victims prefer not to press charges, the article asks us to imagine a robbery victim undergoing the same sort of cross-examination that a rape victim does:
"Mr. Smith, you were held up at gunpoint on the corner of First and Main?"
"Yes."
"Did you struggle with the robber?"
"No."
"Why not?"
"He was armed."
"Then you made a conscious decision to comply with his demands rather than resist?"
"Yes."
"Did you scream? Cry out?"
"No, I was afraid."
"I see. Have you been held up before?"
"No."
"Have you ever given money away?"
"Yes, of course."
"And you did so willingly?"
"What are you getting at?"
"Well, let's put it like this, Mr. Smith. You've given money away in the past. In fact you have quite a reputation for philanthropy. How can we be sure you weren't contriving to have your money taken by force?"
"Listen, if I wanted--"
"Never mind. What time did this holdup take place?"
"About 11 P.M."
"You were out on the street at 11 P.M.? Doing what?"
"Just walking."
"Just walking? You know that it's dangerous being out on the street that late at night. Weren't you aware that you could have been held up?"
"I hadn't thought about it."
"What were you wearing?"
"Let's see -- a suit. Yes, a suit."
"An expensive suit?"
"Well, yes. I'm a successful lawyer, you know."
"In other words, Mr. Smith, you were walking around the streets late at night in a suit that practically advertised the fact that you might be a good target for some easy money, isn't that so? I mean, if we didn't know better, Mr. Smith, we might even think that you were asking for this to happen mightn't we?"
The crime of rape is one experienced by almost all survivors in a very similar way. Most report, for example, that it was a life threatening experience, regardless of whether the perpetrator was someone they knew, or a stranger. Assaults by groups of individuals may last longer, but in other respects the number of assailants does not make the rape less traumatic. There are, however, some considerations to keep in mind, even though, in the vernacular, "Rape is Rape".
Acquaintance rape, or date rape as it is sometimes called, creates problems for the survivor that stranger rape sometimes does not. Significantly, most of these problems derive from the reactions of others to the rape, not from the survivor's experience itself. If those the survivor confides in after an assault react with statements like, "How can you call it rape if you had sex with him before?" They will add to the survivor's sense of guilt or responsibility, and possibly to her fear. If her support system itself tends to place the blame on her, she will have a more difficult time believing that she was not at fault. We must keep in mind that agreeing to see someone is not the same as agreeing to have sex. It is not difficult for a survivor of sexual assault to convince herself otherwise, if she is confronted with this view from others. If others question that she has the right to consent to any sexual encounter, she may feel that she will not be protected in the future. The simple statement, "No one has the right to do that," may assist her more than any other words she could hear.
Acquaintance rape is probably more difficult to prosecute, because the general public, those who sit on juries, often subscribe to many of the myths surrounding rape. An acquaintance rape victim, however, should not be discouraged from pursuing prosecution simply because she knows her assailant.
The myths about rape have long obscured the existence and prevalence of rape by people known to the victim. This may mean the man sometimes seen at the bus stop or grocery, or the friend of a friend, or a neighbor; and includes someone with whom the victim has established a relationship, a date, a boyfriend, lover or husband. Estimates of the incidence of acquaintance rape vary widely, but it is generally accepted that at least one half of all rapes are non-stranger perpetrated.
Concerns
Although the advocate will rely on the same skills and information as with victims of stranger rape, it is helpful to recognize that special concerns may rise with a victim of acquaintance rape.
Labeling as rape: Because of the prevalence of rape myths, it may be difficult for the victim even to recognize the incident as rape. Particularly if she isn't badly physically injured, expect her to be grappling with this.
Betrayal of trust: Some women can begin to regain control after a stranger rape by fortifying their home, and becoming increasingly wary of strangers. Raped by an acquaintance, a victim can't lessen her fear merely by "not talking to strangers". Someone she trusted betrayed that trust, and all men may now be frightening. Her faith in her own judgement may be badly shaken.
Guilt: Not accustomed to viewing "nice" or "attractive" men as potential rapists, she may review her behavior to discover what she did wrong. Women are taught to be responsible for keeping men in line, and for putting on the brakes and enforcing it. She may blame herself for wearing suggestive clothing, for excessive teasing, or for being nice.
Socially, a victim of acquaintance rape may find less support from her friends and family. Her experience may be minimized. ("We've all had to wrestle with dates before. Just forget it.") She may be blamed. ("After all, you knew his reputation as an octopus.") She may have less control over who to tell. If it is within her circle of friends, he may spread the word about their "sexual encounter" complete with explanation about why she is now changing the story.
Legally, a prior relationship with the rapist may be subject to examination during a trial. More immediately, she must decide whether to cooperate in pressing charges, to speak to the police, to describe and/or identify her attacker, and to speak with detectives. This decision may be based on whether, and how regularly, she will see him again. If she decides to press charges, there may be more pressure from the rapist, his friends and family to drop charges.
Gang rape generally involves a situation where the leader of the group meets the profile of either an anger rapist, a power rapist, or a sadistic rapist. The others in the group or gang are followers, undoubtedly with some psychological dysfunctions of their own. The survivor of a gang rape will often evoke more empathy and support from those she encounters following the event. Multiple assaults increase the possibility of genital trauma, disease, and physical injury to all parts of the body. Occasionally a gang rape will involve one individual who observes the assault, but does not participate actively in it. When this occurs, the survivor may react with more anger toward that individual than toward the actual assailants. This occurs because she feels betrayed because the observer did nothing to stop the assault, and also because it is safer to be angry at someone who did not actually inflict physical harm. This sort of anger is healthy, and will probably eventually re-direct itself toward the actual assailants.
Sexual exploitation is a pervasive problem affecting mentally handicapped children and adults. Data compiled during the last two years by the Seattle Rape Relief and the Sexual Assault Center at Harborview indicated that mentally disabled children and adults are most often sexually exploited by relatives or caretakers such as staff persons, volunteers, bus drivers, or "friends". Their statistics for this time period show that 99% of the victims they worked with knew the assailant or was in an authority position to the victim. The incidence of sexual exploitation creates a highly confusing situation for the mentally disabled individual. She or he does not have the knowledge base to understand that the relative, friend, or caretaker is involved in an illegal and immoral activity. This confusion is compounded by the fact that handicapped individuals have been socialized to comply with the requests of this authority figure and that authority offers affection and favors. The handicapped individual often fears reporting these incidents because she or he may be blamed for the incidents or causing a disruption in the family. Another cause of low reporting rates among disabled persons is their ignorance of the community resources which can assist them. Unable to protect themselves or to obtain help, they become repeated victims of rape or incest, sometimes over a period of years. Mentally disabled persons are more vulnerable to exploitative situations. Many disabled children and adults live in highly protected environments such at institutions, or group homes, or private homes. These persons are accustomed to obeying the directions of adults with question, and because of this, they are easily victimized while in the community. For those disabled persons who move out of the sheltered settings into unsupervised settings, the risk of exploitation increases. A recent trend encourages movement of disabled adults into independent settings where staffs support is not constantly available. As the trend toward independent living increases, the need for disabled persons to exercise self-protective practices becomes critical.
Dynamics Of Sexual Assault With The Mentally Disabled Victim
Mentally/Developmentally disabled females and males are more vulnerable to sexual assault; the dynamics are very like those of child sexual assault; secrecy and threats. Because of the mental disability, a 13 year old victim may perceive the assault as a "normal" 13 year old, i.e. If no physical force is used, the victim often does not know that the sexual assault is abnormal, she just knows that it feels good, and that she/he is receiving more attention. The vocabulary of a disabled victim may be less educated and there may be less knowledge of anatomical words. Assault situations may be ongoing because the mentally disabled person feels neglected by society and she/he likes the attention of the abuser.
Mentally disabled children are less likely to pick up "sexual assault cues". They do not question or discuss the abuse. These children most likely live in residential or home settings as assaults and continue the pattern of not talking about the abuse. Also, mentally disabled persons do not learn to evaluate relationships, i.e. are they good/bad abusive???
Skills For Interviewing A Mentally Disabled Victim
The interviewer should assess the degree of disability:
- It's OK to talk to others already involved (teacher, parents) for information on disability, language, verbalizing of the victim.
- What's the attention span (hyperactivity, etc.)?
- What is the living situation (home, institution)?
- Body awareness--vocabulary of body parts?
- What is the victim's concept of time? (What did you do last weekend? What did you have for breakfast this morning?) There may be little concept of the future.
The interviewer should ask some preliminary warm-up questions to get a sense of the vocabulary and understanding of the victim. But be careful not to approach the victim at too high or too low a level. We should not fall into a condescending pattern. Be aware that some high level mentally disabled people learn to talk well to show that they are not disabled. Also, sometimes expressive skills are good and there is a low level of receptive skills or vice-versa. Pose questions in a non-abusive manner, i.e. "Have you learned your address yet?" The affect of mentally disabled persons is like that of children--matter of fact, flat affect. Assess the client's level of understanding. Example: "I need you to help me at my job. Remember that we talked about going to see the police? Why don't you tell me what we're going to do there?"
All victims of sexual assault, regardless of their mental capabilities, have the Right to receive fair, equal and sensitive treatment by the Center, hospital and legal institutions. It is the responsibility of the advocate to insure such treatment within the structure of the Rape Crisis Center and other institutions. In the event that any problem of this type should occur, contact Center staff.
Rape of women over the age of 50 years is likely to be more aggressive and violent then rape of younger women. Physical forced is used in 97% of the cases. It is unknown whether this is a difference in the pathological character of the rapist of older women compared with rapist of younger women. The rapist is likely to be 16-26 years of age, of the same race as the victim, and unknown to her (68% strangers). Most of the victims live alone, and 73% are raped in their home. The rapist is admitted into the home by the victim in 43% of cases, and in another 36% he gains entrance through an open window or unlocked door.
Concerns Of The Victim
The victim's main concern is her fear of death from the assault. There is marked severity of physical injury, especially to genital areas. The aggression is psychologically traumatic, and represents a loss of independence to the victim. She is faced with the recognition of loss of effectiveness and control, which may have a profound and permanent effect on her. She is concerned about family members and their reaction to the assault. The older woman is concerned with sexuality but not pregnancy.
Vulnerability
The older woman is seen as a vulnerable target by an assailant in the following ways;
- Her normal physical capacities may be diminished, thus restricting her ability to escape, defend herself, or identify her assailant. Mental impairments may add to her helplessness.
- She may have a set routine for shopping, banking, and other errands that are easily observable.
- She is likely to depend on walking or public transportation.
- She may live alone and/or change to safer modes of accomplishing the routine.
This fear may by out of proportion to the actual risk of attacks, as such may be more detrimental than the crime itself. Fear can better be used to build a healthy concern about the problem and acceptance of the need for avoidance and protection.
The victimized prostitute experiences as much pain and hurt as other women and is more vulnerable to sexual assault because of her profession. Her pimp may have used rape as his recruitment mode, emotionally crippling the victim to the point where she believed prostitution was "no big thing." She is also often raped by clients who decide not to pay for her services because she is considered "free and fair game". Her assailant knows she has no legal recourse unless she is terribly brutalized or murdered and that she is considered an unreliable witness by the police.
The prostitute is disenfranchised and knows it. She realizes few people, let alone the police, will believe she was assaulted and even fewer will care. She displays anger and hostility as a result of her frustration, sense of futility and helplessness. She may even consider changing her lifestyle. Her primary concern and fear is her pimp's reaction. She may display a biased attitude although she is completely terrified. She is afraid of being punished or beaten because she is losing time on he street and therefore, income. She is also worried about her pimp believing she is lying about the assault to avoid working.
It is especially important in counseling a rape victim who may be a prostitute (or considered one by the police) to maintain nonjudgmental support. Whatever the advocate's prejudices or preferences sexually, a distinction must be made between a voluntary sexual act and the involuntary violent act of rape. Regardless of the prostitute's reasons for withholding her sexual favors, she is always due respect and should be treated with dignity. The advocate may be the first and only woman white or black, to respond to the prostitute with sympathy, compassion, and respect.
Whether or not a victim is a prostitute should not affect the caring and help given to her by the advocate. Be aware, however, that even the suspicion that a woman may be a prostitute will probably alter the care and consideration given to her by the police and even by medical personnel. The advocate will have to be especially diligent in her role as "buffer" between the victim and police/medical personnel. The victim may be fully aware of the suspicion directed at her and will need sincere reassurance that the advocate does believe her. Should the behavior of the medical staff and/or police warrant it, the advocate should ask to speak to them outside of the examining room. If the reaction of any police or medical people becomes extreme (e.g., the police want to arrest the victim for soliciting rather than pursue a rape assailant.) the advocate may call an RVA board member for support/help.
Most people, especially men, are not aware of the sexual victimization of men and boys. Illinois sexual assault legislation which went into effect on July 1, 1984, now includes the sexual assault of men as a crime.
Many people mistakenly assume that either the victim or the assailant are homosexual. Neither of these is necessarily true. It is incorrect to refer to the sexual assault of men as "homosexual rape" since the assault has nothing to do with the sexual orientation of either the victim or the assailant. As is true for women, sexual assault of men is motivated by power, anger and the need to control, not by sexual impulses.
Psychological Reactions
Like women, men who have been sexually assaulted may be afraid or angry and may experience an overwhelming sense of loss of control over their own bodies. They need to view the sexual assault as an act of violence and aggression rather than as an act of sex. They may feel dirty, ashamed, guilty, much as a woman may. In addition, a man may feel as if he has lost his "manhood". However, he may not be able to verbalize his feelings because men are taught that it is unmanly to be emotional. He may need to prove, to himself as well as to others, that he is in control and unaffected by the assault. He may, however, express anger readily, since this is one emotion that is acceptable for men.
Heterosexual men may worry about becoming homosexual. He may exhibit compulsive heterosexual behavior to prove that he is still "a man". For many heterosexual men the rape represents a threat not only to their physical well-being but also to their sense of who they are because it forces them out of the dominant social and sexual roles they are accustomed to.
Homosexual men who are victimized may become withdrawn from sexual activity. He may experience flashbacks while masturbating or during consenting sex.
Often men who have been victims will experience sexual dysfunction in their consenting relationships.
Men may have a desire for revenge. He may see revenge as the only way to get his "manhood" back. Discuss this issue with him.
Some men will be worried because they had an erection during the assault. Point out that it's not true that one has to be sexually aroused to have an erection. Having an erection does not necessarily mean that a man is turned on. He may be confused about ejaculation versus orgasm. He can have ejaculation but no orgasm. Point out to him that involuntary orgasms are possible. The attack on him was still violent.
Fears
Most male victims do not report to the police or to medical facilities. Embarrassment and fear of anyone finding out about what happened may be more intense for men than for women. Again, heterosexual men may be worried about their own sexuality or about other people assuming he is homosexual. You can ask the man why he thinks he might be gay. A good way to be supportive is to ask, "Have you ever been in love with a man?" If the answer is no, then ask, "Why do you think you're gay now?"
Male victims who are homosexuals may worry that by reporting the rape, their lifestyle will be used as evidence that the assault was their own fault and that public exposure of their sexual orientation will cause trouble with employers, family, friends, or landlords.
Men are accustomed to viewing themselves as protectors of women and the fear that they cannot protect themselves may be especially disturbing. Remember that most men are raised believing that they can take care of themselves. They probably have never thought about their own vulnerability.
Intervention
Men may need extra help processing the experience. Help them sort out their feelings. Help them prioritize. Let him see that he is beginning to recover; give encouragement. Remind him that cooperation is not consent. As with women, validate whatever he did that kept him from getting killed and that got him to the hospital. Clarify the transgression. Remind him that he is the victim and victims should not be blamed. He did not commit the crime; the assailant did.
Since men are not generally oriented to counseling the advocate may have to do more aggressive outreach. You may have to use anticipatory counseling to get the man to talk. For example, "I've spoken to other people who said" or, "I want to share some information with you from what I've learned..."
Many men will want their problem solved in one session. This is not possible. Telephone follow-up is necessary. Again, the advocate will have to be more aggressive in pursuing this.
From our experience and the experiences of others, male victims have responded positively to women as advocates. Women are seen as more sympathetic and less judgmental.
Medical Treatment For Male Victims
Until the procedures for evidence collection for male victims are standardized, the individual physical will determine how best to use the Vitullo Kit to collect evidence and what type of medical examination is in order. A proctoscopic examination may be a consideration.
As with female victims, any medical condition requiring immediate attention should be handled first. After that the victim's clothes should be examined for signs of violence and traces of semen and other stains.
The physician may conduct a thorough physical examination looking for any bruises, scratches, etc. The mouth may be examined for signs of trauma. The throat may be examined if oral penetration occurred. A gonorrhea culture may be taken from the throat.
The male genitalia may be examined for signs of trauma, including bites and lacerations. If rectal penetration occurred, the perineum and rectum should be inspected. The physician should look for signs of trauma and rectal fissures and tears as well as rectal bleeding and discharge. If it is possible a digital rectal examination should be performed. The victim's anus may be swollen and tender, so a digital examination may not be possible. In this case, the rectum can be aspirated with saline solution.
If blood is found in the rectum a proctoscopic examination may be performed.
Pubic hair, and head hair combings may be taken as well as fingernail scrapings.
Since there is no standardized procedure for the medical treatment of male victims some of the above mentioned things may not occur. You should be aware of what is going to happen so that you can suggest appropriate medical care.
Myths About Male Rape
Myth: Men cannot be sexually assaulted.
Reality: This simply is not true. Men can be and are sexually assaulted. People assume that the adult male does not get raped unless he is in prison and that once he reached adulthood, a man is safe from sexual assault. Although it is commonly believed that a man is strong enough to defend himself from attack, he is in fact susceptible to the same techniques by which assailants gain control over women victims. This includes entrapment, intimidation or brute strength. More specifically, male victims may be subdued in a number of ways: the assailant may be armed; the assailant may be physically superior; the victim may be outnumbered and faced with gang rape; the victim may be tricked into physical restraints; or the offender may get the victim drunk or drugged.
Myth: Men who are sexually assaulted are homosexuals.
Reality: Men, regardless of their sexual orientation can be sexually assaulted. This mistaken assumption that only homosexuals are raped, stems from the fact that many people view male rape as sexually motivated. In fact, men who rape men do it for some of the same reasons that men who rape women do--power, control, anger.
Myth: Perpetrators of sexual assault against men are homosexuals.
Reality: Believing this myth assumes that the motivation for rape is sexual desire. It is not. Rape is the sexual expression of aggression. Sexual desire is not the primary motivating force behind the sexual assault. The sexual attack may be an expression of contempt on the part of the offender toward someone he perceives as homosexual (whether or not that perception is true) or it may be a way of asserting his superiority and manhood. The assailant's goal is to control or dominate.
Myth: Men who rape other men do so for sexual gratification.
Reality: Again this is simply not true. The motivation for rape of men is not sexual. The victim may symbolize what the assailant wants to control, punish or destroy; something he wants to conquer and defeat. The assault is an act of retaliation, an expression of power or an assertion of strength and manhood.
Myth: If a man is truly being sexually assaulted, he will not be able to have an erection.
Reality: Erection can be a physiological response. A man does not necessarily have to be sexually aroused to have an erection. In fact, an erection does not necessarily mean that a man is turned on. Further, a man can have an ejaculation during the assault without having an orgasm. In addition, for men, involuntary orgasms are possible.
Myth: Men can only be sexually assaulted in prison.
Reality: Many men are sexually assaulted while in prison. However, men are also assaulted where they live, work, travel, and relax. They seem to be at greater risk when engaged in solitary activities or when hitchhiking.
Helping Male Victims
Part I
Men are victims of sexual assault. In the past 5 years, the Sexual Assault Center in San Francisco had 175 cases of adult male victims, which represented 8% of the adult victims they serviced. Most studies say that the rape of a male victim is more traumatic, more brutal, and more sexual assaults are forced upon the victim. However, the more brutal and traumatic the assault, the more likely it is to be reported.
The effect of rape upon a male is similar to that of a female. All of the myths apply to male victims as well as females with the additional myth that he must be homosexual-which is perpetrated by the use of the words "homosexual rape" to refer to the same sex rape. The men feel dirty, shaky, needing support, scared, upset, suicidal, relieved to have escaped, violated, confused, wanting someone he trusts or else be alone, weak, guilty ashamed. Police and medical personnel tend to be even less sympathetic than to females unless there are serious injuries. The long-term effects are that the men tend to avoid sex with either men or women, be more shy, cautious, distrusting, prejudiced, suspicious, less self-confident, self-destructive, and begin addictive behaviors such as alcohol or drug abuse or "workaholic" behavior.
Part II
In Minneapolis there is a Treatment Program for Male Victims of Sexual Abuse which provides therapy for men who were victimized in the past (75% as children, 25% as adults.) When the program opened, they ran a personal classified ad and got 200 responses from male victims the first week! Jay Bischoff, a therapist in this program, explained many of the issues which males deal with in therapy and some points for Rape Crisis advocates to consider in crisis intervention. He has found that most men perceive the assault as even more brutal than it really was - to the extent that they often feel that they were killed at the time. The men tend to internalized the rage and violence and are at first self-destructive or self-abusive and then may begin to victimize others. This also develops from the feeling of powerlessness and attempt to feel more powerful. Guilt is also internalized – they feel that they did wrong, are not worthwhile, deserved it, are inadequate, must have caused it somehow, etc. Shame comes from others laughing or pointing fingers, blaming them, etc.
The men are very angry -- at themselves and at a society that allows them to be victims and doesn't provide them even as much support as for women. They need to let go of the issues which caused the anger, especially at themselves for any similarities to the offender and also to express the anger in safe ways. Jay related that the anger is so strong that even pounding pillows, they sometimes end up breaking their hands. Almost 100% of the men in treatment have some alcohol or drug abuse trouble either themselves (80-90%) or in their families since this is a socially acceptable way to try to cope.
Intimate relationships are extremely difficult. They want and need the love and support, but they feel they don't deserve it, don't know how to ask and their lovers don't know how to give the support needed. One helpful way they have found to work through this is to give peer support to other victims. They can also benefit from a supportive lover who can reaffirm that rape is not sex and therefore sex is not rape.
The men are very fearful of many aspects of life: anyone who reminds them of their assailant, anyone who is larger than themselves, the dark, or being alone. However, it is not "manly " to be afraid and so they are ashamed to admit it and talk about their fears. Trust and control issues are also very important and interrelated with some of the above issues. Sexual identity is another common difficulty.
Many men fear that they will become sexual assailants themselves.
A Couple Of Pointers
When an advocate meets a male victim, she will probably feel awkward because she has been trained primarily to work with women and children-but realize that their feelings are very much the same and so can be treated the same. One work of caution though: the male victim who is feeling powerless may try to regain his sense of power by trying to feel more powerful than the advocate. So acknowledge his need to feel powerful without taking it personally. Also, if a man calls and says he feels like raping someone, talk about how he learned that behavior. Chances are that he was a victim himself; and if he can deal with his victimization by talking and expressing his feelings, he will be less tempted to rape someone else.
The program found that when they gave new clients the choice of having a man or woman therapist, they chose a woman. However, when they gave the choice of a man who had been victimized or a woman who had been victimized, many chose the man who had been victimized. We get very few calls from adult male victims, yet I'm sure they're out there. They need support and an outlet for their feelings--I only hope we can be there for them.