Like female survivors of sexual assault, male survivors experience fear, anger and an overwhelming sense of loss of control over their bodies and selves. The male survivor may also feel dirty, ashamed and/or guilty. He may be very embarrassed. Male-on-male sexual assault may involve genital contact, or may be a generally sexualized, physical attack. Many believe that sexual assault of males is more under reported than sexual assault on females. Frequently, male-on-male attacks are gang-related and result in severe injury to the survivor.
However, male survivors have some concerns that female survivors do not. He may feel particularly disturbed by the fact that he was unable to protect himself from the assault. A male survivor may fear that others will discover that he has been assaulted. Remind him that whatever he did to get away was the right thing.
If the survivor is heterosexual, he may believe that the assault means that he is gay or will become gay. This fear may be generated out of the myth that consensual sex equals rape. There is every reason to believe that he'll continue to express himself sexually based on his sexual orientation prior to the assault. He may feel a strong need to withdraw entirely from sexual relations for a period of time. Some men experience an erection and/or ejaculation during the assault, but both of these responses can occur as involuntary reactions to extreme stress, and my be purely physiological. A male does not have to be sexually aroused to have an erection; he may ejaculate without having an orgasm, or he may have an involuntary orgasm.
Emphasize that the attack was one of violence, not sexuality. The medical examination may include a proctoscopic examination, as well as examination of the genitals for lacerations and other injuries. If oral penetration occurred, the doctor will probably take a throat culture for gonorrhea.
Homosexuals, bisexuals or gay-identified people are often targets for sexual assault. They suffer from many of the same types of trauma as heterosexual men with a few important differences. He may feel that because of his non-traditional life-style, he is to blame for the assault. He may withdraw from consensual sexual activity because it may cause him to experience flashbacks to the assault. Masturbation may also bring on flashbacks. Gay individuals may be treated with suspicion and disrespect, and may fear insensitive treatment from hospital and legal personnel. As with all survivors, be certain to stress that he is in no way responsible for the violence perpetrated against him.