No community is free of sexual assault, rape and abuse. Furthermore, strict study eligibility criteria may reduce the applicability of the research of those affected by complex PTSD and by severe mental health difficulties. Reducing the barriers to access that men face is assisted by ensuring the inclusion of male survivors in developing the evidence base to treat PTSD and other impacts from sexual violence and abuse. There is a clear need for the field to acknowledge male and gender diverse survivors of sexual violence and abuse in adulthood. Over four‐fifths of participants in our review represented the target group; however, we believe that heterogeneity would improve by incorporating sexual violence and abuse suffered in adulthood as an inclusion criterion, which is more common in recently published and ongoing trials. Specifically, research has noted impotence, anxieties over sexual activity, and increased promiscuity with women as a means of validating their sexual identity 41,56,57,116,129. Many men report feeling less masculine, and some assume that they must be “gay” for another male to sexually assault them. One of the major impacts is on the male victim’s thoughts regarding his sexuality and sexual orientation. It is speculated that such a reaction reflects the aspect of male socialization to be emotionally inexpressive to aversive situations. Ben clearly relied on women for emotional support, but then disparaged this type of support in order to maintain a hegemonic masculine status. Nonetheless, Ben attempted to present himself as self-sufficient, denying his own need for emotional connection with women by diminishing these interactions as “just blabber,” and claiming it was women who told him their “problems” and not the other way around. Ben stated that he “compartmentalized” these interactions, having a “different dialogue” with friends who were women than with friends who were men. On the other hand, Ben’s relationships with women entailed talking about his family life and personal problems. These are not considered sexual violence as specified in the DOJ’s definition but are noteworthy for understanding the experiences of men victimized by them. The relatively recent recognition of rape of a male being possible and illegal is reflected in how this issue is denied or misunderstood within society . Until 1994, there was no such thing as “rape of a male” in English law; instead, there existed a felony called “buggery” (unconsenting penile–anal penetration), which had a lesser punishment. Of these, we selected 31 studies that required closer examination before being excluded on the basis of ineligible population. Governmental bodies were reported by seven studies (Acierno 2021; Bass 2013; Bass 2016; Creech 2021; Kelly 2021; Rajan 2020; Schnurr 2007; Surís 2013). In Table 4, we provide a summary of which studies assessed the secondary outcomes. Group 2 included men under 31, living in urban areas, who were single, had higher levels of education, and were formally employed. Group 1 consisted of men over 31 who resided in rural areas, were married, had low educational attainment, and were employed in informal or non-salaried jobs. The study found that 71.2% of violent incidents occurred within the home. This article is part of the Research TopicEnhancing Data Collection and Integration to Reduce Health Harms and Inequalities Linked to ViolenceView all 7 articles OPINION article If appropriate, we also conducted a sensitivity analysis to determine whether assumptions about the effect of the bias impact the estimated treatment effect and the conclusions of the review. If there were 10 or more studies, we constructed funnel plots to investigate associations between effect size and study precision (which is closely related to sample size) (Egger 1997). The Chi2 test is ineffective for analysing heterogeneity in studies with only a small number of participants or trials, so we set our P value at 0.10 (Deeks 2021), and assessed heterogeneity using the I2 statistic, which found the percentage of variability due to heterogeneity outside of the effect of chance (Higgins 2003). From the review we have generated recommendations for policy and practice (box 1). Participant’s descriptions of the criminal justice system are mixed but suggest that at best the police support is short term. It is unfortunate that none of the contributing studies include the views of MSM. That it’s an abusive relationship but you know basically like why are y’all doing this? Some had a sympathetic response but no follow through in terms of applying the law to the abusive partner. EMDR is similar to the behavioural techniques of flooding and systematic desensitisation (Boudewyns 1996a), and studies comparing EMDR with and without eye movements suggest that EMDR without eye movements leads to equivalent outcomes as EDMR with eye movements (Boudewyns 1996b; Pitman 1996). This movement is argued to facilitate the processing of trauma memory through the dual attention required to focus on attending to the therapist’s finger movement (external stimulus) and the trauma scene (internal stimulus). In EMDR, a scene is used to represent the entire trauma. The Royal Commission into Institutional Responses into Child Sexual Abuse (2017b) met with 6,875 individuals in private sessions between May 2013 and May 2017 where 64.3% were male victim/survivors. While girls are more likely to be abused by a male family member, boys experience extrafamilial abuse “. All these factors both perceptually and structurally have impeded focus being given to male victim/survivors of CSA, particularly where it has occurred in an institutional context. There is increasing and strong evidence that most victim/survivors of institutional CSA are male (Romano & De Luca, 2001; Royal Commission into Institutional Responses into Child Sexual Abuse, 2017a), especially in religious institutions (John Jay College of Criminal Justice, 2004; Parkinson & Cashmore, 2017). By collaborating with such organizations and actively promoting their services, we can contribute to breaking the stigma and providing much-needed support to male survivors. However, it is essential to acknowledge the mental health toll that such traumatic experiences can inflict. To do this, campaigns need to deconstruct the hegemonic ideal of the man who is emotionally and socially self-sufficient, does not talk to his friends about his feelings, and can deal with his own problems without support from others. Many men in this study felt the weight of social taboos in their social connections with other men, feeling unable to disclose their personal problems or feelings. The aim of this study, however, was not to generalize the findings to all men in New Zealand, but to explore an undertheorized area and gain a deeper understanding of the relationship between men’s everyday social relations and mental well-being. 11 (sex$ adj3 (victim$ or revictim$ or re‐victim$ or survivor$)).tw,kf. Psychoeducation elements aim to provide information, modelling and training, for example, to explain maladaptive and adaptive coping strategies and to encourage the use of the latter (e.g. see Sikkema 2018). Counselling is likely to be very individually focused in order to discuss issues raised by the survivor, and the necessary variation makes it difficult to specify exactly what is included in each session. On the one hand, the stigma surrounding male victimhood can prevent men from seeking the psychological support they need (10, 12). As a result, the situation becomes amplified, affecting the victim's ability to process trauma and seek solutions for their emotional wellbeing. Men who are victims of IPV often feel powerless due to the perception that they have no control over the violence they experience. This article explores the barriers that male IPV victims face when seeking help in the context of LMICs. 12 ((animal$ or art or colo?r or creative$ or dance or dancing or drama or equine or experiential or music or narrative or play$ or sensory or singing) adj3 (program$ or intervention$ or therap$)).ti,ab,de.This paper reports a systematic review and qualitative thematic synthesis of help-seeking and interactions with services by male victims of DVA.One of Feldman’s alleged perpetrators was the actor Jon Grissom, who was arrested in 2001 for child molestation charges in an unrelated case.It covers oral-genital groping, fondling, kissing, groping, and any other type of unwelcome sexual contact carried out in similar ways .Cognitive Processing Therapy (CPT; Resnick 1997) and Prolonged Exposure Therapy (PET; Foa 1986) are the most common cognitive‐behavioural approaches evaluated in studies of interventions for people affected by PTSD and for those who have been subjected to sexual assault.We celebrate your vulnerability and your strength.They are far from the only celebrities who have come forward.It’s an acknowledgment that what happened was wrong and that the shame belongs to the perpetrator, not the victim. The literature strongly suggests that both adult men and women underreport sexual violence to law enforcement and medical services, and research consistently conveys that men are less likely to report 50,51,52,53,54. This false notion may not only prevent people from believing that men may be abused, but it may also prevent men from recognizing victimization when it does. Another specific rape distortion that affects men is the belief held by the public and healthcare professionals that men cannot be raped . In addition, heterosexual men who were assaulted by other men might not come forward for fear of having their sexual orientation revealed. Men are more likely to encounter reporting issues relating to their sexuality given that they are more likely to be victims of other men. Once relevant studies were identified, a “snowballing” exercise was undertaken—reference scanning relevant studies—which revealed 14 further studies. This has important implications for conducting this scoping study which will consider the emerging evidence, to consider “. A strong evidence base attests to the negative impact of institutional CSA on males over the life course. In total, 36 studies (from 83 reports) met the inclusion criteria for the current review, and nine (from 10 reports) were categorised as ongoing studies that had not yet published outcomes (See Ongoing studies table), and one study was categorised as awaiting classification (See Studies awaiting classification table), see Figure 1. We stratified results for the main comparison (psychosocial interventions versus inactive controls) by type of therapy (see Subgroup analysis and investigation of heterogeneity and Types of interventions), where there were sufficient numbers of studies of the same intervention type, comparison arm and reporting the same outcome. Clinical heterogeneity refers to variability in the participants, setting, interventions and outcomes studied; methodological heterogeneity refers to variability in study design and risk of bias; and statistical heterogeneity refers to variability in the effects reported in the different studies. When studies compared multiple eligible experimental interventions with a single control group, we split the control group to enable pairwise comparisons. Types of sexual assault included rape, attempted rape, forced oral sex, anal sex, penetration with objects, touching of intimate parts and any sexual contact where consent was not given, as well as forcing or manipulating someone to witness sexual acts. Donne and colleagues (2018) note that organizations are far more accustomed to supporting women in this regard . While this is not completely unique to male victims, the misconceptions and lack of understanding can obfuscate the realities of what occurred. One role that helpers can play is supporting victims in acknowledging what has happened. Male survivors would greatly benefit from being recognized as individuals who had suffered a devastating and traumatic event. By promoting diverse narratives that include male victimhood, we can challenge these stereotypes and create a more inclusive dialogue.There are people, services, and communities ready to walk alongside you.For these reasons, psychosocial interventions that avoid discussion of the trauma can be a vital source of support to rape and sexual assault victims.Formal psychological intervention may not be necessary for many men with a sexual abuse history – indeed sexual abuse exposure need not consign boys and men to lives of misery.Male survivors can experience a wide array of emotions following a sexual assault including powerlessness, depression, anxiety, shame, and fear.Supportive therapy can be conducted in either an individual or group format.Following the first round of searches in 2016, the screening included an extra step in which the first author performed an initial screen of the title/abstract removing any obvious female victim citations. Arntz 2007 published data only Everyday experiences of using psychiatric services can re-traumatise survivors and actively prevent healing. I cannot understand how the vast majority of perpetrators of sexual violence walk free in society; whilst people who struggle to survive its after effects are told they have disordered personalities (cited in Coles, 2013). The label ‘personality disorder’, for instance, locates the problem within the individual and de-legitimses the search for meaning in one's responses to, and interaction with, the social world (Coles, 2013). This can be achieved through workshops, community events, and social media campaigns that focus on male victimhood. Encouraging men to speak out against abuse and support their peers can help create a culture of understanding and empathy. Men can be powerful allies in breaking the silence surrounding male victims. Society plays a significant role in shaping perceptions of male victims. He now advocates for male victims, sharing his story to raise awareness and encourage others to seek help. LP was involved in protocol development, screened references with ALH in the systematic review stage, was involved in the discussion of the data and qualitative synthesis and contributed to the final content of the paper. It would seem that services need to be inclusive, to cater to diverse client groups, to involve ongoing support and to be widely advertised. We acknowledge however that MSM is a contentious term and that further refinement of terms is needed.37 It is also important to point out that these qualitative studies have captured the voices of those who were willing to come and speak to someone, whereas more anonymous methods might have yielded some different findings. However, in the Frierson study which clearly defines its participants as gay men we have kept this description. Throughout this systematic review we have used the term men who have sex with men (MSM) as we recognise that some men may not identify as gay or as in a same-sex relationship even when they do have sex with men. 52 ((cope or coping) adj1 (intervention$ or mechanism$ or skill$ or technique $)).tw,kw. 48 ((brief or combination or compass$ focus$ or integrated or integrative or time‐ limited) adj3 (intervention$ or therap$ or treatment$)).tw,kw. 47 ((biofeedback or feedback or imagery) adj3 (intervention$ or therap$ or train$ or treatment$)).tw,kw. These individuals predominantly experienced violence within the household, often perpetrated by female partners using weapons, which resulted in soft tissue injuries. Similarly, a study conducted in Brazil examined 1,520 alleged victims of IPV, of whom 222 (14.6%) were men. With the right support, young male survivors can go on to lead meaningful, connected, and joyful lives. It’s common to struggle with intimacy or trusting others after abuse. 40 ((cope or coping) adj1 (intervention$ or mechanism$ or skill$ or technique$)).tw,id. 38 ((cognitiv$ or cognition) adj5 (therap$ or treatment$)).tw,id. 36 ((brief or combination or compass$ focus$ or integrated or integrative or time‐limited) adj3 (intervention$ or therap$ or treatment$)).tw,id. Several previous reviews of interventions for PTSD have included sexual violence and abuse survivors as a subset of the overall trauma population (Hetrick 2010; Kitchiner 2019; Roberts 2015; Roberts 2016; Steenkamp 2015), and several have called for a focus on specific populations (Bisson 2013; Regehr 2013). Our review considers randomised controlled trials of a wide range of psychosocial interventions for survivors of sexual violence and abuse. We excluded samples made up entirely of individuals (adult or child) who were victims of rape, sexual assault or sexual abuse during their childhood (aged 17 years and under), as well as samples of children (i.e. those younger than 18 years of age). To emphasise the evidence of benefits (and harms) of psychosocial interventions across diverse adult survivor communities, we set out to include studies of sexual assault‐only samples, as well as studies where sexual assault survivors were a subset of a wider trauma sample. The negative effects of rape and sexual assault ripple across generations, having social and economic costs in addition to impacts on physical and mental health by affecting individuals’ capacities to work and to participate in family and community life. That voice is the result of trauma, not truth. You deserve support that works for you. Don’t be afraid to try a few until you find the right fit. No one can force you to take legal action if you’re not ready. Reporting is a deeply personal decision. The Stigma of Male Victimhood Once we had identified and deleted duplicate citations, the searches identified 15,250 records that were potentially relevant to the review. We have reported treatment efficacy at post‐treatment, which constitutes a change in time point from the original protocol (Differences between protocol and review). We created our summary of findings table(s) using GRADEpro GDT (GRADEpro GDT 2015) in RevMan Web (Review Manager Web 2019), and followed standard methods described in the Cochrane Handbook for Systematic Reviews of Interventions (Schünemann 2017). In order to examine any effects of methodological decisions on the overall outcome, we performed the following sensitivity analyses, provided there were sufficient numbers of studies. You’re not defined by your trauma. Some survivors find healing in advocacy. Certain smells, sounds, or situations might bring back memories. Strength is about surviving and choosing to heal. Being strong doesn’t mean never being vulnerable. Bass 2016 published data only It underscores the value of a wide range of treatment options and alternatives to first line therapies. The need to distinguish between PTSD and complex PTSD (CPTSD) has been argued since Judith Herman first proposed the diagnoses in the 1980s, with CPTSD added to the International Classification of Diseases 11th revision (ICD‐11) (WHO 2021). Further insight into factors that shape the treatment preferences of survivors, their families and professionals can be found in our related Cochrane Review (Brown 2020). Comparator interventions consisted of inactive controls, such as usual care, no treatment, delayed provision of psychological interventions (or wait‐list conditions), or pharmacological treatment only, and minimal interventions such as information provision. We included studies involving subsets of eligible participants provided that the subset included at least 50% of those randomised and could be analysed separately. Hence, this review is feasible and timely and addresses an important gap in the current literature. Whilst TF‐CBT and EMDR are recommended for PTSD, none has been fully effective in its treatment (Kitchiner 2019), with most studies reporting that between 60% and 72% of participants retain diagnosis (Steenkamp 2015). • We found evidence that psychological or social (collectively known as ‘psychosocial’) interventions may reduce symptoms of post‐traumatic stress disorder (PTSD) and depression in survivors of rape, sexual assault and abuse experienced during adulthood. Previous studies have called for an urgent focus on intervention-based research for males with histories of sexual abuse, including the roles of formal and informal support groups, psychoeducation and awareness campaigns, and refinement of clinical treatment modalities.8 This may extend to case conceptualisation, assessment and diagnosis, inclusive of older men who may be presenting to mental healthcare services for the first time. Prior meta-analysis in the general population (11 and a recent self-report study adopting convenience sampling among 1277 young men (≤30 years of age) seeking mental health help yielded a childhood sexual abuse prevalence rate of 21.9%.7 This rate is remarkably similar to the 21.1% self-reported prevalence in the Zarchev review, which was notably 11.5% higher than the 9.6% prevalence reported in face-to-face studies. 64 (psychoanalytic$ or psycho‐analytic$ or psychodynamic$ or psycho‐dynamic$).tw,kw. 59 ("Eye Movement Desensitization and Reprocessing" or EMDR).tw,kw. 54 ((couple$ or family or group or systemic$ or multimodal$ or multi‐modal$) adj3 (program$ or intervention$ or therap$ or treat$)).tw,kw. Seven of the 23 studies (with 801 participants) comparing a psychosocial intervention to an inactive control reported on adverse events, with 21 events indicated. We included 36 studies (1991 to 2021) with 3992 participants randomly assigned to 60 experimental groups (3014; 76%) and 23 inactive comparator conditions (978, 24%). We classified psychosocial interventions according to Cochrane Common Mental Disorders Group’s psychological therapies list. Beyond such trauma‐focused cognitive and behavioural approaches, there is a range of low‐intensity interventions along with new and emerging non‐exposure based approaches (trauma‐sensitive yoga, Reconsolidation of Traumatic Memories and Lifespan Integration). Research led by and co-produced with survivors is needed to understand whether and how services meet survivors’ needs, and to investigate the potential – and potential failings – of trauma-informed approaches. Exposure to rape, sexual assault and sexual abuse has lifelong impacts for mental health and well‐being. In our society, discussions surrounding domestic violence, sexual assault, and mental health often revolve around women as victims. Psychosocial interventions include a wide range of interventions that target interpersonal, social and environmental factors that relate to recovery from the trauma of rape and sexual assault in addition to, or instead of, the individual factors that are the focus of psychological therapies. This synthesis of findings from 36 studies represents the most comprehensive analysis to date on the efficacy of psychotherapies and other psychosocial interventions for survivors of sexual violence and abuse in adulthood. They noted that many rape crisis centers either explicitly refused services to male victims, were highly insensitive to their needs, and considered the issue inconsequential. For those who do seek help, Iseley and Gehrenbeck-Shim (1997) reported that most male victims went to rape crisis centers . The uniqueness of male victims requires clinicians to attend to the distinct issues surrounding their assaults. Furthermore, Rogers (1998) suggested that this type of coping strategy renders male victims prone to long-term psychological problems as it makes help-seeking less likely, and denial undermines men coming to terms with their rape. However, many male victims reacted with a “controlled” style of coping exemplified by subdued reaction characterized by a calm, composed, acceptance and minimization of the assault. Silence typically characterises the experience of sexual violence, particularly in childhood. We also write in the knowledge that it can take people many years to understand that what they have experienced constitutes sexual violence. Inter-personal trauma has at its core the abuse of power (see Lovett et al., 2018). This commentary explores some of the ways in which psychiatry reinforces the silencing of sexual violence survivors. For many male survivors, the journey to healing is filled with hurdles. In sharing his story, Mike mentioned that acknowledging and talking about these experiences can be the first step in dismantling the shame and isolation that many men feel. It not only helps individual survivors but also raises awareness about the issue as a whole. Men who experience abuse often face unique challenges in disclosing their experiences, including fears of not being believed or ridiculed. I guess because beyond just saying “I’m depressed” you kind of need to talk about it more than that. And it sort of came out real sort of bland, and it probably didn’t sound like much but it didn’t really go anywhere. I was joking he could shag other birds now, and he’s probably going to get more than me and at least there’s that. The limitations of this review are that not all dimensions of the topic are covered by these qualitative studies, for example, ethnicity and cultural barriers to help-seeking by men. Our final recommendation for practice is that services should aim to give all people seeking support for DVA a choice of professional personnel in terms of gender or sexuality Furthermore, confidentiality and building trust in service provision is essential for male victims of DVA with continuity of contact (care) an essential feature of services for all victims. The perception that victims may have about negative reactions from family; friends and professionals may be reinforced by these behaviours.32 33 In our recommendations for practice we state that service provision needs to be more inclusive and better tailored to more effectively address the needs of all genders and socio-demographic groups. These factors contribute to diminished confidence and persistent despondency for some male victims of DVA. Our review consolidates evidence on mainstay treatments for PTSD, supporting the continued use of trauma‐focused psychotherapies such as EMDR, Cognitive Processing Therapy and Prolonged Exposure as first‐line treatments for PTSD (NICE 2018; VA/DoD 2017). However, trauma‐focused interventions may result in higher treatment non‐completion and may leave some survivors with a high symptom load post‐treatment. However, we took the decision to exclude domestic abuse interventions due to another Cochrane Review (Hameed 2020). Although not formally reported using GRADE, the second comparison of trauma‐focused interventions compared to non‐trauma‐focused interventions provided a much more robust picture about treatment acceptability and adverse events. All included efforts to use culturally adapted measures, local‐language versions of well‐established measures, or translated and adapted interventions to meet the needs of the local women. Research has found that mental health staff often fail to validate disclosures because service users have psychiatric diagnoses (Mantovani and Allen, 2017), and frequently use ‘alleged’ when recording disclosures in medical notes (Trevillion et al., 2014), a subtle form of silencing. My first contact with mental health services was at the age of 12 or 13. We may concede that psychiatry silenced sexual violence survivors in the 1960s, maybe even the 1970s, but surely not now. The preponderance of research indicates that AMSV is more likely to be violent than that directed toward women , although some studies suggest that violence is greater toward women . The identification of variables that influence likelihood of AMSV is fundamental for prevention efforts (Loh et al., 2005) . Examining the case of male-on-male rape, Vearnals and Campbell (2001) hypothesized that rape might be motivated by sex or by men wishing to demonstrate domination; interestingly, Man and Cronan (2001) hold that domination is the main motivation for rape in prison . Man and Cronan (2001) refer to the numbers of prisoner sexual assaults as “simply staggering” and “rampant” (p. 129). To date, most of the research on male rape has focused on institutional rape (e.g., correctional facility) and male-on-male rape. The gap in Section 375 IPC, which labels a woman as the victim and a man as the culprit, went unnoticed by the Supreme Court when it legalised consensual homosexual relations. Women’s rights have greatly benefited by the new legislation pertaining to sexual offences against women that were implemented in the wake of the Nirbhaya incident. It is visible to us Women’s safety has greatly benefited from changes made to the definition of sexual offences against women following the Nirbhaya Case. A significant reaction immediately following the sexual trauma, as Frazier (1994) notes is anger because it is considered more masculine to respond that way . Additionally, research is still required to determine what factors increase the offender’s perception of victim vulnerability, differences between methods used, and factors related to types of violence. Public perception is that substance use is a significant contributing factor of any type of sexual violence 53,122; yet research finds a wide discrepancy in the role that it plays. On the other hand, untreated mental health issues can reinforce feelings of isolation and helplessness, creating a cycle of neglect and harm. The relationship between mental health challenges and help-seeking barriers is bidirectional. As a result, mental health is viewed as a lower priority, further discouraging ictims from reaching out for help. Social stigma and profoundly ingrained gender norms contribute to the revictimization of male survivors of IPV, significantly obstructing their recognition of the need for psychological support. Young males often internalise their trauma and suffer in silence, which is why early intervention and support are critical. For these reasons, psychosocial interventions that avoid discussion of the trauma can be a vital source of support to rape and sexual assault victims. While there is certainly overlap in the populations of interest, in that many sexual assaults and rapes occur within IPV, rape and sexual assault is not exclusive to IPV and many who experience sexual trauma as adults outside a domestic abuse context require support or interventions. Our review suggests that survivors of rape, sexual violence and sexual abuse during adulthood may experience a large reduction in post‐treatment PTSD symptoms and depressive symptoms after experiencing a psychosocial intervention, relative to comparison groups. This review presents a timely assessment of international evidence on any type of psychosocial intervention offered to individuals who experienced rape, sexual assault or sexual abuse as adults. How to Talk About Mental Health with Other Men This requires a social commitment to restructuring attitudes, the development of integrative and accessible support systems, as well as greater community involvement in creating empathetic environments for survivors. Breaking the silence surrounding IPV experienced by men requires a multifaceted approach that prioritizes inclusivity, cultural sensitivity, and evidence-based interventions to address their unique needs and foster equitable support systems. While considerable progress has been made in understanding the role of men as perpetrators of IPV (1), male victims remain an often-overlooked and invisible demographic (2), particularly in low- and middle-income countries (LMICs). Intimate Partner Violence (IPV) is a pervasive public health issue that transcends gender, geography, and socioeconomic boundaries, with significant and far-reaching impacts on the mental and physical health of victims. Breaking down the cultural walls around mental health communication is a significant step towards living healthier lives. A lack of knowledge regarding the physiologic reaction to attack and the fact that erection or orgasm can occur even in traumatic situations may contribute to this belief. Further, Isely and Gehrenbeck-Shim found that most victims were young (ages 16 to 30) and Caucasian (85%). According to some estimates, college-going men between the ages of 18 and 24 are five times more likely to be assaulted than their non-college counterparts, placing them at the greatest risk of victimization . Although the literature may be scant, it does seem to show indications of a prevalence issue significant enough to motivate more study for this demographic. This pattern was exemplified by Steve who described himself as a “very, very private person.” When Steve and his wife experienced marital problems, Steve did not disclose his situation to anyone, including his parents. As a consequence of this experience, Thomas never confided in anyone until he met his girlfriend, Kate, the only person who knew the details of his secret, and the one person he relied on for discussing his personal and emotional life. Thomas decided to approach his best friend, whom he described as “close enough he could almost be like my brother,” for support. The table provides key information concerning the quality of evidence, the magnitude of effect of the interventions examined, and the sum of available data on primary outcomes. To do this, we performed subgroup analyses on the category of intervention (i.e. Cognitive Behavioural Therapies, Behavioural Therapies and low‐intensity psychosocial interventions). Our decision to perform a meta‐analysis was determined by the comparability of populations, denominators and interventions (clinical heterogeneity); the comparability of the duration of follow‐up (methodological heterogeneity); and the comparability of outcomes. All but three jurisdictions in the United States now have gender-neutral rape laws, with Georgia, Mississippi, and Idaho being the three exceptions. Instances of forced or unconsented anal penetration fell under the legal definition of “buggery”, which was punishable by a significantly lighter fine. For example, the sexual coercion of enslaved African American women was permitted without any legal repercussions . If you’re not ready to talk about it, or just want some support, read our ‘Coping with Crisis’ booklet – click here As members of the Male Survivors Partnership, we’re also really pleased to be able to offer you access to their collection of self help Guides on various different issues which you find by clicking here. We make discovering books entertaining, informative, and socially engaging. Never Let Me Go is a great book for those who have ever felt trapped in a cycle of abuse, denial, and secrecy and need to find a way to take the first steps toward a happier adulthood. Psychosocial interventions for survivors of rape and sexual assault experienced during adulthood Our review suggests adult survivors of rape, sexual violence and sexual abuse may experience a large reduction in post‐traumatic stress disorder (PTSD) symptoms in the days and weeks following psychosocial interventions compared to controls. We identified 36 studies (1991 to 2021) that were randomised controlled trials of psychosocial interventions (ranging from intensive psychotherapy to low‐intensity, social, psychoeducation and other interventions) following rape, sexual assault and sexual abuse. The review was designed to measure the effects of psychological therapies and psychosocial interventions for survivors of rape and sexual assault experienced during adulthood, based on a wide range of indicators of a person's health and well‐being, particularly mental health and well‐being. 5 (sex$ adj3 (victim$ or revictim$ or re‐victim$ or survivor$)).ti,ab,de. 2 (intercourse adj5 (coer$ or force$ or unwanted)).ti,ab,de. 65 ((sex$ assault adj3 centre) or (sex$ assault adj3 center) or (sex$ assault adj3 service) or (sex$ assault adj3 support)).tw,id. 60 (therapeutic allianc$ or therapeutic relationship$ or therapeutic communit$).tw,id. 59 ((support or advice or advis$1) adj1 (centre$1 or center$1 or community or group$ or network$ or social or staff$)).tw,id. It is increasingly clear from the meta-analysis of Zarchev et al9 and others11 that sexual abuse among boys and men is massively underrecognised and undertreated. Many men articulately reflect on experiences of post-traumatic growth12 and positive identity development after abuse exposure. Khamoshi ko Towrna (Breaking the Silence) was established in 2012 inresponse to the growing number of Pakistani, Indian and Bangladeshi heritage men reporting childhood sexual trauma. Dim EE, Lysova A. Male victims' experiences with and perceptions of the criminal justice response to intimate partner abuse. Scoping review of healthcare professionals' views on intimate partner violence in the Middle East and North Africa. Similarly, Thomas attempted to seek support from a man who was a close friend when he was struggling with problems in his personal life. Zac described being worried that his friend might think he was being a “prima donna.” Again, the connection between emotionality and femininity can be observed. Zac was left feeling a deep sense of shame and embarrassment for disclosing his unhappiness and going against the unstated hegemonic masculine practice of being self-sufficient. This quote illustrates the considerable effort it took for Zac to disclose his feelings of depression to his friend, and his own awareness that his statement was somewhat “bland” and failed to capture his real feelings. Experiencing sexual violence is linked to significant mental distress (Khadr et al., 2018), with CSA in particular linked to psychosis (Bebbington et al., 2011). Globally, it is estimated that 35% of women have experienced sexual or intimate partner violence, and that women are more likely to experience repeated and severe violence compared with men (Oram et al., 2017). To experience sexual violence and abuse is to experience silence. Shockingly, approximately eight men are sexually assaulted every hour though less than one in 10 men will report their rape or sexual assault to the police. That can be one-to-one, with additional peer support group meetings available every two weeks. “We’re using the most appropriate tool in the toolbox, sometimes that might be eye movement desensitisation and reprocessing, sometimes trauma-focused cognitive behavioural therapy,” Duncan added. This includes the Safer Streets initiative, which works to raise awareness, offer support and disrupt sexual exploitation on the city’s streets. Assessment of risk of bias in included studies Together, we aim to deliver the highest standards in investigation, welfare and support.” “At the time the filming took place, a new collaborative team called Network Supporting Male Survivors was formed. It comes after the force revealed 100 reports of male rape were received in 2017, which resulted in six arrests and two people being charged. One patient reported that he never disclosed it to his wife of 30 years; the sense of stigma from the rape was felt as huge and devastating. Parental disclosure is highly individualized and calls for evidence-based interventions and policies. Had studies used the same continuous outcome measure, we would have calculated the mean difference (MD) with 95% confidence interval (CI). This would have helped address some of the key issues when assessing risk of bias in cross‐over trials, including 1) bias arising from the randomisation process, 2) bias due to deviations from intended interventions, 3) bias due to missing outcome data, 4) bias in measurement of the outcome and 5) bias in selection of the reported outcome. (controlled clinical trial.pt. or randomised controlled trial.pt. or (randomi#ed or randomi#ation).ab,ti. Identifying interventions that are male-specific will help treatment to be targeted and evidence-based. Investigations need to consider an intersectional approach to assessing adult male victimization, which includes perspectives of gender identity, sexual identity, race, ethnicity, socio-economic status, and religious identification and commitment. While forming specific groups for male victims might be difficult geographically, online communities offer a means of connection. Abuse can take many forms, including physical, emotional, sexual, and psychological.This can help identify the number of male victims of sexual assault, which may allow planning of appropriate clinical services and counseling strategies that may support recovery.For others, and those that opt to exit trauma‐focused treatments early, structured non‐trauma‐focused approaches provide a viable alternative.Among those involved in criminal justice proceedings, there may be concerns about material generated as a result of therapy being obtained by police on the basis that it represents a reasonable line of enquiry (CPS 2021).I believe that our lives would have unfolded very differently if … staff had been supported to understand and engage with our pain - if we were encouraged to tell our stories instead of being shut down with looks, words, drugs and ECT (Sweeney, 2016).Furthermore, it should be explored further if the gender of the listener has a role in the underreporting of male sexual violence.Phrases like "man up" or "boys don't cry" reinforce the idea that showing emotion is a sign of weakness. A therapist can help dismantle these beliefs, affirming that the responsibility lies solely with the abuser. Therapy helps address the complex emotions that come with trauma, such as shame, guilt, and self-blame. Silence can be a heavy burden; a constant reminder of the abuse that festers in the dark. Writing about this really matters to me because I have felt the weight of that silence. We’re on Pinterest, Facebook, YouTube, and just about anywhere you can hold a great virtual conversation. According to the National Institute of Mental Health, the suicide rate among men was 4 times higher than women in 2021.It can aid in rebuilding self-esteem and trust - two things that sexual abuse strips away.There is growing attention to the ways in which gender norms affect the social and emotional development of boys and men15 and future tailored interventions and programme development for boys and men affected by sexual abuse must be cognisant and transformative of such norms.Adult sexual assault refers to all types of sexual assault, including rape, which is defined as the penetration of the victim’s mouth or anus by a penile, digital, or foreign object while using force, coercion, violence, threats of violence, or incapacitation.Participant’s descriptions of the criminal justice system are mixed but suggest that at best the police support is short term.Through his writings, Cec drives the fact that there are many survivors of male sexual abuse and if you’re one of them, you’re not alone.It's crucial for all of us to break the silence surrounding mental health and for men to know it's okay to ask for help. It is difficult for male survivors of sexual abuse to discuss the matter in public because of social stigma. Another emotion expressed by male survivors is that of anger (Fater, 2000; Isely et al., 2008), with male victim/survivors of clergy perpetrated CSA expressing anger not only at their abuse but also at the Church’s response to the abuse crisis—denial, coverup, and silence—with this anger being expressed externally as rage and also impacting survivors’ mental health. CSA has been correlated with the development of numerous mental health problems, abused men often displaying externalizing behaviours, including substance misuse, 'risky' sexual behaviours, anti-social behaviour, and offending. To understand help-seeking by male victims of domestic violence and abuse (DVA) and their experiences of support services by systematically identifying qualitative and mixed-method studies and thematically synthesising their findings. Breaking the Silence on Male Sexual Abuse If you have got a bad situation, instead of thinking oh poor me it is like what can I do to fix this situation and that is my focus. I realize from a young age that life isn’t always fair you know and there is nothing you can do about that. Beyond confirming that he and his wife were separating, Steve did not want to discuss his situation in any detail. Even when his wife eventually asked for a divorce, making plans to move out of their marital home, Steve continued to pretend all was well. While substantial research has focused on male perpetrators of IPV, the experiences of male victims remain largely underexplored, particularly in LMICs. The severity of IPV's impact extends beyond gender and borders, influencing victims across different social, cultural, and economic contexts. Mobile health platforms can also be critical in expanding access, offering anonymous and culturally sensitive support to individuals reluctant to seek help in person (39, 40). Public education initiatives are essential for challenging harmful stereotypes and normalizing help-seeking among male IPV victims. Furthermore, societal biases may influence the enforcement of existing laws, with male victims facing additional hurdles in being taken seriously by the judicial system. Dealing with missing data Additionally, the presence of qualified educators in violence prevention programs is essential to effectively address and mitigate the impacts of IPV. Interventions for victims of IPV require strategies tailored to their unique needs and the barriers they face in seeking help. In addition, healthcare providers and law enforcement personnel in LMICs may lack training on how to recognize and address IPV in general (26), and particularly against men (12, 27). There are extensive immediate and long‐term physical and mental health consequences for survivors (Jina 2013). Social and legal marginalisation, exacerbated by gender‐defined services, stigma and discrimination, all mean that sexual assault experienced by gender and sexual minorities is hidden and poorly understood (e.g. see Wirtz 2018). Non‐completion was not more common among survivors who experienced interventions compared to control groups, but this was based on a small number of studies. Some interventions aim to assist survivors by carefully re‐exposing them to aspects of the original trauma to ‘process’ what happened (e.g. Trauma‐focused Cognitive Behavioural Therapy (CBT)). As a result, the majority of victims were afraid to disclose their experiences of sexual assault. It has been described as the sexual victimisation of women by male accomplices, which is a manifestation of the patriarchal culture that condones rape. International research suggests one in six men were sexually abused during childhood, but experts believe the figure could be higher because males are less likely to report or talk about their experience. The issue of men’s mental health and social support has drawn attention from researchers who draw on social theories of gender, where gender is considered to be socially constructed as opposed to biologically determined. The mental health literature also echoes the broader literature on social support, which demonstrates that men, in comparison to women, typically have smaller social networks and less frequent exchanges of social support with family and friends (Fuhrer & Stansfeld, 2002; Liebler & Sandefur, 2002). The most commonly reported finding from sex difference studies is that males place more emphasis on social connections that provide instrumental support, whereas females tend to seek more emotional support (Fiori & Denckla, 2012; Grav, Hellzèn, Romild, & Stordal, 2012; Mair, Diez Roux, & Morenoff, 2010; Tiedt, 2010). This article reports the findings drawn from an innovative qualitative study of New Zealand men which explored the interplay between masculinity, men’s everyday social practices, mental health and well-being. You have the right to receive a Good Faith Estimate of what your services may cost. Whether it’s starting a conversation, sharing resources, or simply being present for a friend, every step counts. This month, we’re called to listen more deeply, advocate more fiercely, and support more consistently. This study has significant implications for future research on IPV in China, as well as for policy formulation and service provision.To emphasise the evidence of benefits (and harms) of psychosocial interventions across diverse adult survivor communities, we set out to include studies of sexual assault‐only samples, as well as studies where sexual assault survivors were a subset of a wider trauma sample.90 ((double or single or doubly or singly) adj (blind or blinded or blindly)).ti,ab.This time, Adam helped me to pick all the issues apart, and I really think it was potentially life-saving.”“For too long, boys have been left out of the conversation around sexual safety.The extant literature clearly dispels the misconceptions that men cannot be victimized outside of prison walls.In addition to the recruitment settings, we considered the settings where the interventions took place.Along with this, normalizing the traumatic aftermath is another means of generating safety. We pooled seven studies for the post‐treatment time point comparing trauma‐focused and non‐trauma‐focused interventions. Three studies reported global mental health/distress symptoms (Anderson 2010; Rajan 2020; Rothbaum 1997). Finally, a small number of studies observed levels of distress or negative affect following therapy sessions; however, a temporary increase in negative mood was not necessarily viewed as problematic, rather, being part of a pathway to improved health. Dropout from treatment could be assessed in the five studies (242 participants) that compared psychosocial interventions to control groups that were defined as minimal interventions (Bell 2019; Brady 2021; Bomyea 2015; Foa 2006; Littleton 2016). Studies reported global mental health functioning/distress using several different questionnaires, including Brief Symptom Inventory (e.g. Feske 2008) and GHQ12 (e.g. Rajan 2020). The concentration of a few researchers in this field, coupled with the limited number of overall studies illustrates the relatively minor attention on this area. The search and analysis (Figure 1) followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and the improved model for scoping reviews (Tricco et al., 2016). Three of the authors (P.O’L., M.T., and A.Y.) are experienced academics and researchers who appraised selected articles and provided direction, guidance, and reviews of drafts. Another author (M.T.) assisted in reviewing and providing advice on studies which were considered borderline for inclusion. The appraisal at this stage considered the setting rationale, appropriateness of the sample, adequacy of the description of fieldwork, and adequate evidence to support analysis (Long & Godfrey, 2004). However, since treatment non‐completion and study attrition were high in both groups, the potential wider harms of exposure to different interventions and/or research participation itself may be missed. The evidence suggests that psychosocial interventions may not reduce treatment completion or increase adverse events when compared to controls. Psychosocial interventions may also reduce depressive symptoms. A study of trauma‐sensitive yoga was included in Comparison 2 (Kelly 2021), a head‐to‐head comparison of active treatments, which performed similarly to the gold standard treatment, CPT. A contribution of the current review is the synthesis of several novel treatments across a range of areas including Lifespan Integration (LI), neurofeedback, Reconsolidation of Traumatic Memories (RTM) and trauma‐sensitive yoga. The attributions of victim responsibility found that men were more likely to be assigned blame than female victims.For the purposes of this review, we organised psychosocial interventions according to the list of psychological therapies of the former Cochrane Depression, Anxiety and Neurosis (CCDAN) and Cochrane Common Mental Disorders (CCMD) Groups.That whole period I just dealt with it myself and I know that’s probably not the smartest way of dealing with it, but I guess I kinda backed myself as well to be able to handle it.And I hoped I could get help for her condition before it was too late.This pattern of protection has meant numerous institutions became havens for pedophiles (Etherington, 2000).Low‐intensity psychosocial interventions (e.g. psychoeducation alone/videos; community interventions where the emphasis on sexual violence and abuse was secondary to other social or health concerns) may not reduce PTSD and depression, but that conclusion is based on low‐certainty evidence.Understanding the experiences of intimate partner violence (IPV) is a critical first step in developing effective responses.Encouraging men to speak out against abuse and support their peers can help create a culture of understanding and empathy. He locked his trauma away for 30 years, held it at bay with drinking, drugs and promiscuity. Rachel Rock brings us one man's search for support. Not confronting this issue only makes recovery harder. Education and awareness campaigns can debunk myths and misconceptions, emphasizing that seeking help is a sign of strength, not weakness. He realized he was not alone and that there were resources available to help him heal. This includes access to counseling services, hotlines, and support groups specifically tailored for men. Many men suffer in isolation, feeling that they cannot share their experiences without being judged or ridiculed. Speaking out, whether to a therapist, a friend, or in a support group, can be the first step in breaking the cycle of silence and pain. As a society, we must challenge the stereotypes that discourage men from being vulnerable. Research shows that 1 in 6 men are adult survivors of CSA. For many men, societal expectations around strength, indifference, and emotional control act as barriers to seeking help. Table 6 outlines additional data reported by the included studies. The results favoured non‐trauma‐focused interventions; those exposed to trauma‐focused interventions may have an increased risk of dropping out from treatment. Funnel plot for the comparison of psychosocial interventions versus inactive control for anxiety symptoms at post‐treatment However, studies lacked feedback from large numbers of non‐completers and those that dropped out from follow‐up assessments, thus potentially missing harms of exposure to interventions and/or research participation. In addition to counts of adverse events, and as Table 5 shows, studies considered harm experiences by examining rates of non‐completion of the intervention, and reporting the reasons for this. We wanted to know whether psychosocial interventions help to relieve the mental health impact experienced by survivors as a result of rape, sexual assault or sexual abuse in adulthood. To assess the effects of psychosocial interventions on mental health and well‐being for survivors of rape, sexual assault or sexual abuse experienced during adulthood. We conclude that a range of behavioural and CBT‐based interventions may improve the mental health of survivors of rape, sexual assault and sexual abuse in the short term. As a result, the assessments of the effects of abuse, such as harm and need for medical care, must be added to measurements of abuse 21,118,119,120,121. Most studies have found that the offender is known to the victim 111,116, whereas Groth and Burgess (1980) interviewed offenders and found that 75% attacked strangers . While some studies have found that most perpetrators are heterosexual , others report homosexuals as the most likely offenders . Studies are mixed on whether heterosexual men or homosexual men are more likely to be victimized 111,112,113,114,115. According to Walker et al., a person’s routine and lifestyle influences the level of exposure one has to potential perpetrators and how vulnerable one is as a target. 66 (psychosocial or psycho‐social or psychoeducation$ or psycho‐education$).tw,kf. 57 ((existential or gestalt or humanistic or interpersonal or milieu or person‐centred or residential or socioenvironmental or socio‐environmental) adj therap$).tw,kf. 49 ((client focus$ or non‐direct$ or nondirect$ or solution focus$ or trauma$ or talking) adj3 therap$).tw,kf. 44 (autogenic or autosuggestion$ or auto‐suggestion$ or breathing exercise$ or hypnosis or hypno‐therapy or hypnotherapy).tw,kf. The way in which the interventions might work will be dependent on the factors that are targeted. It is a silence that is demanded and coerced by perpetrators, and sanctioned by families, communities and society. Whilst this paper has a UK focus, some aspects will resonate globally, particularly given that Western psychiatry is increasingly being exported around the globe. You can opt out of the sale or sharing of your data, at any time clicking the "Do Not Sell or Share my Data" button at the bottom of the webpage. The implications of these findings for promoting men’s social connectedness and mental health are discussed. An in-depth understanding of the gendered nature of men’s social connections and the ways in which the interplay between masculinity and men’s social connections can impact men’s mental health is needed. Men’s mental health has remained undertheorized, particularly in terms of the gendered nature of men’s social relations. Some interventions are designed to be delivered within a short period of time following the assault or rape (less than three months), whereas others are used for survivors over the longer term. We would also like to thank members of the former Cochrane Developmental, Psychosocial and Learning Problems Group for their considerable guidance and support in producing this review. The analysis also went beyond gender and looked more broadly at other areas arising from the literature on men’s mental health including support networks, help-seeking behavior, and health-promoting practices. The topics covered different areas of men’s lives including family relationships, division of labor, education and work history, friendships and romantic relationships, significant life events, help-seeking from friends, and strategies for maintaining mental health and well-being. Six participants in this study had sought professional psychological help either from within primary care settings, or using workplace employee well-being services, for mild to moderate mental health issues including self-reported symptoms of depression, anxiety, problematic alcohol use, and a nonfatal suicide attempt. This theorized life history methodology provides an explicit framework for analyzing gender within men’s accounts that allows the links between masculinity, men’s social practices, and mental health to be theorized. Male victims are perceived to carry a level of blame for not resisting their attacker. Furthermore, the idea of the “ideal victim” is still widely used within this gender-based assumption of sexual victimization research . In contrast, Monk-Turner and Light (2010) found that men who experienced penetration were markedly reluctant and less inclined to report the assault .