Would You Tell Under Circumstances Like That?: Barriers to Disclosure of Child Sexual Abuse for Men

Background and Purpose: Public awareness is increasing in regard to the realities of child sexual abuse (CSA) for both genders. Nonetheless, male survivors continue to face considerable stigma and often delay disclosure of sexual abuse for years or decades. Because disclosure is often a prerequisite to help-seeking and recovery, delays carry high costs for survivors including untreated mental health problems (e.g., depression, anxiety, somatization, suicidality). Little is known, however, about the factors that impede or obstruct disclosure for this population. To address this knowledge gap, the current study analyzed a set of qualitative data on disclosure barriers among a large, non-clinical sample of men with histories of CSA.

Methods: The researchers conducted a secondary analysis of data collected through an anonymous, internet-based survey. The data included responses to an open-ended item on barriers to disclosure. Participants were recruited through three national survivor organizations: the Survivors' Network of those Abused by Priests, MaleSurvivor, and 1in6.org. The final sample consisted of 460 men with histories of sexual abuse ranging in age from 19 to 84 years. Most participants were Caucasian (91%), living with a spouse/partner (70%), and members of a national survivor organization (81%). Through an iterative process that involved four inductive phases, researchers used content analysis to elicit types of disclosure barriers. Researchers coded sections of the data independently and then met regularly over a 12 month period to reach consensus on coding categories. An extensive audit trail was maintained throughout the project.

Results: Our analytic process culminated in the development of a conceptual model, the Quadratic Model of Barriers to Men’s Disclosure of CSA. This model reflects the simultaneous influence of multiple factors on the decision making process surrounding disclosure of CSA for men. The factors have been classified into four domains (socio-political; interpersonal; personal; and practical considerations) with different categories of barriers within each domain. Some of the frequently cited barriers were negative internal emotions (e.g., shame, anger, fear), issues related to masculinity, concerns about sexual orientation, past negative responses, doubts that others could provide help, worries about being judged, stigmatized, or ostracized, issues related to the abuser, lack of support resources, and difficulties naming or remembering the abuse.

Conclusions and Implications: As one of the first studies of its kind, the results document the breadth and depth of disclosure barriers faced by men with histories of CSA. The complexity of the disclosure process suggests that a combination of systemic, interdisciplinary interventions is needed to promote discussion of CSA for men. For example, educational media campaigns could reduce stigma in the general public and improve responses to disclosure. Mental health service providers need to improve the quality and quantity of clinical treatment services for male survivors. Therapists can help clients examine cognitive distortions surrounding disclosure and identify helpful individuals within their support networks for future disclosures. More research is needed in areas such as early assessment of CSA in boys or facilitators of disclosure.