Enhancing Medical Care Practice for Gay Black and/or Latino Male Sexual Assault Survivors

BACKGROUND

Trauma-informed care has been regarded as an evidence-based practice for sexual assault survivors. However, this practice has not been implemented for gay and bisexual Latino and Black male sexual assault survivors, who disproportionately are affected by sexual assault. Barriers to reporting sexual assault among male sexual assault survivors include stigma, medical mistrust, and homophobia. There is a large gap in identifying and implementing evidence-based and trauma-informed practices for engaging with Black and/or Latino gay and bisexual male sexual assault survivors.

This study is qualitative in nature and seeks to understand the existing healthcare practices to effectively engage with gay and bisexual Black and/or Latino male sexual assault survivors to generate trauma-informed practices for this community. We aim to ascertain specific skillsets and training that address both the practitioner's and patient's needs. Our study utilizes the intersectionality lens (Crenshaw, 1991), given the survivors’ multiple marginalized identities.

METHODS

This study consisted of in-depth, one-on-one interviews with healthcare providers and administrators in the greater Boston area. All interviews were audio-recorded and transcribed verbatim. Content analysis guided our study, and data analysis was consistent with content analysis. All procedures received Institutional Review Board (IRB) approval.

RESULTS

Most participants reported little to no experience working with gay and bisexual male survivors. They attributed this to broader cultural and systemic barriers, including norms of masculinity, societal denial of male victimhood, stigma surrounding sexual violence, and the historically cisgender female-centered origins of sexual assault services.

Participants described significant variation across agencies in how providers conducted screening, responded to disclosures, and delivered trauma-informed care. Services for GBM survivors were varied as well as survivors’ access to PEP. Some agencies engaged in community outreach or provided educational workshops. However, few agencies offered group-based interventions or peer support. This gap highlights a lack of collective healing opportunities tailored to this group.

While many participants expressed confidence in general trauma-informed practice, they were uncertain about how effectively these approaches could be successfully applied to Black and Latino GBM survivors. Participants consistently emphasized a lack of specialized training focused on engaging and supporting male survivors. Facilitators to enhance medical care practice for Black and Latino GBM survivors, included: fostering trust, culturally sensitive communication, affirming language usage, and respecting survivors’ identities.

CONCLUSIONS and IMPLICATION

The lack of a standardized practice and development of relevant skills highlights the need for trauma-informed care and culturally competent skills to be tailored for Black and/or Latino male sexual assault survivors. As social workers are dedicated to social justice and equity, it is imperative to ensure trauma-informed practices are implemented for these men. There are various ways to further enhance and develop evidence-based and trauma-informed practices for gay Black and/or Latino male sexual assault survivors.