Servicemen’s Perceptions of Male Sexual Assault and Barriers to Reporting During Active Component and Reserve/National Guard Military Service

Abstract

Despite growing recognition of the high rates of sexual violence experienced by men serving in the U.S. military, male victimization, specifically sexual assault in military (SAIM), is an understudied topic. We qualitatively describe servicemen’s awareness and perceptions of male SAIM, and their understanding of common barriers to servicemen reporting sexual assault. Participants included Midwestern Active Component and Reserve and National Guard servicemen, actively serving or Veteran, who had returned from Iraq or Afghanistan deployments during Operation Enduring/Iraqi Freedom eras. Eleven focus groups were held with 34 servicemen (20 Reserve/National Guard and 14 Active Component). Qualitative analyses used inductive and deductive techniques. Servicemen reported a lack of awareness of male SAIM, a tendency to blame or marginalize male victims, and substantial barriers to reporting sexual assault. Reserve/National Guard participants emphasized barriers such as a perception of greater stigma due to their unique status as citizen-soldiers, an ethos of unit conformity and leadership modeling, and a lack of confidence in leadership and the SAIM reporting process. In contrast, Active Component servicemen emphasized the deployment location and sex of victim and perpetrator as key reporting barriers. Findings make an important contribution to the scant literature on risk and protective factors for male SAIM and servicemen’s perceptions of sexual violence and assault reporting barriers by their service type and location. This work has implications for routine screening for sexual violence experiences of male service members and Veterans. Providers’ knowledge of gender stereotypes regarding sexual assault, assault risks and experiences of deployed servicemen, and potential barriers to SAIM disclosure is vital for patient-centered care delivery. Additional research to address factors that influence post-SAIM care engagement of males is indicated.

Keywords

male military sexual assault Reserve/National Guard leadership reporting barriers masculinity

Introduction

In the past two decades, the U.S. military and the Department of Veterans Affairs (DVA) have dedicated extensive resources, policies, and research efforts to address sexual misconduct in the military (U.S. Department of Veterans Affairs, 2004) (http://www.publichealth.va.gov/docs/vhi/military_sexual_trauma.pdf). Although formal policy is designed to protect all victims of sexual violence and give them equal resources, the practical reality is there has been a lag in recognizing that military men experience sexual violence while serving their country and in responding to their unique needs. Public Law 102-585, known as The Veterans Health Care Act of 1992, authorized the DVA to provide outreach and treatment programs for women who experienced military sexual trauma (MST) during their active duty service. Two years later, Public Law 103-452 authorized the DVA to provide MST services to male Veterans as well. The DVA MST definition comes from Federal Law (Title 38 U.S. Code 1720D) and denotes

psychological trauma, which in the judgment of a Veterans Health Affairs mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty, active duty for training, or inactive duty training. (https://www.ptsd.VHA.gov/public/types/violence/military-sexual-trauma-general.asp)

Despite the gender equity included in DVA definitions and screening, until recently, the “vast majority of scholarly research on rape and rape myths has pertained to the female rape victim” (Allard, Nunnink, Gregory, Klest, & Platt, 2011; O’Brien, Keith, & Shoemaker, 2015; Turchik & Edwards, 2012, p. 211). Policy, education, and intervention efforts have largely clung to the notion of the female victim and the male perpetrator. Moreover, policy and intervention efforts have tended to look at the military as a monolithic organization and male service members’ experiences as homogeneous. However, this is not the case. There are cultural differences among the Active Component and Reserve/National Guard troops. While they can be deployed at any time, Reserve/National Guard are considered “citizen soldiers,” as most do not live on a military base or perform their duties full-time. Unprecedented deployments during the past decade of war in Iraq and Afghanistan have resulted in Reserve/National Guard being one of the fastest growing U.S. populations. Thus, understanding both Active Component and Reserve/National Guard perceptions of unique sexual violence risks and consequent care needs and barriers is critical to their health and safety.

Most researchers agree that sexual assault rates among male service members are vastly underreported. However, given the gender ratio of approximately four men to one woman in the U.S. military, there are roughly as many male sexual assault in military (SAIM) victims as female victims (Hoyt, Rielage, & Williams, 2012). A recent RAND report (Morral, Gore, & Schell, 2016) estimated that nearly 1% of Active Component servicemen experienced sexual assault in the past year (relative to 5% of servicewomen). Rates of sexual assault were found to be lower in Reserve and National Guard service members, with 0.4% of men experiencing sexual assault in the past year, relative to 3.1% of women. Notably, most part-time Reserve/National Guard indicated their assault involved military personnel or setting (85%) (Morral et al., 2016), supporting that these assaults are military-related.

The mental health consequences of sexual victimization are substantial (e.g., posttraumatic stress disorder, depression, substance use, and other anxiety disorders), and men report long-lasting symptoms just as their female peers do (Katz, Cojucar, Beheshti, Nakamura, & Murray, 2012; Kimerling et al., 2010; Maguen et al., 2012; Mondragon et al., 2015; Morris, Smith, Farooqui, & Surís, 2014; Sheppard et al., 2015; Walsh et al., 2014). One review found that male Veterans who experienced sexual violence in military perceive their health is more damaged relative to female peers with these experiences (Morris et al., 2014). Like female peers, shame and embarrassment are notable barriers to care for men who have experienced sexual trauma (Turchik et al., 2013). Furthermore, men are far less likely than women to seek help or treatment for MST (Zinzow, Grubaugh, Frueh, & Magruder, 2008). Both servicemen and women may also have sexual violence histories prior to entering the military, which can further adversely affect physical and emotional health and elevate risk of revictimization during their service (Sadler, Booth, Mengeling, & Doebbeling, 2004). Blosnich, Dichter, Cerulli, Batten, and Bossarte (2014) determined that men who enlist in the military are significantly more likely than men in the general population to have a sexual violence history and, similar to women (Sadler, Booth, Cook & Doebbeling, 2003), many enter the military to escape a troubled home life.

A significant gap remaining in the literature is an understanding of males’ perceptions of sexual violence toward men during military service and the potential impact this has on their postassault interfaces in health care systems. Both researchers and clinicians can be influenced by mistaken beliefs about male sexual trauma that contribute to the marginalization of this population. These beliefs include (a) men who are sexually assaulted must be gay (Stermac, Del Bove, & Addison, 2004), (b) only gay men are perpetrators of male sexual assault (Turchik & Edwards, 2012), (c) men cannot be forced to have sex unless they want to (Stermac et al., 2004), (d) it is impossible for a man to rape a man and for a woman to rape a man (Turchik & Edwards, 2012), (e) men should be able to defend themselves against sexual assaults (Chapleau, Oswald, & Russell, 2008; Groth & Burgess, 1980; Struckman-Johnson & Struckman-Johnson, 1992), (f) it is a man’s fault if he is raped, and (g) men are not traumatized by rape (Voller et al., 2015). Indeed, cultural beliefs about men and sexual violence might underlie victim blaming as well as the omission of male victims from research on sexual assault or unique treatment needs for male sexual assault survivors. Prior research has found that the internalization of stereotypical gender roles, such as the view that men are aggressors and not victims, can result in the tendency of health care providers to overlook men as victims of rape, even dismissing it as a possibility (Oosterhoff, Zwanikken, & Ketting, 2004). These beliefs might also support perpetrators targeting men as a vulnerable population less likely to report assault. It is unclear what role race/ethnicity plays in military male rape risk or postassault care seeking, as limited research, outside of prison populations, has considered this beyond controlling for it. One study found that younger age and reporting any sexual orientation that was not “completely heterosexual” were associated with higher odds of sexual assault during Gulf War I but race/ethnicity was not (Murdoch et al., 2014).

Beliefs in the research and health practice community might also help to explain why research and treatment efforts have primarily focused on female survivors of sexual assault (Kassing & Prieto, 2003; Polusny & Murdoch, 2005; Shechory & Idisis, 2006). It is vital to recognize that men face unique gender-specific barriers to reporting sexual assault experience(s). Bastick, Grimm, and Kunz (2007) found that because of social norms and social constructions of masculinity, male survivors of sexual assault may experience stigma and marginalization more than female victims. Such beliefs about sexual assault among men may also help to account for the underreporting in male victims, as well as a lack of a proper response by agencies and programs available to help victims. It is likely that there may be a bidirectional and additive synergy between providers and male patients in which providers are as unlikely to ask as victims are unlikely to tell.

The goal of this research study was to obtain the phenomenological experience of Active Component and Reserve/National Guard male troops on the topic of male SAIM; to assess their awareness, knowledge, attitudes, and beliefs of SAIM; and to understand their reactions toward SAIM in military men. An understanding of the reactions of male participants toward male SAIM survivors and the barriers they face to reporting and seeking care is the starting point to developing culturally sensitive policies and interventions that are effective and tailored to the needs of service members by service type (Active Component vs. Reserve/National Guard). The results of this study can provide a vitally needed understanding of servicemen’s perspectives of the unique challenges male troops face when addressing SAIM concerns among male service members and Veterans. These findings can enhance our understanding of the barriers to reporting SAIM among Active Component and Reserve/National Guard servicemen and Veterans. This can inform U.S. military prevention and response interventions, health care providers, and also military peers who have the potential to help as bystanders or to provide postassault support.

Method

The research presented in this article is from the qualitative component of two studies that examined the antecedent risks and subsequent health consequences of violence exposure during military service among service members (men and women) in the Reserve/National Guard and Active Component forces of the military. Because barriers to SAIM reporting is a salient theme that has emerged from prior research with servicewomen (Mengeling et al., 2014; Sadler et al., 2003), the purpose of this supplement study was to explore Active Component and Reserve/National Guard servicemen’s awareness of sexual assault among servicemen and identify barriers to SAIM reporting. From fall 2009 to summer 2010, focus groups interviews (n = 11 groups) were conducted with male service members (n = 34) in five Midwestern states (Iowa, Nebraska, Kansas, Missouri, and Illinois). All phases of this study were approved by the local Institutional Review Board and by the Department of Veterans Affairs (DVA) Research and Development committee. A Certificate of Confidentiality for this study was obtained from the U.S. Department of Health and Human Services to further ensure participant privacy.

Study Sample

The Defense Manpower Data Center (DMDC) provided contact information for male enlisted service members and officers. Eleven focus groups were conducted with male service members who had returned from Iraq or Afghanistan deployments. Groups were subdivided by rank, enlisted servicemen and officers, and interviews performed. To be eligible to participate in the study, participants had to meet the following criteria: ≥18 years of age, U.S. military service during the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) eras, and currently resides in the Midwest (Iowa, Illinois, Kansas, Nebraska, Missouri). This Midwestern cohort was chosen for accessibility to perform face-to-face focus groups given the high density of Active Component and Reserve/National Guard service members/Veterans residing in the selected states. We combined Reserve and National Guard service members into one cohort as they have similar drill requirements, typically report to locations near their homes rather than relocate, and most serve on a part-time basis. In contrast, active component service members serve in the military full-time, may live on a military base, and can be deployed at any time. The primary difference between the Reserves and National Guard is in the command. Reserves are a member of the federal armed forces and under presidential command, whereas the National Guard are organized on the state level and called to service by the governor. Servicemen were not eligible to participate if they had any disability that might have influenced their ability to participate independently in a focus group. DMDC provided contact information for service members within driving distance to preidentified meeting locations in each state. Invitation letters with information about the study were mailed to potential participants. Postal mailings were followed by telephone contacts to facilitate obtaining a sufficient number of participants for each group. Prior to focus groups, each participant was mailed a document containing the elements of consent in their invitation letter. Telephone contacts were made with DVA or key military contacts, for example, DVA OEF/OIF Outreach Coordinators or military base mental health leadership, in each region prior to focus group to notify them about this study and answer questions, confirm local protocols for health care services access should any participant require these expeditiously after group participation.

Focus Group Process

Focus groups were led by a primary moderator, a male veteran, licensed marital and family therapist and experienced DVA clinician (MPM) and a male researcher (LBY) with expertise in military populations and an advanced degree in communication studies. The primary moderator used a semistructured interview guide opening with a broad question about challenges that troops experience during deployments. The moderator then asked a series of open-ended questions intended to elicit general information about servicemen’s deployment and combat experiences; leadership, military living, and working environments; deployment and combat stressors; and how service type (Active Component or Reserve/National Guard) influenced health, safety, and risk for violence exposure. When male SAIM issues failed to spontaneously occur as a topic of discussion, the moderator intentionally imposed the topic of SAIM and referred to the rates of SAIM among male and female service members to foster a nuanced discussion. SAIM was posed as occurring throughout military service and not specifically during deployments. The moderator also asked questions to elicit servicemen’s perceptions and use of Department of Defense (DoD) or DVA health care services. Although the same questions were asked across all focus groups, the moderator asked questions to elicit specific information about the experiences of being a male officer or enlisted service members, particularly as those experiences might pertain to reporting of SAIM and how officers and fellow troops would respond. The focus groups lasted 90 minutes each and were digitally recorded. The recorder failed to adequately record one group, but key themes were identified from notes manually recorded by group leaders immediately following the discussion.

Focus groups were conducted separately for officers and enlisted servicemen to increase participants’ comfort and ability in openly expressing their experiences and opinions. Aliases were used to maximize participant anonymity and confidentiality. All focus groups were held in neutral locations on local community college campuses and the number of participants per group ranged from 3 to 13. Participants were compensated US $50 for their time and provided with an informal meal (breakfast or lunch) that occurred prior to the focus group discussion as participants began to gather and during the moderator’s review of the informed consent and round robin introductions. After the completion of each focus group, the moderators provided participants with information on Veteran’s Health Affairs benefits, common post-deployment concerns such as post-traumatic stress disorder, as well as local DVA and community resources for Veterans. No safety interventions were needed to expedite participant mental health care access.

Data Analysis

Using common analytic approaches in health services research, the investigative team employed inductive and deductive techniques to analyze the qualitative data (Bradley, Curry, & Devers, 2007). Predetermined a priori codes were included to represent themes from our previous research and the literature; such themes included sexual assault reporting, health care access and utilization, and leadership. An inductive analysis of the texts, including open (i.e., theme identification), in-vivo (tagging of textual data), and axial (constant comparison) coding, was used to capture unanticipated categories of analysis and the identification of emerging themes (Corbin & Strauss, 2015; Ryan & Bernard, 2003). Using memos and the technique of constant comparison, we identified the “story line” or the major research findings grounded in the data.

All of the coauthors were involved in the development of the coding schema and reiterations of code definition and their application (MacQueen, McLellan, Kay, & Milstein, 1998). The team met to draft an initial codebook that included deductive codes (e.g., leadership) and themes identified through a line-by-line reading of the text. When the team came to consensus on a codebook, the codes were entered into NVivo 8.0, a software program for qualitative data management, and two researchers independently applied to coding scheming to transcripts. During this process, the coders met after independently coding each transcript to test agreement. Intercoder agreement was calculated in NVivo using a comparison of text segments between coders. Discrepancies in code application were discussed among coders and an additional team member. Changes were made to code definitions, the coders independently applying the coding schema to a new transcript, and intercoder agreement was calculated. Once coders obtained 90% or better agreement for all codes, an acceptable percent of agreement between coders (Bernard, 2002), they finalized the codebook. Agreement was reached within four iterations of tagging text, calculating intercoder agreement, and refining the codebook. The coding schema was then applied to all transcripts.

In subsequent stages of data analysis, the qualitative team engaged in a process of axial coding (i.e., constant comparison) to compare and contrast servicemen’s problems. This stage involved memoing, or the writing of analytic notes, to identify patterns and develop the “story line” or theory emerging from the grounded analysis. The major findings were further discussed by the entire team until a consensus was reached in the interpretation of the data.

Results

Participant Characteristics

Thirty-four Midwestern OEF/OIF-era servicemen participated in the eleven focus groups. The servicemen were from different branches of service, including the Army Reserve, Air Force Reserve, and the National Guard (Army and Air), and from differing military ranks. The sample included 20 Reserve/National Guard servicemen (10 officers and 10 enlisted) whose ages ranged from 27 to 58 years at time of interview, and 14 Army or Air Force Active Component servicemen (12 officers and 2 enlisted) whose ages ranged from 29 to 60 years. Race/ethnicity was obtained only for the Active Component service members: two Asian/Pacific Islander, two Black, one other (mixed race); and nine White. Based on observation, the majority of Reserve/National Guard participants were White. Of the 34 participants, 14 had served in both the Reserve/National Guard and the Active Component military. Service in both was determined by their current Reserve/National Guard status and their response to the following question: Are you currently serving or have you previously served active duty Regular Military in OEF or OIF. These participants were included in the Reserve/National Guard service groups.

Key Themes in Male Service Members Perceptions of Male SAIM

Lack of awareness of military men’s sexual assault risk

The concept that males are at risk for sexual assault did not arise spontaneously in either Active Component or Reserve/National Guard focus groups. There was a general lack of awareness of men’s risk for sexual assault and most often SAIM was viewed as something that happens to servicewomen only (Table 1). Once participants were given commonly accepted statistics on rates of men being sexually assaulted in the military, they responded with disbelief and shock. Some participants, often Reserve/National Guard, had difficulty coming to terms with how many men are reported to be sexually assaulted in the military, even when presented with recent statistics. Active Component servicemen appeared to be less surprised about the possibility of male SAIM with males or females as perpetrators. For example, when sexual assault was initiated by the group leader as a possible deployment health concern for both men and women, one Active Component serviceman indicated a gender-inclusive consideration that assault is not just a woman’s issue. Concern for the potential emotional impact of SAIM on servicemen was raised across groups, for example, suicide. One active component officer stated, “we teach soldiers to report things like this, but we don’t teach them how to deal with them.”

Table 1.

Representative Quotes—Theme: Lack of Servicemen’s Awareness of Male Sexual Assault in Military (SAIM).

Service Affiliation and Rank	Quote
Reserve/Guard Enlisted	“So to tell me that men are being raped in the military is one that takes me for a loop. I’m now questioning how many of my soldiers, males, have been raped now?”
Reserve/Guard Enlisted	“That stuff happens in prison. Not our military.”
Reserve/Guard Enlisted	“The fact I’ve been in the military this long and I did not know men were being raped by other men tells you that, hey, this is something that needs to be brought forward right now. Not later, but right now! Because we pushed the issue on suicide but we’re not pushing this?! That’s what’s getting me upset. So now I’m questioning those suicides, because maybe something happened to some of these men that they don’t want to talk about, and as a man, for me to be raped, I’d probably kill myself.”
Reserve/Guard Officer	“I’m not saying they wouldn’t believe a male before they’d believe a female, because I’m—I’m sure the statistic are that it happens a lot more to females. . . It’s got to be?”
Active Component Officer	“Sexual assault is often not spoken about but is still a concern, both at fixed bases and in deployment. There is a tendency, and this may not be woman-specific, that there can definitely be the good old boy atmosphere, which makes it very difficult to sort out, is this a woman’s-specific issue, is this just a squadron isolating in a certain environment a [male] officer who they don’t necessarily particularly like?”

Victim blaming

Beliefs around male sexual assault characterized male victims as partially or primarily responsible for the assault, blaming victims for their lack of self-protection and suggesting that men should defend themselves (Table 2). In the military, as one participant commented, “everybody’s got a gun,” which indicates this can be used for protection, including protection from sexual assault. Participants reported the belief that servicemen who fit traditional masculine stereotypes cannot be the victims of SAIM and that the descriptor of effeminate is equated with being gay, another possible reason for victimization. Participants indicated that male victimization signified weakness and a loss of power.

Table 2.

Representative Quotes—Theme: Acceptance of Rape Myths and Blaming Victims for Male Sexual Assault in Military (SAIM).

Service Affiliation and Rank	Quote
Reserve/Guard Enlisted	“We have this image of our military, that a male can handle himself in any situation, alright? And to tell me a man got raped, the first thing that’s going to go through my mind is, first of all, how did you allow someone to rape you without killing them?”
Active Component Officer	“It’s [male SAIM] not reported because of the stigma associated with it: You didn’t defend yourself? You didn’t do what you could to protect yourself?”
Reserve/Guard Officer	“Men are supposed to be stronger. You don’t want to admit that—that you were taken advantage of—you don’t want to admit that someone violated you, had that power over you, took advantage of you.”
Reserve/Guard Enlisted	“. . . if I was to guess, it would be kinda that schoolyard mentality of there’s the person, ya know, we’re going after . . . he’s on the outside . . . he’s not one of us.”
Reserve/Guard Enlisted	“. . . you’re either macho, or you’re wanted out of there.”
Reserve/Guard Enlisted	“I mean it’s a stereotype, maybe [sexual assault happens to] the effeminate ones. . . I don’t know.”

Barriers to reporting sexual assault in Reserve/National Guard

In addition to the lack of awareness of SAIM and the tendency to blame the victim, participants also discussed that there would be a number of barriers to reporting victimization, including (a) stigma and the status of citizen-soldier, (b) an ethos of conformity and leadership modeling, and (c) lack of confidence in leadership and restrictive reporting (Table 3).

Table 3.

Reserve/Guard Representative Quotes—Theme: Barriers to Reporting Male Sexual Assault in Military for Reserve/National Guard.

Theme Subcategories	Rank	Quote
Citizen-Solider Status	Enlisted	“As a matter of fact—it would be worse because now this National Guard here has got to go back to the community to his wife and kids where he was supposed to have gone off a hero. Okay? He has to go back and, [in] the back of his head ‘This happened to me.’ It’s like coming out of prison: ‘This happened to me.’ He’s not going to share that, and it’s going to manifest, and fester more.”
	Enlisted	“Well of course! You take a historical National Guard unit like the [unit de-identified]. And to have mention that a man was raped . . . c’mon.”
	Officer	“It [reporting SAIM] would be embarrassing . . . you would be facing those same people for the next 20 years . . . and they wouldn’t stop talking about it, so you would be very reluctant to come forward.”
Ethos of Conformity and Leadership Modeling	Officer	“The unit takes the personality of the commander after a while and the senior leadership. If the commander is going to set the example to say, ‘Hey I’m ignoring it [sexual assault], because I got a mission to get done . . .’ the unit will. After a while, the people who don’t conform to that personality, well, life will be so miserable for them they will be gone if there’s a possibility of that [reporting of sexual assault]. And that is a thing that everybody knows.”
	Officer	“Because I would have to defend my integrity as a man, because every unit has its esprit de corps and I don’t want be the one, “Oh that’s that colonel so-and-so, did this to. . .” Then it gets out of hand. So, you all have to defend yourself against that.”
	Enlisted	“Reserve and National Guard units have a tendency of black-balling soldiers who don’t conform to what that unit’s expectation is, okay? Being active Army in a reserve unit, I have seen how the culture of that unit exists and if you go against the culture of the unit, you’re shunned, you’re blacked-balled. And so that you have an incident [sexual assault] like that happen to you in this culture, you most definitely will not express it, it’ll probably eat you up until you get to a point where you will start reacting very hostile and very dangerous in it.”
	Officer	“. . . if the commander just does nothing (male SAIM) it gives an indication to those that are doing it that this is okay.”
Limited Confidence in Leadership and Reporting	Enlisted	“National Guard and Reserve units tend to have a good ’ol boy system. More so than active units because they are transferred in and out on the active side more often. And if, Joe is John’s friend, and he’s the commander and I’m his friend, then it’s going be hard for you to tell him [the commander] anything bad about me. And if you do, and if there’s any way I can, he [the friend] can squash it, and make you look bad in the process, you can rest assured it’s going to happen.”
	Enlisted	“If a man reported (sexual assault)? He’d be mocked out of the service. He might as well commit suicide.”
	Enlisted	“Whoever you file that report with, unless you get awful lucky, is going be one of the boys. And once one of ’em knows it, they all know.”
	Officer	“Administratively it [the reporting of sexual assault] would be similar [to Active Component military] but sure it would be different [in the Reserve/National Guard]. . .in active duty, it’s people from all over the United States, you get reassigned all the time. Whereas in a Reserve unit you’re kind of stuck to, you know, you’re from this region, and if you’re going stay in the Guard or Reserve, everybody, EVERYBODY, knows you. And there’s no way you’re really going to be anonymous anymore.”

The Reserve/National Guard citizen-soldier status

The perception that citizen-soldiers face greater stigma after experiencing SAIM than do men serving in the Active Component military was a salient theme across interviews. The difficulties that some servicemen with SAIM histories might experience as they move between the status of being Reserve/National Guard servicemen and ordinary citizens with jobs and families were discussed. Likening it to returning to the civilian world after a prison sentence, participants indicated the belief that the shame and embarrassment about sexual assault among Reserve/National Guard servicemen might be worse than sexual assault among male Active Component troops as they return to their communities not as “heroes” but as victims of sexual assault. The Reserve/National Guard return to their communities and neighborhoods where sexual assault might not be easily accepted because of gender stereotypes and beliefs about men’s sexual victimization. Participants discussed how their return to permanent residences (as opposed to Active Component servicemen, who are geographically mobile) would also deter Reserve/National Guard servicemen from disclosing a history of SAIM. Many expressed their concern about the stigma surrounding male sexual assault and how this would affect disclosing or reporting sexual assault as well as possible adverse career and self-concept consequences of reporting.

Participants further commented on the military context whereby Reserve/National Guard servicemen might be deployed individually within Active Component units where they have no long-standing relationships with others in that unit. Therefore, this environment might influence both assault risk and reporting likelihood.

Ethos of conformity and leadership modeling

Participants indicated that the rigid hierarchy and structures of power embedded in Reserve/National Guard units that may have lived and trained together over long periods of time near their home communities created an ethos of conformity that are central to both unit cohesion and individual career advancement and that also shape attitudes toward sexual violence against men and deter decisions to report sexual assaults. Reporting sexual assault can signify an act of disconformity, placing soldiers in marginalized positions in their units. Servicemen also explained that reporting sexual assault could infringe on men’s self-concept and was seen as a form of weakness. Participants described the social and career ramifications when soldiers do not conform to expectations, “black balling” and being shunned, which explains some reasons why male victims of sexual assault would remain silent. By nonconforming and breaking the code of silence, servicemen who report risk isolation and retaliation from others.

Lack of confidence in leadership and reporting

A prominent theme across the focus groups was the general lack of confidence in reporting within the command structure, and in particular in the Reserve/National Guard leadership. Participants indicated that sexual assault is not discussed among superiors and that superiors would be unlikely to take reports seriously. Others expressed doubts that Reserve/National Guard commanders would follow through with persecuting perpetrators of sexual harassment and/or sexual assault. In addition, the power structures in the Reserve/National Guard chain of command, a “good old boy’s” system, were thought to make it especially challenging to report sexual assault in contrast to Active Component units. Lack of anonymity, both within the unit and the community, was identified as among of the major barriers to reporting sexual assault among Reserve/National Guard soldiers.

Sexual assault risk and barriers to reporting among active component servicemen

Active component servicemen initiated two key themes regarding sexual assault risk and barriers to reporting: (a) female perpetrators (command rape) and (b) deployment (Table 4).

Table 4.

Representative Quotes—Theme: Women as Perpetrators and Rank Used for Sexual Coercion.

Service Affiliation and Rank	Quote
Active Component Enlisted	“In my point of view, I was hit on more often by female officers this last time around (deployment) than I was any other time. There were some that were ‘you do what I say or you’re not going to get promoted’ from higher ups.”
Active Component Enlisted	“It was the other way around, they (female officers) were trying to get the men, it’s a different turn-around story on that one.”
Active Component Enlisted	“There was a lot of females that were doing the same back to the males (sexual coercion). . .You’re not supposed to have sexual intercourse during combat.”
Reserve/Guard Enlisted	“I don’t think that officially they would look on it (male SAIM) any different, but you know, some people—some guys might go, “what’s he complaining about?”“
Active Component Enlisted	“So there’s a certain level of privacy when it’s a male target as compared to a female target. Things are more well known when it is a female being targeted. . . . Yes, it’s spread around a lot quicker [if it is a female victim and male perpetrator]. . . . There are rumor mills.”

Sex of perpetrator

In contrast to Reserve/National Guard participants, Active Component participants primarily focused on SAIM reporting barriers for servicewomen with fewer acknowledgments about male SAIM reporting barriers. The exception was the discussion of higher ranking female perpetrators and the minimization of males’ experiences with command rape, that is when servicemembers in the chain of command use their rank to sexually coerce a servicemember junior to them. The “advantage” of an Active Component serviceman having a female perpetrator was discussed as preferable to a servicewoman having a male perpetrator because there would be less gossip. Servicemen also indicated they might have more autonomy than servicewomen in saying no to sexual violence from female officers.

Sexual risk during deployment

Within the topic of male victims and female perpetrators, deployment was discussed as an environment that makes sexual violence more possible (Table 5). The clearest differences in perceptions among Reserve/National Guard and Active Component servicemen was that the Active Component participant sees victims “trapped” when deployed and free to seek escape or help when stateside, but the Reserve/National Guard participants indicated they would feel as trapped when embedded in their home communities.

Table 5.

Representative Quotes—Theme: During Deployment Male Sexual Assault in Military (SAIM) and Reporting.

Service Affiliation and Rank	Quote
Reserve/Guard Enlisted	“I think it’s even maybe more of an acute issue in a deployed environment . . .” (SAIM).
Active Component Enlisted	“You know they can’t get away from, they’re (servicemen) going to be working underneath the sergeant major for 365 days, so. . . .” “Here [continental USA/not deployed] they can get out and get away from it (command rape).”
Reserve/Guard Enlisted	“I have to say that most deployments are going to have a very, very high op-tempo. From an op-tempo perspective, things like dealing with sexual harassment would be a distracter from completing the mission.”
Reserve/Guard Officer	“You’ve got to face these people, and if it’s not proven then it’s like the onus is still on you. You accused somebody and it wasn’t proven, but you still have to get up and face these people in a combat environment, where you have to have a lot of trust and communication.” “You become the enemy, so you have to fear physical retaliation and ostracization. As a consequence, the situation “can fester and get bigger and get worse, like a cancer throughout the organization.”

Another reporting barrier Reserve/National Guard members reported was that time taken for paperwork or an assault investigation may have an adverse impact on the safety of a deployed unit as a collective and mission completion or may adversely affect unit cohesion.

Discussion

This qualitative analysis of focus group data reveals common perceptions of male SAIM by servicemen, as well as highlighting the substantial differences in perceived barriers to reporting SAIM between men serving in the Reserve/National Guard and peers in Active Component service. Our findings underscore the limited awareness of male sexual assault, particularly among Reserve/National Guard male servicemen who expressed initial ignorance of male SAIM and in some cases rejected the possibly that this can and does happen in the military. That many participants did not recognize servicemen as potential victims of sexual assault calls attention to the perception that SAIM is not immediately thought of by military men, and in particular those serving in the Reserve/National Guard, as a problem servicemen face during military service or deployments. This makes visible the perception of military males as perpetrators of sexual assault but not as victims of assault, and when they spoke of male sexual assault, it was more often with regard to female officers as perpetrators and risk in deployed environments. This difference in awareness may be a result of the higher rates of sexual assault in active component males (Morral et al., 2016). Yet given that male SAIM is underreported and research has lagged specific to men as victims, it is not surprising that many servicemen have the misperception that male victimization does not happen (Kimerling, Rellini, Kelly, Judson, & Learman, 2002; Morral et al., 2016; Rock, Lipari, Cook, & Hale, 2011). This misperception may increase the likelihood of victimization because potential male victims may be less guarded around sexual assailants who may target them for that very reason.

Another important finding of this study was the shift from denial of male SAIM to endorsement of rape myths and victim blaming—a pattern that surprisingly arose across all Reserve/National Guard focus groups. This process differed substantially from Active Component servicemen who did not initiate victim blaming for either women or men. Participants may have been trying to make sense of male SAIM in the unfortunately more familiar cultural narratives such as gay or prison assaults. Such comments highlight that participants appeared to have limited cognitive constructs to account for male sexual victimization in a military context. These data confirm prior work indicating that men who experience sexual assault are often marginalized and fall victim to rape myths (Kassing, Beesley, & Frey, 2005; O’Brien et al., 2015; Rando, Rogers, & Brittan-Powell, 1998). Civilian men have been found to tend to endorse rape myth acceptance, display negative attitudes toward victims of sexual assault (Hockett, Saucier, Hoffman, Smith, & Craig, 2009), and believe that men are responsible for their victimization (Chapleau et al., 2008; Turchik et al., 2013). This work may have direct relevance to citizen-soldiers with different military environments, training, and cultures from their active component peers.

In our findings, Active Component servicemen more actively than Reserve/National Guard peers expressed awareness that sexual violence with male or female perpetrators can be a manifestation of an abuse of power that isolates, marginalizes, and can ruin men’s military careers. They discussed their experiences with female officers as perpetrators. This is not a rare concern as prior research in active duty servicemembers has found that for male sexual assault victims, offenders are equally split between men and women with many perpetrators in the victim’s chain of command (26%; Rock et al., 2011). A study of male rape in Korean military populations found power dynamics, such as high rank, made resistance difficult for victims, and sexual abuses continued (Kwon, Less, Kim, & Kim, 2007). Our participants indicated that a common view is that it is “just natural” for servicemen to want to have sex if a servicewoman initiates it, even if a female officer is using coercion. Inherent in rape myths is the trivialization of sexual violence as sexual attraction and desired intimacy rather than as enactment of dominance and power (Burt, 1980).

As focus group discussions evolved, participants indicated increased awareness of male victimization and recognition that male SAIM survivors face stigma both within the military and their home communities. They indicated male SAIM is not an acceptable part of military service, acknowledged it as damaging, and recognized that male SAIM victims need mental health care services. Such findings reflect the complexity that military men must navigate when seeking care within the context of a traditionally hypermasculine culture and “band of brothers” (Shields, Kulh, & Westwood, 2017), but this also has substantial implications for educational interventions with military and Veteran populations and their providers. Our data illustrate the importance of focusing clinical and policy interventions not only on awareness education but also on motivating effective reporting and bystander intervention considering males as potential victims of sexual violence.

Our findings furthermore vividly illustrate that, similar to female peers (Mengeling, Booth, Torner, & Sadler, 2014), servicemen face a number of barriers to reporting SAIM. According to our data, reporting is perceived to undermine (a) unit cohesion (b) relationships with other unit members, (c) unit safety during deployment, (d) career prospects, (e) physical safety, (f) individual self-concept, and (g) confidentiality. An ethos of conformity and demand for unit cohesion coupled with the desire to avoid ridicule, accusations of homosexuality, or even Uniform Code of Military Justice (USMJ) charges can deter servicemen from reporting sexual assault. In addition, cultural values of discipline and collectivism and military leadership can arouse fear of retribution or reprisal of various types and instill a code of silence. Stoicism and expectations of emotional control and other types of cultural, emotional, or structural barriers present major obstacles to reporting SAIM by male victims (Hoyt, Rielage, & Williams, 2011). Perpetuation of rape myths makes it difficult to report male sexual assault, especially in the military where available defenses including body strength, training, weapons, and buddies are assumed to protect anyone who wants to be protected.

A novel and important finding of this research is the notable differences in barriers to reporting sexual assault among Active Component and Reserve/National Guard service members. The Reserve/National Guard servicemen in our study emphasized their perceptions that sexual assault among men is not openly discussed, reports might be ignored or shared with others, and social and military connections can impeded further investigation. These findings illustrate the importance of military leadership in establishing the culture whereby sexual violence is actively addressed and not tolerated. Prior work in military women has demonstrated that positive leadership behaviors can decrease women’s risk of SAIM (Mengeling, Booth, Torner, & Sadler, 2014; Sadler, Mengeling, Booth, O’Shea & Torner, 2017) and that laissez-faire leadership can sanction an environment where perpetrators can act without recourse and victims are left to suffer in silence (Sadler, Lindsay, Hunter, & Day, 2018). In addition, the tight-knit nature of the Reserve/National Guard and the informal network of social and military connections that upholds power among military personnel holding prestigious position (e.g., “good old boy’s club”) may deter male Reserve/National Guard victims of sexual assault from reporting their victimization and heighten concerns for confidentiality if they do. The citizen-soldier status creates a unique situation for male SAIM survivors as they return to their communities, neighborhoods, and families in the same group with whom they performed their military service. As participants indicated, disclosing SAIM may be especially challenging for men returning to contexts where gender stereotypes about men depict victimized men as weak and effeminate, ultimately contributing to victim blaming and loss of identity as a man (Onyango & Hampanda, 2011). Active Component servicemen are not immune to these influences, but their routine reassignments to different locations, bases, and units may provide more avenues for them to seek help without fear of their SAIM experience becoming known to friends and relatives through rumors.

For the Active Component participants, a substantial reporting barrier occurred when service members were “trapped” in the physical confines of deployment, whereas for the Reserve/National Guard participants, reporting barriers related more to being trapped in personal and community relationships and expectations.

Active Component servicemen commented that they were less able to avoid female officer perpetrators in deployed environments and that male victims of female perpetrators were less likely to be viewed as rape victims than female victims with male perpetrators. Thus, male SAIM survivors with female perpetrators may downplay the importance of the trauma. If they do not report, perhaps they can salvage their career and maintain unit cohesion. If they do report, they fear a positive outcome is less likely than inaction or that they will not be taken seriously.

Study strengths and limitations should be considered when interpreting these findings. The use of a community sample of servicemen (as opposed to DVA-enrolled Veterans), the inclusion of both Active Component and Reserve/National Guard servicemen, and the sampling of officers and enlisted servicemen added depth and strength to our study. Furthermore, Army and Air Force Active Component and Reserve/National Guard were most frequently deployed during OEF/OIF of which most (three-quarters) were White (http://download.militaryonesource.mil/12,038/MOS/Reports/2014-Demographics-Report.pdf). These characteristics are consistent with our study’s sample. However, we did not purposively select men with histories of SAIM, which limited understanding of the lived experience of sexual victimization during military service. We also used focus groups to elicit shared knowledge about male SAIM and barriers to reporting sexual assault (rather than one-on-one, in-depth interviews). Because this method uses group dynamics to spur discussion, it is possible that the group setting inhibited some participants from sharing personal knowledge or experiences of male SAIM. The overall recruitment emphasis of the focus groups on health and safety of service members during deployment may have reduced selection bias for men who did and conversely did not experience male SAIM, thus resulting in a more general sample of military men. It is also possible that we overlooked unique differences between Reserve and National Guard cultures and members by combining these service types together given characteristics that make them similar in contrast to Active Component cultures. Most group participants were White, and we did not query sexual orientation or current income. Consequently, issues of diversity, such as race, ethnicity, sexual orientation, and socioeconomic status require further study. Although some findings appeared consistent with prior work with servicewomen, all participants were males and thus results cannot be considered generalizable to servicewomen.

Implications

Our findings reinforce that providers need education and training on commonly shared beliefs about SAIM among servicemen and Veterans to (a) better understand the military stoicism, shame, and secrecy involved in disclosing a history of sexual assault and the concern for confidentiality, and (b) promote men’s feeling of safety in seeking treatment within DVA, DoD, or non-DVA health care settings given the substantial adverse military adjustment and career consequences they report occurs in the military setting. In addition, it is important that providers recognize the significant relationship between SAIM and mental health consequences, especially suicide ideation associated with assault as voiced by participants in our study. Such undertakings are of course important to female Veterans as well. Yet there appears to be distinct gender differences in the relationship between sexual victimization and suicide risk, with recent work finding that unwanted sexual experiences during military service were more strongly associated with suicide ideation and suicide plans among servicemen and male Veterans compared with servicewomen and women Veterans. Men reporting unwanted sexual experiences during military service have been found to be 11 times more likely to have made a suicide plan and 7 times more likely to have made a suicide attempt during military service, even when adjusting for premilitary sexual assault (Bryan, Bryan, & Clemans, 2015).

Our findings support that DVA, DoD, and non-DVA health care providers practice routine assessment for male SAIM. Providers in primary care clinics have the opportunity to play a critical role in assessing SAIM among servicemen and Veterans, as primary care settings are entry points for many men and women. However, it is important to understand that servicemen and male Veterans may not openly discuss victimization because it is at odds with returning as a military “hero” and they may fear loss of confidentiality and the repercussions of disclosing a history of assault. These concerns include fear of being seen as weak, leaders treating them differently, or coworkers having less confidence in them (Holland, Rabelo, & Cortina, 2016). In addition, the gender of the provider conducting the SAIM screening may matter. Men have been found to be unlikely to disclose a history of sexual assault to a male provider but may be more inclined to do so with a female provider (Riccardi, 2010).

Our study results indicate that lack of awareness, stigma, and blame are substantial barriers to reporting male SAIM, and this lack of awareness has implications for male victims and providers. Providers must be further educated about male SAIM and, in turn, educate male service members and Veterans about its prevalence (as illustrated in our focus groups) to actively work toward reducing risk factors, stigma, and consequent barriers to health care use (Turchik et al., 2013; Zinzow et al., 2015). Furthermore, providers serving servicemen and male Veterans need to be aware of how their own gender stereotypes influence their beliefs about who is and is not vulnerable to sexual victimization. In general, men are expected to be strong, aggressive, and capable of protecting themselves from sexual aggression. Such gender expectations are especially strong in military contexts, where idealized masculine identities, in contrast to feminine characteristics, are valued (Connell & Messerschmidt, 2005). An uncritical awareness of how such gender expectations can influence providers’ interactions with servicemen and male Veterans may undermine efforts to screen men for sexual assault histories (Polusny & Murdoch, 2005).

Veterans’ apprehension about disclosing experiences of sexual violence extends to health care settings outside of DoD. DVA-enrolled male Veterans have been found to express concern about the sensitivity and reactions of providers who are told about male sexual trauma (Turchik et al., 2013). Provider bias regarding male rape stereotypes may also influence mental health treatment referral and engagement. Like women, male service members and Veterans may have concern about revictimization by a health care provider or organization that does not believe they can be raped or blames them if they are (Mengeling et al., 2014; Sadler, Booth, Cook, & Torner, 2003). As our prior research indicates, this concern may be based on their own or their observations of their peers’ experiences with military leadership and the military organizational responses to sexual violence occurrence or reporting. Such experiences can adversely affect their sense of safety and trust with a provider and ultimately their trauma recovery (Hoyt et al., 2012).

Conclusion

To date, research has largely examined SAIM among female Active Component service members and Veterans. Our research is one of the few studies that considers military men’s perspectives of male SAIM. Our findings emphasize that servicemen report an overall lack of awareness of male SAIM and may accept and perpetuate beliefs and rape myths that pervade military culture and silence both male and female SAIM victims. Compared with Active Component servicemen, men serving in the Reserve/National Guard face unique barriers to reporting SAIM, such as the perception of greater stigma due to their citizen-soldier status, an ethos of unit conformity and leadership modeling, and a lack of confidence in leadership and the reporting process. Active Component servicemen emphasized the deployment location and sex of the victim and perpetrator as key SAIM reporting barriers. Clinician’s must be aware of the high rates of male SAIM and servicemen’s reluctance to disclose this experience, given their context of a military culture that might not believe them or punish them if they do report it. The influential role of leadership on servicemen’s sexual violence risk and reporting barriers was prominent in our findings. More research on male SAIM is needed to inform primary and secondary interventions to prevent and address SAIM across service types and locations as well as to address gender-specific barriers to reporting SAIM and health care engagement.

Footnotes

Acknowledgments

Michael P. McClain, PhD, LMFT (1965-2016) was integral to the success of this research, contributing his expertise in military men, violence in military settings, military culture, and focus group skills. Mike was a Marine Veteran and a martial and family therapist with the Iowa City DVA Health Care System and in private practice. His career was devoted to caring for Veterans and their families. We would also like to note the significant contributions of key staff who contributed to the success of this work: Carrie Franciscus, study programmer; Holly Strehlow, computer-assisted telephone interview lab director, and Brittany Martin, research coordinator.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development (HSR&D) Service grant HSR&D DHI 05-059, DHI 08-136 and U.S. Department of Defense (DoD) Award W81XWH-08-2-0080. The content is solely the responsibility of the authors and does not necessarily represent the views of the Department of Veterans Affairs or the Department of Defense.

ORCID iD

Anne G. Sadler

Author Biographies

Anne G. Sadler, PhD, RN, is an investigator with the Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) and associate professor in the Department of Psychiatry of the Carver College of Medicine at the University of Iowa. She is a health services researcher whose studies have focused on sexual violence in military populations, including antecedent risk factors, consequent health outcomes, and access to care. Recently, her work has focused on eHealth and shared decision-making interventions to support post-deployment mental health care engagement for recent war Veterans.

Ann M. Cheney, PhD, is an assistant professor in the Department of Social Medicine and Population Health in the Center for Healthy Communities at the University of California, Riverside School of Medicine; and a research affiliate for the Greater Los Angeles DVA. She is a medical anthropologist and health services researcher with interests in mental health and substance use services. Her work focuses on social determinants of health, including structural inequality in substance use among women, immigrants, and minorities.

Michelle A. Mengeling, PhD, is an investigator with the CADRE and the DVA Office of Rural Health (ORH), Veterans Rural Health Resource Center—Iowa City (VRHRC-IC) and an associate with the Department of General Internal Medicine, University of Iowa Carver College of Medicine. Her areas of expertise include survey development, measurement, and statistics. Her primary research interests are access to care, rural populations, women’s health, and measurement.

Brenda M. Booth, PhD, has worked in the areas of sexual assault as well as substance abuse for more than 25 years. She has led community research projects studying rural substance abuse, focusing on course of addiction and access to substance abuse treatment. She has published more than 200 research reports in the areas of addiction, health services, and sexual assault.

James C. Torner, PhD, MS, FACE, FAHA, is professor of epidemiology, surgery, neurosurgery, and health informatics, and associate director of the Institute for Clinical and Translational Science, at the University of Iowa. His primary area of research is disability prevention and control. He has expertise in statistical epidemiology, neuroepidemiology, musculoskeletal epidemiology, women’s health, prognostic studies, and acute and preventive clinical trials. He is the director of the Iowa Stroke Registry and advisor for the Iowa State Trauma Registry. He is the Iowa principal investigator for the Multicenter Knee Osteoarthritis Study (MOST). He teaches clinical trial design, evidence-based public health, and neuroepidemiology.

Lance Brendan Young, PhD, is an assistant professor of communication at Western Illinois University—Quad Cities. His area of expertise is health communication, including social support among those with substance use disorder, the antecedents and consequences of interpersonal trauma, and patient–provider communication.

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