Male Victims

Initial Response

Male sexual assault patients should be triaged in the same manner that is suggested for female sexual assault patients.
Male sexual assault patients generally are less likely to report sexual assaults or to seek medical care following a sexual assault due to the stigma and societal views. A non-judgmental response is imperative to facilitate the recovery of male patients.
Male sexual assault patients may experience emotional and psycho/social trauma similar to that of a female. It is just as important for males to be reassured that they were victims of a violent crime which was not their fault, and that other sexually assaulted males have recovered.
Male patients may be more likely to exhibit a controlled response after the assault, with feelings of shock, disbelief and confusion. The assault may cause the patient to question his own sense of manhood and strength.

Ask the male patient whether he would prefer a male nurse and/or a male sexual assault counselor, if one is available. Never assume that a male counselor is preferred.
Call sexual assault crisis services as soon as possible to enhance the timeliness of the counselor’s response.
A male patient may have concerns or problems regarding his inability to resist the assault or confusion about the nature of his role as victim/participant because of the possibility of an involuntary physiological response to the assault, such as stimulation or ejaculation.
Concerns regarding sexual identity may arise for homosexual, bisexual or heterosexual males.

The male sexual assault patient’s oral cavity/mouth should be carefully examined for trauma/evidence. The details of any findings should be recorded on page 2 of the Medical Report.
Male genitalia diagrams have been provided on page 3 of the Medical Report. Special care should be taken to closely examine both the glans and scrotal area, which often are targets of trauma in male sexual assaults.
Evidence of erythema, bruises, suction marks, excoriations, burns or lacerations of the glans, frenulum and anus should be recorded. The presence of testicular or prostatic tenderness or discharge from the urethra are important signs and may reflect trauma or infection.

The evidence collection procedures described on pages 32 through 50 apply to male patients as well as female patients. Minor adaptations must be made, for example, penile swabs and smears (in lieu of vaginal swabs and smears) for possible saliva, feces or other evidence.
Special care should be taken in packaging the male patient’s clothing, especially underpants and pants because the patient may have experienced an ejaculation. (This does not imply consent or pleasure, but rather is a natural physiological response to stimulation.) To avoid cross contamination with the offender’s semen, the garments should be placed over clean pieces of paper or cardboard and secured with tape, pins, etc. This collection information should be recorded on the Step 1 identification label and on line 3 of the Checklist.
The male patient’s back, thighs and buttocks should carefully be examined for dried secretions. The use of an alternative light source with a filter or a Woods short-wave ultraviolet lamp in a darkened examination room can be helpful in locating fluorescence from saliva, blood, semen or feces on the patient.
When collecting combed pubic hair specimens, include combing of hair around testicles and anal area.
Body hair should be closely examined for debris or foreign hairs.