What We Can Do About Domestic Violence When Males Are The Victims

Originally published in Case In Point: November 2012

Walk into a college lecture hall or professional training space and explain that you are to discuss domestic violence and you will mostly conjure images in your audience members of black eyes and frightened women clutching their children as they escape the men they once loved. There is good reason for their minds to construct this picture; the perpetration of violence against a woman by a male intimate partner continues to be a major public health problem in the United States. According to the 2010 National Intimate Partner and Sexual Violence Survey (NISVS) conducted by the Center for Disease Control and Prevention (http://www.cdc.gov/violenceprevention/nisvs/), more than 1 in 3 women (35.6%) have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime. Across all types of violence, the majority of females indicated that their perpetrators were male. However, when understanding the dynamics of intimate partner violence (IPV), our minds must construct a larger, more inclusive picture for victims—it is a picture that must account for male victims. The NISVS also discovered that men experience those same forms of violence at a rate of more than 1 in 4 (28.5%).

Many reasons exist for the disparity between public perception and reality of IPV victimization for both genders, but history is perhaps most responsible. Structural organizing around IPV against women did not blossom until the mid-to-late 1960’s. First dubbed the “Battered Women’s Movement,” the movement to end domestic violence was successful in injecting a problem that was overlooked, outright ignored, or thought to be a private issue into the public consciousness. Activists, researchers, law enforcement, healthcare and mental health professionals responded and developed practices to encourage women to report abuse and for institutions to intervene and prevent IPV against women. But an unintended result of this work created a public unable to recognize that men could be victims of IPV too. As a result, many male victims felt embarrassed or that they would not be believed and it has been hard to develop reliable data on the scope of this issue.

But as domestic violence advocates and researchers slowly increase knowledge of the scope and demographic information for victims of IPV, healthcare professionals and service providers must develop new means of reaching out to overlooked populations just as they had for women in the past. Borrowing from proven practices that decrease and prevent violence against women is a start. For instance, Futures Without Violence (http://www.futureswithoutviolence.org/) cites a promising study that indicates that women in family planning clinics who received both assessment and counseling on harm reduction strategies were 60% more likely to end a relationship because it felt unhealthy or unsafe. But domestic violence affects men in unique ways and we must account for that if best practices are to be developed.

Patrick M. DeCarlo works with male victims of domestic violence.

The Dynamics of Domestic Violence Against Men

An important distinction to our understanding of domestic violence recognizes its legal interpretation and requirements for reporting to law enforcement versus its sociological interpretation advanced by advocates working to end violence globally. Both interpretations are important to healthcare and social service providers because it not only frames their day-to-day work, but offers deeper understanding of a victim’s experience, leading professionals to deliver more empathic care.

Legal definitions of domestic violence are usually narrow in behavior (only including incidences of physical and sexual violence), broader in relationship (inclusive of intimate partner violence and family violence between, say, two siblings), and prosecuted as solitary incidences. Domestic violence laws and requirements for reporting vary state-to-state. Futures Without Violence offers a compendium of state statutes and policies for reporting as well as many other resources for health care professionals such as toolkits for screenings and regular webinars (http://www.futureswithoutviolence.org/section/our_work/health).

A sociological interpretation sees domestic violence as a pattern of coercive and/or assaultive behaviors used in order to establish and maintain power and control over an intimate partner. Perpetrators almost always employ various forms of control – physical, sexual, emotional, verbal, financial, etc. While males are more likely to suffer emotional, verbal, and financial violence from a female intimate partner, and perpetrators of stalking and sexual violence are more likely to be male, the NICVS reports that 1 in 7 males have experienced severe physical violence by an intimate partner (e.g. hit with a fist or something hard, beaten, slammed against something) at some point in their lifetime and that perpetrators were more likely to be female.

Due to a lack of public awareness, male victims of IPV may believe that no one will believe the violence they have suffered, that what they are going through is not intimate partner violence because they believe it is something that only effects females, and fear further stigmatization by friends, colleagues, and community service providers because their victimization does not mesh with the hegemonic constructions of masculinity that sees men as very much in control of not only their lives but others’ lives.

The NICVS reports that IPV takes a tremendous toll on victims’ lives. Survivors cite headaches, chronic pain, difficulty with sleeping, activity limitation, poor physical health and poor mental health as common maladies. Considering the lack of knowledge and stigmatization male survivors suffer at the hands of their abusers and a disbelieving public, only 10% of male victims reach out for help to healthcare providers, crisis hotlines, housing services, victim’s advocate services, and legal services.

The 2SLGBTQI+ community experiences intimate partner violence at higher levels than cisheteronormative couples due to the oppressive structures set by heteronormativity.

Gay, Bisexual, and Transgender Men

Researchers regularly report that physical, sexual, and/or emotional victimization of men by other men in intimate partner relationships is equal to or exceeds that of men in heterosexual relationships, usually around 25% or higher. Gay, bisexual, and transgender men face unique dynamics of IPV. An abusive partner threatening to tell a victim’s friends, family, colleagues, or community members of their sexual orientation, gender identity, or HIV-status can have serious emotional implications and consequences such as loss of employment, housing, or meaningful relationships. Abusers also exploit societal discrimination by telling victims that authorities will not help gay, bisexual, or transgender males. And like many marginalized communities, gay, bisexual, and transgender men may not report abuse because of the fear that the public will categorize all such relationships as deviant and violent.

Discrimination against gay, bisexual, and transgender men puts all male survivors of IPV at risk. A 2010 report conducted by The National Coalition of Anti-Violence Programs (NCAVP) (http://www.avp.org/documents/IPVReportfull-web_000.pdf) recognizes that male-identified survivors of domestic violence are “far less likely to be able to access services, particularly safe haven at domestic violence shelters, due to the historical view of IPV survivors as female-identified” and face “institutionalized discrimination . . . from health care agencies, law enforcement, and domestic violence agencies.”

The NCAVP recommends that healthcare professionals and service providers increase training on the dynamics of intimate partner violence effecting lesbian, gay, bisexual, transgender, queer, and HIV-affected (LGBTQH) IPV survivors and establish non-discriminatory provisions. Public outreach into LGBTQH communities on the dynamics of intimate partner violence and the availability of services is paramount. The assuring of confidentiality and well-trained, culturally competent staff will lead to more survivors coming forward.

Doctors can pledge to assess for domestic violence when males are the victims.

Screening for IPV

Screening for IPV could feel awkward no matter the gender of the client. Safe Space of Butte, Montana offers an excellent resource for medical professionals (http://www.safespaceonline.org/healthcarepro.pdf). The agency says that the best way to uncover a history of abuse is to simply ask about it and be versed on the “red flags” of abuse. These could be: chronic, vague complaints that have no obvious physical cause; injuries that do not match the explanation of how they occurred; an intimate partner who is overly attentive, controlling, or unwilling to leave their partner’s side; a history of attempted suicide or suicidal thoughts; alcoholism or substance abuse.

Adapting questions that previously worked in screening women for violence may prove effective; remember, decades ago it would have been taboo for healthcare professionals and social service providers to ask females about potential violence in their homes. We can ask in a variety of ways--for instance:

“Because violence is increasingly common in men’s lives, I’ve begun asking clients about relationship abuse.”
“I don’t know if this is a problem for you, but many of the men I see are dealing with tensions at home and in their intimate relationships. Some are uncomfortable with coming forward, so I’ve started asking about it routinely.”
“Sometimes when I see an injury like yours, it’s because somebody hit them. Did that happen to you?”

Clinical history and patient intake forms can facilitate the process as well. Recommended

questions to include can be:

“Are you currently in or have you ever been in a relationship where you were physically hurt, threatened, or made to feel afraid”
“Have you ever been raped or forced to engage in sexual activity against your will?”

Like female survivors of IPV, males need empathic and respectful responses to disclosures.

Survivors must be assured that the abuse is not their fault and that violence can escalate over time. Healthcare professionals and social service providers should have literature on-hand and be knowledgeable facilitators of local resources that can help with safety planning, advocacy, and shelter if available. Healthcare professionals and social service should create a medical record of any injuries sustained to the survivor; these documents can be objective evidence in court proceedings and could facilitate access to housing, welfare, or other forms of assistance.

As is the case with screening and advocating for female victims of domestic violence, best practices must be utilized if proven effective; alarmingly, Futures Without Violence also cites a study indicating that few doctors assess pregnant patients for abuse even though up to 1 in 12 pregnant women are battered. Simply, every healthcare and social service provider should be screening for intimate partner violence at multiple levels regardless of gender or sexual orientation.