Best Clinical Practices for Male Adult Survivors of Childhood Sexual Abuse: “Do No Harm”

ACEsConnection members Christopher Anderson and Jaime Romo, along with Les Gallo-Silver, co-authored this article in the summer 2014 issue of The Permanente Journal. 

The health care literature describes treatment challenges and recommended alterations in practice procedures for female survivors of childhood sexual abuse, a subtype of adverse childhood experiences. Currently, there are no concomitant recommendations for best clinical practices for male survivors of childhood sexual abuse or other adverse clinical experiences. Anecdotal information suggests ways physicians can address the needs of adult male survivors of childhood sexual abuse by changes in communication, locus of control, and consent/permission before and during physical examinations and procedures. The intent of this article is to act as a catalyst for improved patient care and more research focused on the identification and optimal responses to the needs of men with adverse childhood experiences in the health care setting.

....We have identified ten recommendations for best clinical practice in providing health care to male survivors of childhood sexual abuse (see Sidebar: Recommendations for Best Clinical Practices with Male Survivors of Childhood Sexual Abuse and Adverse Childhood Experiences). These recommendations cluster around issues of communication, control, and permission. The communications cluster focuses on asking about the man’s sexual abuse history and, if one is present, the interpersonal aspects of processing the information as part of physician-patient relationship building.²¹ Part of the control cluster focuses on integrating the process of anticipation of potentially triggering aspects of a medical examination, tests, and treatments. The permission cluster focuses on the interpersonal interchange that needs to take place before intrusive and intimate aspects of medical care begin. The gradual progression of a physical examination, which includes talking the patient through the process, is a way of pacing the examination at the speed the patient is most comfortable.

http://www.thepermanentejournal.org/issues/2014/summer/5710-clinical-practices.html