Introduction: the phenomenon of male rape

Gay and bisexual men who have been raped by men are an invisible group in social work worldwide. Abdullah-Khan (2008, p 3) claims that through a ‘combination of cultural, social, legal, and psychological issues, male rape remains one of the most unaddressed issues in our society’. The untreated experience of rape renders men silent and prevents them from their rightful access to health and social services, social inclusion and justice. For many men, it triggers a destructive trajectory, especially in the area of sexual behaviour. This chapter explores the phenomenon of male rape and considers the implications for sensitive interventions with this group of survivors in social work practice. The chapter argues that violence and lack of choice in sex or sexual relationships should be recognised as a health inequality. There is supporting evidence for this view. The World Health Organization acknowledges that:

Internationally, there is a growing number of English language research studies about men who are raped by men. Pioneering works include Men behind bars: Sexual exploitation in prison (Wooden and Parker, 1982). International research ranges from rape in the criminal justice system (Lehrer, 2001; Gear, 2007), in wartime (Stener Carlson, 1997; DelZotto and Jones, 2002), among male college students (Scarce, 1997), sexual abuse and rape in various religious denominations (for example, John Jay Report, 2004) and sexual abuse and rape of gay men (Robertson, 2006). Few studies about this phenomenon were published in Sweden until 2013, with Knutagård (2009) being the first paper published in Swedish. What characterises all these studies is that:

• • the abuse takes place in more or less closed groups, where men should expect to be protected;

• • it is framed as a kind of a ritual, like a rite of passage;

• • it involves the lack of access to health and social services for men, a health inequality.

Knowing about the circumstances and events surrounding male rape helps us to comprehend men's experiences.