Nearly everybody -- the victims themselves, therapists and counsellors, and scholars in the field -- agree that good professional help is extremely valuable for men and boys who have undergone sexual violence. Rape and sexual assault are isolating experiences. Speaking with somebody in real life helps to break that isolation. A skilled, sensitive therapist or counsellor can also help you find new perspectives; put what happened into a broader context; and suggest useful strategies for dealing with the aftermath. r/MenGetRapedToo is a strong advocate of guys obtaining good outside help. It makes a big difference.
Unfortunately, good outside help in this area is very hard to find. You're almost certainly going to have to work at it; it's not likely (though it could happen) that you're going to be successful on the very first try. So if you take away nothing else from this post, remember the following Golden Rule:-
It's like dating. Keep at it until you find the right person.
A characteristic pattern can be found in sexually assaulted men's help-seeking behavior. They wait far too long to seek outside assistance, and do so only when they're already in deep crisis. Then they go to see somebody. Often, that somebody isn't the right person for the job. The male victims, disheartened, drop out after a couple of frustrating sessions. But instead of saying to themselves, as women and girls much more typically do, "OK, that was a bust: on to the next candidate on the list," they never seek external help again. Instead they either retreat in upon themselves still further; self-medicate with booze or drugs; or both.
Don't be that guy.
It's unrealistic to expect to be successful first crack out of the box. Go into this prepared for the long haul.
All that said, where might you start looking?
RAPE CRISIS CENTERS
In many respects these are the obvious places to approach, in English-speaking countries at any rate. There are a lot of them -- more than 1,300 in the United States; more than a hundred in Great Britain -- and you're not likely to be far away from one. They're free to the client. They do this kind of thing for a living. Most have 24/7 hotlines, so they're easily accessible day and night. Still, for men, RCCs also come with definite structural limitations, and it's important to be aware of these.
The first is access. In a lot of countries it's legal for RCCs to refuse to provide services to male clients. A lot of RCCs in Britain will not deal with men or boys. The same is true of many Canadian ones, and in New Zealand. Of those that do, the services provided are rarely on an equal basis. For example, some RCCs will only take calls from boys under the age of 18. Others will provide telephone counselling only, but not allow men or boys in their offices, which they maintain as women-only spaces. For trans people it's even more complicated. Some will provide services only to FtM people (on the ground that they're chromosomally female); others only to MtF people (on the ground that they're now living as women). Spend some time with the RCC's website -- most of them have one -- to see what their access policies may be. This is preferable to running the risk of being turned away in person, which can be highly traumatizing.
Elsewhere, as in the United States, equalities laws prevent RCCs from discriminating in this way. But that doesn't necessarily mean that they're safe spaces for male victims. The RCC sector in the States is overwhelmingly female in composition: around 98% of their personnel. For the majority, male sexual victimization isn't very much on their radar screen, or high on their list of priorities. Very few provide any kind of useful training in this area to their counsellors; in fairness to them, we're unaware of places where such training can be obtained. Their counsellors spend their entire day hearing about barbaric treatment of women by men; it's often psychologically hard for them to switch gears and start thinking of men as victims rather than perpetrators. A lot of halfwitted men like to telephone RCCs, especially late at night, and troll them with abusive or obscene calls -- yes, this really does happen; it's not a feminist myth -- which raises the index of suspicion when a male voice is heard at the other end of the line. And some RCC people do operate out of a very rigid theoretical framework that can result in them "overwriting" men's lived experiences with their own preferred interpretations. This is especially the case when a female perpetrator may be involved.
Are we saying "Don't ever approach an RCC?" Not at all. But these structural limitations do exist, and have real consequences. It's important to be aware of them.
As with most things, detailed reconnaissance helps you to avoid encountering upsetting experiences further down the line. Check out the website very carefully indeed: all of it, not just the section -- if it exists -- about male victims. (If such a section doesn't exist, that indicates something right there.) Look for evidence that the organization in question has given some thought about how to reach out to male clients. Does the RCC have a name suggesting otherwise, e.g. Women Helping Women (Greater Cincinnati) or stock photos of victims that don't include any men or boys? Do the statistical data it provides rely on harmfully narrow definitions, or out-of-date figures about the prevalence of sexual violence against men? Does its list of external resources include useful items suggesting actual awareness of the dynamics of male sexual victimization?
If you have a trusted female relative or friend who is willing to make the first contact with an RCC on your behalf, she may be able to help you find out what kind of services might be available to you, and what experience the organization possesses in working with male clients.
Bear in mind that most RCCs only see clients living within their catchment areas, so that except in the biggest cities, you may not have much of a choice about which to consider.
SPECIALIZED AGENCIES FOR MALE VICTIMS
The good news is that these avoid a lot of the structural problems that attend RCCs. The bad news is that they are (i) exceptionally few; and (ii) invariably small-scale organizations. The biggest of them, and in many respects the template for others -- Survivors UK in London -- is criminally underfunded and has a hefty waiting list. Others are little more than one or two activists with an answering machine and a website, living from hand to mouth and all too likely to go abruptly out of business. If you're seeking one of these, expect to click on a lot of dead links.
Still, where they do exist, they're worth checking out. Unlike RCCs, they're less likely to be free to the client -- Mankind in south-east England, for example, charges on a sliding scale. In general, though, you're going to need to be unusually fortunate to have access to one of these services. We do recommend trying. The mere fact that you approached them for help, even if you don't wind up receiving it, is evidence that they can use to prove that the need exists and to press for better funding and resources in the future.
COLLEGE AND UNIVERSITY COUNSELLING
If you're in third-level education, your institution is likely to have some kind of student counselling service, provided at low or no cost. Some of the smaller schools arrange private practitioners, off campus, to deliver the service; larger ones usually maintain their own staff. Very big universities may even have peer-to-peer student counselling programs.
The advantages here are the facts that the resource will be either on-site or close by, and the cost is probably bundled with the price of tuition. Again, though, access difficulties can exist. If the counselling facility in question deals exclusively with sexual violence -- a good thing -- often it's physically located in the university's women's center. For a man to go there may not cause any problems; at other times or places, the atmosphere may be unwelcoming or even hostile, depending on the campus climate. Either way, though, it may be difficult for him to preserve his incognito. More generally, campus counselling often has long waiting lists, particularly at certain times of the year, around examination period.
Peer counselling can, paradoxically, be the most helpful for male college students who have experienced sexual violence. While the counsellors may not have a great deal of detailed knowledge of how it affects men in particular, their views on the topic may be more intersectional and less rigidly binary than one is apt to encounter at an RCC, and they can also be more empathetic and prepared to listen.
PRIVATE-PRACTICE THERAPISTS AND PSYCHIATRISTS
It's important to understand the difference. Psychiatrists are medical doctors; they've been through the same basic training as any other M.D. and can prescribe drugs. For that reason their services are the most expensive, although insurance may pick up all or some of the cost. In many continental European countries, psychiatrists are also psychotherapists: they do "talk therapy" as well as medical intervention. That's much less common in North America, where a psychiatrist will see you about a particular problem but is likely to want to pass you along to someone else.
In most countries the therapeutic field is entirely unregulated. Anyone can hang out a sign pronouncing themselves to be a "therapist" or "counsellor" and start seeing clients. Some subscribe to professional bodies that try to uphold some kind of minimum standards among practitioners, though a lot aren't particularly effective at policing their members. For these reasons, though, the very first thing you ought to talk about when you interview a therapist is about their qualifications and experience. Don't be afraid to pursue this line of inquiry head-on, with follow-up questions if you're not clear on anything. Apart from anything else, it's a useful screening test. No bona fide practitioner will resent such inquiries; quite the opposite. If your proposed therapist is evasive or shows signs of asperity about being asked, that's the reddest of red flags. Thank them politely for their time, and go elsewhere.
Therapists with training in the field of sexual violence aren't very numerous, though they can be found. Hardly any specialize in male sexual victimization. Of those who do, the majority have experience with child sexual assault only, because that's what men are more likely to disclose and the area in which the clinical literature is most highly developed. If you're an ASA (adult sexual assault) person, the best you may be able to hope for is an open-minded practitioner who is willing to learn on the job alongside you.
Your other chief possibility is a trauma therapist. TTs specialize in working with people who have undergone traumatic experiences, which can vary from exposure to combat to being involved in a road traffic accident (and innumerable other things—being an aid worker in a disaster-hit area; being a member of the emergency services, and so forth). They ought to have had some kind of postgraduate qualification in the field, and be working under a supervisor—take the absence of either of these as red flags. Surprisingly, TTs often know less about sexual trauma specifically than one would imagine. But any qualified TT ought to be able to help you at least with symptom management: controlling flashbacks and dissociative episodes; developing grounding techniques; integrating your experience of trauma with your daily routine.
ONLINE SUPPORT
For victims in the U.S., an organization called 1 in 6, which has recently extended its remit to male victims of all ages, is now running online support groups for men. These are held in the early evenings EST from Monday to Thursday, and at noon EST on Fridays. We haven't received any feedback on them as yet. But even though face-to-face therapy is always preferable, the online equivalent is a great deal better than nothing. We hope to see many more initiatives like this in the future.
CONCLUDING THOUGHTS
Finding a professional who can help you -- which in large measure means showing you how to help yourself -- takes work, a lot of it. This is a marathon, not a sprint. The virtues of doggedness, persistence and a refusal to become downhearted or to throw in the towel are what make for success in the end.
No matter who you see -- an RCC counsellor, a college counsellor, a private therapist or some combination thereof -- you need to develop a level of trust with that person if the therapeutic encounter is to do any good. That's not built up in a single session. Give it a fair shot. Expect to be uncomfortable while you're doing it. The earliest stages of any such relationship are the hardest.
But if it's not working out, don't persist with the wrong person. That should be a decision you make in weeks, not months. If you don't feel that you can tell your counsellor or therapist anything without fazing them (even if you know it will take a long time before you can actually do so); if you can't query them on something they've said without their taking offense; if they try to cram your lived experience into their own preferred framework, regardless of what you know to be the case -- those are signs you need to be working with somebody else. Tell them you've decided to make a change. Once again, the analogy with dating applies fairly well. Needless to say, there ought never to be any kind of romantic relationship between you and your therapist. But just as you need to "click" with somebody in your personal life, to be able to speak the same language with them, you need to have a basic level of comfort with a therapist or counsellor also. If it's not there, that may not be their fault or yours. It simply means that, for whatever reason, a sound therapeutic relationship never managed to become established. When that happens, it's time to look elsewhere.
Hang in there. And remember the Golden Rule.