3.1. Forms of Conflict-Related Sexual Violence Perpetrated against Men
As victims of masculine stereotypes, male survivors of sexual violence often lack proper words to express themselves (
Sivakumaran 2007). They generally describe their experience as beaten, hit, tortured, humiliated, and injured rather than with words describing sexual violence. Gender-based violence encompass a wide range of psychological and physical actions not limited to rape, including sexual assault, acts of penetration, genital mutilation, cultural inappropriate actions with intention to sexually harass and humiliate, and non-sexual acts committed on the basis of gender (
Ferrales et al. 2016). Consistent with previous studies, Participants shared the experience of being beaten close to death, tortured, anally penetrated, undressed, humiliated in public, and forced to witness violence perpetrated against others.
In regard to the experience of being beaten and hit, except for Participants 9 and 10, all Participants used the word beat and hit interchangeably to narrate their experience. Participants described multiple horrors, including (a) being beaten close to death, (b) being “hit like an animal”, (c) being hit unconscious and enduring permanent wounds on the body, and (d) beating directed at the genitals or other sensitive body parts. For example, Participant 1 described his experience of being beaten close to death and the extensive bruises and injuries endured on his body as a result of the beating. He even volunteered to show the research assistant permanent physical marks on his body. He stated: “Some of them proposed to kill me, but for others, they suggested to hit me half dead… directly, they caught me, tied me up and began to beat me. Besides, I still have a whip here of the stick they used. I was hit up till the blood covered my whole face. And if I show you all my back, you will see the signs of these strikes.”
Three Participants described the experience of being anally penetrated with different objects without using the word rape. Participants were anally penetrated with sticks, bamboo, and inserted with soap and pepper in their anus. Participant 2 noted, “I was living in Kinyoma. Then the Mai-Mai
2 came and found us at Nyamoma and began to ask if I can join them. When I refused, they began to hit me and put sticks in my ass”. Participant 13 broke his silence and refused to let shame qualify his experience: “Well, please, I will not be ashamed, even to speak. They took the bamboo and introduced it in my ass.”
About torture, participant 7 reported: “We were caught and tortured by the FDLR
3 and Mai-Mai in this village, and we had no way to escape.” Similarly, Participant 2 recounts his re-victimization experience while attempting to escape the dangerous and unstable environment. He notes: “After that, we moved to another place, we crossed the river, unfortunately we met the Hutus who occupied and were looting the village. They took me and tortured me until close to death.”
While sharing the specific characteristics of event (s), Participants 4, 6, 8, 9, 12, and 14 stated that they were undressed and humiliated in front of family, friends, village, and community. For example, Participants mentioned being undressed, emasculated, and left naked in public.
Participant 4 notes:
At that time, I was with my mother-in-law, so they asked me to undress. I refused and told them that I could not do it in front of my mother-in-law. Then they undressed all women and men. They ordered them to look at each other. As I refused, they beat and undressed me. Then they took me to the room in the house. They removed the bedding and put me under the bed so that I would be a support to this bed. They took my mother-in-law and started to rape her in front of me. When they are done, they took us to the forest carrying their burdens. Once there, they still violated the women and hit all the men.
In the initial interview, except for Participant 2, all Participants used words other than rape to describe their sexual victimization experience. However, during the follow up interview, all Participants (1, 5, 9, 13, and 14) used the word rape to describe their experience. When asked specifically if his experience is considered rape, Participant 1 responded: “Yes, it was rape. Eeh… truly a rape, it is rape.” Likewise, Participant 5 reported: “Yes, it is rape, something happened to my body, that I never thought will happen to me one day.” Along the same line, participant 9 reported, “It was rape, what that rebel did to me.” Finally, Participant 14 stated: “It is rape, it is rape.” The frequency at which Participants repeated the word rape sounded like shock that comes with the acceptance of the word rape as an accurate description of what happened to them. Initially, rape seemed to be a forbidden word. Consequently, Participants did not use the word rape to describe their sexual victimization during the initial interview. When asked directly, they did not question the word rape. In fact, they accepted it with strong conviction, emphasizing the word multiple times in a sentence.
3.2. Short- and Long-Term Consequences
Studies have shown a wide and complex range of short- and long-term negative effects of conflict-related gender-based violence on multiple levels, including: psychological functioning (e.g., depression, anxiety, post-traumatic stress disorder, stigma, guilt, shame, self-blame, anger, etc.); behavioral level (e.g., unemployment, substance abuse, self-blame, etc.); relational level (e.g., trust related issues, intimacy issue, sexual dysfunction, attachment difficulties, difficulties creating and maintaining relationships, etc.); and self-image (e.g., low self-worth, low self-esteem, low self-confidence, gender identity issues, issues with masculinity, etc.) (
Purnell 2019;
Lowe and Rogers 2017;
Wilson and Scarpa 2016;
Ferrales et al. 2016;
Forde and Duvvury 2016;
Christian et al. 2011). Sivakumaran 2007). Consistent with past research, participants recounted the “shocking” transformation linked to the financial, physical, sexual, marital, and psychological impacts of the rape. Participants described the short- and long-term sequelae of the trauma in multiple areas of their current lives.
3.2.1. Financial Consequences
Participants shared realities linked to lack of employment, which interferes with their ability to fulfill their roles and responsibilities as providers for their family and household. They also talked about not being able to educate their children. Participants are not able to resume with work due to “ongoing pain”, “lack of strength”, “vulnerability”, and “weaknesses”. They also shared the experience of being paralyzed by the fear of revictimization. The fear of revictimization is more poignant for participants who were victimized on their way to and from work. Participant 7 summarized the suffering and ongoing struggle linked to lack of employment in his current life by stating: “my secret in life is to struggle for me to eat and live”. Most participants’ sense of individual and social identity are linked to their ability to live up to societal expectation of producing, providing, protecting, and procreating. This social expectation is connected to the male code, which appears to be incongruent with men’s experiences of sexual victimization.
As Participants transition from the previous way of structuring their identity to a new way forced by the sexual trauma, they are faced with tremendous loss and grief. The transition is so traumatic that they are struggling to redefine themselves and re-discover meaning after trauma. The trauma is affecting their beliefs about the future via hopelessness and the feeling of being stuck in a pain and hurt. According to Frankl, “as soon as a painful fate cannot be changed, it not only must be accepted but may be transmuted into something meaningful, into an achievement” (
Frankl 1970, p. 51). Participant 7’s current state of despair prevents him from visualizing a different future where life is meaningful. His statement reflects a lack of hope, hope being an important ingredient for living a fulfilled life. Consequently, he uses the same lenses of despair to project into a hopeless future. From that hopeless future projection, he develops the belief that his secret in life is to struggle to meet his basic needs. Acceptance of a painful fate through the lenses of despair keeps this individual stuck. It also interferes with the human motivation to discover the meaning of suffering and the potential of transmuting painful fate into achievement. Participant 7’s experience is shared among other participants.
3.2.2. Psychological Consequences
Most Participants shared ongoing psychological symptoms consistent with Post-Traumatic Stress Disorder (PTSD): re-experiencing via flashbacks, nightmares, intrusive memories and intrusive thoughts, hypervigilance, memory loss, and difficulties sleeping. They also shared their experience of PTSD symptoms being easily trigged internally (e.g., thoughts linked to the traumatic event and feelings such as sadness and powerlessness) and externally by cues in their environment (e.g., hearing news about rebels, seeing soldiers, hearing people talk about the event(s)).
Participants also shared the psychological consequences linked to not fulfilling obligations as providers.
Muldoon et al. (
2019) reviewed the literature on social identity approach to understand how social factors such as group life and social categories determine outcomes following the trauma. In accordance with Participants’ experiences,
Muldoon et al. (
2019) showed that: “(a) negative responses to trauma are more apparent where trauma serves to undermine valued social identity; (b) people prove more resilient in the face of trauma when valued social identities can be maintained or new social identities developed; and (c) where old or new positive identities are reinvigorated or extend the self, this can be a basis for post-traumatic growth” (p. 311). Participants emphasize their individual identity as men, social identity, group memberships, and the ability to live up to the masculine ideology as a source of pride, meaning in life, and psychological resilience. According to
Muldoon et al. (
2019), self-categorization and group membership influence how an individual appraises and interprets their experiences, including trauma. The participants are experiencing severe psychological consequences of the sexual trauma due to loss of masculinity, loss of social status, and role reversal within the family system. The participants used different expressions to convey the psychological impact linked to a sense of failure as providers including feeling “crazy”, “mindless”, disbelief (“how come I can be like this after being in good health, because of others” (Participant 1)), and “mind not working well”. Not being able to provide for their family and household changes the whole family system dynamic. For example, they mentioned having to depend on their wives for survival. Participant 4 illustrates this new reality by stating: “Now she is everything. So, she is starting to take care of us because I do not have any strength anymore”. He goes on to say: “today, my hope is my wife because she is everything now.” They emphasize the role reversal from being a provider, protector, and procreator, essential aspects of masculinity in the context of the DRC (
Le Pape 2013), to vulnerable and dependent, all attributes linked to feminine qualities, according to the male code. They shared the frustration, devastation, and ongoing suffering linked to the new reality as vulnerable dependents. The participants also shared the psychological consequences linked to lack of “sexual force”. The participants described the shift from being able to sexually perform a few times a day to once in a blue moon when their body cooperates. Participant 1 expresses shame for his inability to fulfill his duty to sexually perform by stating, “First of all, I am no longer able to walk in the house”. He uses the word “torturous” to describe his wife’s experience of the lack of a fulfilling sexual life.
3.2.3. Physical Consequences/Medical Problems (and Changes)
Participants shared persistent suffering linked to physical health. They described headaches, back pain, body aches, and ongoing pain, weakness, loss of balance, loss of strength, bloody noses, sensitive stomach, loss of appetite, incontinence of urine, blood in urine, hemorrhoid, reduced strength for sexual activities with their wives, genital mutilation, and more.
Participants described this experience with different statements: “Til now, my body is in pain” (Participant 2); “my body and ribs are still in pain… at the beginning of each month, I begin to feel pain; the wounds begin to hurt” (Participant 2); and “the wound that was not well cared for inside. It’s like a vein that is torn apart. So far, the pain persists” (Participant 13). The trauma redefined the Participants’ relationship with their bodies. They seem stuck in their body like prisoners with no permanent solution other than perpetual suffering. One of the assumptions of logotherapy is the description of human beings as entities consisting of body (physical dimension), mind (mental dimension), and spirit (spiritual dimension) (
Frankl 1970). Although the different entities are separated, they function in unity. The experience of being stuck in one’s body prevents Participants from rising above the physical dimension to a level that will allow them to redefine the self. The ongoing pain and bruises on the body are constant reminders of trauma and the physical impacts of it.
3.2.4. Marital Consequences and Sexual Consequences
Participants shared the ongoing impact of the trauma on their marital life including unhappy spouses, trust-related issues, dissolution of marriage, relocation, physical abuse, role reversal, and infertility. Participants reported feeling unhappy, sad, humiliated, ashamed, grieving, and powerless with their having been victims of sexual violence and impacting on their marriage. Participant 4 described the marital consequences as “suffering again”. The Participants’ experiences continue to emphasize the ongoing suffering linked to their trauma and the impacts on their current life.
Along with the marital consequences, participants also shared sexual consequences. Participants identified ongoing pain, weakness, and genital mutilation as barriers interfering with regular and healthy sexual life. The inability to conform to the notions of masculine sexuality impacts their healing journey and destroys family. Participant 7 identified the lack of fulfilling sexual life as the main issue that led to the dissolution of his marriage.
3.2.5. Treatment Received since the Event (s) Experienced
Most Participants shared the lack of or limited access to health care services immediately after the event and in their current life. Participant 3 described this “shocking” reality by stating, “There are no more medical help options. We tried to get help from the hospital, we did not find it.” As a result, participants sought traditional medicine to address ongoing physical-health-related issues resulting from the sexual trauma. The treatment given by traditional healers were not specified by Participants, with the exception of Participant 5, who mentioned taking the medicine in the form of tea to relieve pain. Participant 5 also mentioned receiving traditional medicine in exchange for livestock such as chickens. The perceived effects of treatment by traditional healers were mainly temporary symptom relief. All Participants mentioned “persisting symptoms”, even after receiving local medicine. Participant 1 summarized the lack of access to medical service after a traumatic experience and persisting symptoms by stating, “all this increased the shock in me”.
Some Participants mentioned having to resort to hot water as treatment to address ongoing symptoms after the event and in their current life. For example, Participant 2 mentioned using hot water treatment to massage the body, reduce inflammation, relax muscles, and temporarily relieve physical-health-related symptoms. Participant 2 illustrated the use of hot water in his current life by stating:
I use it today like treatment, it is medicine, because everywhere on my body, where I was beaten on my body, where I had bruises, when I bathed with hot water or sometime, it starts to tickle, I felt relieved. I took it as medicine too.
Participants described the lack of medical services as a multilayer issue with different dynamics at play, including inaccessible medical services immediately following the event (s), accessed medical services when symptoms got worse, initially accessed medical services until it became inaccessible, and received medical services but symptoms persist. Participants mentioned multiple barriers linked to the lack of and limited services to proper medical care in their new life including lack of money, poverty, lack of services, “not able to find help”, “insufficient help”, “where could I find it”, dislocation, and “hiding in bushes.” Participant 3 described the lack of available services as follows: “we tried to get help from the hospital, we did not find it.”