when man become victims

When Male Becomes Victim – A Case Report
ASEAN Journal of Psychiatry, Vol. 11 (2) July – December 2010: XX XX
This is a case report describing how a
mentally disabled boy became a victim of
sexual molestation.

Case Report
MH is a 14 year old Malay boy diagnosed
with Attention Deficit Hyperactive Disorder
ADHD and Mental Retardation from the age
of 7 years. His impulsivity was not well
controlled with medication due to non
compliance. He was brought to UKMMC in
January 2009 at the age of 14 after being
sexually molested by an Indonesian male,
who often sold food around his housing
area. His mother was working that time and
he was left alone, as usual in his house,
when the incident occurred.
According to an eye witness, the man was
seen masturbating the victim near his house.
The neighbour subsequently reported the
incident to patient’s mother who later lodged
a police report and brought patient to
hospital for further evaluation.
The victim was noted to be traumatized and
he refused to give any information regarding
the incident. In the hospital, the patient was
unable to give relevant history due to his
communication difficulties. He also refused
physical examination thus examination
under  anaesthesia (EUA) had to be carried
out with parental consent. It revealed no
evidence of anal injuries or abnormalities.
The child was referred to a child
psychologist for psycho education (“safe
touch”). Due to lack of evidence of the
abuse, the perpetrator was not charged.
Patient’s parents were also not keen to lodge
a police report as they found the experience
humiliating and felt strongly that it to should
be kept a secret.  The patient has not been
brought for follow up since the first visit.
Discussion
Any male child may become a victim of
sexual abuse. However, studies have found
that boys at highest risk of sexual abuse are
those younger than thirteen years of age, of
low socioeconomic status, not living with
their fathers and who are  disabled. Family
factors such as living with only one parent,
parental divorce or separation and parental
alcohol abuse or criminal behaviour also
contribute to the increase risk of abuse [2].
In the above case, the risk factors identified
were a teenager with mental retardation, low
socioeconomic status and lack of parental
supervision.
Children with disabilities are found to be 4
to 10 times more vulnerable to sexual abuse
compared to non disabled children (National
Resource Center on  Child Sexual Abuse,
1992). Having physical disabilities and co
morbidities such as mental retardation and
ADHD places them at higher risk for abuse
[3]. This could be due to multiple reasons,
such as inability to differentiate between
normal behaviour and abusive behaviour,
difficulties in reporting due to lack of
communication skills, difficulty in being
educated regarding sexuality issues due to
their learning disability and impaired
judgement in differentiating ‘safe’ and
‘unsafe’ environments and persons. The
tendency to show affectionate behaviours to
others (for example in mental retardation),
also placed them as an easy target for abuse.
In this case, as the perpetrator was partially
known to the victim, it was easier for the
perpetrator to coax the victim to cooperate
in the abusive act. As shown in the above
scenario, there is a high probability that the
abuse would not be detected if there was no
eyewitness to the incident.