Orlando Medical News November 2020

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We’ve all heard the words, either uttered by our parents, an uncle, grandparent or friends’ parents…. Man up, Don’t Cry! Be a Man, Pick yourself up, Don’t show emotions and we see our friends clam up, shut down and shrink back, being a little quieter than they were before. As kids, we didn’t get it – we were all told a similar story – Men are ‘strong,’ women are ‘weak,’ breeding an environment of silence and in many cases, abuse.

According to a CDC Study in 2006, 1 in 4 women and 1 in 6 men have been sexually abused before the age of 18. This means there are more than 42 million adult survivors of child sexual abuse in the U.S. and 73 percent of child victims do not tell anyone about the abuse for at least a year. Forty-five percent of victims do not tell anyone for at least five years. Some never disclose, (Smith et al., 2000; Broman-Fulks et al., 2007). Much like we talked about last month, the likelihood of you having treated a patient who has suffered sexual abuse is very high; given victims don’t disclose as they experience shame and guilt, men who have such experiences are less likely to disclose them than are females.1 Only 16 percent of men with documented histories of sexual abuse (by social service agencies, which means it was very serious) considered themselves to have been sexually abused, compared to 64 percent of women with documented histories in the same study.2 This is another silent crime happening in our communities and the long-term effects of not only experiencing abuse, having to hide and bury it deep down inside, can be devastating. If you recall, we referred to a CDC study from 2016 stating in the United States we spent over $124 Billion dollars on treating chronic illnesses that arose from untreated childhood trauma. You are now beginning to see a correlation with late term diabetes, heart disease, arthritis and other chronic illnesses. Why don’t we know about this? And an even

better question is, what are we going to do to not only interrupt the silence your patients may be suffering, what can you do now to help your male patients who may be exhibiting signs for future chronic illnesses or managing an undisclosed mental illness? Let’s start with a brief history of the ‘manly men’ syndrome or as we later coined it “toxic masculinity.” One of my favorite documentaries I invite everyone to watch with their family is “The Mask You Live In” because it addresses the beginning of, and impact of telling boys they can only have two emotions, happy or angry. Nothing in-between works for them or they’ll be called names. So, an 11-year-old boy, who has all the emotions of an 11-year-old girl, has only one way to display them that is ‘acceptable’ – anger. So, fights, arguments, bullying begins. They have no control of how it’s expressed. All they know is they can’t cry or show any other emotion that would be considered “weak,” otherwise, they are the next target. This began as far back as we can remember, when men were ‘trained’ to fight to protect the realm and women, cooked, gathered food, bore children and ‘kept the home fires burning.’ Men had to be strong, virile, show no weakness. Ever. And that has been passed on for generation after generation. Every culture has their version of it. Indigenous warriors had to run miles holding water in their mouth and learn to hunt to prove they’re were a man. In Africa, there were tribes 4





that circumcised their young boys publicly and then sent them out to kill a lion. It was all about hiding emotions, proving they were strong. We all carry that same DNA and generational trauma. This has greatly impacted our society and the willingness of men to disclose abuse or harm that has happened to them, because somewhere in the tiny recesses of their brain, they should ‘have known better’ or ‘done something to stop it’ from a societal perspective. Now we can start to see a pattern forming; millions of men have been traumatized, carrying that around in their cells, end up in your office wondering why they are having chest pains, on the verge of diabetes or high blood pressure with little to no family history of those diseases. Now, how do you, as a health professional, in 15 minutes have a patient open up about possible past experiences that may result in their current trip to your office? Great question which I’ll address here.

Ask questions If there is no family history of their current experiences, that is a GREAT place to start asking some additional questions. The ACE scores test is a great place to start – it takes minutes for them to answer and you’ll get better insight into what they may have never disclosed. Just like we coach parents to begin with a question or a fact...it’s safe, sharing a fact or a story to have someone open up. I recommend you and your team come up with appropriate questions for your practice and patient group. CONTINUED P.5