Dan Neville (Limerick West, Fine Gael)

I welcome the opportunity to speak in this debate and commend Deputy Reilly for tabling the motion. I saw the television programme and it was shocking that such a level of abuse could be inflicted on such young people, affecting them so deeply.

Mr. Michael Shine was struck off the medical register as a result of a Medical Council fitness to practice committee inquiry, which found him guilty of professional misconduct in respect of three patients and of the following allegations: making sexual advances to patients; making indecent suggestions and-or behaving indecently; assaulting and-or indecently assaulting patients; undertaking inappropriate or improper medical examinations and-or treatment of patients; and failing to treat patients with due dignity and respect.

I wish to deal with the effects of child sexual abuse. A common myth that many people hold is that men cannot be victims. The thinking is to the effect, "This is a guy and he could have stopped it if he really wanted to". It is assumed that the survivor must have consented in some way because sexual abuse does not happen to "real men". The very nature of sexual abuse and its associated stigma causes humiliation, shame self-blame, fear and secrecy for survivors. It can be hard for them to speak openly about their experiences. Survivors of male to male sexual abuse have to contend with the additional stigma and impact of homophobia, which increases their shame, isolation and secrecy. Equating the abuse with gay sex leaves most survivors confused and conflicted about their sexuality. If they identify as "straight", they may experience homophobic fear and panic, when perhaps they are not. They may take desperate measures to prove to themselves they are not gay. Some men may behave in a really macho way, for example having sex with a number of women or trying to get women pregnant and harassing gay men.

It is not uncommon for survivors of abuse to blame themselves. However, men blame themselves for different reasons to women. Men often believe, and quite strongly, that they let it happen, simply because they are men. Males are supposed to be all-powerful, never victims, even when they are children. This places an incredible burden on boys and men, often leaving them feeling guilty, ashamed, depressed, self-hating and conflicted about their gender and sexuality.

The level and severity of the effects often depend on a variety of factors, including the age of the child, when the abuse first occurred, how long it lasted, the developmental status of the child and the relationship of the abuser to the child. In this case it was the physician who abused the child. Other factors include whether force was used to ensure the child's participation and the degree of force used will affect the degree of shame or guilt experienced by the child. Then there is the reaction of the child's parents and other professionals if the child reveals the abuse or it is discovered by another person, which has an implication for this case. Children who have been sexually abused may display negative behaviour and attitudes.

Sexual abuse in childhood increases the risk of suicide in men up to ten times, according to research carried out by the University of Bath. A recent study of Australian men has found that those who were sexually abused as children are more likely than women to contemplate taking their own lives. While gender and mental health problems are the most important risk factors in those contemplating suicide, it is being increasingly acknowledged that traumatic experience such as childhood sexual abuse is a significant risk factor. A report on the study stated:

They found the men who were sexually abused as children were up to ten times more likely to have suicidal tendencies; many of these men had not been clinically diagnosed as depressed...Men are particularly vulnerable because they do not like to talk to others about their problems. It's difficult for anyone to come terms with traumatic experiences such as childhood sexual abuse but for men the stigma is worse because they don't tend confide in their friends as much.

Many suffer feelings of failure and isolation and think that it is a sign of weakness to discuss their past abuse with others. Men also tend to visit their doctors less frequently, so those who are risk of suicide often slip under the radar of the health care system. Men are particularly vulnerable to suicide and are three and a half times more likely than women to end their own lives.

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