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Betrayed as BoysReview - Betrayed as Boys
Psychodynamic Treatment of Sexually Abused Men
by Richard B. Gartner
Guilford Press, 1999
Review by Su Hunter, <
Oct 31st 1999 (Volume 3, Issue 44)

Note: The author of Betrayed as Boys, Dr. Richard Gartner, disagrees with some of the claims in this review by Su Hunter. His response to the review follows immediately after.

The title of this book is a little misleading. "Betrayed as boys" may lead one to think that you would be reading case histories and the counseling and the healing that took place when the "now" men came into the office. This is not the case at all. Gartner starts out in the first chapter defining the terms sexual assault and sexual abuse. He goes into detail how to distinguish the difference between the two. While he makes a couple of references to case studies, he mostly refers to research studies. I got the feeling that he was writing to the lay community, yet he also uses clinical terminology that the average lay person would not understand.

In chapter two he continues in the same manner, now defining the difference between sexual abuse and sexual initiation. He has a very useful approach to understanding American society, using social acceptance theory. If a boy is abused by an older women, then it is deemed O.K., especially, for instance, when it is a 12-15 year old boy and an 18-25 year old female. Then the "boy" is suppose to feel like he has been initiated into the "Macho" club and he has performed a feat of conquering. However, this makes no sense when a boy is only 12 years old. Any time someone feels uncomfortable with what someone else is doing to his or her body sexually, it is sexual abuse. Gartner extends his analysis of how Americans accept sexual abuse/play for male children, but is "dirty" and "disastrous" for female children, and explains thoroughly how it is in fact wrong for both.

In the third chapter, he shifts into a slower gear and the book loses interest in the chapter on "Struggles with Masculinity". Nothing there. He states a lot of studies, and actually does an overkill in stating the studies. The following chapter defines the word gay, and goes into too much detail about how a man may decide to become gay or what may cause him to be homosexual or bisexual, and the struggle that he goes through. It is almost as if he would like to say that all gay men had been abused as a child and almost all boys, who have been abused by older men, will turn to be gay. This chapter read like a deeply troubled person -- very scattered, and not sure of a true direction to go. Chapter five begins to pick up a bit, but he still refers to research studies too much, with very little case study at all.

The next few chapters are the meat of the book. Gartner does a wonderful job when he begins actually tell to the stories of abused men. He spends more time in the case studies and less time defining material that, as clinicians, we should already know. His ten case studies will keep your interest well. Furthermore, Gartner tells about some of the treatment plans that he used on the cases, which is very useful. By Chapter 9, he puts his brakes on, and goes back to the tedium of defining and repeating many Psych 101 definitions. For example, he discusses the interaction of a female therapist interaction with abused males, concluding that there are not exceptionless guidelines and we must always be highly sensitive to context.

Overall, Betrayed as Boys was interesting, and the case studies were very helpful. If the "Before" and "After" chapters had been left out, it would have been a wonderful book. Although Gartner starts and ends slowly, the middle of the book is dynamic. I recommend skimming over the first few chapters, then reading the middle, and skimming over the last few chapters. If you need a book to recommend to clients who are men abused as boys, this book would be an excellent option. Indeed, clients will get more use out of the book then the therapist. It might be even better to have the client read the book and discuss it as he reads it through, using it more as a guide and planner for your sessions.

Richard B. Gartner, Ph.D., author of Betrayed as Boys, reponds to Su Hunter's review:

I invite Su Hunter to reread portions of my book. If she does so she will no doubt recognize that several of the assertions she makes about what I wrote in Betrayed as Boys are erroneous.

Hunter writes that in Chapter 1 of my book I define the terms "sexual assault" and "sexual abuse" and then detail how to distinguish the two. But actually I never use the term "sexual assault" or even consider the concept as a contrast to "sexual abuse." Similarly, in Chapter 2, Hunter says I make use of "social acceptance theory," a theory with which I am not familiar and never cite. And, while I am gratified when Hunter notes that my ten case studies will hold the interest of the reader, there are actually thirty-eight case studies in Betrayed as Boys. In addition, she talks about my "treatment plans" for these men, while, as I state in my Introduction, "I do not intend to dictate to clinicians about how men sexually abused as boys should be treated. To try to write such a book would do a deep disservice to the uniqueness, complexity, and ambiguities of each man’s life trajectory and individuality" (p. 9).

Most importantly, Hunter says I talk about how a man may "decide to become gay" and that I "would like to say that all gay men had been abused as a child and almost all boys, who have been abused by older men, will turn to be gay." These statements are diametrically opposite to what I actually wrote in my book. I do not see sexual orientation as a "decision." In addition, I fear that her comments may be damaging to some sexually abused men trying to come to terms with the cultural myth that sexual abuse by a man turns a boy gay. I discuss this myth at length in Betrayed as Boys, and I believe I make a strong case for it being false. As I say in the book, "most researchers believe predominant sexual orientation is established before latency, while most sexual abuse of boys occurs later" (p. 101). I also write that I agree with those who "conclude that there is no reason to believe that sexual abuse alone fundamentally changes or shapes sexual orientation" (p. 101), and "my clinical impression is that sexual orientation is nearly always determined for reasons other than premature sexual activity" (pp. 101-102).

Because there is so little written about male sexual victimization, I wrote Betrayed as Boys for a wide readership that would include trained clinicians of all theoretical backgrounds, rape counselors, clergy, andguidance counselors, in addition to sexually abused men and other lay readers. I therefore chose to make sure that all my terms were clearly defined, understanding and noting that many readers might already be familiar with some of the material and might therefore decide to skip portions of the book. My experience in addressing professional audiences, however, has shown me that many have thought very little about the issues involving masculine gender socialization and sexual orientation that differentiate sexually abused men from sexually abused women. (Nor do all professionals even believe sexual abuse of boys occurs with much frequency.) For these reasons, I focus on these themes before going on to discuss treatment. I do understand that Hunter is impatient with my citations of research and theory and would have preferred that I write only about what happens in the treatment room with this population. However, it has been my experience that many thoughtful clinicians are indeed interested in thinking about the theoretical underpinnings of our work and the research that supports our assumptions, particularly in an area as controversial and emotion-laden as the sexual abuse of men.

To discuss this book, the review, or Dr. Gartner's response, join the Metapsychology Discussion E-Mail Group by going to this URL: http://www.onelist.com/subscribe/metapsy-discussion


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