When Sam was 12 years old, he was targeted by a child molester. Sam (whose name, like all survivors in this story, has been changed at his request) asked a neighbor for assistance on a school project. While he worked, the man surprised him by touching him inappropriately. The abuse continued for another five years and included violent rape and other crimes.

As is the case with so many child sexual abuse cases, the man manipulated and terrified Sam with threats of what would happen if he told anybody. Sam kept quiet, but the abuse affected him profoundly. His grades slipped and he became withdrawn and depressed. Teachers noticed that he was struggling, but never thought to inquire as to why his behavior had gone from upbeat and enthusiastic to depressed and disengaged. In one class, Sam forgot an an assignment, and the teacher gave him two weeks of detention.

It wasn’t that Sam didn’t want help. He desperately wanted to tell people what was happening, but because of his declining grades and withdrawn behavior, there were few welcoming sources of support. He was raised in a very small town, the type where the school principal is also an elected official, and one of his parents was employed by the school district. He feared there was no safe place to turn.

When Sam walked into a school counselor’s office, ready to disclose, he was turned away by an employee who assumed he was there to talk about college applications. Noting the unlikelihood of college in his future, Sam was sent back to class, dashing his hopes of finding somebody, anybody, to talk with about what was being done to him.

Like many male survivors, Sam didn’t disclose his abuse until more than twenty years later. His abuse was his private shame, something the abuser used against him in order to keep him quiet. Many survivors believe that in order to have been chosen as a target, there must be something wrong with them, something that makes them weak or even deserving of the pain. After all, boys are told that being “manly” means never being weak, and certainly never being the subject of sexual abuse. (As a note, “male survivor” is the most commonly used term for any male-identified survivor of abuse, and here includes trans men and non-binary individuals who identify as such.)

Also like many male survivors, Sam’s path to healing began on the internet. Despite his family’s refusal to acknowledge the abuse, he found a supportive community of survivors online, through whom he started to process and understand the terrifying events of his youth.

SSexual abuse, which is typically defined as “unwanted sexual contact involving force, threats, or a large age difference,” is frighteningly common, including among men. It is generally accepted that one in six boys in the United States will become victims of sexual abuse before they turn 18 (one in four girls in the U.S. is thought to have been a victim of sexual abuse — and both figures may be underestimates). Global statistics are harder to ascertain, given the stigma and lack of standard international understanding of what constitutes sexual abuse of minors. But there is reason to believe that similar figures hold true in many places worldwide.

To put it in context, there are likely as many American men who have experienced childhood sexual abuse as there are men who develop prostate cancer, but only one sparks national fundraising efforts and awareness campaigns.

Though more girls are victims of sexual abuse than boys, there have historically been few recovery options for male survivors. Even in major metropolitan areas, support groups dedicated to male survivors — which are a key way for survivors to find healing — are challenging to find. While there may be dozens of support groups for female survivors within any given big city, there are often less than five for men. The numbers become even more bleak as you move into less populated areas.

Group support is not the only area lacking resources. Male survivors have long struggled to find therapists and other clinicians who are trained and knowledgeable in the specific issues facing men who have been abused. A therapist who is uninformed about male survivor issues may not know, for instance, that victims may experience erections or even ejaculation during abuse or rape, as a matter of reflex. Survivors need to be reassured that an erection or ejaculation is not the same as giving consent for sexual abuse, and a therapist who questions whether an experience was consensual may exacerbate a survivor’s shame, pushing him further into silence and suffering.

For so many survivors, disclosing an abuse story is challenging enough — and taking that risk with a therapist who isn’t familiar with the issues can make the experience more traumatic than therapeutic.

In a 2013 report by Canada’s Department of Justice, authors Susan McDonald and Adamira Tijerino noted that, compared to research on female survivors of abuse, there is relatively little data about men and boys. “[W]hile many of the impacts and coping strategies that male victims use are similar to those used by female victims, it remains important to have empirical research focusing on men,” they wrote.

Men have also struggled to find role models or images of hope in the media. In 2010, when The Oprah Winfrey Show featured actor and filmmaker Tyler Perry speaking about the abuse he endured as a child, many men felt instantly less alone. Not long after, Winfrey featured the voices of two hundred men who had survived child sexual abuse. This show helped normalize the faces and realities of men who had been abused — but such shows are few and far between.

One survivor I spoke with, Robert, struggled to find in-person support when he first looked for it. “I was overwhelmed, isolated and frustrated,” he recalled. “I live in a decent sized metropolitan area. There is a wealth of support and information for female survivors. But if you are a male survivor there is zip, zero, nada.”

When he reached out to a rape resource support agent to find a local support group for male survivors, Robert was instead referred to two support groups for male sex offenders, suggesting that he might find some help there. It’s hard to imagine how anybody could think that a survivor of sexual abuse should be trying to heal alongside convicted sex criminals.

Sex abuse, as one would imagine, has a profound effect on its victims. Male survivors have a much higher risk of depression and PTSD, alcohol and drug abuse, and suicide than other men. In the Canadian Department of Justice report, researchers noted that when male survivors described the effects of the abuse they endured, “most were distrustful of others and were extremely ashamed of what had happened, feeling guilty as if it were their fault and feeling unworthy of anyone’s love.”

According to a study reported in the American Journal of Preventative Medicine, survivors of childhood sexual abuse have twice the risk of suicide attempts, and the U.S. Department of Veterans Affairs reports that male survivors also have a higher rate of drug and alcohol abuse and addiction. For example, “the probability for alcohol problems in adulthood is about 80% for men who have experienced sexual abuse, as compared to 11% for men who have never been sexually abused.”

CConsidering how many men are survivors, and the profound mental and physical health effects it has on victims, why is there so much secrecy surrounding male sex abuse — especially compared to our relative openness in discussing abuse of women and girls?

Traditional masculine identity is often dependent upon “toughness.” We tell our boys from the time they’re young that they need to man up. We demand that they push down their feelings in favor of appearing strong and impervious to emotions, and we punish boys for sensitivity and tears. This culture of invincibility is far from welcoming to a boy or man who needs to talk about having been harmed.

Homophobia plays a role, too. Throughout the world, there is a myth that boys and men who are victims of sexual abuse must be gay, or may have been “turned” gay by their abuse. This is patently false, as sexual abuse happens to people of every sexual orientation. Particularly in countries and cultures where anti-gay laws or sentiments exist, being a male survivor can be incredibly dangerous — and can further prevent men from speaking out.

Andrew Smiler, PhD, co-author of the men’s studies text The Masculine Self, believes that we see male pain as weakness or failure. “For individual male victims, it reinforces the notion that [he] is less of a man because he couldn’t defend himself,” he said. This particular type of shame is harmful to men and boys in general, but especially so for survivors, who often need more support and compassion than the world seems willing to give them.

Michael, a 42 year-old survivor, knows all too well how society’s expectations of men can harm survivors. He explained to me that one of his fears when reaching out for in-person support was “being seen as a waste of a man.”

BBut there is some hope for male survivors. Healing is possible at any age, and many men today are finding support in the form of online communities. Each of the men I interviewed reported that hearing from men like themselves brought comfort almost immediately. Beyond that, resources such as lists of trained therapists are invaluable to men who would otherwise use the expensive and discouraging trial-and-error method.

One such organization, 1in6.org has seen staggering growth in the nine years since its launch. Its mission, said founder Steve LePore, is to use new technology as a step toward helping male survivors and their loved ones find holistic healing.

When 1in6 began, they focused on posting written resources, like lists of facts and myths about survivors, and information on the stages of recovery for survivors and their loved ones. They’ve since expanded to offer individual chat lines, staffed by people who are trained to work with male survivors — and most recently, anonymous online support forums. They are dedicated to be a safe space for male survivors to talk in a group. LePore hopes these chats can be expanded from the two nights they currently meet, and that more specialized groups can be developed for men who request them, such as groups for men who identify as queer, partners of male survivors, or men of color.

Similarly, the online resource Male Survivor provides “critical resources to male survivors of sexual trauma and all their partners in recovery by building communities of hope, healing, and support.” They have a resource directory that lists therapists who work with male survivors, as well as a list of support groups around the country. They also have peer-moderated online discussion forums for survivors, friends, and family members. On top of that, they facilitate Weekends of Recovery, where men can make connections in person, facilitated by trained therapists and staff.

Such resources are uniquely valuable in comparison to unmoderated chats that may pop up between survivors elsewhere on the internet — though those can have great value, too. With a formal arrangement including a moderator and a trained therapist, these spaces try to be among the safest and most therapeutic available online.

Sexual abuse of boys and men is, of course, far from being limited to the United States. The Bristlecone Project, a beautiful online resource that tells the stories of male survivors from all over the world, highlights tales of men like Alain Kabenga from the Democratic Republic of Congo. Kabenga is one of the many men and boys who have been victims of sexual torture used as a weapon of war. He now speaks out for other victims of sexual torture, despite the dangers that face him for coming forward.

Men who use these and other resources can learn, most crucially, that they are not alone. This was a common thread that ran through every conversation I had with male survivors.

Victor, a 43 year-old survivor, said that at the beginning of his recovery, online support was invaluable for learning the “universality of issues we face. Each of us suffers doubly for believing we are all alone.”

“For the first time in my life,” said another survivor, “I received affirmations that I wasn’t alone, that I was worthy of support, and that it was truly possible to heal.”

The internet also offers more creative forms of recovery. Artist and illustrator Dean Trippe created a breathtaking comic earlier this year that helped many survivors find hope. The boy in Trippe’s autobiographical story, Something Terrible, is abused and then threatened that if he tells anyone, his family will be killed.

Trippe’s comic works to debunk a prevalent falsehood about survivors called “The Vampire Myth,” which posits that being abused will turn a person into an abuser. When the character in Something Terrible learns that most abused boys do not grow up to be abusers, he feels free of that lifetime of shame and terror.

As a survivor himself, he knows how dangerous The Vampire Myth can be. “I’d had a metaphorical gun with a very real potential consequence to my head my whole life, in case that story were true, and some monster had infected my soul as a result of my experience and would someday want to hurt children,” he said. “I wouldn’t let that happen, no matter the cost, and once I knew the truth, I felt like I had to let anyone else who’d lived under that threat of self-destruction [know] that they could finally disarm.”

Christopher Anderson of Male Survivor agrees. “The myth has its roots in the fact that many, if not most, people who are arrested and tried for sexual victimization (especially of children) will claim to have been victims themselves in an attempt to paint themselves in a sympathetic light,” he said. But research is clear, and the vast majority of survivors of sexual abuse, regardless of gender, will never become abusers.

Trippe has seen the effects his comic has had on male survivors and their families. “It’s rough to hear from folks who knew loved ones who didn’t make it to learning they weren’t the danger, taking their own lives based on a lie,” he said.

He still gets emails and messages weekly, and meets fans at comics conventions who tell him how badly they needed to read his work. “I’ve met young kids whose ongoing recovery was helped by reading my story, which is probably the best result of taking this subject on.”

“We’re not the danger,” Trippe said. “We’re the ones who know how terrible the danger is.”

TThe tide may be turning for male survivors. Steve LePore, of 1in6, believes the Jerry Sandusky case at Penn State was, in a way, a turning point. When the story broke and details were released, many male survivors who hadn’t yet found community went looking for support. Traffic and engagement on 1in6.org increased by around 35% — and it stayed there.

Hit television drama Law & Order SVU has also produced episodes featuring stories of male survivors, and whenever those shows are re-broadcast, they feature a public service announcement directing survivors to support sources.

Essentially, the media is slowly turning the abuse of boys into a conversation people are willing to have, releasing some of the taboo.

Looking forward, there is the dream that someday male survivors everywhere will be able to find offline support groups and therapists who are trauma-informed and have specific knowledge as to the needs of men and boys. Online support can be life-saving for male survivors, but the end goal for the organizations doing this work is that men will be able to walk into rooms where they are accepted, and find community and support in person. If this can happen, and many believe that it can, many more men and boys can hopefully come to terms with their abuse at younger ages. After all, if we can help younger men find the support they need, they can begin their healing earlier and live longer, happier lives.

But for now, men like Christopher Anderson, who tried for years to ignore the effects abuse had upon his life, are grateful to find support online. Chris explained that when he finally found MaleSurvivor’s resources, he felt some hope. “For the first time in my life I received affirmations that I wasn’t alone, that I was worthy of support, and that it was truly possible to heal.”

And in the end, few things are more valuable to survivors than hope.