There are around 1 million male survivors of sexual assault in Australia.

And of the 6,875 survivors to testify at the royal commission into child sexual abuse, almost 65 per cent were male.

The aftermath of sexual assault is an ordeal for all survivors, but the challenges can be different for men and women, and public conversations about the implications of this are relatively few and far between.

Male rape has been the object both of concern and of squeamish silence in Australian since the earliest days of white settlement. Government documents of the time make frequent reference to the problem of forced sodomy in the penal colonies, as do court papers and letters to the press.

But management of the problem seems to have been hamstrung by a widespread reluctance to actually name the offence.

Sodomy — whether forced or consensual — was made a crime under English secular law in the 16th century.

Its earlier roots in ecclesial law are apparent in the particular horror expressed by early British settlers at sodomy in the colonies, not just as a crime but as an offence against God: a secular prohibition backed with Divine force.

Disturbingly, consensual sex between men was a criminal offence in parts of Australia until as recently as two decades ago.

But male rape didn't exist as a legal category until relatively recently. In Queensland, for example, rape was defined under state law until 1997 as something that happened exclusively between a man and a woman.

Today these legal hurdles no longer exist, but there's still an uncomfortable silence around male rape.

Losing your sense of gender identity

Gary Foster, the founder and manager of Living Well, a support service for male survivors of rape and sexual assault, says this has a lot to do with the socialisation of men.

"For males, the idea is that you're supposed to be strong, stoic, self-reliant, able to take care of yourself, nobody's meant to be able to put one over on you," Dr Foster says.

"So being raped can change your whole sense of identity as a man.

Dr Gary Foster is the founder of Living Well. ( Supplied: Living Well )

"When a man's raped, he's not confirmed as being like other men ... then there's the question around sexuality, 'Maybe he's gay?'

"And a big part of the reason that men don't come forward is the fear of being thought of in that way — so it's important to address the issue of homophobia here."

Men are also less likely than women to come forward.

"Guys tend to do what guys do: they stuff it down, they ignore it as much as they can, they do their best to just push through," Dr Foster says.

"When it comes to childhood sexual abuse — the royal commission backs this up — men will disclose 10 years later than women."

Dr Foster says male victims of sexual abuse are often angry, but feel a deep shame. ( Supplied: Pixabay )

Dr Foster believes what's needed is a more gender-nuanced response to the sexual abuse of men and boys.

"The problem of sexual violence against men isn't really on the public agenda yet," he says.

"When a federal strategy was created for addressing violence against women in 2010, it specifically stated that this strategy was for women and children, and that a separate strategy would be required for working with men. That hasn't happened."

He says it's also important to remember that sexual assault "is a gendered crime", and responses must reflect that.

"Men often handle their emotions differently to women, so the types of effective therapy and support are also often going to be different for men and women," he explains.

The 'challenge' of including male stories in #MeToo

On top of the reticence of men in coming forward with their stories, there's the fact that this debate comes at a tricky cultural moment.

Sexual violence against women is as urgent an issue as ever — and it's being given fresh urgency by the #MeToo campaign and the increasing refusal of women to stay silent in the face of abuse.

When rates of sexual violence against women far outstrip those against men, is now the time for men to be claiming space at the centre of public attention?

"It's a challenge," Dr Foster says.

"The majority of sexual perpetrators are male. Harvey Weinstein has blown this up, and it's fantastic that we've now got the silence-breakers and the truth-tellers coming forward and naming that.

"So how do we include male survivors? Because the fear is that if we include males and have some sort of generic response to all this, then we could lose the recognition that females are more likely to be sexually assaulted.

"It's almost like we're struggling to find the language to name this issue of sexual violence against men, without losing the focus on women."

Sexual assault support services: 1800 RESPECT: 1800 737 732

1800 RESPECT: Lifeline: 131 114

Lifeline: Beyond Blue: 1300 224 636

Dr Foster says it can prove to be challenging for governments as well.

"Because in their funding of services, if they don't provide the resources to ensure that both women and men are properly supported, then they're only going to see the people who come to them and knock on the door. And the one thing that guys won't do is knock on the door," he says.

"We can't expect victims of sexual violence to always be talking nicely. They're angry about what happened to them, and they feel deep shame and embarrassment about what's happened to them. So, in the end it's a challenge for all of us, to understand that and create spaces for that."