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.”