MILITARY MALE SEXUAL ASSAULT RESPONSE 1
Community Based Approach to Military Male Sexual Assault Prevention and Response
Paul B. Greer
School of Behavioral Science Liberty University
Author Note
Paul Brian Greer
I have no known conflict of interest to disclose.
Correspondence concerning this article should be addressed to Paul Brian Greer.
Email: pbgreer@liberty.edu
MILITARY MALE SEXUAL ASSAULT RESPONSE 2
Abstract
When it comes to prevention and support for this unique military population, religious and
veterans’ organizations, social services and military supported services are often not aligned in
planning or support efforts thereby leading to redundancy in services or creating gaps in service
to the veteran and military population. Since the COVID pandemic, the mental health system has
been overtaxed among the military and community health systems leading to greater outsourcing
and increase of military chaplain care to fill the gap. One trend that has emerged is male sexual
assault victim self-reporting to chaplains. Military chaplains are unique positioned to offer
pastoral care, but are often ill equipped for this type of service, as are many community support
resources such as churches and veterans support organizations. As such, a sociological-ecological
model that ties together military and community resources in a coordinated community response
as a coalition to organize prevention and response, as well as education and advocacy programs
is critical to assist with the unmet needs of military male sexual assault victims.
Keywords: military, veteran, male sexual assault, community-based approaches, veteran
support organization partnerships, community partnerships, community coalition, prevention,
advocacy, religious support, moral injury, triphasic model of trauma recovery, spiritually
integrated psychotherapy, forgiveness therapy.
MILITARY MALE SEXUAL ASSAULT RESPONSE 3
Community Based Approach to Military Male Sexual Assault Prevention and Response
As a provider in the military-centric community of Hampton Roads, Virginia, which
includes Langley Air Force Base, Army’s Fort Story and Fort Eustis, Naval Weapons Station
Yorktown, Naval Air Station Oceana and Dam Neck Annex, Joint Expeditionary Based Little
Creek, and Naval Station Norfolk which is the largest naval base in the world. According to the
Hampton Roads Economic Development Alliance (2022), the military represents approximately
45% of the region's economy and supports over 315,000 jobs. In terms of military personnel,
there are over 87,000 active-duty service members, over 25,000 civilian personnel, and over
80,000 military family members living in the Hampton Roads region yielding a military
population of over 192,000. As a result, the community and military are inextricably linked and
mutually interdependent, especially when caring for the large population of military members
and their dependents.
Lack of Coordination and Outsourcing
However, when it comes to prevention and support for this unique military population,
religious and veteran service organizations (VSO), local government based social services and
military social support and medical support services are often not aligned in planning or support
efforts, thereby leading to redundancy in services or creating gaps in service to the veteran and
military population. Additionally, since the COVID pandemic, the mental health system has been
overtaxed the military and community health systems with excessive wait times and increase in
virtual care (Wosik et al, 2020). This has led to military referrals and outsourcing of uniformed
service member mental health care through the TRICARE network and Military One Source for
self-referrals. According to a study published in the Journal of Mental Health Policy and
Economics, in 2017, the average wait time for a mental health appointment within the TRICARE
MILITARY MALE SEXUAL ASSAULT RESPONSE 4
network was 22.6 days (Wang et al., 2017). To address this issue, TRICARE outsourced mental
health care to civilian providers, resulting in a reduction in wait times to an average of 5.5 days
(Wang et al., 2017). As such, in Hampton Roads and military centric communities at large,
community partnerships and coalitions are critical to assist with the unmet and under supported
mental health needs for military members, especially military male sexual assault survivors.
Chaplains Filling the Gap
Chaplains are members of the military who are trained to provide religious and spiritual
support to military personnel and their families. In addition to their religious duties, chaplains
can also serve as counselors to military personnel who may be struggling with personal or
professional issues. According to research, mental health issues are prevalent among service
members and as a result, it's crucial to provide adequate support to service members with
shortfalls in mental health caregivers embedded in units, and one way to provide such support is
by having more chaplains (Dyer et al., 2019). The naval service in the Hampton Roads area in
particular is looking to significantly increase the number of chaplains to help support mental
health efforts and support to service members (Wilson, 2023).
Military chaplains offer a unique resource to male sexual assault victims not found in the
local community. Military chaplains have the unique benefit in the Department of Defense as not
being required to abide by mandatory reporting requirements of any kind, including compliance
with local and state law requirements while performing their duties as federal employees, and
have unlimited confidentiality under the clergy penitent tradition and protections of military law
(Wilson, 2023). As such, victims of trauma and sexual assault primarily seek out chaplain
support services first before other resources knowing their story is kept strictly confidential and
can avoid revictimization often associated with reporting. This lends to a unique problem and
MILITARY MALE SEXUAL ASSAULT RESPONSE 5
need for specialized training for military chaplains to avoid doing harm for this unique and
sensitive population in their most critical time of need.
As the leader in the military chaplain community, I can attest first-hand that chaplains are
primarily trained in theology with a minimum of nine hours of pastoral counseling in a Master of
Divinity degree. In the chaplain community, the array of caregiving competencies varies from
those with the minimum education standard, to those with clinical chaplain residency education,
board certification and others holding clinical counseling licensure and credentials. The wide
array of pastoral care and education competencies is likewise mimicked in the local community
among clergy. This creates a unique challenge for chaplain and pastoral care competencies
lacking consistency in the standard of care that is delivered to male sexual assault victims among
community clergy. This issue lends to the need for a coordinated community clergy response and
educational program to increase awareness and competencies for religious professionals
supporting military male sexual assault victims.
Emerging Problem
Further, since the COVID pandemic, not only has there been an increase in mental health
service utilization, but a trend is also emerging among chaplain reporting with increases in sexual
assault disclosure by victims to military chaplains. Specifically, there has been a unique increase
in male service members disclosing sexual assault prior to entry into military service when
seeking primary services for depression, anxiety, and skill-building in response to maladaptive
coping and increases in legal issues from destructive behaviors such as alcohol and substance
abuse, DUIs and self-mutilation. This trend is overtaxing chaplain competencies and the need to
increase education and skill-building. Further, chaplains are struggling to find unique
collaborative support services for client referral and have identified gaps in military and
MILITARY MALE SEXUAL ASSAULT RESPONSE 6
community-based partnerships for victim support. As such, there is a need to develop a coalition
of support for male sexual assault victims from the sociological-ecological model with direct and
indirect approaches to cooperative community-based outreach, advocacy, prevention and care.
Description of the Population
It is important to note that sexual assault can happen to anyone, regardless of their gender
or age. However, men are often less likely to report sexual assault than women due to a variety
of factors including stigma, shame, and fear of not being believed (Davies et al., 2002). In
general, men may be less likely to report sexual assault compared to women and may take longer
to come forward due to attitudes about masculinity and the societal stigma and shame associated
with male sexual assault (Davies et al., 2002). According to a study by Dr. John Briere and
colleagues (2004), the average age of men reporting sexual trauma is around 52 years old, thus
lending to the hypothesis that male sexual assaults are significantly underreported and there is a
significant male population suffering in silence and not receiving the care needed leading to
maladaptive coping impacting society at large.
According to the Department of Defense's "Population Representation in the Military
Services" report as of September 30, 2020, the United States Military is 85.6% male (Department
of Defense, n.d.). This uniquely patriarchal organization with its cultural norms of toughness and
compartmentalization of stressors for mission prioritization does not lend itself to encourage self-
reporting or help-seeking among victims dealing with the effects of sexual trauma.
Identification of Need
To determine any identification of need, there are several steps and approaches to
identification of need. These include social indicators as noted among chaplain caregivers as an
initial indicator in Hampton Roads. Additional assessments is needed, but may include
MILITARY MALE SEXUAL ASSAULT RESPONSE 7
community forums, surveys, interviews with potential consumers or service providers (Lilley,
2023) as well as additional research including longitudinal studies. The following highlights
existing research.
Demographic Research
According to a study by the Department of Defense, out of the estimated 20,500 incidents
of sexual assault in the military in 2018, approximately 38% involved male victims (Department
of Defense, 2019). Another study by the Rand Corporation found that among military personnel
who experienced unwanted sexual contact, approximately 23% were male (Lefebvre et al.,
2014). In a study of male veterans seeking treatment for PTSD at a VA hospital, 15.1% reported
experiencing sexual trauma during their military service (Kimerling et al., 2007) illustrating the
disparity in reporting.
The United States military as a male dominated organization poses unique challenges for
chaplains and mental health providers in caring for male sexual assault victims. Recruits come
from a large swath of American society, especially from socio-economically challenged subset of
culture often associated with neglect and abuse which often leads to revictimization in the
military (Loughran et al., 2018). "Research indicates that higher levels of childhood abuse and
trauma are associated with an increased likelihood of military enlistment, as individuals seek out
the structure and discipline of military life." (Ruscio et al., 2001, p. 199). A review of the
literature on trauma and military service found that up to 30% of military personnel may have a
history of childhood trauma, and that this is associated with an increased risk of PTSD,
depression, and substance abuse (Griffin et al., 2018). A study of Army recruits found that 12.5%
reported a history of physical abuse, 14.5% reported a history of sexual abuse, and 25.9%
reported a history of family violence (Brenner et al., 2011). In the United States, a study
MILITARY MALE SEXUAL ASSAULT RESPONSE 8
published in the Journal of Interpersonal Violence found that 1 in 6 males had experienced sexual
violence at some point in their lives, predominantly before the age of 18 (Swartout et al., 2014).
It can be assumed from the data that the military reflects this societal statistic but poses unique
challenges for male victims of sexual trauma due to military recruitment pools compared to other
civilian hiring agencies. Military cultural values including those of masculinity, stoicism,
toughness and resiliency, further negatively impacting self-reporting and help seeking among
make victims, as well as contributing to increased maladaptive coping and destructive behaviors.
Intervention Strategies
Triphasic Model
The triphasic model of trauma recovery is a framework developed by Judith Herman
(1992), a psychiatrist and trauma specialist, which describes the stages of recovery that
individuals go through after experiencing trauma. The triphasic model has been widely used in
the field of trauma treatment and has informed many evidence-based interventions. The three
phases of the triphasic model are:
Safety and Stabilization: In this phase, the focus is on establishing safety, both physically and
emotionally. This may involve creating a safe environment, establishing routines and structure,
and developing coping strategies to manage symptoms.
Remembrance and Mourning: In this phase, the focus is on processing and integrating the
traumatic experience. This may involve talking about the trauma, expressing emotions, and
working through feelings of guilt, shame, and anger.
Reconnection and Integration: In this final phase, the focus is on reconnecting with the world
and establishing a new sense of normalcy. This may involve reconnecting with others,
establishing new goals and interests, and finding meaning in the trauma experience.
MILITARY MALE SEXUAL ASSAULT RESPONSE 9
In Herman’s (1992) theory, she suggests that recovery from trauma involves a process of
resolving contradictions between two opposing needs: the need for safety and the need for
connection. In an effort to explain these dialectics, Goodwin (2013) developed what he calls the
wobble adaptation proposing that survivors may experience a "wobble" between these two needs
as they move through the recovery process which help describe how a male sexual assault
survivor experiences the recovery process. This "wobble" may involve moments of feeling
unsafe or disconnected, followed by a return to a sense of safety or connection. There is a
wobbling between a constriction of numbing and avoidance and intrusion and re-experiencing
the trauma. This is experienced in cognitive, emotional, relational and behavioral spheres. This
leads to a polarization of cognition with constricted or intrusive thoughts, dysregulated emotions,
unpredictable behavior and inconsistent interpersonal behaviors and relational needs (Goodwin,
2013). Understanding this wobbling theory is critical in aiding male sexual assault survivors
through psychoeducation for awareness of the way they experience trauma recovery through the
tri-phasic model (Herman, 1992), and for the caregiver to aid them in navigating through the
recovery process in a safe and supportive environment.
Clergy Interventions
According to the American Psychological Association (APA), chaplains can play an
important role in helping individuals cope with trauma and its aftermath (APA, 2013). Chaplains
and clergy in general play a unique role in caring for male sexual assault survivors and aid in the
recovery process through the use of their pastoral authority. In the context of spiritual care,
pastoral authority can be a powerful tool for promoting healing and growth among those who are
seeking support and guidance. One study that highlights the use of pastoral authority in spiritual
care by Min-Ah Cho and colleagues (2018) found that pastoral authority played a significant role
MILITARY MALE SEXUAL ASSAULT RESPONSE 10
in empowering individuals to confront their challenges and pursue growth and healing. Pastors
who were able to use their authority in a compassionate and supportive way were able to foster a
sense of trust and safety among those seeking spiritual care (Min-Ah Cho et al., 2018).
Chaplain interventions for trauma can include spiritual care, emotional support, and
counseling, as well as dealing with moral and spiritual injuries and provide a safe space to
process their trauma. One study by Flannelly et al. (2017) examined the effectiveness of chaplain
interventions for patients who experienced trauma in a hospital setting. The study found that
patients who received chaplain interventions had lower levels of anxiety and depression
compared to those who did not receive chaplain interventions. Another study by Pargament et al.
(2019) investigated the role of chaplains in providing spiritual care for individuals who
experienced trauma. The study found that chaplains can provide a safe space for individuals to
discuss their spiritual needs and concerns, which can help promote healing and recovery. Overall,
chaplains can offer important support for individuals who have experienced trauma and can
complement the work of mental health professionals in providing holistic care.
Role of Forgiveness
Forgiveness therapy is a type of psychotherapy that aims to help individuals who have
experienced trauma to forgive themselves and others who have caused harm. In the context of
sexual trauma, forgiveness therapy can help survivors to heal from the emotional and
psychological wounds caused by their experiences (Enright et al., 1998). Forgiveness therapy has
been studied as a potential intervention for survivors of sexual assault to help reduce symptoms
of distress, anger, and resentment. According to a study by Worthington et al. (2007), forgiveness
therapy involves a series of steps aimed at promoting forgiveness, including acknowledging the
harm done, accepting negative feelings, offering empathy and compassion to the offender,
MILITARY MALE SEXUAL ASSAULT RESPONSE 11
making a commitment to forgive, and finally, working to release negative emotions and thoughts
related to the offense.
Forgiveness is a critical biblical principle that aids in healing and one’s own relationship
with the divine. Matthew 6:14-15 states “For if you forgive others their trespasses, your heavenly
Father will also forgive you, but if you do not forgive others their trespasses, neither will your
Father forgive your trespasses” (ESV). While one may not be the offender and justice not be
fully recognized, the Bible helps to teach that it is bitterness that hurts from the inside out. In fact
Ephesians 4:31 teaches “Let all bitterness and wrath and anger and clamor and slander be put
away from you, along with all malice.” Bitterness itself is described by the Bible as an internal
poison that creates self-harm and can even harm others (Hebrews 12:15). As such, Jesus example
serves as a model to address forgiveness among those who had wronged him unjustly. 1 Peter
3:21-23 states “Look to Jesus, who despite being betrayed, persecuted, hated and left to die a
sinner’s death alone did not respond with insults or scorn but entrusted Himself to the Father
who judges all things justly” (ESV).
Chaplains can play an important role in providing forgiveness therapy to survivors of
sexual assault as part of a larger spiritual care approach. According to a study by Flannelly et al.
(2017), chaplains can use forgiveness therapy to promote healing and reduce symptoms of
distress in survivors of sexual assault, but it must be used appropriately, timely and judiciously as
part of a process in the recovery journey. To address forgiveness too quickly and not a part of a
forgiveness process could do harm to the recovery process.
Moral Injuries
Moral injury is a psychological response to experiencing an event or events that violate
one's moral or ethical values (Currier et al., 2019). Chaplains, as religious leaders, can play a
MILITARY MALE SEXUAL ASSAULT RESPONSE 12
crucial role in providing moral injury interventions to service members who have experienced
traumatic events during their service. In a randomized controlled trial of chaplain-led spiritual
interventions with military service members undergoing treatment for PTSD and moral injury
The results demonstrated that the chaplain-led interventions were effective in reducing symptoms
of PTSD and moral injury, and increasing spiritual well-being (Currier et al., 2019) This study
suggests that chaplains can play an important role in providing effective interventions for moral
injury in military service members by addressing moral injuries.
Spiritually Integrated Approaches
One way to build spiritual strength with trauma survivors is through a therapeutic
approach that integrates spirituality into the healing process. This approach has been called
"spiritually integrated psychotherapy" (SIP) and has been shown to be effective in helping
trauma survivors increase their spiritual strength and resilience (Hodge, 2019). SIP is an
evidence-based approach that incorporates the client's spiritual and religious beliefs into the
therapeutic process. It involves using spiritual practices, such as prayer, meditation, and
mindfulness, as well as exploring the client's beliefs and values to help them find meaning and
purpose in their lives (Hodge, 2019). Chaplains and clergy in a community-based approach to
males sexual assault caregiving can greatly benefit from SIP integration in their pastoral care, as
with professional counselors for true holistic care in a biopsychosocial-spiritual model.
Studies have shown that SIP can help trauma survivors increase their sense of hope,
meaning, and purpose, which can lead to greater psychological and emotional well-being
(Hodge, 2019). It can also help them cope with symptoms of trauma, such as anxiety and
depression, by providing a sense of connection and support. One study of SIP with trauma
survivors found that participants reported increased spiritual well-being, greater meaning and
MILITARY MALE SEXUAL ASSAULT RESPONSE 13
purpose in life, and improved mental health outcomes (Frazier et al., 2015). Another study found
that SIP helped survivors of childhood sexual abuse decrease symptoms of PTSD and depression
(Korbman et al., 2021). Overall, incorporating spirituality into the therapeutic process can be an
effective way to build spiritual strength and resilience in trauma survivors.
Maintaining spiritual practices is a critical part of recovery from moral and spiritual
injuries. One study by Harris (2019) explored how trauma survivors use spirituality to build
resilience and cope with trauma. The author found that trauma survivors often use spiritual
practices such as prayer, meditation, and connecting with a higher power to build spiritual
strength and find meaning in their trauma.
In another study by Howard et al. (2017) the authors conducted qualitative interviews
with adults who had experienced trauma and identified as having spiritual strength. The authors
defined spiritual strength as "the ability to transcend traumatic experiences, to find meaning and
purpose in life, and to maintain a sense of hope and faith" (Howard et al., 2017, p. 2). The study
concluded that it was that spiritual fortitude that played a significant role in the trauma survivors'
ability to cope and recover. The participants reported that their spiritual beliefs and practices
helped them to find meaning in their experiences, provided a sense of comfort and support, and
enabled them to maintain a positive outlook on life (Howard, et al., 2017). The authors
concluded that spirituality and spiritual resources that serve as an important resource for trauma
survivors that can promote healing, wholeness and growth (Howard, et al., 2017). These studies
highlight the importance of incorporating spirituality in trauma-informed care and why clergy
and religious professionals play a critical role in a community response to male sexual trauma.
Resiliency Factors
MILITARY MALE SEXUAL ASSAULT RESPONSE 14
Resilience factors for male victims of sexual violence are crucial for their recovery and
well-being. According to Dworkin et al. (2017) factors that can contribute to resilience in male
victims of sexual violence include:
Social support: Having supportive friends and family members can help male victims of sexual
violence to cope with the trauma and feel less isolated. This can include emotional support,
practical assistance, and access to resources. This is why a community based approach and
coalition is so important for trauma recovery, especially among military male sexual assault
survivors due to their sense of camaraderie among the military community. Here, veteran support
organization and religious organizations and churches helps provide social support to the
recovery process.
Positive coping strategies: Developing healthy coping strategies can help male victims of sexual
violence to manage the trauma and reduce the risk of developing mental health problems such as
depression, anxiety, or post-traumatic stress disorder (PTSD).
Self-efficacy: Believing in one's ability to cope with the trauma and overcome challenges can
increase resilience in male victims of sexual violence.
Cognitive restructuring: The ability to change negative thought patterns and beliefs can help
male victims of sexual violence to develop a more positive outlook on life and cope with the
trauma more effectively.
Positive interpersonal relationships: Building positive relationships with others, whether
romantic, platonic, or professional, can provide a source of support, validation, and a sense of
belonging. This again is where veteran service organizations, group work and religious
organization in a community-based approach help foster these positive social and interpersonal
relations.
MILITARY MALE SEXUAL ASSAULT RESPONSE 15
Access to mental health care: Seeking professional help can be beneficial for male victims of
sexual violence to process their trauma and develop healthy coping strategies. Male survivors of
sexual violence can benefit from professional counseling or therapy to address issues related to
trauma, receive trauma focused therapy and psychoeducation to promote healing. This is why
advocacy in a community based approach is so critical to enhance access to care.
Education and awareness: Educating the public about male sexual assault and challenging
harmful stereotypes can help reduce stigma and promote understanding and support for
survivors.
Positive self-image: Encouraging a positive self-image and self-esteem can help survivors
rebuild their confidence and sense of self-worth. In the tri-phasic model of trauma recovery
(Herman, 1992), the ultimate goal is to connect with the authentic self through reconnection with
a positive self-image.
Spirituality: For some individuals, religious or spiritual beliefs can provide comfort, hope, and
meaning during difficult times, as well as spiritual disciplines and practices. There is evidence to
suggest that certain spiritual disciplines and practices can be beneficial for trauma recovery such
as mindfulness and meditation, prayer, forgiveness, scripture reading and gratitude (Harris et al.,
2003). These practices can help individuals develop a sense of meaning and purpose, improve
coping skills, and reduce feelings of anxiety and depression (Harris et al.,2003).
Military Resilience Factors
Literature also notes unique resiliency factors found among military members that assist
in trauma recovery. These include:
MILITARY MALE SEXUAL ASSAULT RESPONSE 16
Positive coping strategies: Military members who use positive coping strategies, such as seeking
social support and engaging in physical activity, tend to be more resilient. (Bartone et al., 2008).
Optimism: Optimism, or the tendency to view situations positively, has been linked to greater
resilience in military members. (Morgan et al., 2013).
Sense of purpose: Military members who have a strong sense of purpose and meaning in their
lives tend to be more resilient in the face of challenges. (Westerhof et al., 2010).
Emotional intelligence: Military members who are emotionally intelligent, meaning they are able
to recognize, manage and regulate their own emotions as well as those of others, tend to be more
resilient. (Chiang et al., 2018).
Training and preparation: Military members who receive adequate training and preparation for
the challenges they may face tend to be more resilient. (Patterson et al., 2013).
Strengths Based Approach
Understanding these resiliency factors and how to utilize them is critical in recovery
especially when utilizing a strengths-based approach with males. A strengths-based approach to
trauma recovery focuses on identifying and utilizing the personal strengths and resources of
individuals to help them overcome the effects of trauma. According to this approach, trauma
survivors are viewed as having the ability to heal and recover, and the therapist's role is to
support and facilitate this process by helping them identify and draw upon their existing
strengths and resources.
One study that highlights the effectiveness of a strengths-based approach to trauma
recovery is by Friborg et al. (2014). The study examined the effectiveness of a six-session
strengths-based intervention for trauma survivors with posttraumatic stress disorder (PTSD). The
intervention involved helping participants identify and utilize their personal strengths, and the
MILITARY MALE SEXUAL ASSAULT RESPONSE 17
results showed significant improvements in PTSD symptoms, as well as reductions in depression
and anxiety.
The importance of a strengths-based approach cannot be understated. Individuals who
have experienced sexual assault may engage in maladaptive coping strategies, such as substance
use or avoidance, to cope with the trauma they have experienced. These coping strategies may
provide temporary relief, but in the long run, they can be harmful and prevent individuals from
fully processing and healing from the trauma they have experienced. Trauma survivors who have
developed these maladaptive coping strategies may be reluctant to give up these behaviors
without something in replacement, thus reconnecting and drawing upon strengths aids in helping
to make a healthy transition.
To address the need for a strengths-based approach for individuals who have experienced
sexual assault, the American Psychological Association (APA, 2019) recommends focusing on
building resilience and coping skills. This approach emphasizes the strengths and resources of
the individual and recognizes that each person has unique strengths and abilities that can be used
to promote healing.
One example of a strengths-based approach is trauma-focused cognitive-behavioral
therapy (TF-CBT), which has been shown to be effective in treating individuals who have
experienced sexual assault (Deblinger et al., 2011). TF-CBT focuses on building coping skills
and resilience by addressing negative thoughts and beliefs related to the trauma, developing
relaxation and grounding techniques, and promoting social support networks (Deblinger et al.,
2011). Study participants who received TF-CBT showed sustained improvement in PTSD
symptoms compared to those who received non-directive supportive therapy. The study also
found that the TF-CBT group had a significantly greater reduction in depression and behavior
MILITARY MALE SEXUAL ASSAULT RESPONSE 18
problems than the non-directive supportive therapy group (Deblinger et al., 2011). The research
thus demonstrates that strength-based approaches to trauma focused therapy can significantly
improve trauma recovery for male sexual assault survivors.
Coalition
A Coordinated Community Response (CCR) to male sexual assault involves the
collaboration of various community agencies and organizations to provide support, prevention,
and intervention services to male survivors of sexual assault (Greeson et al., 2016). This
approach recognizes that male sexual assault is a complex issue that requires a comprehensive
response from various sectors of the community, including law enforcement, healthcare, social
services, education, and advocacy groups, which by extension includes veteran support
organization, local government and community clergy for holistic care, prevention and advocacy.
Dr. Greeson has worked with the American Psychological Association (APA) to develop
guidelines for implementing a coordinated community response to male sexual trauma. These
guidelines provide a framework for identifying and addressing the needs of male survivors of
sexual trauma, as well as promoting prevention efforts. The guidelines emphasize the importance
of a trauma-informed approach, which recognizes the impact that sexual trauma can have on
individuals and focuses on creating a safe and supportive environment for survivors. They also
highlight the need for culturally sensitive and responsive services that take into account the
unique experiences and needs of men from diverse backgrounds (Greeson et al., 2016).
One study that examined the effectiveness of CCRs in addressing male sexual assault is
"Evaluation of a coordinated community response to male sexual assault" by Ullman et al.
(2005). The study evaluated the impact of a CCR program in a large urban area in the United
States. The program involved the collaboration of a rape crisis center, a mental health center, a
MILITARY MALE SEXUAL ASSAULT RESPONSE 19
hospital emergency department, and law enforcement agencies. The results of the study showed
that the CCR program had a positive impact on male survivors of sexual assault. The program
improved access to services, increased reporting of sexual assault, and reduced the stigma
associated with male sexual assault, all aims for a coordinate community response and offer a
promising approach for addressing male sexual assault and best practices for implementing a
coalition approach. Gleaning from this study, by expanding a CCR approach to military male
sexual assault clients to include veteran and military centric organizations, religious and local
leadership, a more holistic approach to care could exist.
Local, state and federal governments, military leadership, religious organizations, clergy,
veteran support organizations, social services, mental health practitioners, professional
counseling organizations and their lobbyists, non-government organization and not for profits
such as 1in6.org have a unique opportunity to develop a community-based ecological approach
in support of male sexual assault survivors. By coordinating and collaborating in planning and
programming, their combined efforts could reduce redundancies, fill gaps in services provided,
maximize resources and community-based efforts to share the case management and prevention,
thereby increasing program capacity, capability and effectiveness. By aligning as a community-
based collation, CCRs combined efforts aid to promote professional advocacy resulting in policy
changes, greater accountability for offenders, increased resource funding and support services for
victims, as well as strengthen efforts in outreach and messaging which aids in reducing male
sexual assault stigmatization.
Advocacy Program
Veteran support organizations have been the voice of advocacy and support for policy and
legislative changes. Jasinski et al. (2017) suggests that veteran support organizations could play a
MILITARY MALE SEXUAL ASSAULT RESPONSE 20
critical role in the community due to their nationwide community presence and unique
understanding of the military culture. Veteran support organizations play a crucial role in
advocating for legislative and policy changes that benefit veterans and their families. They use
various methods to influence policy and decision-making, including lobbying, grassroots
organizing, media campaigns, and public education.
One example of a veteran support organizations that engage in advocacy and lobbying is
the Veterans of Foreign Wars (VFW). The VFW has a long history of advocating for policies and
legislation that support veterans, such as access to healthcare, education, and employment. They
use their strong network of members and volunteers to push for changes at the local, state, and
federal levels. According to a report by the Congressional Research Service, veteran service
organizations like the VFW provide a valuable perspective on veterans' issues, as well as a well-
organized lobbying presence in Congress (Schwartz, 2019).
Another example is the Disabled American Veterans (DAV), which also engages in
advocacy and lobbying on behalf of disabled veterans. The DAV has been successful in
influencing policy and legislative changes that improve the lives of disabled veterans, such as
expanding healthcare benefits and increasing disability compensation. In a study published in
the Journal of Military and Veterans' Health, the authors note that veteran service organizations
have been successful in leveraging their political power to shape public policy and legislation
that affect the well-being of veterans and their families (Meadows et al., 2017). Overall, veteran
service organizations play a crucial role in advocating for the needs and concerns of veterans and
their families. Their efforts have led to important legislative and policy changes that have
improved the lives of countless veterans. The main issue with veteran service organizations is
that they are fractured and often competitive failing to synchronize efforts (Phillips, 2021).
MILITARY MALE SEXUAL ASSAULT RESPONSE 21
Challenges and Barriers to Services
Veteran Service Organization Fracturing
Veteran service organizations (VSOs) can provide significant social support for military
male sexual assault victims. This comes in the form of assistance in filing claims with the
Veterans Administration, and peer to peer support among a community that understands military
service and culture. Unfortunately, veteran service organization are not well prepared to provide
peer to peer support or facilitate military peer sexual trauma support groups, nor are they
necessarily collaborative in their approach to veteran support and care. According to Pope (2016)
the organizational culture of veteran service organizations and negatively impacts their ability to
effectively serve veterans. One aspect of organizational culture discussed is the competition and
struggles between VSOs. Pope (2016) notes that these conflicts can arise due to differences in
ideology, funding sources, and the desire to be seen as the primary voice for veterans. This can
lead to a lack of collaboration and duplication of efforts, which can ultimately harm the veteran
population.
Non-male Focus
A cursory review of available service in the greater Hampton Roads area demonstrates
that the Virginia Sexual and Domestic Violence Coalition, as well as local crisis services focus
primarily on women, children, and the LQBTQ community, but rarely mention or provide
services specific to males or military males. In fact, it was not until 2012 when the American
Psychological Association published a report highlighting the need for greater attention to male
sexual victimization and addressing some of the barriers to reporting and treatment (Stemple et
al., 2014). Defentions for rape and sexual assault generally involved receptive penetration for
females only (Stemple et al., 2014). When the definition of sexual assault was expanded to
MILITARY MALE SEXUAL ASSAULT RESPONSE 22
include nonconsensual sexual contact, the rates of sexual assaults began to equalize between men
and women (Stemple et al., 2014). While professional associations and laws have begun to
catchup to the equality needed in recognizing and validating male sexual assault, society and
culture at large have a long way to go.
Perceptions of Masculinity in Culture
Men may experience unique challenges in disclosing and seeking support for sexual
trauma due to social attitudes and stigma surrounding male victimization. Research suggests that
men may face societal pressures to conform to traditional masculine norms, which may
discourage them from disclosing experiences of sexual trauma (Koss, 1990; Bullock et al., 2011).
Male socialization can contribute to male sexual victimization by fostering beliefs and attitudes
that condone and normalize sexual aggression and discourage men from reporting or seeking
help for victimization experiences (Peterson et al., 2004). For instance, traditional masculine
gender roles emphasize dominance, aggression, and control, which may lead some men to view
sexual conquests or coercion as a way to assert their power or masculinity (Koss, 1990). These
attitudes and behaviors can perpetuate sexual violence and make it difficult for male survivors to
seek support or disclose their experiences (Davies, 2002). Moreover, men who disclose
experiences of sexual trauma may face skepticism or disbelief from others, including mental
health professionals, due to prevailing societal stereotypes that men are perpetrators rather than
victims of sexual violence (Rozée et al., 2001).
How culture views men through the social lens of beliefs and attitudes, and the
misperception of how men on a personal level experience trauma creates the need for greater
education through this social lens due to the barriers it creates in society and in male victims
seeking help. One approach to a community-based coalition to overcome this barrier it to partner
MILITARY MALE SEXUAL ASSAULT RESPONSE 23
with education and advocacy groups such as in6.org and the Rape Abuse and Incest National
Network (RAINN) through the education and advocacy programs. Specifically, 1in6.org utilizes
their “Truth Telling” seminar which could be used for community clergy, veterans organization
caregivers, first responders, sexual assault victim advocates, sexual assault response
coordinators, mental health providers and military social workers. This seminar focuses on male-
centered approaches to psychotherapy, male psychology and how this “coding” of masculinity
intersects with the lives of men facing trauma and post-traumatic responses. An overview of
current research on both male sexual abuse and assault, and an analysis of how trauma
commences, and a conceptual lens to the recovery process. With proper awareness, education
and skills-based learning, community coalition stakeholders could fill a critical void in the
community by meeting the needs of military male survivors of sexual assault with support and
resources that do not currently exist.
Lack of Advocacy
Advocacy for male sexual assault victims is an essential aspect of addressing the issue of
sexual violence. However, there are several barriers that prevent effective advocacy for male
survivors. These barriers can be categorized into individual, systemic, and cultural factors that
influence attitudes towards male sexual assault and the provision of services.
One of the individual barriers is the reluctance of male survivors to disclose their
experiences. Men may fear being stigmatized or not believed, leading them to remain silent
about their experiences (Katz, 2018). Additionally, some male survivors may not recognize their
experiences as sexual assault due to societal stereotypes that perpetuate the myth that men cannot
be sexually assaulted (Widanaralalage et al., 2022).
MILITARY MALE SEXUAL ASSAULT RESPONSE 24
Systemic barriers also play a significant role in hindering advocacy for male sexual
assault victims. For example, services such as rape crisis centers are often geared towards female
survivors, making male survivors feel unwelcome or uncomfortable seeking help. Furthermore,
there may be a lack of funding and resources dedicated to male sexual assault advocacy, resulting
in a lack of programs and services available to support male survivors.
Cultural factors also contribute to barriers to male sexual assault advocacy. Stereotypical
notions of masculinity and gender norms that associate men with power, strength, and control
that reinforce the idea of men as powerful and in control may make it challenging for male
survivors to come forward and seek help (Rozée et al., 2001). These stereotypes may lead to
assumptions that men cannot be victims of sexual assault, or that if they are, they should be able
to man up and deal with it on their own (Peterson et al., 2004). These cultural messages
perpetuate the myth that sexual assault only happens to women may lead to the marginalization
of male survivors and a lack of public awareness and understanding of their experiences that
leads to advocacy, support and funding for male oriented sexual assault recovery programs.
Conclusion
In conclusion, sexual trauma can have significant and lasting impacts on men, including
physical, emotional, and psychological consequences. However, social attitudes and stigma
surrounding male victimization can make it difficult for men to disclose and seek support for
sexual trauma, highlighting the need for increased awareness and understanding of male sexual
victimization. Addressing these barriers requires a multifaceted approach that involves
addressing societal stereotypes and myths, as well as increasing funding and resources for male
sexual assault advocacy programs and services, and providing education and training to
professionals, as well as community-based stakeholders. By developing a community-based
MILITARY MALE SEXUAL ASSAULT RESPONSE 25
approach in a coordinated community response to military male sexual assault support and
prevention, planning and programming can reduce redundancies, fill gaps in services, maximize
existing resources and increase service utilization among potential clientele and provide the
social support needed that these men may no longer suffer in silence. Partnerships with clergy
and veteran support organizations provide a critical linchpin for social support and with
specialized education, an avenue for spiritual and group intervention strategies for male veterans
in their recovery from sexual trauma.
References
MILITARY MALE SEXUAL ASSAULT RESPONSE 26
American Psychological Association. (2013). Chaplain interventions for health care. Retrieved
from https://www.apa.org/pi/about/publications/caregivers/practice-settings/religious-
spiritual/chaplain-interventions
American Psychological Association. (2019). Guidelines for Psychological Practice with
Survivors of Sexual Assault. Retrieved from
https://www.apa.org/practice/guidelines/sexual-assault-survivors-guidelines
Bartone, P. T., Roland, R. R., & Picano, J. J. (2008). Psychological hardiness predicts success in
US Army Special Forces candidates. International Journal of Selection and Assessment,
16(1), 78-81. https://doi.org/10.1111/j.1468-2389.2008.00412.x
Brenner, L. A., Ivins, B. J., Schwab, K. A., Warden, D., Nelson, L. A., Jaffee, M. S., & Terrio, H.
(2011). Traumatic brain injury, posttraumatic stress disorder, and postconcussive
symptom reporting among troops returning from Iraq. Journal of Head Trauma
Rehabilitation, 26(4), 312-318. https://doi.org/10.1097/htr.0b013e3181cada03
Briere, J., Kaltman, S., & Green, B. L. (2004). Accumulated childhood trauma and symptom
complexity. Journal of Traumatic Stress, 17(1), 67-75.
https://doi.org/10.1023/B:JOTS.0000014671.90356.7a
Bullock, C. M., & Beckson, M. (2011). Male victims of sexual assault: Phenomenology,
psychology, physiology. Journal of the American Academy of Psychiatry and the Law
Online , 29(2), 197–205 Retrieved from https://jaapl.org/content/39/2/197
Chiang, H.-H., Chen, K.-J., & Yang, C.-C. (2018). Model of coping strategies, resilience,
psychological well-being, and perceived health among military personnel. Journal of
Medical Sciences, 38(2), 73. https://doi.org/10.4103/jmedsci.jmedsci_60_17
MILITARY MALE SEXUAL ASSAULT RESPONSE 27
Currier, J. M., Holland, J. M., & Malott, J. (2019). A randomized controlled trial of chaplain-led
spiritual interventions with military service members undergoing treatment for PTSD and
moral injury. Journal of Traumatic Stress, 32(3), 422-432.
https://doi.org/10.1002/jts.22390
Davies, M. (2002). Male victims of sexual assault and rape: Challenges and barriers to accessing
services and support. Journal of Aggression, Maltreatment & Trauma, 6(1), 131-148.
https://doi.org/10.1016/s1359-1789(00)00043-4
Davies, M. (2019). Sexual Violence Against Men and Boys: A Hidden Problem. Journal of
Interpersonal Violence, 34(3), 471–479. https://doi.org/10.1177/0886260519871532
Deblinger, E., Mannarino, A. P., Cohen, J. A., & Steer, R. A. (2011). A follow-up study of a
multisite, randomized, controlled trial for children with sexual abuse-related PTSD
symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 50(5),
526-537. https://doi.org/10.1016/j.jaac.2011.01.017
Department of Defense. (2019). Sexual Assault Prevention and Response Office Annual Report
on Sexual Assault in the Military. Retrieved from
https://www.sapr.mil/public/docs/reports/FY18_Annual/FY18_Annual_Report_on_Sexua
l_Assault_in_the_Military.pdf
Department of Defense. (n.d.). 2020 population representation in the military services. 2020
Population Representation in the Military Services – OPA.gov. Retrieved from
https://www.opa.mil/research-analysis/recruiting-awareness/population-
representation/2020-population-representation-in-the-military-services/
MILITARY MALE SEXUAL ASSAULT RESPONSE 28
Dyer, J. G., & Smith, L. (2019). The role of chaplains in promoting mental health in the military:
A literature review. Journal of Psychology and Theology, 47(2), 110-119.
https://doi.org/10.1177/0091647119829255
Enright, R. D, Freedman, S., & Rique, J. (1998). The psychology of interpersonal forgiveness. In
R. D. Enright & J. North (Eds.), Exploring forgiveness (pp. 46-62). University of
Wisconsin Press.
Flannelly, K. J., Handzo, G. F., Weaver, A. J., & Dusek, J. A. (2017). A systematic review of
chaplaincy interventions for patients with trauma. Journal of Health Care Chaplaincy,
23(1), 3-21. https://doi.org/10.1080/08854726.2017.1344501
Flannelly, K. J., Weaver, A. J., Handzo, G. F., & DuBard, L. C. (2017). The chaplain's role in
providing spiritual care to survivors of sexual assault. Journal of Healthcare Chaplaincy,
23(2), 49-62. https://doi.org/10.1080/08854726.2017.1314258
Frazier, P. A., Tix, A. P., Barron, K. E., & Mintz, L. B. (2015). Spiritually integrated
psychotherapy: Understanding and addressing the sacred. Guilford Publications.
Friborg, O., Martinsen, E. W., Martinussen, M., Kaiser, S., Overgård, K. T., & Schmierer, P.
(2014). Composing the Strains of Recovery from Trauma: A Prospective Longitudinal
Mixed Method Study of Within-Person Processes That Change During Intervention.
Psychological Trauma: Theory, Research, Practice, and Policy, 6(6), 553–560.
https://doi.org/10.1037/a0037281
Goodwin, J. (2013). The wobble hypothesis: an adaptation of Herman's dialectic of trauma.
Psychological Trauma: Theory, Research, Practice, and Policy, 5(1), 89-91.
https://doi.org/10.1037/a0024422
MILITARY MALE SEXUAL ASSAULT RESPONSE 29
Greeson, M. R., & Campbell, R. (2016). Coordinated community response to male survivors of
sexual violence: A review of the literature. Trauma, Violence, & Abuse, 17(2), 185–197.
https://doi.org/10.1177/1524838015587509
Griffin, M. G., McDevitt-Murphy, M. E., & Wangelin, B. C. (2018). Trauma and military
service: A review of the literature. Trauma, Violence, & Abuse, 19(4), 399-410.
https://doi.org/10.1177/1524838016683459
Hampton Roads Economic Development Alliance. (2022). Annual Report 2022. Retrieved from
https://www.hreda.com/wp-content/uploads/2022/01/HREDA-Annual-Report-2022.pdf
Harris, A. H. S., Thoresen, C. E., & Johnson, R. J. (2003). Spiritual practices and health: A
review of the literature. Journal of the American College of Health, 50(6), 325-332.
https://doi.org/10.1080/07448480309595758
Harris, J. I. (2019). Building spiritual strength in trauma survivors: A qualitative study. Journal
of Religion and Health, 58(2), 666-680. https://doi.org/10.1007/s10943-018-0661-9
Herman, J. L. (1992). Trauma and recovery: The aftermath of violence--from domestic abuse to
political terror. Basic Books.
Hodge, D. R. (2019). Spiritually integrated psychotherapy: A review of empirical evidence.
Journal of Clinical Psychology, 75(10), 1773-1785. https://doi.org/10.1002/jclp.v75.10
Howard, K. J., & Yates, B. T. (2017). Spiritual strength in trauma survivors: An exploratory
study. Journal of Spirituality in Mental Health, 19(1), 1-11.
https://doi.org/10.1080/19349637.2016.1192054
Jasinski, J. L., & Kaufman, M. (2017). Meeting the needs of male survivors of sexual assault:
Recommendations for best practice. Journal of Interpersonal Violence, 32(1), 3-24.
https://doi.org/10.1177/0886260515587237
MILITARY MALE SEXUAL ASSAULT RESPONSE 30
Katz, J. (2018). The invisibility of male sexual victimization: Implications for family therapists.
Journal of Marital and Family Therapy, 44(3), 386-397.
https://doi.org/10.1111/jmft.2018.44.issue-4
Kimerling, R., Gima, K., Smith, M. W., Street, A., & Frayne, S. (2007). The Veterans Health
Administration and military sexual trauma. American Journal of Public Health, 97(12),
2160-2166. https://doi.org/10.2105/AJPH.2006.093490
Korbman, M. D., Pirutinsky, S., Feindler, E. L., & Rosmarin, D. H. (2022). Childhood sexual
abuse, spirituality/religion, anxiety and depression in a Jewish community sample: The
mediating role of religious coping. Journal of Interpersonal Violence, 37(15–16).
https://doi.org/10.1177/08862605211001462
Koss, M. P. (1990). The hidden rape victim: Personality, attitudinal, and situational
characteristics. Psychology of Women Quarterly, 14(3), 327-354.
https://doi.org/10.1111/j.1471-6402.1985.tb00872.x
Lefebvre, R., Srinivasan, S., & DeVoe, E. (2014). Sexual assault and sexual harassment in the
U.S. military: Volume 2. Estimates for Department of Defense Service Members from the
2014 RAND Military Workplace Study. Retrieved from
https://www.rand.org/pubs/research_reports/RR870z2.html
Lilley, S. (2023). Subject matter conversations: program development [PowerPoint
slides]. Retrieved from
https://canvas.liberty.edu/courses/421318/discussion_topics/3837754?
module_item_id=48004028
Loughran, D. S., & Humphreys, M. (2018). The US military and the socioeconomic divide.
Annual Review of Sociology, 44(1), 599-620. https://doi.org/10.4324/9781315126616
MILITARY MALE SEXUAL ASSAULT RESPONSE 31
Morgan, N. R., Acker, M. A., & Zimmerman, M. A. (2013). Optimism and resiliency in military
families experiencing a combat deployment. Journal of Family Strengths, 13(1), 1-15.
https://doi.org/10.4135/9781483369532.n196
Office of the Assistant Secretary of Defense for Manpower and Reserve Affairs. (2020).
Population Representation in the Military Services: Fiscal Year 2020 Summary Report.
Retrieved from https://www.cna.org/CNA_files/PDF/DOP-2021-U-029989-Final.pdf
Pargament, K. I., Smith, B. W., Koenig, H. G., & Perez, L. M. (2019). The role of chaplains in
providing spiritual care for survivors of trauma. Journal of Trauma & Dissociation,
20(5), 550-564. https://doi.org/10.1080/15299732.2019.1663600
Patterson, J., Arthur, W., & LaPorta, A. (2013). Military training and the development of
resilience. In C. L. Cooper & M. F. Flint-Taylor (Eds.), From stress to well-being (Vol. 2,
pp. 218-232). Palgrave Macmillan.
Peterson, Z. D., & Muehlenhard, C. L. (2004). Was it rape? The function of women's rape myth
acceptance and definitions of sex in labeling their own experiences. Sex Roles, 51(3-4),
129-144. https://doi.org/10.1023/b:sers.0000046608.19947.75
Philipps, D. (2021, February 27). Veterans’ Groups Compete With Each Other, and Struggle With
the V.A. The New York Times. Retrieved from
https://www.nytimes.com/2021/02/27/us/veterans-va-groups.html
Pope, J. E. (2016). When veterans come home: The impact of organizational culture on veteran
service organizations. Armed Forces & Society, 42(1), 92-113. https://doi.org/
10.1177/0095327X14535432
Rozée, P. D., & Koss, M. P. (2001). Rape: A century of resistance. Psychology of Women
Quarterly, 25(4), 295-311. https://doi.org/10.1177/036168430102500305
MILITARY MALE SEXUAL ASSAULT RESPONSE 32
Ruscio, A. M., Borkovec, T. D., & Ruscio, J. (2001). A taxometric investigation of the latent
structure of worry. Journal of Abnormal Psychology, 110(2), 193–200.
https://doi.org/10.1037/0021-843X.110.2.193
Schwartz, M. A. (2019). Veterans service organizations: Background and issues for Congress.
Congressional Research Service. Retrieved from https://fas.org/sgp/crs/misc/R40076.pdf.
Stemple, L., & Meyer, I. H. (2014). The sexual victimization of men in America: New data
challenge old assumptions. American Journal of Public Health, 104(6).
https://doi.org/10.2105/ajph.2014.301946
Swartout, K. M., Koss, M. P., White, J. W., & Thompson, M. P. (2014). Trajectories of the
likelihood of experiencing forced sex: Effects of victimization and characteristics of
sexual assaults. Journal of Interpersonal Violence, 29(13), 2333-2357.
https://doi.org/10.1177/0886260514534524
Ullman, S. E., Townsend, S. M., & Filipas, H. H. (2005). Evaluation of a coordinated community
response to male sexual assault. Journal of Interpersonal Violence, 20(8), 977-992.
https://doi.org/10.1177/0886260505277547
Wang, P. S., Berglund, P. A., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2017).
Failure and delay in initial treatment contact after first onset of mental disorders in the
National Comorbidity Survey Replication. Archives of General Psychiatry, 64(6), 603-
613. https://doi.org/10.1001/archpsyc.64.6.603
Westerhof, G. J., & Keyes, C. L. (2010). Mental illness and mental health: The two continua
model across the lifespan. Journal of Adult Development, 17(2), 110-119. https://doi.org/
10.1007/s10804-009-9082-y
MILITARY MALE SEXUAL ASSAULT RESPONSE 33
Widanaralalage, B. K., Hine, B. A., Murphy, A. D., & Murji, K. (2022). “I didn’t feel I was
a victim”: A phenomenological analysis of the experiences of male-on-male survivors of
rape and sexual abuse. Victims & Offenders, 17(8), 1147–1172.
https://doi.org/10.1080/15564886.2022.2069898
Wilson, A. (2023, February 27). Chaplains to serve as counselors aboard all Navy destroyers by
2025. Stars and Stripes. Retrieved March 17, 2023, from
https://www.stripes.com/branches/navy/2023-02-27/navy-chaplains-destroyers-
counseling-suicide-9268265.html
Worthington, E. L., Witvliet, C. V. O., Pietrini, P., & Miller, A. J. (2007). Forgiveness, health, and
well-being: A review of evidence for emotional versus decisional forgiveness,
dispositional forgiveness, and reduced unforgiveness. Journal of Behavioral Medicine,
30(4), 291-302. https://doi.org/10.1007/s10865-007-9105-8
Wosik, J., Fudim, M., Cameron, B., Gellad, Z. F., Cho, A., Phinney, D., ... & Curtis, L. H. (2020).
Telehealth transformation: COVID-19 and the rise of virtual care. Journal of the
American Medical Informatics Association, 27(6), 957-962.
https://doi.org/10.1093/jamia/ocaa067
