Man Up? Understanding Sexual Distress and Functioning Problems After Childhood Sexual Abuse in Men

Childhood sexual abuse (CSA) can have enduring consequences for sexual well-being, yet research on adult sexual distress and functioning has focused predominantly on women. A specific focus on men is needed because masculine expectations of strength, control, and sexual competence may shape how male survivors interpret both victimization and subsequent sexual difficulties. This study examined whether CSA is associated with sexual distress and sexual functioning among men, and whether these associations are moderated by masculine discrepancy stress and intrusiveness during sex. A cross-sectional sample of 586 adult men with a history of CSA completed validated self-report measures assessing all constructs. Hierarchical ordinary least squares regressions were conducted while adjusting for demographic and abuse-related characteristics. CSA severity was initially associated with greater sexual distress and functioning problems, but these associations were no longer significant after accounting for masculine discrepancy stress and intrusiveness during sex. Intrusiveness during sex was consistently associated with both greater sexual distress and more functioning problems, whereas masculine discrepancy stress was independently associated only with sexual distress. Masculine discrepancy stress moderated the association between intrusiveness and functioning problems: contrary to expectations, this association weakened as discrepancy stress increased. No comparable interaction emerged for sexual distress. These findings suggest that men's sexual difficulties following CSA cannot be understood solely as direct consequences of abuse severity. Gender-sensitive, trauma-informed interventions should address both trauma-related experiences during sexual activity and the masculine meanings through which survivors understand their sexual well-being.