“Destroyed from Within” Sexual Violence against Men and Boys in Syria and Turkey

Country Report by All Survivors Project, The Williams Institute and UCLA School of Law Health and Human Rights Project.

Acronyms

3RP – Regional Refugee and Resilience Plan in response to the Syria crisis
AFAD – Afet ve Acil Durum Yönetimi Başkanlığı/Disasters and Emergency Management Presidency (Turkey)
ASP – All Survivors Project
CAAFAG – Children Associated with Armed Forces and Armed Groups
CMR – Clinical Management of Rape
COFEM – Coalition of Feminists for Social Change
COI – International Independent Commission of Inquiry on the Syrian Arab Republic
CP – Child protection
CRSV – Conflict-related sexual violence
CVT – Centre for Victims of Torture
DGMM – Directorate General of Migration Management (Turkey)
DRC – Danish Refugee Council
FSA – Free Syrian Army (Syria)
FTR – Family tracing and reunification
HNO – Humanitarian Needs Overview
HRP – Humanitarian Response Planning
HRW – Human Rights Watch
HTS – Hayat Tahrir al Sham / Organization for the Liberation of the Levant (Syria)
IASC – Inter-Agency Standing Committee
ICC – International Criminal Court
ICRC – International Committee of the Red Cross
IDPs – Internally Displaced Persons
IIIM – International, Impartial and Independent Mechanism (to Assist in the Investigation and Prosecution of Persons Responsible for the Most Serious Crimes under International Law Committed in the Syrian Arab Republic since March 2011)
ILO – International Labour Organization IMC International Medical Corps
INGO – International non-governmental organisation
IOM – International Organization for Migration
IRC – International Rescue Committee
ISIL – Islamic State of Iraq and the Levant (an armed group)
LGBT+ – Lesbian, gay, bisexual, transgender and inclusive of other sexual and gender minorities
MHPSS – Mental Health and Psychosocial Support
MOFSP – Ministry of Family and Social Policy (Turkey)
MOSAL – Ministry of Social Affairs and Labour (Syria)
MRM – Monitoring and Reporting Mechanism on grave violations committed against children in times of armed conflict
NATO – North Atlantic Treaty Organization
NGO – Non-governmental organisation
PSS – Psychosocial support
PTSD – Post-traumatic stress disorder
SDF – Syrian Democratic Forces (a coalition of forces fighting ISIL primarily made up of the YPG)
SJAC – Syrian Justice and Accountability Centre
STIs – Sexually-transmitted infections
SOGI – Sexual orientation and gender identity
SOP – Standard Operating Procedure
TP ID – Temporary Protection Identification (Turkey)
UASC – Unaccompanied and separated children
UN – United Nations
UNFPA – United Nations Population Fund
UNHCR – United Nations High Commissioner for Refugees
UNICEF – United Nations Children’s Fund
UNOCHA – United Nations Office for the Coordination of Humanitarian Affairs
UN OHCHR – United Nations Office of the High Commissioner on Human Rights
UN SC – United Nations Security Council
UN SG – United Nations Secretary-General
WoS – Whole of Syria
YPG – Yekîneyên Parastina Gel/People›s Protection Unit (Syria)

Executive summary

The armed conflict in Syria has resulted in a human rights and humanitarian crisis of staggering proportions in which the civilian population suffers daily threats to life, dignity and wellbeing. Humanitarian needs far outstrip the capacity to respond, and access to aid is routinely denied by all sides. The conflict has also given rise to massive internal displacement and an unprecedented refugee crisis in which millions of people have fled the country. Turkey hosts by far the greatest number of refugees from Syria, at just over 3.5 million people, or 63.3% of registered refugees from Syria in the region.

Conflict-related sexual violence is among the many human rights violations that have characterised the armed conflict in Syria. While remaining a devestating problem for women and girls, sexual violence against men and boys has also been documented by the UN and by international and national non-governmental organisations (I/NGOs). Previous research has also revealed the ongoing risk of sexual violence to men and boys and to specific groups such as LBGT+ people as they flee Syria and in countries of asylum.

Research by All Survivors Project (ASP) for this report was conducted with the aim of deepening existing knowledge of patterns and vulnerabilities of men and boys to conflict-related sexual violence in Syria and exploring risks and vulnerabilities to sexual violence of men and boys fleeing from Syria to Turkey, both during the journey to and within Turkey itself. It also sought to gather the views from key stakeholders on the extent to which sexual violence against men and boys is factored into strategies, plans and programmes to prevent sexual violence and respond to the needs of survivors in Syria and Turkey, and to consider how these responses can be strengthened.

The research was conducted between September 2017 and July 2018 and involved a review of publicly available literature and interviews with 66 key informants which were conducted face-toface during a field mission to Turkey in September 2017 or remotely by phone or Skype. Informants included representatives from UN agencies working on protection, child protection, and genderbased violence (GBV); experts in medical, mental health and psychosocial support (MHPSS) working with national and international NGOs or independently; human rights defenders; LBGT+ activists; and academic researchers.

Many ASP informants believed that sexual violence against men and boys in Syria was more prevalent than has previously been documented and that the vulnerabilities of men and boys to sexual violence there are insufficiently understood. Their accounts also underscored continuing risks to men and boys who, far from finding safety when they flee from Syria, have also been subjected to sexual violence at the Syria/Turkey border and within Turkey itself.

Of the 66 informants interviewed by ASP, more than 60% were able to relate specific incidents of sexual violence against men and boys that had taken place in Syria. Consistent with existing documentation, almost all of those interviewed considered Syrian government detention to be the site of greatest risk of sexual violence for men and boys, although some also recounted incidents that had taken place in armed group detention. Interviewees also referred to cases of sexual violence that had occurred during house searches or at checkpoints and during forced recruitment by armed groups. However, informants also spoke of other risks that arise from or have been exacerbated by the armed conflict in Syria and the way in which civilian actors, including employers, family and community members, have been able to exploit the breakdown of law and order and of formal and informal protection mechanisms to commit acts of sexual violence.

ASP informants particularly emphasised the vulnerability of adolescent boys in Syria. They spoke about widespread rape and other forms of sexual violence against boys in Syrian government detention. In the words of one, “age is no barrier: from children to young men are targeted. There is a pattern that young men in their late teens or early twenties are specifically targeted although it can happen to everybody”. There was also significant concern about wider risks to boys of sexual violence arising from their gender-specific roles or expectations of them, including boys who are recruited and used as child soldiers or engaged in child labour. Concerns were raised about the lack of detailed information on the experience of boys and the need for further research into their vulnerability to sexual violence in these and other contexts. Likewise, gender minorities or those perceived as gender non-conforming were considered to be particularly vulnerable to sexual violence in Syria and in need of particular attention.

Although ASP’s primary research focus was on Syria, information gathered reinforced concerns about the risk of sexual violence to men and boys from Syria as they attempt to flee to Turkey. Interviewees spoke about the difficulty of crossing the border and of physical violence including of a sexual nature by Turkish border guards and smugglers. In one case, a humanitarian worker told ASP that they had provided support to a man who had been raped by four men involved in smuggling people from Syria into Turkey.

Within Turkey, the precarious legal, economic and social situation of many refugees and the lack of effective protection mechanisms contribute to an environment in which men and boys from Syria are vulnerable to sexual violence. This includes the context of child labour and the workplace, where men and boys have reportedly faced sexual exploitation and violence from employers; in refugee camps; in orphanages; in public spaces; and at home, where there are reports of sexual violence by members of the host community, landlords, neighbours and family members. Concerns were also raised about sexual harassment and violence against LBGT+ people from Syria.

Whether sexual violence occurred in Syria or Turkey, ASP interviewees attested to the devastating consequences for male survivors, their families and communities. They described physical injuries, and the short- and long-term psychological impacts on survivors including shame, loss of confidence, sleep disorders, feelings of powerlessness, confusion and suicidal thoughts. Feelings of emasculation and self-blame were also common issues, which were attributed to cultural norms and expectations of the roles of men and boys, including their role in protecting themselves and their families. Discriminatory laws, prejudice against LBGT+ people, rigid gender norms, and misunderstandings of sexual violence against males, was also seen as contributing to survivors being perceived as homosexual and of creating fear and anxiety among survivors about their own sexual orientation or identity. Interviewees also spoke of repercussions for relationships with spouses, families and communities, and of the stigma, blame, disbelief, mistrust and rejection suffered by survivors.

“It is completely destroying for men. If it becomes known that this man [was subjected to sexual violence], it means that this man has to leave this community [and go] where nobody knows that he has been sexually abused.”^[1]

For men and boys who have suffered sexual violence as part of wider torture and ill-treatment in detention the consequences can be particularly severe and long-lasting when untreated. Information provided by ASP informants also suggests a complex narrative in which male detainees are treated as heroes on their release (in contrast to female detainees, who are socially stigmatised), but at the same time the reality of the sexual violence that has been experienced by many former detainees is ignored or treated as a source of shame to be silenced and denied.

“For the men they celebrate when he comes out. They do not know or will not assume that he has been raped. But at the same time he will not be able to adapt or will not be able to express what happened.”^[2]

Despite the apparently significant scale of sexual violence against men and boys in Syria and their continued vulnerability as they flee across borders and in countries of asylum including Turkey, ASP’s research highlights the inadequacy of current responses to it.

Within Syria a combination aof factors facilitate sexual violence against men and boys and contribute to the de facto impunity for those responsible. These include the lack of protection against rape for men and boys under Syrian law; the lack of access by independent monitors and humanitarian actors to places of detention; the lack of progress in agreeing to action plans to end and prevent grave violations against children, including sexual violence, with UN “listed” state security forces and non-state armed groups; and the lack of criminal prosecutions of those responsible.

At the same time, information provided by ASP interviewees also revealed a lack of a proactive or systematic effort to provide care and support for male survivors of sexual violence in Syria. Although child protection services appear better developed than other sectors and offer some possibility of support to boys who have experienced sexual violence, overall ASP informants described a situation of structural exclusion of male survivors from accessing timely, quality, safe, confidential, survivorcentred assistance and support.

“These cases are not dealt with inside Syria, there are no organisations that take care of them and men don’t talk.”^[3]

Although there has been significant investment in strengthening capacity for the Clinical Management of Rape (CMR), there remain significant gaps in geographical coverage of medical services for survivors of sexual violence. Concerns remain raised about the quality of medical services and the lack of referral systems for male survivors. It was also evident that, while routes to accessing support exist for women and children through women and girls’ safe spaces, community centres and child protection programmes, there are currently no equivalents for adult males. The lack of MHPSS services for male survivors of sexual violence inside Syria was likewise regarded as a significant problem and there was particular concern about the total absence of capacity and skills needed to provide the highly specialised and individually tailored interventions needed to support victims of sexual torture, many of whom are men and boys.

There exist significant external obstacles to providing humanitarian assistance to male survivors of sexual violence in the face of so many acute and competing needs and in the complex and dangerous operating environment that exists in Syria. However, they also highlighted many issues within the humanitarian community that contribute to the exclusion of male survivors, particularly adult men, from services. Key among the “internal barriers” highlighted by ASP informants was a lack of acknowledgement that sexual violence can affect men and boys as well as women and girls. As a result, men and boys are largely overlooked in policy and planning discussions which in turn translates into a lack of outreach to and specific services for male survivors and an absence of entry points for them in existing services. Stereotypical ideas of masculinity were also seen as reinforcing perceptions among humanitarian workers that men can look after themselves and do not need help, and/or of men as perpetrators rather than victims.

Linked to a lack of acknowledgement is insufficient investment in organisational capacity building and staff training. Many interviewees spoke about a lack of expertise on sexual violence against men and boys within their own organisations, their partner organisations and in the humanitarian community more generally. Although some training is reportedly being rolled out which is said to include modules on case management of male survivors of sexual violence, there was criticism of the lack of attention to men and boys in existing training packages. It was also noted that, in addition to skills training, there is a need to challenge negative attitudes towards sexual violence against men and boys among humanitarian workers and to tackle cultural barriers which, according to interviewees, permeate much of the humanitarian community.

The lack of leadership within the humanitarian community on the issue of sexual violence against men and boys was also highlighted as undermining action and co-ordination. While a general problem, the lack of leadership was seen as having particular implications for men, who fall outside programs designed for women and children and for male survivors (both men and boys) of sexual torture in detention settings. Comments by some informants suggested confusion and tensions around the respective roles of human rights and humanitarian actors in protecting persons in detention and providing services and support to former detainees who have been subjected to sexual violence.

 Lack of funding was seen as a fundamental obstacle to addressing sexual violence against men and boys. Notwithstanding significant shortfalls in the overall Syria appeal, interviewees noted the need for dedicated funding for responses to sexual violence against men and boys in order that funds are not diverted from much-needed programmes for women and girls.

Many of these same barriers to responding to the needs of male survivors in Syria also exist in Turkey, although a range of country-specific issues exist as well. Notwithstanding the significant pressure on public services created by the high numbers of refugees hosted by Turkey, and the efforts that have been made by the government to support refugees from Syria and elsewhere, the overall picture is one in which access to medical, MHPSS and other necessary support for male survivors is distressingly limited.

Many reasons were cited by interviewees for this situation: those who are not officially registered for Temporary Protection in Turkey do not qualify to receive services and support; there are huge difficulties and sensitivities involved in identifying male survivors among the Syrian refugee population in Turkey; there is insufficient knowledge among service providers in Turkey about the experiences of men and boys who have been detained in Syria and who may therefore be survivors of sexual violence; and finally, the lack of legal protection for sexual minorities in Turkey and more general intolerance and discrimination, creates specific barriers to accessing support for LBGT+ people among the Syrian refugee community. Language barriers faced by Arabic speakers from Syria in Turkey can prevent them from reporting sexual violence and accessing support. As was the case in Syria, MHPSS services lack specialists for survivors of torture, including sexual torture, although efforts are underway to build NGO capacity to provide these services for refugees and migrants in Turkey.

Relative to Syria, Turkey’s legislative framework provides legal protection for men and boys against sexual violence. However, there was little confidence among informants of the capacity of the Turkish legal system to deliver justice to male survivors of sexual violence. They spoke of a lack of sensitivity to male survivors by the police, judges, prosecutors and other judicial officials. Fear of negative responses and lack of action in response to complaints were seen as particularly prevalent concerns among LBGT+ refugees.

ASP informants made many recommendations about how responses to sexual violence against males could be strengthened in both Syria and Turkey. ASP has elaborated on these recommendations based on fundamental human rights norms and principles, and ASP’s analysis of information and its experience of working on sexual violence against males in other situations of armed conflict. A summary of these recommendations is provided below; further recommendations on achieving each objective are provided at the end of the main report.

Summary recommendations on Syria

• Humanitarian and human rights stakeholders working in/on Syria should consider ways in which data on patterns of sexual violence against men and boys in Syria and the needs of survivors can be safely gathered and anonymously shared among them in order to support the development of a common analysis of risks, patterns and prevalence of sexual violence against men and boys.
• Coordinated strategies should be developed and implemented by human rights, humanitarian and other relevant stakeholders to prevent sexual violence against men and boys in Syria. Priorities should include the amendment of national laws to provide legal protection for men and boys and decriminalisation of homosexuality, independent monitoring of all government and non-state armed group detention facilities in Syria, and high-level engagement with state armed forces and armed groups listed in the UN Secretary-General’s Annual Report on Children and armed conflict for committing sexual violence and other grave violations of the rights of children to agree action plans to end and prevent such violations.
• The humanitarian community should intensify efforts to ensure that free, quality and confidential medical care is available to all survivors of sexual violence, including men and boys in all regions of the country.
• The humanitarian community should invest in ensuring that appropriate MHPSS is available to all survivors of sexual violence including men and boys. Gender-competent, genderspecific and age appropriate services for men and boys should be included in strategies and plans for the development of MHPSS in Syria and capacity built to deliver specialised, longterm mental health support for survivors of sexual torture.
• International efforts to ensure the right to remedy of victims of human rights violations in Syria should be intensified and conflict-related sexual violence against men and boys should be addressed in justice processes, including criminal trials, truth-seeking processes and reparations.

Summary recommendations to the Turkish government and organisations working in Turkey

• The Turkish government and human rights, humanitarian and other relevant stakeholders should work together to develop and implement co-ordinated strategies to prevent sexual violence against men and boy refugees from Syria in Turkey.
• Government, UN and I/NGO strategies and plans for the provision of medical care and MHPSS to all refugees from Syria in Turkey, regardless of whether or not they are officially registered, should include appropriate support to male survivors of sexual violence.
• Allegations of sexual violence against refugees from Syria (and elsewhere) in Turkey should be promptly investigated and where there is sufficient evidence, perpetrators held to account.

Summary general recommendations

• The UN should clarify sectoral responsibility for responding to sexual violence against men and boys and develop co-ordinated, inter-sectoral responses to it.
• Humanitarian organisations should invest in increasing their capacity and that of their partners in Syria and Turkey to respond to sexual violence against men and boys and should ensure that the issue is included in strategies, plans and programme design.
• The humanitarian community, where possible working with national authorities, should design and implement strategies aimed at sensitizing and building awareness among communities within Syria and Turkey to the issue of sexual violence against men and boys as a way to reduce stigma and remove other barriers to reporting and disclosure by survivors.
• Donors should make funding available for programmes to support responses to male survivors of sexual violence and also use their position to ensure that sexual violence against men and boys forms an integral part of all relevant responses. Funding for men and boys should be additional; that is, it should not simply be moved from much needed funding for women and girls.

Background and Introduction

“Since its inception, sexual and gender-based violence has been a devastating feature of the Syrian conflict… If any political and reconciliation efforts are to succeed, survivors must obtain justice and reparation, and be provided with adequate psychosocial support.” ^[4]

The armed conflict in Syria has resulted in a human rights and humanitarian crisis of staggering proportions in which the civilian population suffers daily threats to life, dignity and wellbeing. Parties to the conflict have systematically flouted international norms and standards designed to limit the impact of hostilities on the civilian population, and repeated calls for accountability have been ignored. As the crisis continues into its eighth year, humanitarian needs far outstrip the capacity to respond and aid is routinely denied, leaving millions of people without food, medicines and other vital supplies and with little or no access to basic services including medical care.

The crisis, which began with anti-government protests in March 2011, has since escalated into a highly complex and fast-moving armed conflict involving multiple armed actors including Syrian government security forces and associated armed groups, numerous armed opposition groups, and an array of international actors including Iran, Israel, Russia, Turkey, and the USA and its NATO allies.

The conflict has given rise to massive internal displacement and a refugee crisis in the region. More than 6.6 million people have been internally displaced within Syria and more than 5.6 million people have fled the country.^[5] The vast majority of those who have fled are residing in neighbouring countries including Jordan, Lebanon and Turkey, with the latter hosting more than 3.5 million people, or 63.3% of registered refugees from Syria in the region.^[6]

Conflict-related sexual violence is among the many grave violations of human rights that have characterised the conflict and remains one of the drivers of displacement. While remaining a devastating problems for women and girls, sexual violence against men and boys has also been documented by the UN and by NGOs. Reports by UN human rights experts and agencies and international and national NGOs paint a picture in which sexual violence is routinely used as a form of torture against men and boys detained by Syrian security forces. It has also been documented in other settings such as at checkpoints, during home raids and in public spaces, both by state security forces and non-state armed groups. Certain categories, in particular LBGT+) people, are recognised as being highly vulnerable to sexual victimisation.^[7] Other studies have focused on the ongoing risk of sexual violence to men and boys as they flee Syria and in countries of asylum.^[8]

Research by ASP for this report was conducted with the aim of deepening existing knowledge of patterns and vulnerabilities of men and boys to conflict-related sexual violence in Syria and further exploring risks and vulnerabilities to sexual violence of men and boys fleeing from Syria to Turkey, both during the journey to and within Turkey itself. The research also sought to gather views of key stakeholders on the extent to which conflict-related sexual violence against men and boys is factored into human rights and humanitarian responses in Syria and Turkey and how these responses could be strengthened to prevent such violations from occurring and to better address the needs of male survivors.

Methodology

This report is based on research conducted between September 2017 and July 2018, which involved a review of publicly available literature, and semi-structured interviews with 66 key informants working inside Syria, cross-border from Turkey, and within Turkey itself. Interviewees included representatives of UN agencies working on protection, including child protection, and genderbased violence; experts in medical care, mental health and MHPSS, and LBGT+ issues, either working with national or international NGOs or independently; human rights experts; and academic researchers. Interviews with 17 informants were conducted in person during a seven-day field mission to the Turkish cities of Istanbul and Gaziantep in September 2017. Others were interviewed by phone or Skype. All interviews were conducted in English by ASP researchers or in Arabic with interpretation provided by a local interpreter. ASP shared key findings with the Ministry of Health, Ministry of Family and Social Policies, Directorate General of Migration Management (DGMM) and AFAD, Prime Ministry Disaster & Emergency Management Authority, and requested written responses to questions. However, by publication, ASP had not received a response.

Due to the security situation in Syria, ASP was unable to travel to the country and meet directly with informants there. This inevitably resulted in certain limitations to the research, although ASP was able to conduct interviews remotely with six individuals based in Syria by phone or Skype and also spoke to 14 informants working cross-border in Syria from Turkey and Jordan. Patterns of displacement and challenges in identifying interviewees in Syrian government-held areas who were willing to be interviewed meant that informants were disproportionally from opposition-held areas. ASP recognises that this creates the possibility that information, particularly in relation to incidents of sexual violence, may be biased more heavily towards violations perpetrated by Syrian government security forces. However, it also notes that many of the findings in this report are consistent with previous research by the UN and I/NGOs. ASP did not interview survivors of sexual violence and this report therefore does not contain first-hand accounts of sexual violence. However, it does include examples of incidents described by interviewees based on cases of which they had knowledge either through their work or through their personal relations. Personal details including names, precise locations and other identifying information about incidents of sexual violence are not included in this report to ensure the confidentiality of survivors, their families and witnesses and to protect them against possible repercussions. Likewise, the interviewees quoted in this report are given generic professional titles to protect their identities. ASP has also respected requests for anonymity by some interviewees, in which case they are referred to simply as a “confidential source”.

All research was conducted in accordance with Institutional Review Board (IRB) approvals obtained through the University of California, Los Angeles (UCLA) School of Law and in line with IRB ethical guidelines.^[9]

Patterns of and vulnerabilities to sexual violence in Syria

“All the disclosed cases are nothing compared to the reality of what is happening.” ^[10]

Conflict-related sexual violence against men and boys in Syria has been documented to some extent. However, the true scale of the problem remains largely unknown, and understanding of the risks and vulnerabilities of men and boys to this crime is limited. While ASP’s research was not intended to establish the prevalence of sexual violence against men and boys in Syria, it found significant knowledge about the issue among humanitarian, human rights and other actors. Added to what has been previously reported, this awareness could significantly help to inform responses.

Syria is among the most challenging situations in the world for human rights monitoring and reporting. This makes it all the more difficult to obtain a complete picture of sexual violence in general, and against men and boys in particular. The Syrian government continues to deny access to the country to UN human rights agencies and experts, including the Office of the High Commissioner for Human Rights (OHCHR) and to the Independent International Commission of Inquiry on the Syrian Arab Republic (COI). The latter was established by the UN Human Rights Council in 2011 to investigate all alleged violations of international human rights law in Syria.^[11] Access to areas held by some armed groups is extremely restricted or simply denied. Ongoing insecurity makes it difficult for human rights I/NGOs, academic researchers and activists to conduct research in conflict-affected areas, and Syrian human rights defenders face arbitrary arrest, unlawful killings and enforced disappearance by both government and armed opposition groups.^[12]

The humanitarian community also faces significant obstacles in gathering data. Humanitarian assessments and evaluations that are necessary to establish the vulnerabilities and needs of the population and to inform programme priorities and design are hampered, including by restrictions on access, insecurity and political interference. There are particular sensitivities involved in gathering data on sexual violence, including social taboos, shame and stigma related to the issue, which creates additional challenges. Contrary to many other situations of armed conflict, a Gender-Based Violence Information Management System (GBVIMS) has not been established in Syria, thereby limiting the ability of humanitarian organisations to collect, pool and analyse data on patterns and trends of gender-based violence, including sexual violence.^[13]

Given such challenges, it is unsurprising that many ASP informants believed that sexual violence against men and boys in Syria is more prevalent than has so far been documented or reported. Indeed, of the 66 informants interviewed by ASP, 40 (around 60%) were aware of incidents in which men and boys had been subjected to sexual violence in Syria. Some had direct experience of providing medical and other humanitarian support to male survivors or were involved in documenting incidents for human rights purposes. Many others had heard of incidents directly from survivors whom they knew personally or indirectly via friends, family or colleagues. In some cases, informants had directly witnessed sexual violence involving men or boys.

Consistent with existing documentation, most interviewees considered Syrian government detention to be the site of greatest risk of sexual violence for men and boys. Some also described incidents that had occurred during house searches or at checkpoints. When asked about vulnerabilities, informants thought that boys were particularly at risk of sexual violence. They identified particular situations of risk for boys which they felt should be a priority for further research and action. In particular, the situation of boys in government detention, boys engaged in child labour, boys associated with armed forces or armed groups, and boys who are unaccompanied or separated from their families. Gender minorities or those perceived as gender non-conforming were also considered by informants to be particularly vulnerable and therefore in need of further attention.

Also consistent with existing documentation, ASP interviewees referred to perpetrators as being from the state security forces, in particular Military and Air Force Intelligence branches of the security forces and associated militias, as well as, although to a lesser extent, from non-state armed groups.^[14] However, ASP informants were also concerned about sexual violence committed by non-armed actors who, although not directly party to the armed conflict, are able to exploit the breakdown of the rule of law and of formal and informal protection mechanisms to sexually victimise men and boys. In this regard they spoke of risks posed by civilian actors including family and community members and employers.

Sexual violence in Syrian government detention

The use of rape and other forms of sexual violence and physical torture against detainees held by Syrian government security forces and associated militias is well established. According to OHCHR, individuals held by government forces are routinely subjected to physical violence, including sexual violence amounting to torture.^[15] Investigations by the COI have found that torture, including sexualised torture, has been used against thousands of people in detention including men and boys as young as 11 years old, at a level that amounts to war crimes and crimes against humanity.^[16] UN Secretary-General reports on conflict-related sexual violence also refer to systematic sexual torture of men in detention centres.^[17] The UN-led Monitoring and Reporting Mechanism for Syria on grave violations against children in situations of armed conflict has also verified incidents in which both boys and girls have been subjected to torture, including rape, threats of rape and other forms of sexual violence to force “confessions”, to humiliate, or to pressure a relative to surrender or confess.^[18]

While it is not possible to put a figure on the number of men and boys who have been subjected to sexual violence in government detention since the start of the armed conflict, it is possible that it could run into many hundreds, if not thousands, given the large number of people who have been detained and the apparently widespread nature of sexual violence in government detention facilities.^[19] Several ASP informants, including two who had themselves been detained in Syria, emphasised the widespread nature of sexual violence in government detention:

“Anyone who is detained has heard about it [sexual violence], seen it or been a victim… It is a hierarchical decision to systematically perpetrate… Forced nudity, jokes, making fun – everyone experiences this.” Programme manager, Syrian NGO, 29 September 2017.

“If you talk about sexual violence… there is no one who goes into detention without this happening to him… Sexual violence was mainly in detention [and was] systematic. All the survivors, men and women, are subjected to forced nudity… One of the main forms of torture of males is with an electric stick which is used on the sexual organs.” Representative of a Syrian human rights NGO, 1 November 2017.

“Everyone [suffers] verbal sexual harassment, almost everybody. [They say] ‘we will fuck you’, threaten rape towards them or their families, female family members. They say we will do this or that to you, bad things for you.” Confidential INGO source, 24 September 2017.

ASP interviewees referred to various forms of sexual violence experienced by men and boys in government detention, including anal rape with the penis or with objects (including bottles, metal objects, sticks and other objects), perpetrated by members of the Syrian security forces and male prison guards, as well as threats of rape against both detainees and their female relatives, being forced to rape or witness the rape of female relatives or fellow detainees (male and female), electric shocks to the genitals, beatings of the genitals and genital mutilation, forced and extended periods of nudity in some cases lasting many weeks or even months, and other forms of physical and psychological violence of a sexual nature.

Some informants provided detailed accounts of the experience of friends or relatives who had been detained. For example, a Syrian NGO worker described the experience of his uncle who was arrested by Syrian government security forces in 2015. The informant told ASP that his uncle was released after three months but he was unrecognisable, having lost more than 30kg and appearing to have aged considerably. He saw scars on his body including what looked like burn marks on his thigh. When he asked what had happened his uncle started to cry and explained that he and his fellow detainees were kept naked at all times and that he was forced to lie naked on the ground in the snow for an extended period. He also told his nephew about other violence, including of a sexual nature, to which he had been subjected:

“After one or two weeks he started to talk. [He told me that] they put something like a pen or some metal in his back, in his arse, and he was so old and he was feeling pain and they were laughing, and they did many times, and also they gave him electric shocks to his penis. They did this once a day for two or three hours… There was a lot of physical violence. When they took him to [location omitted] it was freezing, I remember that day it was 10 degrees below zero, it was so freezing, they took him and told him to go play in the snow.”

The same NGO worker described another incident in which he had received a telephone call from his best friend pleading with him to help his brother who was under guard in a hospital. The NGO worker explained his shock when he saw his friend’s brother: “When I went inside I swear, I swear, I swear, I saw him on the bed, he’s a tall, thin man, but when I saw him he was [badly injured], they put handcuffs on the bed with his hands. When he saw me he began to cry.”

According to this account, the young man had been arrested from his place of work several weeks earlier by Syrian security forces. He was held in different places before being taken to a private apartment where he was ordered at gunpoint to rape a girl who had been brought into the room where he was held. When he refused he was forced to the ground and held down by six or seven security guards while his genitals were kicked and squeezed until he fell unconscious. After his release, he fled the country but has since told the NGO worker of his recurring nightmares about the girl: “He said that he saw her face, he can’t forgot… She was moving alone, no one was pushing her, but he said she was like a robot.”^[20]

A Syrian psychiatrist described having met a 40-year-old man who had been raped with an unspecified object when he was himself detained in 2014 in a Syrian government Military Intelligence facility. According to the psychiatrist, “he was in so much pain, what could I do? I think he was feeling humiliated, what with being raped and so on, he said it felt like a bottle, but his eyes were covered. All of us [had our eyes covered] when we were tortured”.^[21]

Several interviewees also described incidents in which male detainees had been forced to watch female relatives and fellow male and female detainees being raped as part of a wider pattern of torture used to generate fear, obtain information, force confessions or coerce relatives into surrendering.

A human rights researcher related an incident from 2013 in which a man from a city in the southwest of Syria was accused of supporting the opposition. He was forced to watch his wife and daughter being raped by two security officials in a Military Intelligence detention facility. According to the man’s wife, who was interviewed by the researcher, her husband was handcuffed and each time he closed his eyes they were forced open by the guards. She said that he later died under torture. The researcher also referred to a pattern of abuse in which detainees are forced to watch other men being raped, to generate fear. According to the researcher: “Generally, sexual violence happens in front of other detainees just to spread fear and to get information more easily.”^[22]

A gender-based violence programme manager working for a Syrian NGO recounted an incident in which her organisation had assisted a woman who had been raped. The rape was carried out in front of her husband in a detention facility in Damascus, in or around 2015, to pressure him into giving the names of his associates in an armed opposition group. The same NGO worker also spoke of another client who was in a “state of trauma”, having seen a young man being repeatedly raped and electric shocks applied to his genitals. According to the interviewee, male and female detainees are generally kept apart but are sometimes brought into the same room to witness violence against others as a means of creating fear.^[23]

Another interviewee, the representative of a Syrian human rights NGO, spoke about the way in which sexual violence is used to punish people, and also highlighted an incident in which there appeared to be a sectarian element to the crime. He described the case of a military officer whose wife and sister were raped in front of him as a punishment for him having defected from the government security forces sometime after 2012. He also related another incident in which Sunni women were raped in front of Sunni men. The informant explained that, although they were strangers, their captors assumed that they would regard each other as sister and brother because of their shared religious affiliation: “[T]hey say I will rape your sister, I will ejaculate on you, Sunnis deserve that.”^[24]

Sexual violence by Syrian security forces and associated groups in non-detention settings

Independent human rights investigators have regularly reported incidents of sexual violence against men and boys at checkpoints and during house raids by Syrian security forces and associated armed groups.^[25] Several ASP interviewees also referred to such incidents:

“Sometimes government [security forces] enter a house and start to rape the father in front of the family to… harm him mentally. When I was in Syria the daughters, when they come to the centre, they talked about their father being raped in front of them.” Mental health worker, INGO, 3 November 2017.

“I know from one of my friends in an area under the control of the regime militia, [they] entered his house, they found him alone, they raped him, but they didn’t arrest him. My friend talked about this incident and I advised him to go to one doctor or psychologist… This happened in the middle of 2015.” Protection co-ordinator, Syrian NGO, 22 September 2017.

“[We have] some cases of sexual violence at checkpoints… and at home in front of his kids and his wife, including beating the genitals and forced nudity. At home they usually try their best to humiliate the guy.” Representative of a Syrian human rights NGO, 1 November 2017.

“I had three cases [of men] who were abused by government police – men in their homes. [In one case] the wife was telling the story about her husband – the government army entered the house and in front of the family they started to have sex with him, in front of the whole family.” Mental health worker, INGO, 3 November 2017.

Sexual violence by non-state armed groups in Syria

According to the COI, the pattern of sexual violence by non-state armed groups differs from that of government security forces. Its investigations have found no evidence of a systematic practice or policy on the part of armed groups to use sexual violence to instil fear or extract information, but it has documented sexual violence that appears to be motivated by exploitation, religious affiliation and revenge. Most of these incidents involve women and girls. However, a few documented cases have involved males, including men and boys being raped while held in detention by the group Al-Nusra Front,^[26] and the torture of male detainees by Syrian Democratic Forces (SDF), including the burning of, and threats to burn, the genitals. The COI has also concluded that the treatment of sexual minorities in Syria by the armed group calling itself Islamic State in Iraq and the Levant (ISIL) constituted the crime against humanity of persecution.^[27]

ASP informants also spoke about incidents of sexual violence against men and boys involving nonstate armed groups. Although several had encountered survivors during the course of their work, most of the incidents described were anecdotal or otherwise unverified. The reported incidents took place in different situations including in detention, at checkpoints, and as a tactic of forced recruitment (see also “Boys associated with armed forces and armed groups” below). Some of the incidents described appear exploitative in nature which are addressed in the section on sexual violence against boys below.

Four informants spoke about rape and other forms of sexual violence of men or boys in ISIL detention. A human rights researcher described a case from August or September 2015 in which a non-Syrian ISIL commander allegedly raped 12 boys who were detained in a city in eastern Aleppo. According to the researcher, the same commander had also raped boys who had been recruited by the group as child soldiers.^[28] Another interviewee spoke of a friend who had been captured by ISIL because he was working for the foreign media. He was held for two months in a cell where he claimed to have witnessed another man being subjected to sexual violence: “His friend in the cell was treated really badly sexually, until this day he still remembers how his private parts were harmed.”^[29]

A mental health specialist also referred to incidents of rape in the context of forced recruitment by ISIL: “I’ve heard from men [boys] as young as 17 that they have been raped and been videoed being raped [and] if they do not join they are threatened that the video will be posted online. I have heard this consistently over the years since 2013 until 2017. I know five [males] whom I spoke to personally to whom this had happened… they say that the perpetrators wanted to shame them into joining.”^[30]

One informant referred to the use of sexual violence against detainees held by other non-state armed groups, notably Ahrar al-Sham, Jaysh el Islam and Al-Rahman Corps. According to the interviewee, such incidents included beatings on the genitals and verbal threats of sexual violence.^[31] Another referred to an incident in Manbij following its takeover by SDF forces in 2016, in which a boy was taken out of his cell by a prison guard who was intoxicated at the time. When the boy returned he was crying and reportedly told his cellmate that he had been raped.^[32] There was also a reference to the rape of a family of three – one man and two women – at a checkpoint by an unknown nonstate armed group in 2013. According to the informant, who was the case worker for the survivors, the incident occurred as they were travelling from Damascus city to the surrounding countryside to take advantage of a suspension of hostilities to check on their property which they had been forced to flee. During their journey to their home, the man, his mother and his sister were stopped and accused of being Shi’a spies and then raped before being released.^[33]

Sexual violence against boys in Syria

UN assessments have found that the exposure of boys and girls to grave violations of their rights and other forms of violence in Syria increases as they transition into adolescence and, as is the case with adults, there is also a distinct gender-dimension to the nature of the risks and vulnerabilities. Adolescent girls are regarded as being particularly at risk of early marriage and other forms of gender-based violence, while adolescent boys are more likely than girls and younger boys to be killed and injured, detained, recruited by parties to the conflict, or involved in child labour.^[34] Adolescent girls were perceived by communities assessed by the 2018 Syria Humanitarian Needs Overview as being at the highest risk of sexual violence, followed by adolescent boys, although threats to younger girls and boys were also seen to exist.^[35]

Many ASP informants considered that the gender-specific roles and expectations of boys contributes to their vulnerability to sexual violence. For example, boys are more likely than girls to be detained, to be associated with armed forces or armed groups, and involved in hazardous and other forms of child labour outside of the home where the risk of sexual violence may be heightened. Although much of the information on boys was based on observations and unsubstantiated reports rather than documented cases, responses by interviewees suggest the need for further exploration of the risks and vulnerabilities to boys in these and other contexts.

Boys in Syrian government detention

ASP informants spoke about rape and other forms of sexual violence against boys in Syrian government detention. According to one, “age is no barrier: from children to young men are targeted. There is a pattern that young men in their late teens or early twenties are specifically targeted although it can happen to everybody”.^[36]

This comment is consistent with UN reporting, which showed that in the early years of the conflict children were among those arrested in large-scale arrest campaigns. Reasons for their arrest included their or their relatives’ actual or alleged participation in demonstrations or support of opposition groups. UN reporting showed that they were subjected to acts that amount to torture including rape or threats of rape, electric shocks to the genitals and other forms of sexual violence.^[37] The UN has continued to document the arbitrary detention and ill-treatment of boys by government security forces. For example, it reported that, in 2017, 72 children were detained by Syrian government forces (46 boys and 26 girls) for their alleged association with armed groups. At least 38 of these children were reported to have been subjected to torture and/or other ill-treatment, including in some cases rape, during their detention.^[38]

One interviewee, who was detained four times between 2011 and 2014, spoke about a 13-year-old boy he had encountered in 2012 in an Air Force Intelligence detention facility. The boy, who was being held to pressure his father to turn himself into the authorities, had been raped by a member of the security services. He said that the boy told him about bleeding to his anus and sometimes asked for advice on how to manage his injuries. The informant witnessed the boy being tortured by being hung from his hands. He remembered that the boy “sometimes screamed when he was sleeping but he spoke so little about what happened”.^[39]

Several informants had professional experience of working with boys who had experienced sexual violence in Syrian government detention. A mental health expert recalled an eight-year-old boy from Syria to whom she had provided support and counselling in Lebanon. The boy’s captors had pulled out his finger nails and electrocuted his genitals to force him to tell them where his father was hiding.^[40] A Syrian NGO worker spoke about a 17-year-old boy she had encountered who had been arrested by the Syrian government security forces in Damascus and held for four years. According to the NGO worker, “he is now impotent on account of being continually raped anally. He was often unconscious due to the rapes and was taken to doctors and provided medicines. The rapes continued after he recovered. He now lives within armed group-controlled territory because he feels safer there. He has joined the armed group”.^[41] Another informant referred to the case of a teenage boy who had come to his organisation for support: “He told me, he was tortured by electricity on the penis more than once, in 2012 or 2013… They hit him for sure. He was participating in media, publishing things against the government.” ^[42]

Boys associated with armed forces and armed groups

Informants raised concerns about the vulnerability of boys associated with armed forces and armed groups, in particular in the context of forced recruitment and use of children by ISIL and other jihadist groups.^[43]

“Some jihadi groups used boys for recruitment and they send them to training, and of course we heard stories of sexual violence during recruitment and after recruitment.” Programme manager, Syrian NGO, 18 September 2017.

“In opposition areas there are some people who came from outside Syria… and there are some who come on purpose who try to find young Syrian boys to enrol in their militia and while they are in that militia they abuse them. They use drugs in the tea and this makes them consent… these boys get disoriented when they take the big dose of that substance and even they have some sphincter relaxation so they won’t feel the pain” Syrian psychiatrist, Syrian NGO, 19 September 2017.

“In Syria the problem is that ISIL were targeting ethnic and religious minorities. We have a lot of reports on how boys were forced to be sex slaves; it is a kind of humiliation for them.” Manager, humanitarian organisation, 21 September 2017.

One informant expressed concern that sexual violence against children associated with armed forces and armed groups is not being systematically monitored or documented.^[44] However, it was also noted that there are significant challenges to gathering data on sexual violence and other grave violations against children inside Syria. Additionally, because children who are released from fighting forces are not screened for sexual violence during post-release assessments, there is currently no reliable data on the extent of the problem of sexual violence against children associated with armed forces and armed groups.^[45]

Boys involved in child labour and in other situations of risk in Syria

Boys engaged in work outside the home, including the worst forms of child labour, may be at increased risk of sexual violence, exploitation or abuse.^[46] The problem of child labour in Syria existed before the conflict, but has been greatly exacerbated by it, including because of diminishing livelihood opportunities, increased levels of impoverishment, the loss of family breadwinners, and displacement. As a result, many children have been forced into economic activities that are mentally, physically or socially harmful. ^[47] As one interviewee noted: “That change within the household and the family structure is a real driver of vulnerabilities.” ^[48]

UN data indicates that boys are the most affected by child labour: 81% of communities assessed for the 2018 Syria Humanitarian Needs Overview felt that adolescent boys between 15 and 17 years were the most affected, followed by boys between the ages of 12 to 14 years (77% of communities) and then adolescent girls (70% of communities). Boys are also more likely to be involved in labour outside of the home including hazardous labour such as goods smuggling, operating heavy machinery in factories and workshops, working as blacksmiths, in oil refineries, begging and scavenging, and other types of work that are classified by the ILO as the worst forms of child labour.^[49] One informant referred to boys subjected to sexual exploitation in exchange for food or money, although within Syria this practice has been mainly documented in relation to women and girls. Several also referred to sexual exploitation of boys by armed groups, community members or criminal gangs:

“Poverty… pushes boys to leave home and spend most of their time outside the home so they will be at risk. In most of the cases [that I know] it was for money, they pay them money and then they have sex with them. Sometimes a shop keeper will give the boy something for free and then he practices sexual violence against him.” Programme manager, Syrian NGO, 18 September 2017.

“I remember one time I was walking from the office to my place in east Aleppo. I saw a little boy dragging a big container of water and I saw a man who whistled for him and he entered a building…When the child didn’t appear I went inside the building. I saw the man trying to abuse him, the child was very close to his private parts and the man was holding his head. I shouted very loud, everybody came from the building and the neighbourhood, the man who was abusing the child disappeared.” Programme manager, Syrian NGO, 10 October 2017.

“In areas under regime control there are Shabiha, these are gangs, they are trading in everything… abuse medicines, alcohol, they run the sex industry, they are like mafia. These people are trying to use the youngsters, males or females, especially those who are very vulnerable like Iraqi refugees.” Syrian psychiatrist, Syrian NGO, 19 September 2017.

Informants highlighted categories of children whom they believe to be at risk of sexual violence, including unaccompanied or separated boys and girls and children with disabilities. Specific situations of heightened risk for both boys and girls raised by interviewees included internal displacement settings. A protection co-ordinator with a Syrian NGO providing medical and mental health services described an incident in which an eight-year-old boy was raped by a man in a camp for internally displaced people (IDPs) in southern Syria in July 2017. He was treated by the organisation for physical injuries to the anal canal. Both the boy and his family were being provided with psychosocial support at the time of the interview. This interviewee and others expressed concern that conditions in IDP camps contribute to a situation where children are at risk: “[Y]ou know about the camps inside Syria, they are not organised for the CCCM [Camp Co-ordination and Camp Management] clusters, no one cares about dignity or privacy in these camps.”^[50]

Sexual violence against LBGT+ and other gender non-conforming people

ASP interviewees spoke about human rights abuses against LBGT+ people by armed actors and highlighted broader problems of harassment, discrimination and violence against them by their families and communities. This is consistent with previous research, which has highlighted the increased vulnerability of LBGT+ persons to sexual violence in Syria as a result of the armed conflict. Yet the conflict has merely exacerbated a pre-existing problem of discrimination and persecution against LBGT+ people. Syria’s laws de facto criminalise same-sex sexual relations, while social, cultural and religious attitudes create a hostile environment towards individuals who do not conform with accepted gender norms.^[51]

According to a lawyer working on LBGT+ rights in Turkey: “In Syria there are reasons that don’t have anything to do with war, we have heard about this kind of violence from childhood, but sometimes it can be also be related to the war. It can be in the form of threats of detention or during detention there can be sexual violence. But… there doesn’t have to be a reason, in Syria now it is a very complicated issue, because they are a target of every group.”^[52]

Nevertheless, UN investigators and human rights organisations have documented serious human rights violations against LBGT+ persons that are specifically related to the conflict, including cases of summary execution, arbitrary detention, torture, rape and other forms of sexual violence, as well as harassment, discrimination and exploitation of men and women because of their sexual orientation and gender identity, both by Syrian government security forces and non-state armed groups.^[53]

A representative of an NGO working on LBGT+ rights in Turkey with refugees from Syria and elsewhere highlighted the vulnerability of LBGT+ persons to blackmailing, including for sex. The informant cited the example of a transgender woman (a woman assigned male sex at birth) who was living in a government-controlled area but had to cross into armed group-controlled territory each day to go to school: “[T]here was somebody who was associated with the rebel group who blackmailed her for sex. She had to cross that every day, she quit school, if she didn’t have sex then they would [expose her gender identity].”^[54] Another interviewee told ASP about an 11-year-old boy who was sexually molested by members of ISIL as a form of punishment for having long hair and was therefore considered to be homosexual based on his appearance.^[55]

Vulnerabilities of men and boys to sexual violence in Turkey

Sexual violence against men and boys during flight to Turkey

Turkey hosts more refugees from Syria than any other country in the world. While officially maintaining an “open door policy”, in practice the border with Syria has become increasingly strictly managed since 2015/16 and is now effectively closed.^[56] According to UNHCR, the UN refugee agency, Turkey continues to grant admission on humanitarian grounds, for example for medical emergencies. However, ASP was informed that survivors of sexual violence would not be considered to constitute a medical emergency. In practice, most people who flee Syria have little choice but to use unsafe and irregular routes which expose them to multiple dangers.^[57]

Even before entry into Turkey became so restricted, there were reports of violence and mistreatment including sexual violence and sexual humiliation of refugees from Syria at the Turkish border. For example, in 2014 Amnesty International reported 10 separate incidents that occurred between November 2013 and August 2014 at different locations on the Syria/Turkey border in which 31 people were beaten and some humiliated – including being stripped naked, urinated upon, or made to crawl like an animal. According to Amnesty International, adult men who were not travelling in the company of family members appeared to have been particularly targeted.^[58] More recently, there have been reports of men who have been captured trying to cross the border being forced to wear women’s underwear as a form of humiliation.^[59] ASP interviewees in Turkey spoke about the difficulty of crossing the border and described illtreatment of refugees by Turkish border guards and smugglers. One humanitarian worker with an INGO told ASP that her organisation had provided support to two men who had been subjected to sexual violence as they fled Syria for Turkey. In one of the cases, a man from Syria was raped by four men involved in smuggling people across the border.^[60]

Another source raised concern about the sexual exploitation of boys, especially unaccompanied and separated boys, in return for money to pay the cost of being smuggled across borders. She told ASP: “[M]en and boys… usually young boys who sell their bodies in order to make it forward, this is true all around the region, this is true especially from those who are fleeing from Turkey to Greece, this is one way that young minors and unaccompanied minors pay for their journey, they do it out of desperation.”^[61]

Sexual violence against men and boys from Syria in Turkey

ASP interviewees identified a range of different situations in which they consider male refugees from Syria to be at risk of sexual violence in Turkey. These include the workplace, where some men and boys have reportedly faced sexual exploitation or violence from employers. Interviewees also raised concerns over the lack of effective protection mechanisms and the way in which this contributes to the vulnerability of boys, in particular in refugee camps, orphanages, public spaces and at home. In the latter, there are reports of sexual violence by members of the host community, landlords, neighbours and family members. Concerns were also raised about sexual harassment and violence against LBGT+ people from Syria.

Sexual violence in workplace settings

The situation for many refugees from Syria in Turkey is precarious, with more than 64% of refugee households outside of camps living below the poverty line, according to the UN.^[62] The Turkish government has taken steps to increase self-reliance among refugees from Syria including through the introduction in January 2016 of the Regulation on Work Permits of Refugees under Temporary Protection. Recipients of Temporary Protection permits are in theory able to work legally in Turkey subject to quotas and restrictions.^[63] However, in reality even those with permits face significant challenges in accessing formal employment, and many continue to work illegally. In the meantime, poverty continues to force boys and girls from Syria into child labour in Turkey.^[64]

In this context, ASP interviewees highlighted the vulnerability of men and boys to sexual violence and exploitation in the workplace, and several provided specific examples. One described an incident in which a man from Syria had been pressured into having sex by the owner of the factory where he worked in return for money. According to the source, the man lost his job because he refused.^[65]

Representatives from another INGO told ASP that they had provided support to nine boys who had suffered sexual violence in the workplace. One described the case of “a 13 year-old boy, who was subjected to sexual violence in his workplace by the Turkish owner and another man. They were raping him and threatening him that if he tells anyone they will kill him”.^[66] Another interviewee had heard indirectly of cases of sexual victimisation of child labourers: “[M]y friend is working in factories and told me about incidents of sexual violence against boys. The perpetrators are not only Turkish people but are also Syrians. It is not only factories: mechanical workshops, tailoring workshops”. ^[67]

Sexual violence against refugee boys in camps

Several sources working with I/NGOs expressed concern about the lack of protection in refugee camps in Turkey, which held almost 215,000 Syrian refugees as of June 2018.^[68] According to one, it is the most vulnerable who live in camps, the ones “without qualifications, unaccompanied children and vulnerable widows,” adding that “[w]e are kind of blind about what is going on in the camps”.^[69]

Although ASP received some information on incidents of sexual violence against Syrian refugee children in camps in Turkey, it was not able to establish the extent of the problem. However, one case that reached public attention and which points to serious protection concerns was that of a Turkish cleaner who was convicted of the sexual abuse or rape of 30 Syrian boys in a camp in Nizip in the southeast of Turkey in late 2015/early 2016. According to media reports, the perpetrator was sentenced to 108 years’ imprisonment in June 2016, having confessed to sexually abusing the boys, who were between the ages of eight and 12, in return for a small amount of money.^[70] Following the trial, the Turkish Grand National Assembly was requested by an opposition party to establish a parliamentary inquiry to investigate allegations of sexual violence in all refugee camps and to determine accountability for them.^[71] To ASP’s knowledge, the request was still pending at the time of writing.

Other vulnerabilities of men and boys to sexual violence in Turkey

Other situations in which boys from Syria have been subjected to, or may be vulnerable to, sexual harassment or violence in Turkey were also highlighted by informants. Several related accounts of sexual violence against young teenage boys in parks and other public spaces, either by other refugees or by members of the host community, in which the boys were forced to give oral sex or to watch sexually explicit videos.^[72] One informant referred to a case involving a 13-year-old boy who was raped by a Turkish man as he made his way to work. “He was going to work early in the morning when the streets were empty, so the Turkish man stopped him and raped him”.^[73]

Informants also spoke about incidents in which young boys had been subjected to sexual abuse in their homes by family members, neighbours or landlords.^[74] One highlighted the vulnerability of children in alternative care, having provided support to a 12-year-old boy from Syria who had been referred because he was suffering from epileptic seizures, and who later revealed that he had been touched sexually by a volunteer in the orphanage in which he was living.

The vulnerability of LBGT+ people from Syria to sexual violence in Turkey was highlighted by some interviewees within a broader context of discrimination against LBGT+ and other gender nonconforming persons in Turkey.^[75] They described incidents involving harassment, verbal abuse, threats, physical attacks and blackmail against LBGT+ persons from Syria by relatives and by members of the broader Syrian and Turkish community. According to one: “LGBT people are at risk of sexual violence. They are not wanted in the community. People think they deserve anything. Some hate LGBT people because they think it is not God’s order so they have to be punished.”^[76]

Impacts and perceptions of sexual violence against men and boys

“The level of invasion caused by sexual assault is difficult to match because it goes to the most private, core identity of a person.”^[77]

Physical and psychological impacts of sexual violence on men and boys

Male survivors of sexual violence may have suffered a range of physical injuries, both genital and non-genital. They are at increased risk of sexually transmitted infections (STIs) including HIV, and can also experience incontinence, problems urinating or defecating, genital and rectal trauma and pain, fistulas and fissures, impairment and damage to reproductive capacity or sexual dysfunction.^[78]

In its March 2018 report on sexual violence in Syria, the COI found that survivors of particularly violent rapes including rape by multiple perpetrators, and rape with objects, often sustained severe physical injuries that were often untreated, because treatment was denied to them in the context of detention or because of lack of adequate health care in areas in which they live.^[79] Research by UNHCR on sexual violence among Syrian refugee communities in Jordan, Lebanon and the Kurdistan Region of Iraq found that the most frequently reported physical consequence among male survivors was rectal trauma resulting in significant pain due to sexual violence with the use of an object.^[80] In their work or elsewhere, ASP interviewees likewise referred to having encountered male survivors suffering from genital and rectal injuries, rectal bleeding, faecal bleeding, and severe pain including when urinating and defecating.

The mental health consequences of sexual violence are recognised as being equally serious and long-lasting and can include, among other things, psychological distress, depression, post-traumatic stress disorder (PTSD), panic, difficulties with intimate relations, social withdrawal, and inability to engage in particular livelihoods.^[81]

ASP’s sources reported a wide range of psychological consequences for male survivors, including symptoms of PTSD, shame, self blaming, guilt, anger, loss of confidence, sleep disorders, confusion, self harm and suicidal thoughts. According to one mental health professional: “The biggest impact is this overwhelming sense of shame, and that can turn into all sorts of things. It can turn into depression, feeling disgusted, not being able to function, not feeling like a man anymore. It could be transformed into anger, aggression, [as they] try to prove their manhood, showing they are still in charge, with that feeling of powerlessness there is a possibility for it to turn outward, there is more of the possibility of men needing to overcompensate for feelings of powerlessness and shame to over-assert their masculinity.”^[82]

Feelings of emasculation, powerlessness and failure were also common themes mentioned by interviewees in relation to male survivors. They attributed these feelings to cultural and gender norms and expectations of the roles of men and boys including their role in protecting themselves and their families. They also highlighted the negative impacts of being forced to witness female relatives and other women and girls being subjected to sexual violence:

“The male survivors blame themselves a lot, [they experience] fear, loss of self-confidence, avoidance, sometimes [they report] nervousness, sleep problems and nightmares.” INGO mental health worker, 3 November 2017.

“I think that men exposed to sexual violence [for them]… it is even more difficult because they are supposed to be strong, supposed to be men, there are so many things attached to being a man and being strong, recognising that you are a victim would be an extra barrier.” Confidential source, INGO, 2 November 2017.

“A man who suffered sexual violence would be completely de-manned and emasculated in the eyes of the community” Protection co-ordinator, INGO, 8 October 2017.

“For men especially who were forced to watch or hear other females being raped… they expressed these feelings of ‘I’m not a man’, ‘I wasn’t able to save or protect her or stop it’. It created that feeling of emasculation.” Confidential source, INGO, 11 October 2017.

Discriminatory laws, prejudice against LBGT+ people, rigid gender norms, and misunderstandings of sexual violence against males, its dynamics and its impacts can also result in survivors being viewed as weak and feed fears among survivors about their own sexual orientation or identity. According to one interviewee: “They have this idea that if a man is raped he will become gay.”^[83]

Another explained the way in which perpetrator and victim are viewed differently in Syrian society: “They consider as homosexual the person who has been penetrated and not the person who penetrates, [so] they can use it [rape] as a weapon. If you are a soldier and you [commit] rape, your manhood is not debated. It is the other one [the victim] who is considered a homosexual.”^[84]

The impact of sexual torture

For men and boys who have suffered sexual violence as part of wider torture and other ill-treatment in detention the consequences can be particularly severe and long-lasting. The Center for Victims of Torture (CVT) has described rape, by its very nature, as being a particularly traumatic form of torture. Others have also documented wide-ranging negative psychological, familial, social and economic impacts on male survivors of sexual torture in Syria.^[85]

ASP informants referred to survivors of sexual torture who are now impotent and who suffer intrusive memories during sexual intercourse. A psychologist recalled patients who, “are not able to remove themselves from the memory of being raped, and [when having intercourse with their wives] suddenly they feel like the violator”. Some male survivors had described becoming violent or fearing that they would become violent towards their partner as a result. The same informant, who works with torture/sexual violence survivors in the region, described how many of her male patients from Syria “are alone, they have lost their whole family when I meet them, some of them are entirely hopeless and suicidal”. She noted that others try to reconstruct a sense of masculinity by marrying and having children, but noted that this can also bring its own challenges.^[86]

Information provided by ASP interviewees also suggests a complex narrative in which male detainees are treated as heroes on their release, but at the same time the reality of the experience of sexual violence is ignored or treated as a source of shame that should be denied or not spoken of. A mental health professional interviewed by ASP described the contrasting narratives relating to men and women in which female detainees are assumed to have been subjected to sexual violence and are ostracised because they are automatically considered to have been dishonoured. Whereas for men “they are the freedom fighters, they are fighting for a noble cause, [they have] suffered for a noble cause, there is a difference and it is less likely that men will be rejected”. However, the interviewee also explained that at some level it is probably known that they could have been raped or otherwise sexually violated, “but it’s not talked about, nobody is comfortable talking about it including activists or people that have been in detention”.^[87] Another spoke about the same dynamic: “For the men they celebrate when he comes out. They do not know or will not assume that he has been raped. But at the same time he will not be able to adapt or will not be able to express what happened.”^[88]

Social consequences of sexual violence on male survivors

“Such an act is so humiliating that… [survivors] would try to hide from people… they want to be invisible or hidden… would never be involved in public life… would try to shun or avoid gathering because he is destroyed from within.” Protection Coordinator, International NGO, 8 October 2017.

Sources spoke of repercussions for survivors’ relationships with spouses, families and communities and of the stigma, blame, disbelief, mistrust and ostracism suffered by survivors. One described how a 17-year-old boy who was tortured, including with rape, in detention “was socially withdrawn and didn’t want to meet anybody, he was so shy, feeling shameful”.^[89] Other interviewees explained the negative reactions from those around them:

“It is completely destroying for men. If it becomes known that this man [was subjected to sexual violence], it means that this man has to leave this community [and go] where nobody knows that he has been sexually abused.” Programme manager, INGO, 7 October 2017.

“They are rejected, this is something that ruins them. If it is known that he is subjected to sexual violence he will leave the area, he will never be respected.” Syrian psychiatrist, Syrian NGO, 19 September 2017.

“They are not treated as a victim, they are treated as a criminal. They are blamed, their families talk to him in bad way: ‘What did you do? Why did you do this?’ There is the feeling that they did not fight the person off.” Confidential source, 21 and 26 September 2017.

Although victims experience many harmful psychological impacts of sexual violence, ASP’s research also revealed the resilience of many survivors and positive examples of support from family and friends. Interviewees pointed to the ways in which survivors have found healthy ways of coping with trauma, are able to engage in positive relationships with family and friends, play active roles within their communities, and have found fulfilling employment. In the words of one: “I’ve been astonished in the last six years by people’s resilience. It’s stunning. I have seen a lot of cases, I think that there are hundreds of boys and men [who have been] sexually abused, raped, traumatised, or their family has been slaughtered… they are functioning better than me.”^[90]

Exacerbated impacts among refugees from Syria

Existing research has found that conditions of flight and prolonged refugee situations have detrimental mental health impacts and that pre-existing conditions are exacerbated by the experience of flight and the difficulties faced in countries of asylum.^[91] Mental health professionals interviewed by ASP described additional challenges faced by male survivors of sexual violence who have been forced to flee Syria. According to one: “It’s so dehumanizing, there is a lot of shock that this could happen to them, it’s something that takes a long time to recover from particularly because they are often refugees in a setting that further emasculates them, not being able to work, you can do therapy all you want but [it is difficult] if there are no concrete ways of how to regain that.”^[92]

LBGT+ people can face additional challenges having fled extreme insecurity in Syria only to face discrimination and the threat of violence in Turkey.^[93] Sources spoke about the impact of attacks on them and the adoption of adaptive behaviours to try and stay safe. However, these behaviours can severely restrict their lives and their ability to work and to seek support.

“After they suffer abuse, LGBTI men hide in their homes. They are forced to change the way they dress, behave and where they live. They can be killed – it is as dangerous as that.” Confidential source, Turkish NGO, 19 September 2017.

“Housing is hard because it’s hard for them to find a way where they can live their true self in a safe situation, whether they are living with family or friends, it’s hard to find a situation where they can live safely.” LBGT+ activist, Turkish NGO, 15 September 2017.

Preventing sexual violence against men and boys in Syria

Under Syrian law there is no legal protection against rape for men and boys. Article 489 of the Syrian Penal Code addresses rape and sexual assault in such a way that females are recognised as the only possible victims of sexual violence, while males are recognised only as perpetrators.^[94] Lack of protection under national law undoubtedly contributes to the facilitation of sexual violence against males. However, it is also fuelled by a lack of respect of international human rights and humanitarian law by parties to the armed conflict, lack of co-operation with international mechanisms and processes aimed at promoting and protecting human rights, and the impunity enjoyed by state security forces and non-state armed groups.

Lack of monitoring access to places of detention

Given that Syrian government detention is widely seen as being the site of the highest risk of sexual violence to men and boys, the lack of access by independent monitors and humanitarian actors to places of detention is of particular concern. Last year, the UN High Commissioner for Human Rights decried that fact that “no international human rights observers had been admitted to places where, very probably, tens of thousands of people were being held and where torture was taking place”.^[95] The International Committee of the Red Cross (ICRC), whose mandate to protect and assist victims of armed conflict and other situations of violence includes securing humane treatment and detention conditions for detainees, has only very limited access to Syrian government detention facilities.^[96]

Interviewees referred to ongoing efforts by UN agencies and humanitarian actors to obtain Interviewees referred to ongoing efforts by UN agencies and humanitarian actors to obtain access to government detention facilities, but according to one, “it is difficult to talk confidently about any level of success”.^[97] Another noted that “[e]ven asking about detainees could be sensitive”.^[98]

Others raised concern about potential risks of humanitarian support to prisoners being perceived as condoning an unlawful system of detention.^[99] In the case of access to detention facilities controlled by some non-state armed groups, concern was also raised about the security of humanitarian workers and the potential risk that they could be detained or subjected to other human rights abuses as a result of efforts to engage with such groups.^[100]

The need to agree action plans to prevent and end sexual violence against children

Engaging with armed actors to prevent and end grave violations against children has proved equally challenging. Government forces, including the National Defence Forces and pro-government militias, along with ISIL, have been “listed” by the UN Secretary-General for having committed rape and other forms of sexual violence against children and are among a total of seven parties to the conflict in Syria that have also been listed for the military recruitment and use of children, and other grave violations against children.^[101] Once listed, groups are required to agree with the UN action plans on measures that will be taken to prevent and end the abuses for which they have been listed. However, so far there has been no tangible progress towards agreeing plans. According to one source, “this is a massive stumbling block – there is a lack of leadership on this issue”.^[102] Other sources attributed the lack of progress to other reasons including the non-co-operation of the Syrian government, the fragmentation of armed groups, lack of direct access by the UN to opposition-held areas, and insecurity.

Total impunity: A need to hold perpetrators to account

The COI has concluded that rape and other acts of sexual violence, in particular when perpetrated against detainees by Syrian government forces and affiliated militias, constitute war crimes and crimes against humanity. The COI has also concluded that acts of sexual violence by non-state armed groups also constitute war crimes as well as violations of international human rights and humanitarian law.^[103] There have been repeated calls for the Syrian authorities to investigate and prosecute members of state security forces for committing acts of rape and sexual violence; for non-state armed groups to take urgent measures to discipline or dismiss individuals under their command responsible for such acts; and for the international community to refer the situation to the International Criminal Court (ICC), an ad hoc tribunal or another independent, impartial justice mechanism.^[104] To date, however, no case of sexual violence committed by any party to the armed conflict has been prosecuted either in Syria or abroad.

“Nobody now inside Syria believes that the law can protect them or [that] there is an authority or legal body that they can refer to. They don’t think about the future, they think that there is no need to document these accidents [sexual violence]. Very few people understand the necessity to do so.” Programme manager, Syrian NGO, 10 October 2017.

“We are not able to send cases to court. In reality there are no courts, these places are just under the control of certain individuals and they refuse [to listen] to such stories.” Gender-based violence case manager, Syrian NGO, 18 September 2017.

Syria is party to international human rights treaties that require it to take measures to prevent sexual violence and hold perpetrators to account, yet it was evident from early in the conflict that a lack of political will and shortcomings in the judicial framework make genuine, independent prosecutions unrealistic.^[105] Interviewees spoke about the lack of confidence in the Syrian justice system. According to one:

 “In Syria you can never prosecute anyone belonging to the military or intelligence, [or] you can do so only through military courts, and if you think of suing someone there you will probably end up dead before the case is filed… there is no way that people can be prosecuted for what they have done.” Protection co-ordinator, INGO, 8 October 2017.

In the long term, transitional justice arrangements should include assistance to strengthen the capacity, independence, impartiality and effectiveness of the Syrian national justice system. However, in the short term, justice must be pursued elsewhere. Because Syria is not a party to the Rome Statute of the ICC, and because the UN Security Council has been unable to agree that the situation of Syria should be referred to the Court, the ICC option is currently blocked.^[106] Hopes for justice therefore currently rest primarily with the UN General Assembly mandated mechanism, the International, Impartial and Independent Mechanism on Syria (IIIM), whose role it is to collect and preserve evidence and to support criminal proceedings in national, regional or international courts.^[107] The IIIM’s mandate reflects the expectation that sexual and gender-based crimes, as well as crimes against children, will receive special attention. In line with this, commitments have been made to the recruitment and training of specialised staff to address barriers to prosecuting such crimes.^[108] Although no specific reference is made to sexual violence against men and boys, ASP hopes that this will be addressed as part of its work.

Cases being pursued by other states under the principle of universal jurisdiction also provide opportunities for investigating and prosecuting allegations of sexual violence against men and boys, with or without the support of the IIIM, although they have not done so to date.^[109]

Responding to the humanitarian needs of male survivors of sexual violence in Syria

“These cases are not dealt with inside Syria, there are no organisations that take care of them and men don’t talk.” Gender-based violence case manager, Syrian NGO, 18 September 2017.

Capacity for medical and mental health care for survivors of sexual violence in Syria was already limited before the conflict but has been severely degraded in the past seven years. In the absence of national capacity, the humanitarian community is left to respond, but ASP sources spoke about the enormous external obstacles they face in addressing the acute and competing needs in the complex and dangerous operating environment that exists in Syria.

In additional to external challenges, interviewees also highlighted many internal issues within the humanitarian community that contribute to the lack of a proactive or systematic effort to provide medical and psychosocial care for male survivors of sexual violence. Although child protection services appear better developed than other sectors and offer some possibility of support, at least in some locations within Syria, to boys who have experienced sexual violence, ASP sources overall described a situation of structural exclusion of male survivors from accessing timely, quality, safe, confidential, survivor-centred assistance and support. The reasons for this are multiple and complex, but many interviewees attributed it to the way in which sexual violence against men and boys is understood and addressed by the humanitarian community. Lack of leadership, capacity and funding were among the reasons cited for the insufficient attention to the needs of male survivors, but a lack of acknowledgement and even denial of the phenomenon was widely regarded as being at the root of the problem.

Barriers to providing services for male survivors of sexual violence

External challenges

Sources spoke of the multiple external challenges involved both in establishing the needs of male survivors and providing services to them. Among these is the fast moving and constantly changing situation in the country. In the words of one interviewee, “the problem is that services are not keeping up as the situation changes”. Restrictions on humanitarian access and insecurity compound this difficulty, with many sources raising concerns about the security of their staff and facilities. In the words of one interviewee: “As an organisation we are not protected so we are very careful not to have any problems with any side or individuals… there is a kind of disorder… lots of individuals have weapons, if you do something they don’t like then they can do something to you… We are not protected well, it is difficult for us to deal with these cases, our organisation told us not to go deeper.”^[110]

In government-controlled areas, restrictions on humanitarian organisations and interference in their work was raised as a particular obstacle. Several sources spoke about the challenges involved in conducting independent needs assessments in general and of the difficulties involved in gathering data on sexual violence specifically. Other interviewees described the sensitivities involved in protection work and the constraints this imposes. According to one: “Sensitivities are so high that even protection services are called ‘social services’, and protection monitoring is called ‘community assessment’.”^[111] Another explained: “In government-controlled areas, everything that is related to protection is followed and framed and controlled and the government wants to know exactly what you are doing, who you are going to target.”^[112]

Internal barriers

Lack of acknowledgement of sexual violence against men and boys

Informants described how the primary focus on women and girls results in men and boys being overlooked in policy and planning discussions. This translates into lack of outreach to and specific services for male survivors, and an absence of entry points for them to access existing services. According to a protection expert with one INGO: “There is an assumption in Syria that women and girls are more vulnerable to GBV [gender-based violence]… No attempts have been made to assess risks and vulnerabilities of males to sexual violence. There is a bit of bias when it comes to GBV, there is a high focus on women and girls but a gap in terms of data collection [on men and boys].”^[113] Other interviewees raised similar concerns:

“I haven’t heard anything specific for men and boys within the work that is being done at the cluster and hub level. I have never heard them mention a specific initiative on men and boys.” Confidential source, INGO, 2 November 2017.

“All the clusters and working groups concentrate on women and girls and actually I didn’t hear about any NGO or INGO raising any concerns about men and boys who have survived [sexual] violence… the mainstreaming approach talks about women and girls and no one talks about this issue.” Protection co-ordinator, Syrian NGO, 22 September 2017.

“The main challenge is that we have not tried to reach them… we have not been intentional enough… I am trying to remember all the cases I supervised and the programmes I have designed, for some reason we have never thought about men and boys as survivors.” Protection co-ordinator, INGO, 8 October 2017.

Stereotypical ideas of masculinity further reinforce views that men can look after themselves. According to one source, “conceptually, men are not seen as persons in need of help”.^[114] According to another, “[t]here is this attitude of ‘you’re a man you can deal with it,’ from both foreigners and local staff”.^[115] Another explained that men are often regarded by service providers as perpetrators rather than victims.^[116] An INGO representative told ASP that questions about sexual violence are often not even asked (even when it is on the assessment form) due to discomfort in discussing this issue by service providers.^[117] There was consensus among interviewees that such attitudes act as a barrier that prevents men and boys disclosing sexual violence against them and seeking help.

Limited organisational capacity and expertise

Many interviewees spoke about the lack of capacity and expertise on sexual violence against men and boys both within their own organisations, their partner organisations and in the humanitarian community more generally. A representative of a Syrian child protection NGO based in Turkey explained that their partner NGOs in Syria focus primarily on women and girls, but added: “I don’t think it is intentional that males are ignored, but it is not a specialised sector. We don’t have any male sexual or gender-based violence specialists.”^[118] The head of an INGO which specialises in child protection and gender-based violence likewise admitted that their staff “can manage for boys, but for men I don’t think we can manage. I know how to handle women and girls’ cases and boys but men survivors would pose a particular challenge”.^[119] Another INGO worker, said “it would be hard to find qualified staff to work on this specific issue”.^[120]

Building this capacity in Syria is particularly challenging where the UN and INGOs are not present in much of the country and are therefore required to work through local partners who may not have had previous experience of working on sexual violence, and whose training and support must be done remotely from cross-border hubs. According to one source, intensive training packages on gender-based violence for Syrian case workers working outside Syria are being rolled out in neighbouring countries. These include modules for the case management of male survivors of sexual violence.^[121] Nevertheless, several interviewees were critical of the lack of attention to men and boys in existing training and spoke of the need for dedicated training on sexual violence against men and boys. According to one Syrian NGO worker based in Turkey, there is “no training about men and boys. All the time the trainings focus on women and girls”.^[122]

It was also stressed that negative attitudes towards sexual violence against men and boys must be challenged and cultural barriers to speaking about the issue addressed. A gender-based violence expert with an INGO, who noted that most of their case workers are women, said: “[W]e equip our case workers, but there are certain limitations relating to cultural norms as well as capacity and confidence of case workers in providing support and speaking freely to male survivors… in a context where cultural and gender norms make it difficult to speak with men.”^[123] According to another: “A big challenge for us is that we need to do a lot more capacity-building within our staff for people to understand and have the comfort working with sexual violence in general and especially with men. There are staff who hold all the community and cultural assumptions who feel very uncomfortable asking the questions.”^[124]

Absence of leadership and co-ordination in responding to male survivors

In the same way that UNHCR’s research in Jordan, Lebanon and the Kurdistan Region of Iraq found there to be a lack of clarity on sectoral and institutional responsibility for sexual violence against men and boys,^[125] ASP interviewees also highlighted how the issue falls between the gaps in Syria. While this was regarded as a general problem, it was seen as having particular implications for responses to adult males and for male survivors of sexual torture in detention settings.

Responsibility for addressing sexual violence against boys rests with gender-based violence and child protection actors jointly. However, there is no clear lead on sexual violence against adult males, with the result that there is no organisation responsible for ensuring that their needs are considered up front in planning, fundraising and resource allocation or further down the line in programme design and implementation.

In relation to detainees, comments by some interviewees suggested confusion and tensions around the respective roles of human rights and humanitarian actors in protecting persons in detention and providing services and support to former detainees who have been subjected to sexual violence.

According to one interviewee, there is an assumption among some humanitarian workers that detention is a human rights issue and there is concern that working with human rights actors on the issue could affect their security and perceptions of their neutrality.^[126] According to another, the detention of opponents by the Syrian government is regarded by humanitarian stakeholders as a political issue, and consequently the human rights of detainees have not been sufficiently prioritised in their engagement with the Syrian authorities. ASP is not aware of any initiatives aimed at supporting male former detainees inside Syria who have been subjected to torture, including sexual violence.

Lack of funding

Lack of funding was considered by many sources to be a fundamental obstacle to addressing sexual violence against men and boys. The overall humanitarian response to the conflict had only received 31.1% of the required funds for the year as of July 2018, and the protection response had only received 10.1% of required funds.^[127]

Notwithstanding these shortfalls in the overall humanitarian appeal, interviewees noted the need for dedicated funding for responses to sexual violence against men and boys in order that funds are not diverted from much needed programmes for women and girls. The need for donors to be more aware of the issue and of appropriate responses to it was also noted by some. Interviewees working with survivors of sexual torture in particular stressed the need for support to provide long-term, indepth rehabilitation programmes for survivors of sexual torture and other traumatic forms of sexual violence but noted that this model is less attractive to donors because the intensive, one-on-one nature of the work means that beneficiary numbers are lower than more generalised psychosocial support programmes.

Designing services for male survivors of sexual violence

Other studies, including ASP’s research in other countries, indicate that good practice in design of services for sexual violence survivors should be gender inclusive and have the capacity and competency to respond to the specific needs of male survivors. While this can involve adapting and integrating services for men and boys into existing programmes, it may also require male-targeted services to be developed along with specific referral pathways towards gender-competent services with expertise and experience in responding to the particular needs of this group.

It is important that services, including medical care and MHPSS, ensure the confidentiality, safety and security of survivors of sexual violence. This can be achieved, for example, by ensuring that there are safe and confidential spaces for disclosure and treatment for male and female survivors, as well as discreet entry points to facilities and referral systems that enable survivors to access care and complementary services. Both female and male staff should be available to allow survivors the choice of who interviews and examines them, and all staff should be trained in the identification of survivors of sexual violence, including male survivors, and how to sensitively interview and examine them. All support services should be designed, where possible, with the direct involvement of survivors and the community to ensure maximum accessibility, acceptance and effectiveness.

Sources noted that safe spaces for women and girls, community centres and other gender-based violence programmes and activities are increasingly providing women and girl survivors of sexual violence with a route to accessing support in Syria.^[128] It was also noted that child protection programming including via schools and child friendly spaces can offer opportunities for the identification of younger survivors (see below).

However, many sources were concerned that there are currently no equivalent services for adult males. One humanitarian worker described how the lack of entry points for male survivors means that services end up being “non-inclusive by default”. She explained that, although her organisation has trained counsellors and medical professionals to whom they could refer men and boys, they have not received a single case. In her view, the lack of reported cases does not indicate an absence of survivors, but rather the need to be more creative in encouraging and enabling men and boys to come forward.^[129]

Other interviewees spoke about approaches that have been used or that they thought could be used to encourage disclosure and enable male survivors to access support, although it was also acknowledged that this is long-term work that involves building trust and changing attitudes:

“We need to create the healthy environment where people can express their problems and face their fears.” Syrian psychologist, NGO, 26 September 2017.

“It takes outreach strategies, building trust and eventually (people) will reveal.” Confidential source, INGO, 23 October 2017.

Approaches via communities and families are potentially useful. Some informants suggested that home visits could help to create awareness of services and reach men whom for reasons such as lack of work and fear of forcible conscription are spending the greater part of their days in the home. ^[130] A psychologist suggested children’s or parenting programmes as an entry point, noting that her contact with male survivors often results from having worked with their children through whom a relationship of trust has been built: “Fathers come because they see you with their children and they see you in their community; they will see whether you share other people’s stories… and then decide if they can trust you.” ^[131]

Several sources advocated for the establishment of safe spaces specifically for men where they can meet, talk and participate in joint activities and where trained social and psychosocial workers can be present, facilitate discussions and identify possible survivors. According to one Syrian NGO worker: “One has to create ‘men-friendly’ spaces to reach men. Inside community centres, you can find gyms or places where men feel comfortable and social workers can approach them.” ^[132] Another referred to a project that had established “shisha tents” for men to come together and smoke, where male social workers would spend time with them. She explained how the tent project “essentially became group therapy, but it wasn’t framed that way. We approached it that therapy starts with how you give people dignity, pride, laughter and humour and if people didn’t show up we could check in their tent and see how they were”.^[133]

Hospitals, health facilities and mental health services were also seen as being important first points of contact for male survivors, not only to seek care but also as places to disclose their experiences. According to one source with experience of working with male survivors from Syria: “I think they would be less likely to describe [their experiences] to a family and friend and more [likely] to a mental health professional, there is something that feels safer disclosing to someone who isn’t too close to their community. That’s where the role of mental health professionals comes in, there are boundaries, confidentiality, containment, a lot of time, trust.” ^[134] However, sources emphasised the need for training of medical and mental health professionals to identify male survivors.

In reality, a combination of different approaches is likely to be needed and detailed consultation, including with survivors themselves and communities at large, is required on what would be most appropriate and effective. In addition, and despite the strong emphasis on creating entry points for male survivors, interviewees spoke of the importance of the “do no harm” principle.^[135] In particular, it was noted that identifying survivors can put them at risk and that, unless safe referral pathways are in place, there is significant potential for harm.

In this regard, several sources raised concerns about the lack of referral systems for male survivors of sexual violence in Syria. According to one, efforts are being made to develop referral tools that would be applicable to both male and female survivors. These include an online form through which humanitarian organisations can request information on available services to which survivors can be referred; a database of referral services phone numbers for humanitarian organisations working with survivors; and a direct phone line for survivors to case workers trained in providing remote support. However, it was also acknowledged that far greater investment is needed in order to establish effective referral pathways for male survivors.

Concerns relating to medical care for male survivors of sexual violence in Syria

The 2018 Humanitarian Needs Overview for Syria describes access to health care in Syria as poor, especially in UN-declared besieged and hard-to-reach areas. More than half of public hospitals and health centres in the country are closed or are only partially functioning. There are critical shortages of staff and medical supplies, local health services are highly fragmented, and attacks on health facilities and health workers continue to weaken the system further. Referral systems for trauma and surgical services are insufficient and there is limited mobile capacity to reach displaced communities.^[136]

In this context, ASP noted that, despite significant investment in recent years in strengthening capacity for the clinical management of rape (CMR), there remain significant gaps in geographical coverage of medical services for survivors of sexual violence. According to one, medical care for survivors is “available in various pockets, but not in all areas”, while another described services as being “very piecemeal”.^[137]

CMR training to health professionals in Syria is provided by the “Health Cluster”, a group of I/NGO partners working in co-ordination with the gender-based violence Area of Responsibility, a broader group working under the auspices of the UN to strengthen gender-based violence programming in Syria. ASP was told that the CMR training includes a session on men and boys. However, several sources also explained that it is not known to what extent health facilities in Syria are able to provide emergency medical care in practice, including treatment and management of genital, anal and other injuries, or whether they are equipped with the necessary medication and other supplies such as post-exposure prophylaxis to prevent HIV infection, prophylaxis and treatment for STIs, and vaccinations against hepatitis B and tetanus.

A representative of an NGO providing frontline health care inside Syria described the challenges in locating appropriate, quality medical care for sexual violence survivors. For these patients: “I have to go to a surgeon or general doctor and this general doctor might not be trained and it might cause more harm.”^[138] Others raised concern about the quality of the care and several spoke about the challenges involved in remote monitoring of the quality of care from cross-border hubs.^[139]

Several interviewees also raised concerns about whether the confidentiality of patients is adequately respected in Syrian health facilities. According to one, the fear that their experience will become public knowledge deters male survivors from seeking medical care: “[Men and boys] are afraid to go to [health] centres… you know in Syria the workers are from the same community and I think this is one of the main challenges for them.”^[140]

A representative of an INGO explained that the issue of confidentiality is a broader problem: “You cannot guarantee either the confidentiality or the follow-up. If I imagine myself sending someone in need of health care to the hospital… if something happens and the doctor tells someone, the security [forces] will come. This system is very strong, you cannot imagine the pressure they [health providers] are under.”^[141]

International standards and guidelines on quality, free and confidential care for survivors of sexual violence

In line with international standards and guidance, all survivors of sexual violence should have access to quality, free and confidential health care services that are available 24 hours a day. Emergency medical care should include post-exposure prophylaxis to prevent HIV transmission where appropriate and referral to HIV services including for testing, prevention and counselling; complete physical and genito-anal examination; prevention and treatment of STIs, hepatitis and tetanus; treatment of injuries; and treatment and referral for life-threatening complications and surgical care.

Survivors, their spouses and others indirectly affected should also have access to appropriate psychosocial support to prevent and mitigate the mental health and social impacts of sexual violence, which can be just as damaging as physical harm and may be more longlasting. Livelihood support may also be needed in some cases, such as short-term income and housing support and longer-term assistance to re-establish the means of making a living. When needed, safe accommodation should be provided, and, in the case of minors, family tracing or alternative care arrangements put in place.

Quality care should be provided in a survivor-centred, equitable, non-discriminatory manner according to identifiable needs and regardless of gender, age, ethnicity, religion, sexual orientation, gender identity, ability, HIV status, socio-economic status and geographic location. An intersectional approach which examines and responds to vulnerabilities arising due to multiple aspects of a person’s identity is recommended. In the case of children, attention to their best interests by promoting and protecting safety is of utmost importance.

Humanitarian and state-provided services and programmes should be gender inclusive and have the capacity and competency to respond to the specific needs of male survivors. Services and programmes should be accessible to all survivors. Survivors should be provided with a free medical-legal certificate to support their pursuit of criminal cases against perpetrators and for the purposes of obtaining support of claiming asylum.

Services should be designed to be accessible to all survivors. For example, this can be implemented by ensuring that there are safe, confidential spaces for disclosure and treatment, and discreet entry points to facilities and referral systems within these spaces that enable survivors to access care confidentially without disclosing to multiple staff.^[142]

In addition, concerns were raised about requirements under Syrian law for the mandatory reporting by medical professionals and service providers of sexual violence to the Syrian police. According to sources, enforcement of the law differs from governorate to governorate and is more strictly applied in government-controlled areas. However, the policy discourages survivors of sexual violence from seeking medical care, as well as discouraging medical professionals from sharing information on the services that they provide and the patients they treat. As one source explained: “[P]artners don’t like reporting on CMR care… they just don’t want it on paper… the doctors don’t want to be identified and [required] to report [to the authorities].”^[143]

Gaps in MHPSS services for male survivors of sexual violence in Syria

The absence of specialist mental health services for survivors of sexual violence inside Syria was regarded by many interviewees as a significant problem. ^[144] As one UN protection expert noted, “there are huge gaps in mental health services”, and while there “are numerous teams trained to do psychological first aid and varying degrees of PSS [psychosocial support], the health cluster has identified a mental health gap”.^[145] According to another: “Mental health services are extremely limited across the country; most specialists left the country a long time ago. You don’t have a workforce [able to respond] to the needs.”^[146]

An INGO representative noted that their case workers are trained in psychosocial support but are not mental health professionals, and that they are only now beginning to recruit staff who will have specialist training.^[147] Particular concerns were raised by interviewees about the inadequacy of psychosocial support provided via gender-based violence or child protection programmes for survivors of sexual torture. According to one source, “when you experience sexual violence within torture, a specific response is needed. A normal child protection organisation or gender based violence organisation is not the best one to respond”.^[148] The same point was reinforced by an INGO protection expert, who explained to ASP that the organisation for which they work does a lot of psychosocial first aid but that “[i]t is difficult to move from generic activities to those which require specialisation and capacity”.^[149]

Experts in working with survivors of torture to whom ASP spoke stressed the need for different levels of intervention and noted the lack of a specialist response to meet the unique, multiple and complex needs of survivors of sexual violence in Syria. According to one: “There is often not an understanding… of the need for specialist care. Some of the low-level interventions are not going to heal people. Sexual violence is an incredibly difficult trauma to recover from. It is long-term work and [sometimes] you feel that these general programmes are perhaps doing harm.”^[150] They described the need for highly tailored support depending on the profile of the individual, which requires both time and experienced staff.

Nevertheless, sources referred to a range of psychosocial support services for survivors of genderbased violence and sexual violence that are available in Syria through health and community centres, mobile clinics, women and girls’ safe spaces, child-friendly spaces, children’s clubs and schools. However, it was also acknowledged that these are mainly targeted at women and girls and that there are few equivalents, particularly for adult males. The importance of designing MHPSS services specifically for male survivors was stressed by one interviewee: “Men need specialised MHPSS – we cannot just bracket them into services that are already available; their needs are different.”^[151]

Specialist support for survivors of torture

The Center for Victims of Torture (CVT) operates two clinics for refugees, including from Syria, in the Jordanian cities of Amman and Zarqa. In these centres, CVT’s clinical staff members (psychosocial counsellors, physical therapists and social workers) provide specialised interventions for patients in 10-week group sessions. Given that needs far exceed available resources, CVT prioritises those with the highest level of need, in particular those who display a low level of functioning and who may benefit most from specialised intervention. All services are closely supervised by highly qualified mental health and physical therapy professionals. This includes “live” in person supervision to ensure quality care.

After a detailed assessment, patients participate in 10-week group cycles with individual, couples and family sessions with counsellors provided to supplement group participation. Children’s groups are divided by age and parents may be involved in the group sessions. Adult groups are generally separated by gender. With some adjustments according to the particularities of each group, CVT’s counsellors guide clients through the 10-week cycle. The holistic, interdisciplinary service model is designed to provide a safe space for survivors and to create an environment for survivors of sexual violence to build trust, reveal what happened to them at their own pace, and begin to heal the psychological, relational and physical effects of sexual violence.^[152]

Services for boy survivors of sexual violence

Child protection actors to whom ASP spoke explained that the gender based violence response was being increasingly integrated into child protection services. Several described individual cases in which child survivors of sexual violence including boys had been identified via their programmes and provided with medical care and psychosocial support. However, it was also acknowledged that sexual violence has not been a focus of the child protection response, that there has not been a focus on sexual violence against boys at a strategic level, and that there are currently no initiatives specifically aimed at supporting former boy detainees.^[153] As one child protection expert explained, “the current system would have enormous challenges in responding appropriately to a boy who had experienced sexual violence, whether in the context of family or community violence or at the hands of parties to the armed conflict”.^[154]

It was nevertheless evident that child protection experts to whom ASP spoke were alert to the issue and that there is active thinking about how to strengthen support to child survivors of sexual violence. One initiative, that of “drop-in centres” for children living on the streets or engaged in child labour, was highlighted as potentially offering an entry point for the identification and care of boy survivors of sexual violence in Syria.^[155] The first such centre, established by UNICEF in partnership with a local NGO, is currently being piloted in Aleppo and is designed to provide an integrated package of services such as care, psychosocial support, non-formal education, vocational training, as well as access to specialised health, legal, protection, and family tracing and reunification services.^[156] While not specifically targeted at child survivors of sexual violence, the initiative represents a potentially useful route through which they could be identified and receive comprehensive support. In addition, joint efforts by the Gender Based Violence and Child Protection AoRs are also underway to provide remote training and technical support to staff in drop-in and other types of community centres in Syria to provide them with the knowledge and skills to help them to identify and support child survivors.^[157]

Key sources also acknowledged that insufficient attention has been paid to developing protection services for boy survivors of sexual violence. Particular concern was raised about a lack of safe alternative care arrangements for unaccompanied boys, including those who are survivors of sexual violence.

Responding to sexual violence against men and boys in Turkey

Although ASP’s own research on responses to sexual violence in Turkey was relatively limited, interviewees highlighted a range of concerns that need to be addressed in order to ensure that survivors of sexual violence from Syria have access to appropriate support. Such measures include: the lack of processes to identify survivors of sexual violence; lack of access to medical and MHPSS services for non-registered refugees; lack of specialist services for survivors of sexual torture; and language barriers. These concerns relate both to male and female survivors. However, as is the case in Syria, specific strategies are needed in Turkey to encourage reporting and disclosure by male survivors, and the provision of appropriate support.

In general, there remains insufficient understanding of the needs of vulnerable populations among refugees from Syria in Turkey, including male survivors of sexual violence, to inform the design of appropriate responses. A recent review by the International Medical Corps (IMC) of MHPSS capacities for refugees from Syria in Turkey recommended that an evaluation should be undertaken into the needs of specific populations, including survivors of sexual and gender-based violence, torture survivors, and the LBGT+ community.^[158] ASP strongly concurs with this recommendation and considers that it should include a specific focus on male survivors of sexual violence and be broadened beyond MHPSS needs to medical, legal and protection needs and capacity.

Identifying male survivors and encouraging disclosure

There are currently no systems or processes through which survivors of sexual violence from Syria can be safely or systematically identified in Turkey. In reality, many refugees are likely to be unwilling to disclose their experience to the authorities for fear of repercussions. In the absence of quality, safe and confidential support for survivors, identification via registration or other processes could potentially be harmful and stigmatising.

In place of systematic screening, ASP recommends that authorities charged with the reception of refugees systematically provide information to all refugees on access to support in case they have suffered sexual violence, thereby providing survivors with the choice to seek support, if and when they are willing and ready to do so. ASP also believes that there is a need for authorities responsible for receiving refugees to be trained on the impacts of sexual violence, the needs of survivors and on processes to confidentially and safely refer them to services if required. Additionally, there is a need to ensure that registration and reception services are equipped at all times with trained cultural mediators and interpreters whose training includes an understanding of the impacts of sexual violence.

The difficulty in identifying and supporting survivors of sexual violence is compounded by the same social and cultural barriers to disclosure that exist inside Syria, including the intense stigma and shame associated with it. A representative of a national NGO noted that they had received several male beneficiaries who they believed were probably survivors of sexual violence but were unwilling to disclose what had happened to them: “Nobody will tell us about sexual violence because of the shame. We have suspicions about two people… one of them told us he was in jail in Syria and that ‘something bad happened’, but when we asked what, there was no answer. The other was a boy, around 13 or 15 years old. He was also in jail in Syria for a short -time, but he didn’t want to talk about this.”^[159]

As in Syria, a lack of awareness of the issue among service providers can also constitute a barrier to identification and disclosure. An INGO representative with experience of working with survivors of torture from Syria elsewhere in the region felt that there was insufficient knowledge among service providers in Turkey about the experiences of men and boys who have been detained in Syria. According to the representative, “in Turkey, a lot of the organisations have talked about women who have been detained and been rejected by their families [but] nobody talked about men or males who had been detained or raped, of whether they were rejected by their families. I think it is so uncomfortable, it’s hard to know about why they don’t talk about it, the community norms, if I were to guess this is from my professional experience there would just be a complete conspiracy of silence, just pretending it didn’t happen.”^[160]

Others spoke of the additional challenges facing LBGT+ people in speaking about their experience of sexual violence, whether it occurred in Syria or Turkey. The lack of legal protection for LBGT+ people is a problem in this regard: although Turkey’s laws do not explicitly discriminate against individuals on the basis of sexual orientation or gender identity, these individuals are also not explicitly protected from discrimination or hate crime under Turkish law.

This is compounded by general intolerance and discrimination, which means that LBGT+ people among the Syrian refugee community can face multiple barriers to accessing support. LBGT+ people who suffer attacks in Turkey are often afraid to approach the police for protection and do not receive an adequate police response to their complaints of violence and harassment. According to one, “they don’t come forward because they don’t want to be seen as LGBTI or as victims of sexual violence”.^[161] Other interviewees noted that a gay man “cannot tell the truth, because he will be at risk”. It was also suggested that geographic location within Turkey has a bearing on whether individuals can seek help; it was suggested that it is more difficult in the more conservative towns and cities close to the border with Syria, compared to the more liberal cities of Istanbul and Ankara.^[162]

Notwithstanding these and other challenges, interviewees highlighted positive examples of awareness-raising and outreach to Syrian refugee communities by NGOs. These include sexual health and gender based violence awareness programmes in schools, orphanages and with caregivers, community leaders and mukhtars (neighbourhood officials) and psychoeducation to men through door-to-door outreach workers. Several informants referred to initiatives that they facilitate with young children to teach them what is “appropriate touching” and what to do if someone touches them inappropriately. Others spoke of efforts being made to inform refugees about available services including through “information protection centres” where individuals in need of help can speak to trained staff who can refer them to appropriate services in the area, and an IOM “Self help booklet for men facing crisis and displacement”, which is designed to help men understand and cope with their experience as refugees.^[163] However, ASP is not aware of initiatives that are specifically designed for male survivors of sexual violence.

Providing culturally appropriate services and language support

Accelerating efforts to address language barriers to reporting sexual violence and accessing support in Turkey was seen as a priority by many interviewees.^[164] Adequate interpreting services are lacking in public hospitals as well as in police stations and prosecutors’ offices.^[165] According to one INGO representative, “the most difficult things is the language barrier, because of the misunderstanding, miscommunication. It is a completely different language and the people do not understand what is needed”.^[166] In addition to interpreters/cultural mediators receiving training on sexual and gender-based violence, including sexual violence against men and boys, interpreters/ mediators should be trained in and be sensitive to LBGT+ issues and how to support people from this group.^[167]

It is important to ensure that the same interpreter is available to the survivor so that continuity and confidence can be built overtime: “[B]uilding trust is really hard, if you have to change translators… you can basically take the whole process back to zero.”^[168]

Strengthening national medical and MHPSS services and making them available to all refugees

The influx of refugees from Syria has put enormous strain on public services in neighbouring countries, including Turkey. Increased capacity is needed if quality health care is to be available to the millions of refugees in Turkey, in addition to Turkey’s own population. In recognition of these pressures and the continuing nature of the crisis in Syria, the Regional Refugee Response Plan (3RP) is prioritising support to strengthen national health care services. In Turkey, this has included a process to enable qualified medical personnel from Syria to be employed by the Turkish Ministry of Health. According to the 2018-2019 3RP, 1,000 Syrian doctors and nurses had completed courses to adapt to the Turkish health system since the beginning of 2017, and more than 400 had been hired to work in more than 80 refugee clinics throughout Turkey.^[169]

ASP could not determine whether these Syrian doctors and nurses are trained to identify and respond to survivors of sexual violence. However, interviewees raised general concerns about the lack of medical and mental health clinicians in Turkey with specialist training in and experience of working with survivors of sexual violence. According to one source: “There is no specific medical support for these people. There are general hospitals, but no specialist support.”^[170]

Moreover, not all refugees in Turkey can access services. Under Turkey’s legal framework, Syrians who are registered for Temporary Protection are eligible to receive the same health care as Turkish nationals through the national health system with insurance premiums paid by the government, while free onsite services are available to Syrian refugees residing in camps.^[171] However those without Temporary Protection permits must pay for health care services, which can constitute a barrier to accessing services. Syrians interviewed by Human Rights Watch in Turkey reported that hospitals and schools have refused to admit them without permits, and NGOs working with refugees are only allowed to provide services to asylum seekers and refugees who can provide evidence of their legal entry into Turkey.^[172] Crucially, mental health services are not covered by the health care package available to those under Temporary Protection.^[173]

Notwithstanding these limitations, there are continuing efforts to strengthen NGO capacity to provide specialist MHPSS for refugees and migrants in Turkey who are torture survivors, including survivors of sexual torture. This includes a recently opened centre in Istanbul that offers psychological and social support as well as medical case management to migrants and refugees who suffered torture or other forms of violence in their country of origin or during their migratory journey.^[174] However, further capacity will be necessary to respond to the likely level of need, including the particular needs of male survivors of sexual violence from Syria.

ASP interviewees also described a range of psychosocial support services provided by their organisations including through social workers, community mental health teams, child friendly spaces, women and girls’ spaces and door-to-door outreach programmes. However, according to ASP sources, the majority of these programmes currently focus on women and girls. A gender based violence expert working in Turkey acknowledged, “even though we have GBV case management systems in place for men and boys, the focus is more on women and girls”. Yet the expert also noted that there are plans to increase the focus on men and boys by increasing the capacity of service providers on gender based violence case management with men and boys through training and supervision.^[175]

Ensuring accountability for sexual violence in Turkey

Relative to Syria, Turkey’s legislative framework provides legal protection for men and boys against sexual violence. Under Turkey’s 2014 Criminal Code, gender-neutral language is used in provisions relating to rape and other forms of sexual violence, and sexual violence against men and boys is prohibited and in theory can be prosecuted.^[176] Other forms of sexual violence that do not constitute rape or sexual assault are regulated under Article 105 of the Criminal Code, under which both the perpetrator and the victim can be male or female.^[177] Sexual and psychological abuse by family members is proscribed under the Law on the Protection of the Family and Prevention of Violence against Women.^[178] Despite its name, the law recognises that both women and men may be victims of domestic violence. The Turkish Criminal Code requires a complaint by the victim to initiate investigation and prosecution of sexual assault and rape within marriage,^[179] but rape outside the family and rape against children does not require a complaint to be made.

There are nevertheless practical obstacles that deter male survivors of sexual violence from Syria from engaging with the criminal justice system in Turkey. While the high-profile trial and conviction of a Turkish national for sexual violence against boys in the Syrian refugee camp in Nizip in 2016 was important (see above), ASP informants generally expressed a lack of confidence in the capacity of the Turkish legal system to deliver justice to male survivors of sexual violence. They spoke of insensitivity to male survivors by the police, judges, prosecutors and other judicial officials. According to one: “The police don’t take men who have been sexually abused seriously. There was an incident where a man was attacked in his neighbourhood, he went to the police and showed them his scars, but they didn’t try to help.”^[180] Another noted the lack of knowledge and sensitivity of the police to the issue, adding: “Prosecutors and judges can be very rude to the people who have been attacked.”^[181]

 Fear of negative responses and a lack of action in response to complaints were seen as particularly prevalent among LBGT+ refugees. According to a lawyer working with a Turkish LBGT+ rights organisation: “There are challenges for LGBT people, first of all sometimes they don’t trust the police because they think they will discriminate against them. Second, even if the police listen, they don’t believe anything will happen afterwards.” The same lawyer, whose organisation offers legal support to survivors, also explained that in many cases refugees are not aware of their rights or that there is legal assistance available to them from NGOs such as his. In his words: “There is no system to inform them.”^[182]

Moving forward: Recommendations for action

Interviewees made many recommendations about how responses to sexual violence against men and boys could be strengthened, some of which are already reflected in the body of the report but are set out in more detail below. ASP was encouraged by the importance with which interviewees regarded the issue and their desire to see it integrated into their own work and that of the broader human rights and humanitarian communities. Their recommendations addressed a broad range of issues, many of which are relevant to responses in both Turkey and Syria, although some country-specific suggestions were made. Where relevant, ASP has added to and elaborated on recommendations based on its analysis of research information and its experience of working on sexual violence against males in other situations of armed conflict.

Recommendations for organisations working in Syria

• Consider ways in which data on patterns of sexual violence against men and boys in Syria and the needs of survivors can be safely gathered and anonymously shared among relevant human rights and humanitarian stakeholders. Despite the significant challenges to conducting research, needs assessments and other data collection exercises in Syria, ASP found interviewees to be well informed about patterns of sexual violence against men and boys and of possible areas of vulnerability and risk to them. Based on this, ASP believes that there is potential to draw on existing knowledge among UN and I/NGO workers to inform preliminary, internal discussions on how to strengthen responses. In addition, and taking into account the security of all those involved, data gathering and safe, anonymous information-sharing on sexual violence against men and boys needs to be strengthened as part of broader efforts to monitor and report on conflict-related sexual violence and to inform responses to it both in Syria and in countries receiving Syrian refugees. Co-ordination between organisations conducting human rights research and those that provide humanitarian services should be maximised to the extent possible to ensure the development of a common analysis of risks, patterns and prevalence of sexual violence against men and boys. Resources should also be dedicated to developing safe and effective methodologies for conducting assessments to develop better understandings of vulnerabilities of men and boys to sexual violence and the needs of survivors. The safety, security, wellbeing and informed consent of survivors should be prioritised in all data collection processes and referral pathways to appropriate support services for survivors and other participants in investigations, and other data collection processes.
• Develop and implement co-ordinated strategies by human rights, humanitarian and other relevant stakeholders to prevent sexual violence against men and boys in Syria. Government detention is generally regarded as the most common site of sexual violence against men and boys in Syria. However, ASP sources also identified a wide range of other situations of potential risk, and categories of men and boys who may be particularly vulnerable to sexual violence. These include, among others: LBGT+ people; children associated with armed forces and armed groups; child labourers; displaced, unaccompanied and separated children/boys; men and boys with disabilities; and boys in alternative care settings. Although the picture is incomplete, existing information could be used to inform the development of prevention strategies that could be elaborated and nuanced over time as more information becomes available. Based on its interviews, ASP considers the following to be among the priorities for advocacy and action in relation to prevention:
  • Laws relating to rape and other forms of sexual violence in Syria should be amended to provide legal protection for men and boys;
  •  Homosexuality should be decriminalised;
  • Efforts should be intensified to persuade the Syrian government to allow independent monitoring of all detention facilities by UN human rights experts and access by the ICRC and other relevant humanitarian organisations, including child protection stakeholders;
  • High-level engagement should be undertaken with state armed forces and armed groups listed in the UN Secretary-General’s Annual Report on Children and Armed Conflict as having committed sexual violence and other grave violations of the rights of children, with the aim of agreeing action plans to end and prevent such violations.
• The humanitarian community should intensify efforts to ensure that free, quality, confidential medical care is available to all survivors of sexual violence, including men and boys in all regions of the country. Ongoing initiatives to build capacity for the CMR within Syria should continue and medical staff should be provided with training in the identification of male survivors and in the clinical management of men and boy victims of sexual violence. All survivors should have access to quality, free and confidential health care services that are available at all times. Emergency medical care for survivors should include: treatment and management of genital, anal and other injuries; post-exposure prophylaxis to prevent HIV transmission and referral to HIV services if needed including for testing, prevention and counselling; treatment of STIs; vaccination against hepatitis B and tetanus; and treatment for other injuries. Requirements under Syrian law for the mandatory reporting of sexual violence by medical personnel to the police should be removed as it can deter survivors from seeking medical care. Specialised medical care for survivors of sexual violence/sexual torture with complex needs, including specialised services for torture survivors, physiotherapy and rehabilitation, should be put in place.
• The humanitarian community should invest in ensuring that appropriate MHPSS is available to all survivors of sexual violence including men and boys. Gender-inclusive, genderspecific and age appropriate services for men and boys should be included in strategies and plans for the development of MHPSS in Syria and capacity built to deliver specialised, long-term mental health support for survivors of sexual torture. Linking the delivery of MHPSS with medical services could provide a way to de-stigmatise mental health issues and allow for cross-referrals. Suggested possible and wider entry points to services for male survivors by ASP sources are documented in this report and could be considered as part of broader discussions on how to encourage disclosure and enable male survivors to safely access timely and appropriate medical and MHPSS services.
• International efforts to ensure the right to remedy of victims of human rights violations in Syria should be intensified; conflict-related sexual violence against men and boys should be addressed in justice processes, including criminal trials, truth-seeking processes and reparations. Although criminal prosecutions and other accountability processes may not currently be feasible in Syria, international efforts should be supported. The COI should continue and build on its work to investigate sexual violence against men and boys in Syria, and the UN International, Impartial and Independent Mechanism on Syria should include collection of evidence on and support prosecution of these crimes, including in other states under the principle of universal jurisdiction. Survivors of sexual violence should have access to free legal services and other support to enable them to pursue justice and participate in criminal justice processes including in other countries. Consideration should also be given to the early establishment of a comprehensive, victim-centred, genderinclusive reparations programme that is accessible to all survivors of sexual violence.

Recommendations to the Turkish government and organisations working in Turkey

• The Turkish government and human rights, humanitarian and other relevant stakeholders should work together to develop and implement co-ordinated strategies to prevent sexual violence against men and boy refugees from Syria in Turkey. ASP interviewees highlighted a wide range of possible risks and vulnerabilities to sexual violence among refugees from Syria in Turkey which point to the need for stronger protection, particularly of groups who may be more vulnerable, such as boys and LBGT+ people.
• Government, UN and I/NGO strategies and plans for the provision of medical care and MHPSS to all refugees from Syria in Turkey, regardless of whether they are officially registered or not, should include appropriate support to male survivors of sexual violence. The Turkish authorities should guarantee the right to health of all refugees from Syria and elsewhere regardless of whether they have Temporary Protection status and should permit national and international aid agencies to provide support to registered and non-registered refugees. ASP’s research also indicates the need for greater awareness among service providers in Turkey of the possibility that men and boys from Syria, particularly those who were detained, may have been subjected to sexual violence, and for increased efforts to identify and build capacity to respond to the needs of male survivors, including of sexual torture. A first step could include an evaluation of the needs of survivors of sexual violence (male and female) from Syria and of their MHPSS, medical, legal and protection needs, together with a detailed mapping of existing services to establish where there are gaps and where additional capacity is needed.
• Allegations of sexual violence against refugees from Syria (and elsewhere) in Turkey should be promptly investigated and where there is sufficient evidence, perpetrators held to account. The police and other criminal justice stakeholders in Turkey should receive comprehensive training in investigating and prosecuting crimes of sexual violence, including sexual violence against men and boys. Refugees should be provided with legal, interpretation and other appropriate support to enable them to make complaints and participate in domestic criminal justice proceedings.

General recommendations

• The UN should clarify sectoral responsibility for responding to sexual violence against men and boys and develop co-ordinated inter-sectoral responses to it. ASP’s research highlighted a lack of clarity and tensions around who provides the lead on responding to sexual violence against men and boys within the international humanitarian cluster system and inter-agency co-ordination structures, and the way in which this can contribute to the issue being overlooked in responses.
• Humanitarian organisations should invest in increasing their capacity and that of their partners in Syria and Turkey to respond to sexual violence against men and boys and should ensure that the issue is included in strategies, plans and programme design. Investment is needed in building awareness of the risks and vulnerabilities to sexual violence of men and boys and increasing expertise among humanitarian workers at all levels in responding to the specific needs of male survivors. Relevant stakeholders in Syria and Turkey should receive in-depth and continuous training and supervision on how to respond to sexual violence in a gender inclusive and gender competent way. Interviewees emphasised the importance of not only creating awareness and skills, but also of working in-depth to challenge rooted attitudes and prejudices towards male survivors of sexual violence within their own organisations and the broader human rights and humanitarian communities in Syria and Turkey.
• The humanitarian community, where possible working with national authorities, should design and implement strategies aimed at sensitizing and building awareness among communities in Syria and Turkey to the issue of sexual violence against men and boys as a way to reduce stigma and remove other barriers to reporting and disclosure by survivors. Key interviewees identified a lack of community awareness, stigma and shame as among the obstacles that prevent male survivors from disclosing what has happened to them and seeking help. This is long-term work that will require cultural shifts but is essential to providing a supportive environment for survivors. Awareness raising and sensitisation activities on sexual violence (whether direct, or through media or other indirect means) should be culturally appropriate. Messaging should make it clear that men and boys can be victims of sexual violence; it should be gender inclusive and avoid gender stereotyping, and gender-specific guidance should be given on how to sensitively respond to male survivors. Finally, information should be provided on where male survivors can access support.
• Donors should make funding available for programmes to support responses to male survivors of sexual violence and use their position to ensure that sexual violence against men and boys forms an integral part of all relevant responses. Interviewees raised concerns about the lack of funding for training and interventions on sexual violence against males and in particular for specialist MHPSS for victims of sexual torture, which constitute many male survivors from Syria. Some interviewees also highlighted the potentially positive role that donors could play in promoting this issue and ensuring that it is addressed including through participation in relevant cluster meetings and in ensuring it features in funding proposals. Funding appeals should reflect any additional resources needed to ensure that programming and the provision of services for male survivors of sexual violence is not to the detriment of women and girls who have suffered sexual violence or other forms of gender based violence.

Armed conflict in Syria has resulted in a massive human rights and humanitarian crisis. Millions of people have fled the country, many to Turkey. Conflict-related sexual violence against women, girls, men and boys has characterized the armed conflict in Syria.

In Syria, sexual violence against men and boys is mainly reported as taking place in Syrian government detention. However, it also occurs at checkpoints, during house raids, in public places and as a tactic of forced recruitment by Syrian security forces, associated groups and non-state armed groups. Boys are vulnerable to sexual violence – especially boys associated with armed forces and armed groups, those involved in child labour and boys who are unaccompanied and separated from their families. While fleeing to safety, men and boys experience sexual violence during the journey and after arrival in Turkey, where they are vulnerable to sexual violence, exploitation and abuse from employers and in refugee camps, orphanages, public spaces and at home, including by members of the host community. LGBT+ face increased vulnerability to sexual violence in both Syria and Turkey.

 Sexual violence has devastating consequences for male survivors, their families and communities. In addition to physical injuries, short- and long-term psychological impacts on survivors include shame, loss of confidence, sleep disorders, feelings of powerlessness, confusion and suicidal thoughts.

ASP’s research highlights the lack of systematic efforts to prevent and respond to sexual violence against men and boys in Syria and as they flee across borders and in countries of asylum. The reasons for this are multiple and complex. Humanitarian needs are immense, yet delivery of humanitarian assistance is incredibly challenging. Shame and stigma prevent men and boys from seeking help. There are interlinked and mutually reinforcing social, legal and institutional factors that contribute to a vicious circle of lack of protection, under-reporting of incidents, and unmet needs of male survivors. This results in a lack of awareness-raising, design of accessible entry points and delivery of specialized services to meet the complex needs of men and boys subjected to sexual violence.

More must be done to prevent sexual violence against men and boys in Syria. The needs of survivors of sexual violence in Syria and in the countries of their refuge requires an urgent, intensified and co-ordinated response.