A Systematic Review of Sexual Dysfunction Measures for Gay Men: How Do Current Measures Measure Up?

The measurement of subjective components of sexual functioning is of increasing importance in clinical research and practice. Differences have been reported in prevalence rates and experiences of sexual difficulties between heterosexual and gay men. The aim of this article is to identify reliable and valid measures of sexual dysfunction suitable for use with gay men. Seven measures were reviewed; details about item development, dimensionality, reliability, and validity are provided. Heteronormative and heterosexist wording were evident throughout. Several areas of concern emerged in relation to psychometric properties (e.g., questionable validity). No psychometrically robust sexual function measure was identified for use with gay populations.     

“All of My Lovers Fit Into This Scale”: Sexual Minority Individuals’ Responses to Two Novel Measures of Sexual Orientation

Previous qualitative research on traditional measures of sexual orientation raise concerns regarding how well these scales capture sexual minority individuals’ experience of sexuality. The present research focused on the critique of two novel scales developed to better capture the way sexual and gender minority individuals conceptualize sexuality. Participants were 179 sexual minority (i.e., gay, lesbian, bisexual, pansexual, queer, asexual) individuals who identified as cisgender (n = 122) and transgender (n = 57). Participants first completed the new scales, then provided qualitative responses regarding how well each scale captured their sexuality. The Sexual-Romantic Scale enabled the measurement of sexual and romantic attraction to each sex independently (same-sex and other-sex). Participants resonated with the way the Sexual-Romantic scale disaggregated sexual and romantic attraction. Although cisgender monosexual (lesbian/gay) individuals positively responded to the separation of same- and other-sex attraction, individuals with either plurisexual (bisexual, pansexual, or fluid) or transgender identities found the binary conceptualization of sex/gender problematic. The Gender-Inclusive Scale incorporated same- and other-sex attraction as well as dimensions of attraction beyond those based on sex (attraction to masculine, feminine, androgynous, and gender non-conforming individuals). The incorporation of dimensions of sexual attraction outside of sex in the Gender-Inclusive Scale was positively regarded by participants of all identities. Findings indicate that the Sexual-Romantic and Gender-Inclusive scales appear to address some of the concerns raised in previous research regarding the measurement of sexual orientation among sexual minority individuals.     

Latino Gay and Bisexual Men's Relationships with Non-Gay-Identified Men Who Have Sex With Men

This study investigated relationships between Latino gay-identified men in metropolitan New York City and their non-gay-identified male partners. Phase 1 consisted of in-depth interviews (N = 33), and Phase 2 consisted of quantitative surveys (N = 120) with Brazilian, Colombian, and Dominican men who have sex with men (MSM). A majority of participants reported having had sex with heterosexually identified men, and in many cases, the relationship was sustained over time. We found mixed results concerning an attitude sometimes attributed to Latinos that sexual orientation is defined by sexual role, with receptive MSM seen as gay and insertive MSM seen as straight. Although there were no significant associations between partner sexual orientation and unprotected anal intercourse, gay men were less likely to take the insertive role in oral or anal sex with straight-identified male partners than with gay partners.     

Rural Men,Sexual Identity and Community

The relationship between rurality and men's sexuality remain relatively unexplored. This study addresses the knowledge gap in the research literature by focusing on men who have sex with men in rural areas across Ontario, Canada. Employing a constructivist grounded theory methodology, interviews were conducted with 32 men across 28 geographic locales consisting of populations of less than 10,000 people. Men identified as gay, bisexual, queer/bisexual, or refused labels. These self-selected identifiers were then explored to determine how participants conceptualized and organized their sexual identities in relation to context. Participants held divergent management strategies that resulted in two general identity grouping: “natives” and “transplanters.”     

When the Emotions Really Started Kicking In,Which Ended Up Being a Problem: Sex,HIV, and Emotions Among Young Gay and Bisexual Men

Interviews from 10 young gay and bisexual men aged 18 to 29 were examined to explore how young gay and bisexual men make decisions regarding sexual behaviors in the age of AIDS. Three main themes emerged: (a) disconnections between what an individual knows about HIV, their motivations to remain HIV-negative, and their sexual behaviors; (b) a struggle to connect emotionally and intimately with another man; and (c) a power dynamic whereby the individual acts as an autonomous decider in the decision-making process. Participants indicated high levels of HIV knowledge, and were engaged in a struggle to balance emotional experiences with sexual partners in a complex gendered dynamic. Findings from this analysis indicate a need to reexamine the social-cognitive theoretical frameworks that have guided gay men's HIV-prevention efforts, as these frameworks have failed to account for the psychologically complex emotional experiences and gender dynamics that are part of sexual decision making.     

Sexual Satisfaction,Solitary, and Dyadic Sexual Desire in Men According to Sexual Orientation

ABSTRACT

Research on male sexual desire and satisfaction according to sexual orientation remains insufficient. An online survey was fulfilled by 415 men (142 gay; 273 heterosexual), and participants completed the SDI-2 and the GMSEX. Main findings suggested that gay men scored significantly higher on both solitary sexual desire and attractive person-related dyadic sexual desire subscales, but not on a partner-related dyadic sexual desire subscale, compared to heterosexual men. Despite sexual orientation, partner-related dyadic sexual desire positively predicts sexual satisfaction, whereas solitary and attractive person-related dyadic sexual desire negatively predicts sexual satisfaction in men. Overall, gay men appear to experience higher levels of both attractive person-related dyadic and solitary sexual desire. Also, experiencing sexual desire toward a partner predicts positively, whereas experiencing desire to engage in sexual behavior with oneself and toward an attractive person predict negatively sexual satisfaction in men.     

Methods Used and Topics Addressed in Quantitative Health Research on Gay,Bisexual and Other Men Who Have Sex With Men: A Systematic Review of the Literature

Research on sexual minority men (gay, bisexual, and other men who have sex with men) was examined with regard to the measures of sexual orientation used, the methods of research, and the main health outcomes under study. A systematic review of English-language quantitative studies was conducted focused on the health of sexual minority men published in 2010 (n = 250). The results provide a snapshot of the literature and revealed that research on sexual minority men overwhelmingly focused on HIV, STIs, and sexual health for which sexual orientation was most commonly defined behaviorally. For topics of mental health or body/fitness outcomes, sexual orientation was most commonly defined by identity. Most study samples were venue-based, and only 8.8% of published papers drew data from population-based samples. The findings suggest that there exists a need for research on sexual minority men’s health beyond STIs and HIV that will examine mental and physical health outcomes beyond sexual risk, uses probability-based samples, and addresses intersectional concerns related to race/ethnicity and age.     

On Holiday: A Risk Behavior Profile for Men Who Have Vacationed at Gay Resorts

Sexual risk behavior is higher when people vacation as compared to when they are at home. The current study uses survey data to compare sexual risk behavior of gay men who vacation at gay resorts to those who do not. Independent predictors of vacationing at gay resorts included income level, relationship status, ever having attended a circuit party, and HIV serostatus. For men who visit resorts to meet sex partners, independent predictors included relationship status, ever having attended a circuit party, HIV serostatus, number of male sex partners in the past six months, and number of anal insertive male partners using a condom. These results show a need for the development of structural interventions in the gay resort and hotel setting.     

Difference in Condom Use Between Bear Concordant and Discordant Dyads During the Last Anal Sex Event

The purpose of this study was to understand how bear identity influenced condom use during the last anal sex event. Participants were recruited to complete an online, anonymous self-report survey through bear-related sexual and social networking websites. A total of 1,080 men who identified as gay or bisexual and as a member of the bear community and were 18 years or older completed the survey. Overall, fewer than a third of men reported condom use during the most recent receptive (28%) and insertive (30%) anal sex event. Men in bear concordant pairings were less likely to use a condom during receptive and insertive anal sex compared to those is discordant pairings (p < .05). Findings suggest that bear identity concordance influences condom use during anal sex after accounting for an individual’s relationship to their most recent partner as well as other confounding variables.     

A Population-Based Study of Coupling and Physical Activity by Sexual Orientation for Men

ABSTRACT

Research has suggested that men in relationships are more physically active than men who are single. This study provides a weighted analysis of physical activity by coupling status for men of different sexual orientations. Aggregated data from the United States 2013–2014 National Health Interview Survey were used to conduct multivariate logistic regression analyses. Compared to straight men (n = 29,926), gay men (n = 623) were less likely to be in a relationship (AOR 0.32, CI: 0.25–0.41). Coupled gay men did more physical activity than coupled straight men and were 1.62 (CI: 1.05–2.50) times more likely to be active, 1.67 (CI: 1.10–2.51) times more likely to be high active, 1.89 (CI: 1.24–2.89) times more likely to engage in muscle-strengthening activities, and 2.00 (CI: 1.28–3.11) times more likely to meet aerobic and muscle-strengthening recommendations. Coupling facilitates physical activity for men. However, more research is needed to help explore underlying mechanisms for differences by sexuality.     

“And Now I’m Just Different,but There’s Nothing Actually Wrong With Me”: Asexual Marginalization and Resistance

This article explores the relationship between contemporary asexual lives and compulsory sexuality, or the privileging of sexuality and the marginalizing of nonsexuality. Drawing on 30 in-depth interviews, I identify four ways the asexually identified individuals in this study saw themselves as affected by compulsory sexuality: pathologization, isolation, unwanted sex and relationship conflict, and the denial of epistemic authority. I also identify five ways these asexually identified individuals disrupted compulsory sexuality: adopting a language of difference and a capacity to describe asexuality; deemphasizing the importance of sexuality in human life; developing new types of nonsexual relationships; constituting asexuality as a sexual orientation or identity; and engaging in community building and outreach. I argue that some of these practices offer only a limited disruption of compulsory sexuality, but some of these practices pose a radical challenge to sexual norms by calling into question the widespread assumption that sexuality is a necessary part of human flourishing.     

Gay Community Involvement: Its Interrelationships and Associations With Internet Use and HIV Risk Behaviors in Swedish Men Who Have Sex With Men

We measured aspects of “community involvement” chosen for men who have sex with men (MSM) in Sweden (gay places, media accessed, Internet, gay festivals, and social engagement, measured as proportion of gay friends) in two Swedish Internet-based samples from 2006 (n?=?3,202) and 2008 (n?=?4,715). Data showed low to moderate reliability with a moderate (0.57) alpha coefficient. While there is moderate internal consistency, as might be anticipated from measures of actual community involvement, they can be treated as scales. The Internet scale indicated the lowest reliability, perhaps due to respondents having Internet sites of primary choice, rather than a high level of usage across several sites. A hypothesized lack of correlation between traditional domains of the gay community and the Internet did not appear: correlations between the Internet measure and the other measures were positive and significant, but among the lowest correlations obtained between the community measures, ranging from 0.06 to 0.24. Those who use the Internet extensively are less likely to be involved in other aspects of the community. Sexual risk was associated with high social engagement at sexual meeting sites and with Internet use. Gay community involvement, including the Internet community, may be complex and associated with both increase in HIV sexual risk behaviors (by measuring use of sexual risk sites) and preventive measures (HIV testing).     

Several Common Bonds: Addressing the Needs of Gay and Bisexual Men in LGBT-Specific Recovery Housing

ABSTRACT

Recovery housing is a promising way to augment the substance use continuum of care, but we know little about the experiences of members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community who live in them or about residences specifically for them. Within the LGBTQ community, gay, bisexual, and other men who have sex with men (MSM) often experience co-occurring syndemic conditions (e.g., trauma, depression, HIV) that present unique recovery challenges. Using qualitative data gathered from residents living in a recovery residence specifically for gay and bisexual men and from community key informants, we examine the experiences of men living in the home and factors that facilitate operating it. Findings highlight the need for residences that can address syndemic burden among gay and bisexual men in recovery and identify programmatic and community-level factors critical to operating residences for this population.     

Influence of Family,Religion, and Social Conformity on Client Participation in Sexual Reorientation Therapy

This study examined the likelihood of participating in sexual reorientation therapy (SRT) based on actual or expected family reactions to the disclosure of one's same-sex sexuality, religious fundamentalism, social conformity, and several demographic variables. A sample of 52 SRT participants and 211 SRT nonparticipants who had ever identified as gay, lesbian, or bisexual completed a survey either online or in hardcopy format. Actual or expected negative family reactions, high religious fundamentalism, and identifying as spiritual significantly increased one's odds of participating in SRT. The findings are essential for preparing practitioners in any clinical practice setting to work with clients struggling with their sexuality.     

Psychological Violence Experienced by Men Who Have Sex With Men in Puducherry,India: A Qualitative Study

Men who have sex with men are a hidden population in India. This study explores the psychological violence such men are exposed to in Puducherry, India. Eleven in-depth interviews probe experiences of blackmail, discrimination, and rejection. Some informants modified their behaviors or appearances to avoid harassment and safeguard their families' reputations. Others told how Indian men accepted their behaviors, but rejected their identities. Social pressure to marry was also a recurring theme. Understanding the factors behind these violent experiences may facilitate their amelioration.     

The Relationship Between Body Image and Sexual Functioning Among Gay and Bisexual Men

ABSTRACT

Gay and bisexual men report high body dissatisfaction compared to heterosexual counterparts, but no studies to date have examined how this may impact their sexual functioning. The present study investigated body image domains as predictors of sexual functioning problems (inhibited desire, erectile dysfunction, and premature ejaculation) among an online community sample of 185 gay and bisexual men, ages 18–40. Participants reported moderate to high body image satisfaction and sexual functioning consistent with previous literature with nonclinical male samples. Overall, the total variance accounted for by regression models was low. Body image variables were not predictive of sexual desire. However, increased drive for muscularity and lower affective body esteem were predictive of erectile difficulties. Additionally, negative behavioral body image in sexual situations and evaluative body dissatisfaction were associated with premature ejaculation. Understanding this relationship may have implications for gay and bisexual men’s health and wellbeing. Future research directions are discussed.     

“We’re Disgusted With Queers,not Fearful of Them”: The Interrelationships Among Disgust,Gay Men’s Sexual Behavior,and Homonegativity

ABSTRACT

Using a combination of personal reflections, published literature, and original empirical research, we argue that the disgust triggered by gay men’s sexual practices (specifically, anal intercourse) is a critical, though overlooked, contributor to heterosexual men and women’s homonegativity (i.e., negative attitudes and behaviors directed toward men who are or are perceived to be gay). We conclude our article by articulating several directions for future inquiry that we believe will advance current understanding of prejudice and discrimination directed toward gay men.     

Feminine Sexualities in the Chick Genre

This paper foregrounds the voices of women who read chick lit or watch contemporary chick flicks or both, and who, to date, have been absent in the scholarship on representations of women's sexuality in this genre. It is informed by an empirical study of responses from forty-one Australian women to an anonymous Internet survey that asked, “How do you think women's experiences of sex are portrayed in the chick genre?” and “If you were a writer of the chick genre, how else would you portray women's sexual experiences?” Following the works of Jonathan Potter and Margaret Wetherell, and Joke Hermes on “interpretive repertoires,” the data reveal that most readers draw on two repertoires to interpret representations of women's sexuality—one, as “passive or asexual,” and the other as “perfect with Mr Right”—both of which are situated within a wider “romantic love” frame of reference. Participants are, predominantly, critical of the way women's sexuality is represented in the chick genre. The findings, that also show that most readers have a preference for texts that show a broader range of sexual representations for women, are discussed in the light of current theorizing about postfeminist texts.     

Measure of internalized sexual stigma for lesbians and gay men: a new scale

The goal of this study is to propose a new Measure of Internalized Sexual Stigma for Lesbians and Gay Men (MISS-LG) that assesses three dimensions of internalized homonegativity: identity, social discomfort, and sexuality. A convenience sample of 735 Italian lesbians and gay male participants was used to demonstrate the psychometric validity of the scale. Results of confirmatory factor analysis supported three identifiable factors reflecting theoretically based constructs of the MISS-LG. The correlations with other instruments demonstrate the convergent validity: lesbian and gay participants with high internalized sexual stigma describe lower levels of self-disclosure and wellbeing. Implications for research and practice are discussed.     

Not in the Same Mental Drawer: Internalized Sexual Stigma,Dissociation, and the Role of Religion in a Sample of Italian Gay Men

ABSTRACT

Several studies have highlighted the relationship between internalized sexual stigma (ISS) and dissociation. The aim of the present study was to empirically investigate this relationship through a quantitative study. The Measure of Internalized Sexual Stigma for Lesbians and Gay Men (MISS-LG) and the Dissociation Scale (DIS) of the Trauma Symptom Inventory (TSI) were administered to 120 Caucasian participants who self-identified as gay men. Findings suggested that dissociative symptomatology, as measured by DIS—an estimation of the use of dissociation as a defense mechanism—was positively associated with MISS general index and all dimensions of MISS, especially the sexuality dimension (ISS-S). Moreover, the effect of the ISS-S on DIS was amplified in Catholic participants, suggesting a moderating role of religiosity. Implications for future research and clinical practice are discussed.