The relationship between homosexuality, internalized homo-negativity, and mental health in men who have sex with men

Whether homosexuality or internalized homo-negativity is the critical variable affecting the mental health of men who have sex with men has long been debated. As part of a larger study, 422 Midwestern homosexual men completed questionnaires examining degree of homosexuality, internalized homo-negativity, and depression. Logistic regression modeling identified internalized homo-negativity, but not degree of homosexuality, as significantly associated with greater adjustment depression (OR = 1.5), major depression (OR = 2.6), dysthymia (OR = 1.5), and likelihood of being in therapy (OR = 1.4). Internalized homo-negativity was also negatively associated with overall sexual health, psychosexual maturation, comfort with sexual orientation, "outness," and peer socialization. Internalized homo-negativity, not homosexuality, appears associated with negative health outcomes. Providers should promote sexual health and avoid interventions that reinforce internalized homo-negativity.     

Minority Stress,Parenting Styles,and Mental Health in Brazilian Homosexual Men

ABSTRACT

Homosexual men are constantly exposed to prejudice and violence in Brazil. The aim of this study was to investigate the relationship between minority stress, parenting styles, and indicators of mental health problems in a sample of homosexual men. Method: quantitative, cross-sectional, correlational, and retrospective design. Participants were 101 Brazilian men who selfidentified as homosexuals, aged between 18 and 55 years. Results: concealing sexual identity was a predictor of depression and stress. Parental responsiveness was associated with a lower incidence of enacted stigma and depression. Conclusions: the mental health of homosexual men can be negatively affected by the need to conceal their sexual orientation. Parental responsiveness is a protective factor in terms of experiencing enacted stigma and depression. The results found in the study may be useful for counselors and social workers who are working with LGBT people and their families.     

The Interrelations Between Internalized Homophobia,Depressive Symptoms,and Suicidal Ideation Among Australian Gay Men,Lesbians, and Bisexual Women

ABSTRACT

Internalized homophobia has been linked to depression among gay men, lesbians, and bisexuals. Relatively little research has investigated the link between internalized homophobia and suicidal thoughts and behaviors. The current research investigated the interrelations among internalized homophobia, depressive symptoms, and suicidal ideation by testing additive, mediation, and moderation models. Self-identified Australian gay men (n = 360), lesbians (n = 444), and bisexual women (n = 114) completed the Internalized Homophobia Scale, the Center for Epidemiological Studies Depression Scale, and the suicide subscale of the General Health Questionnaire. Results supported the additive and partial mediation models for gay men and the mediation and moderation models for lesbians. None of the models were supported for bisexual women. The findings imply that clinicians should focus on reducing internalized homophobia and depressive symptoms among gay men and lesbians, and depressive symptoms among bisexual women, to reduce suicidal ideation.     

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.     

Exploring First Sexual Intercourse,Sexual Orientation,and Sexual Health in Men

In this study the characteristics of the sexual debut of men who have sex with men (MSM) and men who have sex with women (MSW) age 35 or younger (N = 1,201) were compared with one another. We investigated whether these characteristics were associated with sexual health and behavior, and to what extent. Compared to MSW, MSM tended to be older when they had their first sexual intercourse; their first sex partner was older, they felt less ready, and they experienced more pain. We also found that they reported a higher number of lifetime sexual partners and less condom use compared to MSW. Similarities were also ascertained, such as the fact that individuals from both groups do not differ significantly regarding how they experienced their first sexual intercourse emotionally. Many differences between these groups should not always be seen as problematic, whereas others still indicate a need for targeted interventions.     

A National Survey on Depression,Internalized Homophobia,College Religiosity,and Climate of Acceptance on College Campuses for Sexual Minority Adults

ABSTRACT

Sexual minority persons have an increased risk for negative mental health outcomes in adulthood. This seems to largely be due to experiences of stigma in social settings. This study sought to understand the relationship between attending a religiously conservative college, internalized homophobia (a measure of sexual stigma), and depressive symptoms for sexual minority adults. Sexual minority adult participants (n = 384) from across the U.S. were recruited and completed a Web-based, anonymous survey. A mediation model predicting depression through college religious conservatism, college acceptance of sexual minority identities, and internalized homophobia was tested using path analysis. Results revealed an indirect effect of increased religious conservatism of a college predicted higher depression through lower college acceptance and higher internalized homophobia. Implications for the mental health of sexual minority adults and future research are examined.     

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.     

Gender,Age, and Place of Residence as Moderators of the Internalized Homophobia-Depressive Symptoms Relation Among Australian Gay Men and Lesbians

Internalized homophobia is a risk factor for depression among gay men and lesbians. The aim of the study was to test whether the internalized homophobia-depression relation was moderated by gender (stronger among gay men compared with lesbians), age (stronger among younger compared with older gay men and lesbians), and place of residence (stronger among gay men and lesbians who live in rural areas compared with those who live in urban areas). An Australian sample of 311 self-identified gay men and 570 self-identified lesbians, aged 18 to 70 years, completed the Internalized Homophobia Scale and the Centre for Epidemiological Studies Depression Scale. Results indicated that age and gender did not moderate the internalized homophobia-depressive symptoms relation. Place of residence was a significant moderator for gay men but not lesbians. In contrast to the hypothesis, the internalized homophobia-depression relation was significant only among gay men who resided in urban areas. Those who work with gay men should be particularly aware of the significant relationship between internalized homophobia and depressive symptoms among gay men who reside in urban areas.     

The Role of Individual Differences and Situational Variables in the Use of Workplace Sexual Identity Management Strategies

ABSTRACT

Examination of individual difference variables have been largely ignored within research on the use of workplace sexual identity management strategies. The current study examined personality traits (extraversion, openness, and neuroticism), facets of sexual identity development (identity confusion, internalized heterosexism), and situational variables (e.g., perceptions of workplace climate and heterosexism) in explaining the use of management strategies, as well as possible interactions between individual and situational factors. Perceptions of the workplace climate toward lesbian and gay individuals significantly related to the use each of the management strategies, and Internalized Heterosexism was found to significantly predict the use of the Explicitly Out strategy. Most interactions between individual difference and situational variables were not supported, with the exception of an interaction between workplace heterosexism and internalized homophobia in explaining the use of the Explicitly Out strategy.     

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.     

Internalized Homonegativity,Sense of Belonging,and Depressive Symptoms Among Australian Gay Men

Internalized homonegativity has been directly linked to depression among gay men. The aim of the study was to test whether internalized homonegativity is indirectly related to depressive symptoms via a sense of belonging to the broad gay community, gay groups, gay friends, and the general community. A sample of 246 self-identified Australian gay men, aged 18–82 years, completed the Internalized Homophobia Scale, the Psychological subscale of the Sense of Belonging Instrument, the Sense of Belonging Within Gay Communities Scale, and the Centre for Epidemiological Studies Depression Scale. Results indicated that the final model was an excellent fit to the data. Internalized homonegativity was indirectly related to depressive symptoms via sense of belonging to gay groups, with gay friends, and to the general community. Interventions aimed at reducing internalized homonegativity among gay men have the potential to enhance sense of belonging and, in turn, decrease depressive symptoms.     

Mental Health Concerns of Gay and Bisexual Men Seeking Mental Health Services

ABSTRACT

Little data exist about the mental health needs of gay and bisexual men. This is due to limitations of existing studies such as small and nonrepresentative samples, failure to assess sexual orientation, and concerns about stigmatization, possibly causing sexual minority individuals to be reluctant to disclose their sexual orientation to researchers. Fenway Community Health is a large urban health center that serves the LGBT community. The large number of gay and bisexual men who present for mental health treatment allows for a unique opportunity to gain insight into mental health, prevention, and intervention needs for this group. The current study is a review of the mental health information from all of the gay and bisexual men who reported that they were HIV-negative during their mental health intake over a six-month period at Fenway Community Health (January to June 2000; N = 92). The most frequent presenting problems were depression, anxiety, and relationship issues. Additionally, presenting problems included current or past abuse, substance abuse, finance and employment, recent loss, and family issues. The most frequent diagnoses were depression, anxiety disorders, and adjustment disorders. These findings support the notion that presenting problems and mental health concerns among gay and bisexual men are similar to those frequently reported by individuals in other mental health facilities, however, specific psychosocial stressors are unique to this population.     

Internalized Homophobia,HIV Knowledge,and HIV/AIDS Personal Responsibility Beliefs: Correlates of HIV/AIDS Discrimination among MSM in the Context of Institutionalized Stigma

ABSTRACT

There exists a paucity of research on the psychosocial risk factors of HIV/AIDS among men who have sex with men (MSM) in settings where they are stigmatized or face prosecution. The present study investigates discrimination against people living with HIV (PLHIV), internalized homophobia, HIV/AIDS personal responsibility beliefs and HIV knowledge in a purposive sample of 106 self-identified MSM obtained through a web-based survey disseminated by two voluntary welfare organizations. Results indicate that internalized homophobia is positively associated with discrimination against PLHIV. Internalized homophobia also substantially mediates the effect of HIV/AIDS personal responsibility beliefs on discrimination against PLHIV, highlighting the confounded nature of HIV/AIDS and homosexual stigma in a setting where stigma is deep-rooted and institutionalized. Internalized homophobia may thus serve as a barrier to the effectiveness of HIV prevention efforts among MSM in Singapore.     

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.     

What Men Who Have Sex With Men in Peru Want in Internet-Based Sexual Health Information

We aimed to gather information among gay men regarding their preferences for online sexual health information; 1,160 Peruvian MSM, 18 years or older, completed an online survey hosted on www.tunexo.org. The mean age was 26.8 years. Around 90% had post–high school education. The self-reported HIV prevalence was 12.3%. The acceptability of sexual health content was greater in the most highly educated group. The highest rated topics and services of interest were those related to improving sexual and mental health. The least educated group was significantly more interested in “getting prevention messages on mobiles” compared to men with the highest level of education (71% vs. 52%; p < 0.001). Men’s sexual health was of more interest to the 30–39-year-old group compared to the 18–24-year-old one (97% vs. 87%; p = 0.005). Future Web-based interventions related to sexual health among targeted groups of MSM in Peru can be tailored to meet their preferences.     

Hungarian Medical Students’ Knowledge About and Attitude Toward Homosexual,Bisexual, and Transsexual Individuals

ABSTRACT

Discrimination that LGBTQ individuals experience in health care settings might affect their health and intention of using health care services. However, health needs of LGBTQ patients are still inappropriately addressed in the medical curriculum. First-, third-, and fourth-year medical students (N = 569) from the four Hungarian medical universities participated in a study in 2017 to assess knowledge about homosexuality, homonegativity, and their attitude as health care professionals toward sexual minorities. We found that higher levels of knowledge about homosexuality were associated with lower levels of homonegativity, upper-grade level in university, not being religious, and having close LGBTQ acquaintances. Our results suggest that it may be necessary to introduce LGBTQ themes in the medical curricula (not only in Hungary, but also in other countries) in order to improve the knowledge and attitude of medical students and thereby improve the health care of LGBTQ individuals.     

Heterosexual Marital Intention: Effects of Internalized Homophobia,Homosexual Identity,Perceived Family Support,and Disclosure Among Chinese Gay and Bisexual Men

ABSTRACT

The present study explored the factors that influence the likelihood that 217 Chinese gay/bisexual men will engage in heterosexual marriage, focusing on the Chinese cultural context, in which filial duties to marry, have children, and support one’s parents in their old age are taken seriously. Data on heterosexual marital intention (HMI) were examined in relation to demographics, internalized homophobia, homosexual identity formation (HIF), perceived family support, and disclosure. We estimated a multinomial logistic regression model for HMI. Internalized homophobia was a predictor for HMI. Lower levels of HIF and disclosure were found in gay/bisexual men who have married or who intend to marry; and the more family support gay/bisexual men perceived, the more likely they were to enter heterosexual marriages. The findings could help to better evaluate and comprehend the factors leading to heterosexual marriages involving Chinese gay/bisexual men. The social implications of this research are also discussed.     

Observing Erotic Videos With Heterosexual Content Induces Different Cerebral Responses in Homosexual and Heterosexual Men

ABSTRACT

To determine the cerebral functionality associated with the perception and processing of erotic stimuli in men with different sexual orientation, this work evaluated the electroencephalographic activity (EEG) from several cortical areas, as well as subjective arousal in homosexual and heterosexual men during observation of an erotic film with heterosexual content. The heterosexual men rated the erotic video with higher general and sexual arousal than the homosexual participants. During observation of the neutral and erotic videos, both groups showed a decreased amplitude of the alpha band in prefrontal and parietal cortices, indicating increased attention. When watching the erotic video, the homosexual men showed an increased amplitude of the theta and fast bands only in the prefrontal cortex, which could be related to the cognitive processing of the erotic stimulus. These EEG results should broaden our knowledge of the cortical mechanisms related to the different perception and processing of erotic stimuli in men with different sexual orientations.     

How to Be a Healthy Homosexual: HIV Health Promotion and the Social Regulation of Gay Men in the United Kingdom

ABSTRACT

Primary Objective: Health promotion has arisen as the main response to the problem of HIV prevention among gay men. Using the linked concepts of governmentality and health promotion as a neoliberal disciplinary technology, this article argues that health promotion in the time of AIDS has contributed to new forms of social regulation and governance for gay men. Methods and Procedures: This article presents an analysis of data from a study of U.K. HIV health promotion for gay men (interviews with health promoters and analyses of health promotion materials). Conclusions: This analysis of health promotion is helpful in describing an emerging form of governance dependent on incentive rather than censure (censure, pathology and “cure” are how we traditionally describe the use of medical knowledge in the regulation of homosexuality).     

Navigating Islam and Same-Sex Liaisons Among Men in Turkey

ABSTRACT

This study reports the experiences of 20 Turkish men in having sex with men in an Islamic society. As part of a broader study on Turkish homosexualities, the article analyzes responses to the question, “What joys and difficulties have you experienced regarding your sexual orientation in relation to Islam?” to elicit responses on how Islam and homosexuality might coexist in everyday life.