The Relationship Between Homosexuality,Internalized Homo-Negativity,and Mental Health in Men Who Have Sex with Men

ABSTRACT

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.     

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 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.     

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.     

The development of an Internalized Homonegativity Inventory for gay men

Because existing scales measuring internalized homonegativity suffer from various content validity flaws, a more valid instrument is needed. The purpose of this study was to develop and provide preliminary reliability and validity evidence for the Internalized Homonegativity Inventory (IHNI), which measures internalized homonegativity in gay men. Forty-two items were initially generated from a construct definition and were administered to 241 gay men living in the U.S. Exploratory factor analyses suggested that 23 items loaded on 3 subscales, which were labeled Personal Homonegativity, Gay Affirmation, and Morality of Homosexuality. IHNI scores correlated in expected directions and magnitude with measures of extroversion, emotional stability, stage of gay identity development, and another internalized homonegativity instrument. Implications of the three-factor structure of the IHNI for the conceptualization of internalized homonegativity are discussed.     

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.     

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.     

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.     

Comparing Heterosexuals’ and Gay Men/Lesbians’ Responses to Relationship Problems and the Effects of Internalized Homophobia on Gay Men/Lesbians’ Responses to Relationship Problems in Turkey

The purpose of the present study was twofold: (1) to investigate the effects of sexual orientation (heterosexuals and gay men/lesbians) and gender difference on responses to romantic relationship problems (Exit, Voice, Loyalty, and Neglect [EVLN] responses) and of perceived partner’s EVLN responses in Turkey, and (2) to examine whether internalized homophobia was associated with EVLN responses and perceived partner’s EVLN responses for gay men and lesbians. Responses to Dissatisfaction Scale-Accommodation Instrument, Internalized Homophobia, and Demographics Information were administered to 187 participants (44 lesbians, 44 gay men, 53 heterosexual women, 46 heterosexual men).The MANCOVA results showed that men reported higher loyalty than women, whereas women presented more exit responses than men. Further, the interactions between gender and sexual orientation on the participants’ EVLN responses and on the perceived partner’s EVLN responses were significant. With respect to heterosexual women, heterosexual men displayed more loyalty responses. Lesbians had higher scores on loyalty than did heterosexual women. Lesbians also had higher scores on perceived partner’s exit response than did heterosexual women and gay men. On the contrary, heterosexual women reported more perceived partner’s voice response than lesbians. In addition, lesbians reported higher perceived partner’s neglect responses than heterosexual women. Compared to heterosexual women, heterosexual men reported higher perceived partner’s exit response. Finally, internalized homophobia was associated with destructive responses for both lesbians and gay men.     

Mental health concerns of gay and bisexual men seeking mental health services

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.     

Differences between previously married and never married 'gay' men: family background, childhood experiences and current attitudes

Despite a large body of literature on the development of sexual orientation, little is known about why some gay men have been (or remain) married to a woman. In the current study, a self-selected sample of 43 never married gay men ('never married') and 26 gay men who were married to a woman ('previously married') completed a self-report questionnaire. Hypotheses were based on five possible explanations for gay men's marriages: (a) differences in sexual orientation (i.e., bisexuality); (b) internalized homophobia; (c) religious intolerance; (d) confusion created because of childhood/adolescent sexual experiences; and/or (e) poor psychological adjustment. Previously married described their families' religious beliefs as more fundamentalist than never married. No differences were found between married' and never married' ratings of their sexual orientation and identity, and levels of homophobia and self-depreciation. Family adaptability and family cohesion and the degree to which respondents reported having experienced child maltreatment did not distinguish between previously married and never married. The results highlight how little is understood of the reasons why gay men marry, and the need to develop an adequate theoretical model.     

The mediating effects of attitudes toward homosexuality between secure attachment and disclosure outcomes among gay men

Past research has found that a stronger secure attachment style, developed in childhood, enhances one's ability to acknowledge negative feelings, cope with negative life events, and develop satisfying social relationships. Because an integral part of the "coming out" process for gay men is the ability to seek support from the gay community in order to reevaluate negative beliefs toward homosexuality, a gay man's attachment style may strongly impact this critical stage of his life. Results demonstrated that men who more strongly endorsed a secure attachment style reported more positive attitudes toward their own homosexuality, and that these more positive attitudes could mediate the relation between more secure attachment style, greater levels of self-disclosure regarding their homosexuality, and greater self-esteem. Implications of these data for internalized homophobia, the coming-out process, and effective social functioning are discussed.     

To hide or not to hide, that is the question! Lesbians and gay men describe experiences from nursing work environment

Homosexual nursing staff (n = 21) from different parts of Sweden were interviewed about experiences from their psychosocial work environment and about what they consider important points to communicate about lesbians and gay men in nursing. The findings show that most of the informants were partly open about their sexual orientation at work, the women less so than the men. All informants spoke of the fear of being socially excluded. Reported negative experiences included being neglected, harassment, and verbal discomfort based on sexual prejudices. The informants regarded responsibility, the need for knowledge, the consequences of invisibility, and the lesbian's specific situation, important points to communicate regarding homosexuality and nursing.     

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.     

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.     

Gay youth in four cultures: a comparative study

Young and older homosexual men in four countries (Sweden, Finland, Ireland, and Australia) were compared on a number of psychological, social, and psychometric indices to determine what differences existed between them, and the effect of culture on any such differences. Data show that there are greater differences between younger and older homosexual men as the culture appears more antihomosexual, and that younger homosexual men are less likely to accept their sexual orientation and more likely to accept myths surrounding homosexuality. Younger homosexual men were also more likely to have had gonorrhea (regardless of their number of sexual partners), to prefer receptive anal intercourse, and to have contacted partners by cruising. These data confirm that mental health consequences of antihomosexual environments are most negative where homosexuality is most severely stigmatized.     

Theoretical considerations in psychotherapy with gay men and lesbians

This paper examines certain issues relevant to psychotherapy with gay men and lesbians. The roles of general factors in psychotherapy in relation to homosexuality, including the theoretical orientation of the therapist, the nature of the presenting problem, the mode of therapy, and the personal characteristics of the therapist, are discussed. Special issues of concern to gay men and lesbians, specifically the question of pathology, the amount of information the therapist has about homosexuality, the sexual orientation of the therapist, and the unique problems of gay men and lesbians, are reviewed. Finally, an overview of the role of homophobia in psychotherapy is presented, and the importance of further exploration in this area is discussed.     

Personality correlates of positive identity and relationship involvement in gay men

Six personality variables (social anxiety, trait anxiety, locus of control, sensitization, depression, and self concept) were correlated with variables relevant to a positive gay identity (degree of communication about sexual preference and degree of comfort being gay) and to relationship involvement (being in a gay relationship, number of months in a gay relationship, and living with a partner) in a volunteer, nonclinical sample of 51 gay males. Men who informed others of their sexual preference were low on trait anxiety, sensitization, and depression and high on self concept. Men comfortable with their gay identity were low on social anxiety, sensitization, and depression and high on self concept. Men involved in long-term relationships were low in trait anxiety, had an internal locus of control, and were low in depression. Men living with a partner had a higher self concept than men not living with a partner. Results are discussed in terms of previous studies of gay male relationships.     

Navigating Islam and same-sex liaisons among men in Turkey

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.