New Directions for Research Examining Sexual Trauma Histories of Gay Men

Summary

Research efforts have been unable to accurately examine the effect of childhood sexual trauma in the adult lives of gay men. Complications stemming from precise definitions of abuse, as well as the subjectivity inherent in the terms, make comprehensive research difficult. As abuse and traumatic events may sometimes be subtle and not involve overt violence, these more delicate events are often overlooked or unaccounted for. Further, because it is a complex endeavor to obtain accurate reporting from children, research efforts rely on the self-reports of adults remembering traumatic events. The symptomatology that results from trauma, including amnesia and dissociation, also affects the reliability of self-report. Additionally, gay men have been notably absent from sexual trauma research efforts for a variety of reasons. A research study which investigates childhood sexual trauma in the histories of adult gay men is discussed. Directions for future research efforts are suggested.     

Childhood Sexual Trauma in Gay Men

Summary

Social context is a crucial lens through which to see and understand the experience of gay men who have been sexually abused as children. Clinicians who recognize the complex interplay of forces within this context will be better able to serve their gay male sexual abuse survivor clients. Given the trauma inherent in a cultural context which stigmatizes, devalues, pathologizes and punishes homosexuality, the added trauma of childhood sexual abuse in effect exponentially intensifies the trauma and the task of healing. It is particularly important that clinicians assist clients to separate sexual abuse and its effects from sexual orientation. Ideally, the former comes to be seen as imposed from without due to another's pathology, and the latter as an intrinsically good and positive part of self that exists entirely apart from the former. The phenomenon of an “Imprinted Arousal Pattern” (IAP), common among sexual abuse survivors, induces the individual to continue to be eroticized by stimulation and circumstances that overtly or covertly resemble the abuse circumstances. Case illustrations are provided to aid the reader in understanding and assisting others to work through this dynamic.     

HIV and the Cycle of Trauma in Gay Men

Summary

Forged within the sociocultural context of the collective trauma of AIDS, HIV prevention efforts became rigid, focusing almost exclusively on patient education as risk reduction. However, while some people have not been able to incorporate risk reduction into their behavioral patterns, others have indeed returned to high-risk behavior after a period of reduced risk as evidenced by the “Bareback” movement. HIV prevention education has overlooked the effect of oppression and sexual trauma on the lives of gay men, and the impact of these phenomena on the gay male's interest in, and ability to, negotiate safer sex. Sexual trauma has been shown to have a direct effect on HIV risk and seropositivity. Additionally, as sexual trauma (often in the form of homophobia) and HIV infection have numerous parallels, the gay man may have analogous ways of relating to, processing and dealing with the two phenomena. Case histories are offered to illustrate how the relationship between HIV and sexual trauma may be examined in an effort to enhance the self-esteem and self-concept of the gay man, and thereby offer greater possibilities for him to protect himself.     

Context is Everything

SUMMARY

As we approach the third decade of AIDS, HIV prevention in the United States confronts expanding public concern about continuing infections among gay men. This paper provides a brief history of HIV prevention efforts among gay men in the United States, as well as a succinct analysis of its successes and failures. By focusing on lessons learned from work in the 1980s-as well as lessons which have not yet' been learned-the author suggests future directions in HIVprevention for gay men which emphasize critical analysis of epidemiological trends, and countering the merging of gay identity with HIV infection. Supporting men to gain greater authority and responsibility¹ for their sexual community-building and redevelopment is necessary for lowering the infection rate among successive generations of gay men.     

Realities and Hopes for Older Gay Males

Abstract

Data about gay men in the Midwest over the age of 50 are extracted from a larger study of gay men and lesbian women. Information is sought regarding the role of sexual orientation, social networks, and social programs and activities in personal assessments of both the aging process and life satisfaction. The sample was divided into two groups: men 60 years of age and older, and men between the ages of 50 and 60. Differences were found between these subgroups, especially regarding acceptance of the aging process; yet these men were more similar than different in most aspects of life. Participation in gay community activities, social and religious, was found to be important for the quality of life of these men. Those integrated into the community, formally and informally, were also more likely to believe that their sexual orientation had helped their aging process.     

Illusions of Intimacy

Summary

Gay men share the common human need for meaningful intimate contact in which the connection is genuine, open and honest. This need can be frustrated, complicated and undermined by a sexual trauma history. The child's sense of personal boundaries, of sexual integrity and of affectional relationships is deeply impacted by a sexual trauma. The child learns that his needs become secondary to the offender's and as a result the victim learns to barter with his sexuality to get those needs met. The offender may foster a sense of isolation in the child, creating a perspective of the world that is harsh and dangerous, so that the child becomes terrified of abandonment. Homophobia is understood to be a “sexuality abuse” and as a result gay men often come in contact with other survivors. As a result, distinguishing between sex and love and recognizing genuine intimacy become difficult. This creates a spiral of difficulties whereby gay men may take enormous risks to “belong” or to avoid abandonment, often with profound consequences in terms of health and self-esteem.     

The Adolescent Sexual Development of African American Gay Men with AIDS: Implications for Community-Based Practice

ABSTRACT

This qualitative study describes the adolescent sexual development of ten African American gay men living with AIDS. The informants retrospectively describe the challenges of being a gay adolescent in a mostly heterosexist and homophobic environment. They report unsupportive homophobic and heterosexist family members, community members and school officials. They also describe their burgeoning sexual orientation, sexual initiation as well as consensual and non-consensual sexual experiences with their peers. Additionally, several informants describe seeking sexual experiences with adult men. Later they suggest the adult men became their primary sources of emotional and psychological support. Implications for community practice, intervention and research with both African American gay adolescents and adult men living with AIDS are discussed.     

Factors Influencing the Sexual Relationships of Lesbians and Gay Men

ABSTRACT

This study examined the rewards and costs that lesbians and gay men experience in their sexual relationships. Participants were 23 lesbians and 15 gay men who completed questionnaires and participated in a semi-structured interview. Frequently identified sexual rewards included emotional and physical intimacy, feeling accepted and supported, communication, and a positive view of self. Sexual costs included feeling vulnerable and negative social and cultural attitudes toward same-sex relationships. Sexual rewards and costs tended to cluster into three main categories: relationship factors, sexual factors, and factors related to being a sexual minority. The participants' responses illustrate the limitations of applying conventional (biomedical) models of sexual response to men as well as to women. Moreover, they strengthen calls for theories of sexual functioning that are based on diverse experiences and that consider sociocultural, political, economic, relational, psychological, and medical factors.     

Gay and Lesbian Couples at Home: Identity Work in Domestic Space

ABSTRACT

Social research into gay/lesbian experiences of home has tended to posit domestic environments as alienating for gay/lesbian subjects, silencing their sexual identities. Meanwhile, work on the spatiality of sexual identity more broadly has largely focused on individuals or communities, not couples or households. In this context, this article aims to recover the importance of home for gay/lesbian couples. I explore how cohabiting gay/lesbian couples generate shared identities through domestic space, examining various ways in which these couples use homes to establish and consolidate their partnerships. Empirical data is drawn from twenty-three in-depth interviews with gay/lesbian Australians who are cohabiting, or have cohabited, with a long-term partner. The sample is largely limited to white, educated, middle-class gay men and lesbians living in urban Australia, providing an ethnographic window into the domestic identity-formation of a particular community of practice. Four key themes regarding “coupled identities” at home emerged from the interviews: (i) the importance of privacy and control at home for enabling gay/lesbian partnerships; (ii) the negotiated creation and use of shared domestic spaces; (iii) the accumulation and arrangement of household objects in those domestic spaces; and (iv) the importance of maintaining separate “personal” spaces for each partner for the well-being of the relationship.     

Male Survivors of Childhood Sexual Abuse: A Qualitative Study and Issues for Clinical Consideration

ABSTRACT

This qualitative study explored the effects of childhood sexual abuse with 10 adult male survivors. The men who participated in the research were largely motivated by their perception that North American society does not acknowledge the sexual abuse of boys. They described the abuse as having significantly affected their sexual identity, as well as their emotional and sexual relationships as adults. The implications of these issues for clinical intervention are described.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

Community Corrections Officers' Attributions for Sexual Offending Against Children

ABSTRACT

The present research examined gender differences in community corrections officers' (CCOs') attributions for child sexual offending. Eighty-five CCOs were asked to write down the reasons why they thought men sexually abused children, and then rate their reasons using Benson's Attributional Dimensions Scale. The results found that CCOs' reasons regarding why men sexually abuse children strongly paralleled current scientific theories on the etiology of child sexual abuse. Also, significant gender differences were found regarding the frequency with which participants cited certain types of reasons for child sexual abuse. Female CCOs were more likely to cite power and control as a reason, while male CCOs were more likely to cite psychopathology as a reason for child sexual abuse. No other gender differences were found. The research, clinical, and educational implications pertaining to these findings are discussed.     

Strategies Used by Gay and Bisexual Young Men to Cope With Heterosexism

ABSTRACT

Although the pervasiveness of heterosexism in the lives of gay and bisexual youth is well established, little is known about the strategies these youth use to cope with stigma and discrimination based on their sexual minority status. In this qualitative study, the authors present findings and implications for clinical practice based on interviews with 43 gay and bisexual young men. Respondents’ coping strategies are discussed in relation to current theory and research on coping with stigma, as well as the emerging field of emotion regulation. The narratives from the current study suggest that the emotion regulation paradigm is well suited to understanding the functions of strategies for coping with heterosexism and similar types of stigma.     

Silence and Assumptions: Narratives on the Disclosure of HIV Status to Casual Sexual Partners and Serosorting in a Group of Gay Men in Barcelona

ABSTRACT

Disclosing HIV status and seeking sexual partners with the same serostatus (serosorting) are strategies used by some gay and bisexual men to have unprotected anal intercourse (UAI). This study aims to gain an understanding of the occurrence of disclosure and serosorting with casual sexual partners. A grounded approach was used to analyze 22 interviews with gay men from Barcelona. The results reveal that disclosure of serostatus or the seeking of sexual partners of the same HIV status are not behaviors in the repertoire of most HIV-negative men and were not even taken into account when they engaged in UAI with casual sexual partners. The opposite was observed in HIV-positive respondents who did consider the possibility of revealing their serostatus. Some relied on intuition or subjective elements to evaluate the HIV status of their occasional partners.     

Free Symbolic Play and Assessment of the Nature of Child Sexual Abuse

ABSTRACT

This article highlights the potential value of free symbolic play to the field of sexual abuse. The following two points are argued: (1) free symbolic play is a modality well suited to the expression, reworking and mastery of psychic trauma and therefore offers sexually abused children a channel for communication; (2) free symbolic play is a potential source of information to mental health professionals when attempting to understand the context of a child's experience of sexual abuse. Preliminary guidelines are suggested regarding the appropriate use of free symbolic play to gain information about possible sexual abuse. In addition, a case study is presented illustrating application. Furthermore, the potential impact of research comparing the free symbolic play of sexually abused and nonabused children is considered.     

Abstracts of the Scientific Programs of the American College Health Association Fifty-Eighth Annual Meeting April 9-12, 1980, San Diego,California

Abstract

Gay male university students less than 25 years old were studied to determine whether they had changed their sexual activity patterns to reduce the risk of HIV infection. Most had not established sexual behavior patterns typical of the older gay men who had been studied in earlier research. Although most of the participants surveyed were concerned about HIV infection, some did engage in risky sexual behavior. The riskreduction strategies most often used were having fewer sexual partners and being more selective in choosing partners. Future HIV-prevention interventions must be designed to address the needs of this generation of gay men.     

Research with Gay Drug Users and the Interface with HIV

Abstract

Studying the co-occurrence of drug use and sexual risk behaviors among gay men poses special challenges for research. The importance of conducting such research, however, is underscored by current trends in the gay community, including increases in methamphetamine and club drug use. This increase has been associated with high-risk behavior for the transmission of HIV and other diseases (e.g., hepatitis B and hepatitis C). The author describes methodological issues related to initiating and conducting research among gay male drug users, and discusses how such research can guide more effective prevention, treatment, and policy initiatives related to drug abuse and HIV/AIDS.     

Stigma and family relationships of middle-aged gay men in recovery

The primary objective of this study was to explore how middle-aged gay men in recovery cope with stigma and family relationships. For gay men, perceptions of acceptance of their sexual orientation and degree of social connectedness can play a role in their recovery from alcohol and substance use disorders. Yet gay men may have a more difficult time accessing certain family-level health resources because their families of origin may stigmatize, reject, or silence them on account of their sexual orientation. Semi-structured interviews were used to explore how participants in recovery constructed and coped with their experiences of stigma, family relationships, and alcohol and substance use. Participants (30 gay men ages 50 to 64) completed a questionnaire and interview. We used constructivist grounded theory method and minority stress theory as a theoretical framework to interpret the data. We identified the following themes: Internalization of Stigma, Changes in Coping Strategies, and Ongoing Stigma. Future research should explore how to incorporate familial support into gay men's recovery, address ongoing internalized stigma, and develop a social response to stigma, rather than leaving it to individuals to confront on their own.     

Not All Alike

Abstract

Most published research regarding same-sex relationship abuse experienced by lesbian, gay, bisexual, and transgender (LGBT) people notes a need for services. However, the LGBT community is quite heterogeneous, and useful support may vary based on demographic characteristics. This research examined within group differences regarding type of support sought and its usefulness. Eighty nine percent (n = 677) of a diverse sample of LGBT people (N = 760) experienced abuse in a same-sex relationship. Of those who experienced some type of emotional, physical, and /or sexual abuse, differences in help sought and its usefulness were found based on age, income, gender, sexual orientation, and ethnicity.