Effect of a Web-Based Sexual Health Enhancement Program for Women with Gynecologic Cancer and Their Husbands

Objectives: This study examined the effects of a web-based sexual health enhancement program on of women with gynecologic cancer and their husbands. Methods: Twenty-one couples attended the program for 4 weeks and 22 couples were assigned to a control group. Results: The experimental group reported significant improvements in the sexual function of the women with gynecologic cancer (effect size [ES] = .75; p?p?=?.015). Conclusions: Therefore, our results can help provide interventions for patients and their husbands to identify and resolve sexual problems after gynecologic cancer treatment.     

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.     

Integrating Sexual Orientation in Career Counseling: Acting to End a Form of the Personal-Career Dichotomy

Ignoring sexual orientation in career counseling practice is presented as a specific case of failing to integrate an aspect of the personal dimension into career counseling. Three case examples illustrate specific actions that career counselors must take to integrate this important aspect of the personal dimension into career counseling. The actions suggested involve three general areas: (a) signaling lesbian and gay affirmation in career counseling practice, (b) enhancing the development of a positive gay or lesbian identity in the context of career development work, and (c) recognizing and integrating the reality of anti-gay stigma in career counseling.     

Minority Stress Theory: An Examination of Factors Surrounding Sexual Risk Behavior Among Gay and Bisexual Men Who Use Club Drugs

Background: Few studies have examined the impact of minority stress theory (MST) upon sexual risk behavior among gay and bisexual men using club drugs. Similar studies have focused on ethnic minorities and women; however, gay and bisexual men demonstrate greater likelihood for risk behaviors leading to HIV/AIDS. Objective: This study examines sexual risk behavior from the perspective of minority stress theory upon substance-using gay and bisexual men and their partners. Methods: Multivariable logistic regression analysis examined minority stress associations with participant sexual risk behaviors, drug use, and partner type, controlling for demographics. Results: 396 gay and 54 bisexual respondents, ages 18–67, reported at least one-time drug use while engaging in sexual risk behavior. In the adjusted model, expectations of rejection associated with lower odds of sexual risk behavior, while older age approached significance. Conclusions: Theoretical origins for examining risk behavior among gay and bisexual men may underscore risk and protective factors, while ultimately holding implications for prevention and treatment interventions.     

Gay Men

Summary

This report presents the findings from four ethnographic studies of older gay men (Brown, 1997; Brown, Sarosy, Cook & Quarto, 1997; Cook, 1991; Quarto, 1996; Sarosy, 1996). There were 69 total participants who ranged in age from 36 to 79 years; most were from 50 to 65 years of age. The purpose of these studies was to examine how older gay men have adjusted, psychologically and socially, to their sexual orientation and aging process. Participants reported that they spend 50% time or more with gay friends within their own age cohorts. Many reported being involved with the gay community in some capacity, while about 15% had no involvement with the gay community. Most participants were in regular contact with their families. Most stated that their families were aware of their sexual orientation. Most of the participants reported experiencing discrimination due to sexual orientation, and one third had experienced discrimination within the gay community based on age or ethnicity. With regard to sex life, the studies found an overall lowered frequency of sexual activity. Participants felt that HIV/AIDS has had a devastating impact on older gay men, interrupting the normal aging process for those who have contracted it and prematurely aging those who care for them. The studies' findings identified the qualities of healthy adaptation to aging for older gay males: having satisfying relationship, self-acceptance as one ages, good health, an active life with a variety of interests, and financial security.     

“It Takes a Man to Put Me on the Bottom”: Gay Men’s Experiences of Masculinity and Anal Intercourse

In anal intercourse between gay men, men who are typically insertive (“tops”) are often perceived as, and may identify as, more masculine than those who are typically receptive (“bottoms”). “Versatile” men, who may adopt either position, may be perceived as more gender balanced and may transcend the gender-role stereotypes associated with self-labeling as top or bottom. The aim of this study was to explore how gay men’s beliefs about masculinity were associated with their beliefs about the gendered nature of sexual self-labels and their behavior in anal intercourse. Individual semistructured interviews were undertaken with 17 UK-based gay men. Interpretative phenomenological analysis (IPA) identified that perceptions of tops and bottoms as gendered social identities varied depending on the extent to which gay men subscribed to the mandates of hegemonic masculinity, the dominant masculinity in Western society. The findings also suggested that some gay men differentiated between top and bottom as social identities and topping and bottoming as gendered behaviors. This had implications for gay men’s behaviors in anal intercourse. It is suggested that future efforts to engage with gay men about their sexual behavior should account for their beliefs regarding the gender-role stereotypes associated with gay sexual self-labels.     

‘Coming Out Tales’: Adult Sons and Daughters' Feelings About Their Gay Father's Sexual Identity

Coming out to their children is a dilemma that concerns many gay, bisexual, and lesbian parents with children from previous heterosexual relationships. How children found out about having a father who identified himself as gay, and their feelings about their father's sexual identity, were explored through qualitative analysis of semi‐structured interviews with 36 sons and daughters (aged 19 to 36 years) whose gay fathers participated in the Gay & Bisexual Parenting Survey (Barrett and Tasker, 2001). Interpretative Phenomenological Analysis revealed that awareness of their father's sexual identity was often left unspoken for various reasons, and that acceptance came about through gradual understanding as well as direct discussion. Interview data indicated the complexity of the relationship between the young adult's personal acceptance of their father's gay identity and their consideration of social context when deciding how open to be to others about their father's sexual identity. This research has varied implications for therapeutic work with gay and bisexual fathers coming out to their children from previous heterosexual relationships.     

Sexual identity development among gay, lesbian, and bisexual youths: consistency and change over time

A longitudinal report of 156 gay, lesbian, and bisexual youths examined changes in sexual identity over time. Fifty-seven percent of the youths remained consistently self-identified as gay/lesbian, 18% transited from bisexual to gay/lesbian, and 15% consistently identified as bisexual over time. Although youths who consistently identified as gay/lesbian did not differ from other youths on time since experiencing sexual developmental milestones, they reported current sexual orientation and sexual behaviors that were more same-sex centered and they scored higher on aspects of the identity integration process (e.g., more certain, comfortable, and accepting of their same-sex sexuality, more involved in gay-related social activities, more possessing of positive attitudes toward homosexuality, and more comfortable with others knowing about their sexuality) than youths who transited to a gay/lesbian identity and youths who consistently identified as bisexual. Contrary to the hypothesis that females are more sexually fluid than males, female youths were less likely to change identities than male youths. The finding that youths who transited to a gay/lesbian identity differed from consistently gay/lesbian youths suggests that identity integration continues after the adoption of a gay/lesbian sexual identity.     

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.     

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.     

Gay marriages and communities of sexual orientation

This article focuses on gay male couples as they exist within friendship networks of other gay men. By comparing homosexual men who are part of a gay community with those who are less integrated into a gay community, we attempt to show that the sexual liaisons of the former are more “marriage-like.” Gays committed to a community of other homosexual men were found to live more often with their lovers, be more sexually faithful to their lovers, and to have more emotionally intimate relationships. Also, they were found more likely to associate with other gay couples. Commitment to a gay community was not found to be associated with length of a liaison, and it seemed that when respondents defined emotional intimacy in terms of sexual exclusiveness there may have been a tendency for disruption of relationships. The gay community validates the sexual liaisons of gay men in the same way that the heterosexual world validates the pairings of heterosexuals and transforms their subinstitutional sexual liaisons into the institution of marriage.     

Social‐developmental factors affecting lesbian and gay youth: a review of cross‐national research findings

Lesbian and gay youth face a great many challenges as they grow up. In this article, research focusing upon the social‐developmental factors that affect the positive development of a lesbian or gay identity are reviewed, comparing and contrasting data from the United States (US) and United Kingdom (UK). Consideration is also given to the efficacy of behaviours utilised by young lesbians and gay men to avoid harassment and discrimination. It is suggested that lesbian and gay youth represent a particularly vulnerable group of young people who engage in a number of health risk behaviours that are associated not only with sexual orientation, but also fears for personal safety. Finally the authors discuss whether or not strategies to conceal sexual orientation hold benefits for lesbian and gay youth in terms of their physical safety and mental health. Copyright © 2003 John Wiley & Sons, Ltd.     

Redefining Sex and Intimacy: The Sexual Self-Images,Outlooks, and Relationships of Gay Men Living with HIV/AIDS

This paper examines how gay men living with HIV disease come to terms with the profound sexual implications of their illness. Based on interviews with 25 gay men diagnosed with HIV/AIDS, this paper highlights (a) the disruptions that these men experience in their sexual feelings and self-images as a result of their illness; (b) the challenges they encounter in negotiating and sustaining sexual relationships; (c) the declines they experience in their sexual attractiveness, desire, and capacities as their illness advances; and (d) the changed meanings they give to sex and self as they come to terms with the erotic implications of their illness and try to preserve valued, intimate identities. In focusing on these themes, this paper offers an “insider's view” into key dimensions of the moral experience of gay men with HIV/AIDS. It also illustrates how the moral experience of these men shifts over the course of their illness, especially in response to the changes and challenges that arise in their intimate relationships and subcultural networks. On a broader, analytic level, this paper addresses a research question that has been neglected in previous studies of the experience of illness—that is, how does serious illness affect the sexuality of diagnosed individuals, particularly their construction of sexual and intimate identities? Through examining this question, this paper contributes to and extends the growing interactionist literature on the consequences of illness for self.     

Autocastration and autopenectomy in a patient with transsexualism and schizophrenia

Previous research focusing on changes in gay male sexual practices as a result of AIDS often avoids taking into consideration the meanings which sexual practices have within the gay community. As an alternative, the present study used a content‐analysis of personals advertisements within the personals section of The Village Voice to assess changes in the language gay men use to refer to their sexuality between the years 1978, 1982, 1985, and 1988. A significant increase in personals advertisements suggesting a concern with health is noted from 1982 to 1985. This increase continues from 1985 to 1988. Corresponding in time with these changes are increases in the number of personals advertisements which express a rejection of “stereotypical” presentations of self within the gay community. This rejection is seen as an attempt at self‐affirmation of characteristics perceived by gay men themselves as being desirable at particular historical moments. Implications for the basis of future policy interventions in reaction to AIDS are discussed. Finally, the utility of personals advertisement columns as an indicator of the meanings which people of various sexual preferences attach to their sexuality is discussed.     

The Insidious Effects of Sexual Stereotypes in Clinical Practice

The present study investigated the influence of sexual stereotyping on the diagnostic impressions and treatment expectations of gay and straight male patients. Italian male, straight, licensed psychotherapists (N = 152) were presented with clinical vignettes that described a gay (versus straight) male patient reporting either a straight-stereotypical disorder (i.e., rage dyscontrol) or a gay-stereotypical disorder (i.e., sexual compulsivity). Results revealed that treatment efficacy expectations were influenced by the patient’s sexual orientation and the stereotypicality of the disorder. Specifically, psychotherapists anticipated fewer benefits from psychotherapy when gay patients reported a sexual disorder rather than a rage disorder. Furthermore, explicit and implicit levels of sexual prejudice did not play any role in driving such results. Taken together, these findings reveal that sexual stereotyping might exert its subtle effects among clinicians by influencing their clinical evaluations.     

Not All Men,Situations, and Actions Are Equal

SUMMARY

Since 1985, annual surveys conducted in the French gay press show that gay men in France have made considerable changes in their sexual behavior due to the AIDS epidemic. However, risky behavior still occurs. In this article, some ideas which have been assumed concerning residual risk among gay men are tested. The research questions were: (1) Should all unprotected acts of anal intercourse be considered risky? (2) Has a phenomenon of relapse really occurred among gay men in France? and, (3) Are risks only limited to men who are on the margin of the gay community? Before answering these questions, major landmarks in HIV prevention for gay men in France are reviewed. Then, on the basis of the results of the 1995 Gay Press Surrey, subjects' perception of the degree to which they are socially accepted, and the diversity of homosexual lifestyles are presented, finally, we describe how respondents have adjusted to HIV-risk at a time when there has been much talk about the re-emergence of risk behaviors and a resurgence of the AIDS epidemic among homosexual men.     

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.     

“I Want to Feel Like a Full Man”: Conceptualizing Gay,Bisexual, and Heterosexual Men’s Sexual Difficulties

Current understandings of sexual difficulties originate from a model that is based on the study of heterosexual men and women. Most research has focused on sexual difficulties experienced by heterosexual men incapable of engaging in vaginal penetration. To better understand men’s perceptions and experiences of sexual difficulties, seven focus groups and 29 individual interviews were conducted with gay (n = 22), bisexual (n = 5), and heterosexual (n = 25) men. In addition, the extent to which difficulties reported by gay and bisexual men differ from heterosexual men was explored. Data were analyzed using thematic analysis applying an inductive approach. Two intercorrelated conceptualizations were identified: penis function (themes: medicalization, masculine identity, psychological consequences, coping mechanisms) and pain (themes: penile pain, pain during receptive anal sex). For the most part, gay, bisexual, and heterosexual men reported similar sexual difficulties; differences were evident regarding alternative masculinity, penis size competition, and pain during receptive anal sex. The results of this study demonstrate the complexity of men’s sexual difficulties and the important role of sociocultural, interpersonal, and psychological factors. Limitations and suggested directions for future research are outlined.     

Negotiating Emotional Support: Sober Gay Latinos and Their Families

This study explores how sober gay Latino men obtain support from their families. Familial ties can be a protective health factor, yet many gay Latinos experience rejection from family members because of their sexuality. There are very few studies that examine the extent and quality of emotional support from kin for this population. Understanding family dynamics within the context of recovery and sexuality can increase our understanding of how to leverage family ties to develop alcohol abuse interventions. The study was conducted via semistructured interviews with 30 sober gay Latinos using a grounded theory approach. Analyses of the qualitative data identified the following themes: family values shaped the participants’ perception of their range of choices and emotional responses; participants reported feeling loved and supported even when sexuality was not discussed with parents; and family support for sobriety is essential. Findings suggest that familial ties shape perceptions of support and importance of disclosing sexual identity. Family support often results from agreements about sexual identity disclosure, and some families can overcome cultural and religious taboos on sexuality. Future studies should investigate families that negotiate acceptance with their gay members, and whether they exhibit heterosexual biases that may influence the psychological stress of gay Latino men who wish to be sober.