Coming Out Experiences and Psychological Distress of Chinese Homosexual Men in Hong Kong

This study adopted a cognitive-behavioral conceptual framework based on the Theory of Reasoned Action (TRA) in understanding coming out experiences and psychological distress of 187 Chinese gay men. Results showed that participants' coming out experiences were characterized by same-sex sexual fantasy at teenage years, followed by awareness of homosexual tendency, same-sex sexual contact, and then self-identification and disclosure of homosexual orientation in young adulthood. Regarding targets of disclosure, participants tended to disclose their sexual orientation to their gay friends first, followed by heterosexual friends, siblings, parents, and coworkers. This study also supported the extension of the TRA conceptual framework to Chinese societies. Results showed that a low level of psychological distress in Chinese gay men was linked to their coming out experiences, which were in turn related to TRA components of involvement and identification with gay communities and positive attitudes toward coming out. Limitations and implications were also discussed.     

Gay and Bisexual Identity Development Among Female-to-Male Transsexuals in North America: Emergence of a Transgender Sexuality

We studied a North American sample of female-to-male (FtM) transsexuals sexually attracted to men, aiming to understand their identity and sexuality in the context of a culture of transgender empowerment. Sex-reassigned FtM transsexuals, 18 years or older and attracted to men, were recruited via an FtM community conference and listserv. Participants (N = 25) responded to open-ended questions about identity development, sexual behavior, and social support. Data were analyzed by content analysis. Scores for sexual identity, self esteem, sexual functioning, and psychological adjustment were compared to those of a comparison group (N = 76 nontransgender gay and bisexual men). Of the 25 FtMs, 15 (60%) identified as gay, 8 (32%) as bisexual, and 2 (8%) as queer. All were comfortable with their gender identity and sexual orientation. The FtM group was more bisexual than the nontransgender gay and bisexual controls. No significant group differences were found in self esteem, sexual satisfaction, or psychological adjustment. For some FtMs, sexual attractions and experiences with men affirmed their gender identity; for others, self-acceptance of a transgender identity facilitated actualization of their attractions toward men. Most were “out” as transgender among friends and family, but not on the job or within the gay community. Disclosure and acceptance of their homosexuality was limited. The sexual identity of gay and bisexual FtMs appears to mirror the developmental process for nontransgender homosexual men and women in several ways; however, participants also had experiences unique to being both transgender and gay/bisexual. This signals the emergence of a transgender sexuality.     

Disclosure,discrimination and desire: experiences of Black and South Asian gay men in Britain

Using findings from a qualitative investigation based on in-depth email interviews with 47 Black and South Asian gay men in Britain, this paper explores the cross-cutting identities and discourses in relation to being both gay and from an ethnic minority background. Taking an intersectional approach, detailed accounts of identity negotiation, cultural pressures, experiences of discrimination and exclusion and the relationship between minority ethnic gay men and mainstream White gay culture are presented and explored. The major findings common to both groups were: cultural barriers limiting disclosure of sexuality to family and wider social networks; experiences of discrimination by White gay men that included exclusion as well as objectification; a lack of positive gay role models and imagery relating to men from minority ethnic backgrounds. Among South Asian gay men, a major theme was regret at being unable to fulfil family expectations regarding marriage and children, while among Black gay men, there was a strong belief that same-sex behaviour subverted cultural notions related to how masculinity is configured. The paper concludes by highlighting the importance of social location, particularly education and income, when examining the intersection of ethnicity and sexuality in future research.     

Exploring talk about sexuality and living gay social lives among Chinese and South Asian gay and bisexual men in Auckland,New Zealand

ABSTRACT

Objective: To identify ways Chinese and South Asian gay and bisexual men living in Auckland talk about issues related to sexuality and experiences of living ‘gay social lives.’ Results will be available to inform health policy and practice.

Design: A qualitative design with individual interviews and thematic analysis was used. Semi-structured digitally recorded interviews were undertaken with 27 Chinese and 17 South Asian gay and bisexual men living in Auckland.

Results: Four themes in the data related to talk about sexuality and living gay social lives are reported: (a) ‘Happy in my skin’: Being gay is Ok! (b) ‘To come out or not’: Managing sexual identity, (c) ‘Places to go, people to see’: Connecting with others, and (d) ‘What's wrong with being Asian’: Tolerating discrimination.

Conclusion: There are many similarities in the ways these men talked about their identity and sexuality that can be usefully considered by health policy makers and service planners. The concept of gay (and bisexual) sexuality had some salience for the men interviewed, despite the adoption and acknowledgement of same-sex identity being a relatively new phenomenon in some Asian countries. This supports the use of these terms in local health interventions. However, as these men closely managed their gay identity and typically had not disclosed their sexuality to others, including healthcare professionals, interventions to address the skills and comfort of healthcare providers in addressing sexuality in clinical settings appear warranted to facilitate optimal healthcare. These men are not well connected with others and this has implications for HIV health promotion that is based on creating cultural norms among networks to encourage safe sex. Discrimination results in many Chinese and South Asian gay and bisexual men disengaging from connecting with others and should be addressed.     

Experiences of racism,sexual objectification and alcohol use among gay and bisexual men of colour

ABSTRACT

Objective: Previous research has shown that experiences of racial discrimination and sexual objectification are associated with health risk behaviours among gay and bisexual men of colour. However, little is known about whether racial discrimination and sexual objectification are associated with alcohol use among this population. This community-based study examined the association between racial discrimination, sexual objectification and alcohol use in a sample of 369 gay and bisexual men of colour (Black/African/Caribbean, Latino/Latin American, South Asian, and East and Southeast Asian) in Toronto.

Design: Data were drawn from an online survey designed to examine issues of racism, homophobia, health and well-being among gay and bisexual men of colour in Toronto. Regression analysis assessed the relationship between scores on the Racism and Life Experiences Scale, Sexual Objectification Scale, and the CAGE questionnaire (a screen for alcohol use disorder).

Results: Multivariable logistic regression analyses revealed that experiences of racism and sexual objectification are significantly and positively associated with a screening for alcohol use disorder. The interactions between Latino/Latin American race/ethnicity and experience of sexual objectification were also positively associated with a screening for alcohol use disorder.

Conclusions: Health professionals should consider the role of racial discrimination and sexual objectification within the context of risk and treatment for alcohol use disorders, harm reduction, and HIV prevention for gay and bisexual men of colour.     

Exploring the implications for health professionals of men coming out as gay in healthcare settings

Coming out as gay is a social process which redefines the relationship between the persons who have decided to disclose their homosexuality and their listeners. This paper, drawing upon Bakhtin's (1984) theories of dialogue, the coming-out literature of gay men and lesbians and contemporary literature on doctor-patient communication, explores the coming-out experiences of gay men with their general practitioners and sexual health clinic staff. The findings are based upon a study of 38 gay men and 12 health service managers in London. The informants were recruited purposively to reflect some of the diversity of the London setting; recruitment was carried out through the channels of gay voluntary organisations and through snowballing. Semi-structured interviews were conducted and a grounded-theory approach was adopted. It was found that coming out in general practice was often/mostly followed by silence/noncommunication on the part of the practitioner; coming out could, however, result in an improvement in communication if the patients were well supported and assertive. If coming out in sexual health clinics did not result in improved communication, the informants in this study were likely to change clinics until they did find improved communication. This paper raises questions about the communication and training needs of general practitioners. It also raises questions about inequalities of access to 'respectful' sexual health clinics; while men who are articulate about the narratives of their lives as gay men are able to exercise informed choices, there were grounds for concern about the choice behaviours of men who are less articulate about their life narratives.     

A Framework For the Formation of Gay Male Identity: Processes Associated with Adult Attachment Style and Support From Family and Friends

We propose a novel conceptual framework for the study of gay male identity formation in relation to the person's self, family, and social relations. The three basic processes of gay male identity are defined—self-definition, self-acceptance, and disclosure—and theoretically linked to attachment style and social support. The results, based on an Israeli sample of gay men (n = 121), indicated that self-acceptance and friends' support predict secure attachment in close adult relationships, and that self-definition and support from family and friends predict disclosure. Supportive family attitudes toward same-sex orientation mediated the effect of general family support on disclosure. These results suggest that the independent assessment of identity processes provides a flexible alternative to stage models' assumption of a single linear developmental process, that the formation of gay identity is associated with inner models of adult relationships, and that support of family and friends have a different role in the coming out process and in the formation of one's adult attachment model.     

Muslim and gay: seeking identity coherence in New Zealand

The process of accepting oneself as gay and of ‘coming out’ to family and friends is well documented. For Muslim men, this is complicated by the tension between their emerging sexual identity and their religious and cultural birth identity, which labels homosexuality as sinful. This paper explores this process in a sample of five gay Muslim men living in New Zealand, a liberal secular society where homosexuality is widely accepted and gay rights are endorsed in legislation. Identity Process Theory drives the analysis, which identifies five themes encapsulating the process of striving for psychological coherence: resistance, acceptance, tension, renegotiation and pretence. Initial phases of denial and anger at their emerging sexuality are strongly linked to the conflict with their religious identity. Later, acceptance of their sexuality as natural and even God-given protects them from blame for their ‘sins’. In contrast to earlier work in the UK, for most men, renegotiation of their Muslim identity is adopted as the key strategy for achieving intrapsychic coherence. However, at an interpersonal level, families remain a source of conflict, temporarily resolved through pretence. Renegotiating religious identity leaves men having to pretend not just to be straight, but also to be strongly religious.     

Sex Toy Use by Gay and Bisexual Men in the United States

Recent studies have documented that vibrators are an important part of the sexual repertoires of both men and women and have demonstrated positive sexual health outcomes among individuals who use such products. However, little is known about the use of other sexual enhancement products, particularly among gay and bisexually identified men. This study sought to document the extent to which gay and bisexually identified men report using sex toys and the sexual and relational situations within which they used them. Data were collected via an internet-based survey from 25,294 gay and bisexually identified men throughout the U.S. recruited from an Internet site popular among men seeking social or sexual interactions with other men. A majority (78.5%) of gay and bisexually identified men reported having used at least one type of sex toy, including dildos (62.1%), non-vibrating cock rings (51.9%), vibrators (49.6%), butt plugs (34.0%), masturbation sleeves (27.9%), and anal beads or balls (19.3%). Among users, toys such as dildos or butt plugs were commonly inserted into one’s own anus during masturbation (95.7%, n = 11,781) and insertion into their partners anus (72.0% n = 4,197) during partnered sexual activities. These data suggest that sex toy use is common among gay and bisexual men during both solo and partnered sexual activities and considered by these men as enhancing the quality of their sexual experiences.     

Family Size in White Gay and Heterosexual Men

There is some evidence for a genetic influence on sexual orientation. However, gay men have fewer children than heterosexual men. Increased fecundity in the biological relatives of gay men could offset this selection pressure. We measured family size in gay (n = 301) and heterosexual (n = 404) men, attending clinics for sexually transmitted infections. The main outcome measure was the number of each man’s uncles and aunts, first cousins, siblings, nephews and nieces, and his own children. With the exception of the participants’ own offspring, mean family size of each category of relatives was significantly larger for gay men (paternal and maternal total OR = 1.02, CI = 1.01–1.03). This remained the case after adjustment for other predictors of family size (paternal and maternal total OR = 1.02, CI = 1.00–1.03). We found increased fecundity in the relatives of gay men and this is one explanation of how a genetic influence might persist in spite of reduced reproductive fitness in the gay phenotype. There are, however, a number of alternative explanations for our finding, including unknown psychological and social factors, which might mediate the association between family size and sexual orientation.     

Sexual Orientation and Professional Dance

The stereotypical professional male dancer is a gay man. However, little if any systematic research has investigated the validity of this stereotype, much less the reasons why male sexual orientation would be associated with interest in dance. We interviewed 136 professional dancers about the prevalence of homosexuality among dancers, the dancers' own sexual development, and relationships between dancers of different sexual orientations. Dancers estimated that over half of male dancers are gay, but that only a small minority of female dancers are lesbian. Gay men recalled more intense early interest in dance compared to heterosexual men and women, and were more feminine as boys than were heterosexual men. Gay men's homosexual feelings typically preceded their dance experience, and only one gay man felt that his dance experiences may have influenced his sexual orientation. Heterosexual men voiced some mild complaints about gay male dancers, but these were balanced by positive sentiments.     

An integrated model of care to counter high incidence of HIV and sexually transmitted diseases in men who have sex with men – initial analysis of service utilizers in Zurich

Background  

As other countries, Switzerland experiences a high or even rising incidence of HIV and sexually transmitted infections (STI) among men who have sex with men (MSM). An outpatient clinic for gay men (" Checkpoint ") was opened in 2006 in Zurich (Switzerland) in order to provide sexual health services. The clinic provides counselling, testing, medical treatment and follow-up at one location under an "open-door-policy" and with a high level of personal continuity. We describe first experiences with the new service and report the characteristics of the population that utilized it.     

Internet Use and Sexual Health of Young Men Who Have Sex with Men: A Mixed-Methods Study

Young gay, bisexual, and other men who have sex with men (MSM) experience sexual health disparities due to a lack of support in settings that traditionally promote positive youth development. The Internet may help to fill this void, but little is known about how it is used for sexual health purposes among young MSM. This mixed-methods study reports quantitative results of a large survey of 18- to 24-year-old MSM in an HIV testing clinic (N = 329) as well as qualitative results from interviews. Level of Internet use was high in this sample and the majority of participants reported using the Internet to find HIV/AIDS information. Black and Latino youth used the Internet less frequently than White youth, and after controlling for age, education, and frequency of Internet use, Black youth were 70% less likely to use the Internet to find HIV/AIDS information. Qualitative analyses identified themes related to the role of the Internet in finding sexual health information, sexual minority identity development, and sexual risk taking behaviors. Participants reported that the Internet filled an important and unmet need for sexual health education. It allowed for connections to the gay community and support during the coming out process, but also exposure to homophobic messages. There was no evidence of increased risk behaviors with partners met online, but at the same time the potential for the use of the Internet to facilitate safer sex communication was largely untapped. Our findings generally present an optimistic picture about the role of the Internet in the development of sexual health among young MSM.     

If I was infected with HIV,I would be letting my family down: Family influences on risk and protective factors for unsafe sex among gay Asian Pacific Islander men

This article examines family influences on risk and protective factors associated with unsafe sex among gay Asian Pacific Islander men. Twenty-five gay Asian Pacific Islanders completed individual interviews regarding factors that may lead them to engage in unsafe sex as well as factors that may lead them to engage in protective sex. Analysis of qualitative data revealed three ways by which family members influence sexual behaviour. We found that the way that (1) the way these men perceived family obligation and the need to avoid shame, (2) the level of active family participation, and (3) internalisation of what these men perceived to be ‘Asian’ values influenced whether their families acted as a protective factor or not in terms of HIV risk behaviours.     

Dimensions of racism and their impact on partner selection among men of colour who have sex with men: understanding pathways to sexual risk

While many studies have established the relationship between experiences of racism and sexual risk among men of colour who have sex with men, the pathways by which this occurs are underdeveloped. To address this gap, we must better investigate the lived realities of racism in the gay community. In this study, we had the unique opportunity to examine experiences of racism among African American, Asian/Pacific Islander and Latino men who have sex with men living in Los Angeles through focus groups and individual in-depth interviews. We found three themes of racism: exclusion from West Hollywood and the mainstream gay community, sexual rejection based on race/ethnicity and sexual stereotypes. There were differences across the three racial groups in the experiences of each theme, however. We then considered how racism impacted partner selection and found that race played a salient role in determining power differentials within mixed-race partnerships. Finally, we discussed several future areas for research that can better establish pathways between racism and sexual risk.     

A Qualitative Exploration of the Relationship Between Racism and Unsafe Sex Among Asian Pacific Islander Gay Men

Although reported cases of HIV/AIDS among gay Asian Pacific Islander (API) American men and API men who have sex with men (MSM) are still relatively low, current research findings indicate that incidences of unsafe sexual activity may be higher for this group than for any other group. Among the explanations offered to explain the levels of increasing unsafe sex among gay API men have been sexual norms found in Asian cultures, the lack of culturally relevant and/or linguistically appropriate intervention material, lack of integration into the mainstream gay community, and internalized homophobia. What are often ignored in these analyses are the contextual norms in which sexual behavior for gay API men occur. In this article, I develop the argument that racism within the gay community leads to socially and contextually prescribed sexual roles for gay API men that may also contribute to the practice of unsafe sex among this group.     

The role of the Black Church in the lives of young Black men who have sex with men

In the USA, the Black Church is among the most important institutions in the Black community, offering numerous spiritual, social and health benefits. Yet, the presence of homonegativity in many Black Churches may mitigate those effects for gay Black youth. This research examines the role of the Church in the lives of gay and bisexual Black youth to understand how they reconcile any tension between their religious and sexual identities. Through interviews with pastors of Black churches (n = 21) and young Black men who have sex with men (n = 30), we explored homonegativity and young men’s experiences within the Black Church. Findings reveal that despite the prevalence of homonegativity within Black churches, religious involvement remains important for young men and many remain involved in non-affirming churches. The importance of the Church for young men stems from their significant involvement as youth and the integration of religion, family and community. Young men may not be able to leave their religious homes as readily as other gay youth given the cultural relevance of the Church. As a result, young men made attempts to conceal their sexuality in church to avoid shame and gossip and find opportunities to balance their sexuality and religiosity.