Gay Identification and Psychological Health in HIV-Positive and HIV-Negative Gay Men1

This paper reports a study of HIV-positive and HIV-negative gay men focusing on comparisons between the HIV-positive and HIV-negative on gay identification, the interrelationships among gay identification variables, and the psychological correlates of gay identification. We hypothesized that better psychological health would be related to gay self-acceptance, participating in gay organizations and groups, socializing with other gay men, and parental disclosure and acceptance of being gay. The sample was composed of 169 gay men, including 98 asymptomatic HIV-positive and 71 HIV-negative men. The findings are largely consistent with our hypotheses. A strong and consistent relationship of the gay identification measures with psychological variables was observed, explaining up to one fifth of the variance in current level of mood and self-esteem. Among the HIV-positive subjects, participating in gay organizations and groups and having parents who accepted their sexual orientation were important correlates of psychological adaptation. Despite this, 36% of subjects had parents who disapproved of their sexual orientation, and 69% of HIV-positive subjects were not in any gay organizations or groups. Among the HIV-negative subjects, gay self-acceptance and disclosing their sexual orientation to parents were associated with better psychological adjustment. These results suggest that the psychological health and outlook of gay men may be influenced by gay self-acceptance, participation in gay groups, and parental disclosure and acceptance of their children's sexual orientation.     

The importance of feeling sexually attractive: Can it predict an individual's experience of their sexuality and sexual relationships across gender and sexual orientation?

Limited research exists on the implications of feeling sexually attractive for various aspects of sexuality and sexual relationships. This article examined associations between self‐perceived sexual attractiveness and sexual esteem, sexual satisfaction and amount of sexual experience, among both men and women who identified as heterosexual (n = 1017), gay or lesbian (n = 1225) or bisexual (n = 651). Results of the study demonstrated that positive self‐perceptions of sexual attractiveness predicted greater sexual esteem, greater sexual satisfaction, a higher frequency of sexual activity with others and a larger number of sexual partners among both men and women who identified as heterosexual, gay, lesbian or bisexual. The findings suggest that feeling sexually attractive may have implications for how an individual experiences their sexuality and sexual relationships regardless of their gender or sexual orientation. The importance of considering an individual's self‐perceptions of sexual attractiveness when they present with concerns related to their sexual experiences or relationships, and the potential benefits of educational and therapeutic interventions designed to enhance self‐perceptions of sexual attractiveness are discussed.     

‘Coming out’ in therapy? Perceived risks and benefits of self‐disclosure of sexual orientation by gay and lesbian therapists to straight clients

Primary objective: The study's primary objective was to investigate the experiences of gay and lesbian therapists, when considering self‐disclosure of their sexual orientation to straight (i.e. heterosexual) clients. This qualitative study set out to ascertain the key factors gay therapists take into account when considering this decision and to explore the effects this self‐disclosure may have on themselves, their clients and their therapeutic relationships. Research design: The research design was based on the use of semi‐structured interviews, undertaken with a non‐random, purposive sample of counsellors and psychotherapists (n=8) in current practice. The rationale for this method was to aid exploration of therapists' experiences of the process of self‐disclosure. Methods and procedures: Inclusion criteria were for therapists who self‐identified as being gay or lesbian, and who were experienced in clinical work with straight clients. Transcribed data was analysed using inductive thematic analysis. Main outcomes and results: Some therapists reported being confident with self‐disclosure relating to their own sexual orientation. However, a common theme related to the reportedly high levels of anxiety and vulnerability, which therapists identified. Key themes emerged around: respondents' fears of client judgement; a need for therapist self‐protection; self‐awareness of the potential impact of their own fears and prejudices on the therapeutic relationship; and the potential relevance of internalised homophobia, as an overall constraining factor. Conclusions: Self‐disclosure of their sexual orientation to straight clients is constructed, in this initial survey, as being potentially problematic and risky for some gay therapists.     

Does Knowing Why Someone is Gay Influence Tolerance? Genetic,Environmental, Choice,and “Reparative” Explanations

In the U.S., belief that sexual orientation is genetically based is tied to greater tolerance toward gay men and lesbians and a belief that they deserve rights equal to those of other citizens. This study explores whether evidence for a particular causal explanation of sexual orientation influences participants’ tolerance toward gay men and lesbians. Participants were 224 heterosexual college students provided with scientific evidence that sexual orientation is genetically caused, environmentally caused, or a choice, who then answered questionnaires assessing their attitudes toward science, their tolerance toward gay men and lesbians, their selection of the best explanation for sexual orientation, and their assessments of statements about an imagined gay man (which, together, comprised their level of support for a “reparative” explanation of gay male sexuality viewed as the result of trauma, poor father–son relations, and immorality). Participants who were male, black, religious, or believed that the environmental or choice explanation of sexual orientation was the best, were less tolerant and more supportive of the reparative explanation than, respectively, participants who were female, white, nonreligious, or believed that the genetic explanation was the best. By contrast, participants were less tolerant when they read that scientific findings support a genetic explanation than when they read that scientific findings support choice as an explanation. Participants’ level of support for the reparative explanation correlated positively with their level of intolerance, suggesting that increasing tolerance toward gay men and lesbians may be more dependent on diminishing support for tenets of the reparative explanation than in convincing heterosexuals that sexual desires are under genetic control, which may influence some heterosexuals who believe otherwise to feel more intolerant.     

Psychological Adjustment of Lesbians and Gay Men

Previous research has documented that lesbians and gay men proceed through a series of stages in developing a positive lesbian and gay identity. The relationship between lesbian and gay identity and subsequent psychological adjustment has not been evaluated. These empirical studies found that positive lesbian and gay identity is related to psychological adjustment as measured by lower neurotic anxiety and greater ego strength in both an older and a younger sample of lesbians and gay men. Two coping strategies—self-labeling as a homosexual and self-disclosure of sexual orientation to others—were related to development of a positive lesbian or gay identity. These findings suggest that development of a positive lesbian or gay identity is an important task in promoting the psychological adjustment of lesbians and gay men.     

“Coming out” among gay Latino and gay White men: implications of verbal disclosure for well-being

We examined how verbal disclosure affects subjective well-being among gay Latino and White men. In Study 1, increased gay identification predicted increased verbal disclosure for gay White men but not for gay Latino men, who reported verbal disclosure levels in line with a tacit coming out strategy (expressing one’s sexual orientation to others more non-verbally) regardless of their gay identification. Moreover, low verbal disclosure hindered subjective well-being only for gay White men. In Study 2, we show that increased intrinsic self-expression and higher relational self-construal explained the positive relationship between verbal disclosure and well-being among gay White men. This mediational model did not hold for gay Latino men. We discuss verbal disclosure in relation to mainstream understandings of coming out.     

Relations among media influence,body image,eating concerns,and sexual orientation in men: A preliminary investigation

The current study explored the relation between sexual orientation, media persuasion, and eating and body image concerns among 78 college men (39 gay; 39 straight). Participants completed measures of sexual orientation, eating disorder symptoms, appearance-related anxiety, perceived importance of physical attractiveness, perceptions of media influence, and media exposure. Gay men scored significantly higher on drive for thinness, body dissatisfaction, and body image-related anxiety than their straight counterparts. Additionally, perceptions of media influence were higher for gay men, and significantly mediated the relation between sexual orientation and eating and body image concerns. Sexual orientation also moderated the relation between perceived media influence and beliefs regarding the importance of physical attractiveness, as this relation was significant for gay men, but not straight men. The current findings suggest that gay men's increased vulnerability to media influence partially accounts for the relatively high rate of eating pathology observed in this population.     

Differences in relationship investments between gay and heterosexual men

Previous Investment Model research found that investments are a weaker predictor of relationship commitment for gay men compared with heterosexual men. The present study examined whether this effect is characteristic of investments in general or whether it is specific to certain types of investments. Results indicated that tangible investments significantly predicted commitment among heterosexual men, but not among gay men. In contrast, intangible investments predicted commitment regardless of sexual orientation. Furthermore, adding measures of tangible and intangible investments to the traditional Investment Model variables significantly increased explained variance in commitment for both gay and heterosexual men. These findings highlight the importance of reevaluating how relationship investments are conceptualized and suggests that not all investments are equally consequential across different romantic involvements.     

Implicit and explicit measures of sexual orientation attitudes: in group preferences and related behaviors and beliefs among gay and straight men

The relations among implicit and explicit measures of sexual orientation attitudes and sexual-orientation-related behavior and beliefs among gay men (Study 1) and straight men (Studies 1 and 2) were explored. Study 1 found relations between implicit and explicit measures of sexual orientation attitudes, large differences between gay and straight men on both implicit and explicit measures, and that these measures predicted sexual-orientation-related behaviors among gay men. Also, only straight men exhibited a negative relation between their attitudes toward homosexuality and heterosexuality. Study 2 found that as straight men held more negative attitudes toward homosexuality, they more strongly endorsed the importance of heterosexual identity and of traditional masculine gender roles. These endorsements mediated the negative relation between their attitudes toward heterosexuality and homosexuality. Implications for assessing attitudes toward sexual orientation and their relations for sexual orientation identity are discussed.     

Heteronormativity,Disgust Sensitivity,and Hostile Attitudes toward Gay Men: Potential Mechanisms to Maintain Social Hierarchies

Within a social hierarchy based on sexual orientation, heteronormative ideology serves as a social force that maintains dominant group members’ status (e.g., heterosexual men). Disgust may be an emotional reaction to gay men’s violation of heteronormativity (i.e., same-sex sexual behavior) and motivate hostile attitudes toward gay men to promote interpersonal and intergroup boundaries. Based on this theoretical framework, we hypothesized that sexual disgust—compared to pathogen or moral disgust—would be most strongly associated with antigay hostility and would statistically mediate its relationship with heteronormativity. Heterosexual men in the United States (n?=?409) completed an online questionnaire assessing heteronormative ideology, disgust sensitivity, and hostile attitudes toward gay men. Results support the hypotheses and suggest that gay men’s sexual behavior is the most likely elicitor of disgust and antigay hostility, as opposed to a perceived pathogen threat or moral transgression. The findings indicate that heteronormative attitudes and sexual disgust are likely contributors to antigay hostility. Thus, intervention efforts should seek to improve tolerance of same-sex sexual behavior among heterosexual men, which may mitigate emotional reactions and hostile attitudes toward gay men.

     

Experiencing gay affirmative therapy: An exploration of clients' views of what is helpful

Gay affirmative therapy is a counselling approach that emphasises an affirming, non‐pathologising approach to therapeutic work with lesbian, gay and bisexual clients. In this study, lesbian and gay clients who had experienced counselling that they defined as affirming identified what they perceived to have been helpful. Questionnaires and interviews were used to collect the views of a sample of lesbian, gay and bisexual informants. The material gathered was analysed using a grounded theory approach, which generated six main categories: communicating a non‐pathologising perspective on homosexuality; the counselling relationship; the counselling space; what the counsellor brought to the relationship; humanity; and the counsellor adopting a holistic approach. Some of these identified affirming elements are unique to gay affirmative therapy and cannot be attributed to other factors. The possible significance of the findings for practitioners is discussed.     

SIMILARITIES AND DIFFERENCES IN RELATIONAL BOUNDARIES AMONG HETEROSEXUALS, GAY MEN, AND LESBIANS

This study investigated the relative contributions of gender and sexual orientation as factors associated with the formation of boundaries in dyadic intimate relating in both same- and opposite-sex couples. The study examined a relational pattern previously not empirically investigated but widely accepted as an actuality unique to lesbians; specifically, that lesbians tend to remain connected to ex-serious-relationship partners after breakup. The study utilized a research design approach emphasizing the methodological utility and heuristic value of including sexual orientation as an independent variable in studies of gender dynamics. Two general classes of theoretical frameworks, those emphasizing gender role socialization influences and those emphasizing systems influences, were discussed in terms of their relative goodness of fit as conceptual bases for the data. Questionnaires were completed by 60 lesbians, 37 gay men, 45 heterosexual women, and 39 heterosexual men. Lesbians and gay men reported higher levels of connection to ex-serious-relationship partners than heterosexuals. The data reflect how inclusion of sexual orientation can broaden understandings of gender differentiated phenomena beyond more traditional gender-only based accounts.     

Toward a Greater Understanding of Antigay Prejudice: On the Role of Sexual Orientation and Gender Role Violation

Prejudice against gay men and lesbians could be driven by at least two types of expectancy violations: those pertaining to sexual orientation per se, and perceived violations of traditional gender roles (e.g., the fact that gay men are often inferred to be feminine and lesbians to be masculine). However, it is unclear whether one or the other (or both) of these expectancy violations are actually important in driving prejudicial reactions. In a completely crossed design, participants were asked to evaluate a target who varied with respect to biological sex, sexual orientation, and gender role (i.e., whether they were masculine or feminine). In addition, we also examined the contingency of these variables on preexisting individual differences in prejudice toward gay men and lesbians as a whole. Results showed a moderate trend among high prejudice participants to disparage “double violators,” that is, individuals who simultaneously violate expectations about both sexuality and gender roles. Implications for current research and practice are discussed.     

Integrated Cognitive Behavioral Therapy for Social Anxiety and HIV Prevention for Gay and Bisexual Men

Little information is available to cognitive-behavioral therapists about how to integrate HIV prevention into standard cognitive behavioral (CBT) treatments among gay and bisexual men, especially for those gay and bisexual men who are at risk for contracting HIV due to their social anxiety. The purpose of the present paper is to assist cognitive behavioral therapists who are treating HIV-negative gay and bisexual men who have high social anxiety. This paper provides an overview of the extant research on social anxiety and its effects on sexual risk behaviors and how to integrate these two types of problems into a coherent treatment plan for gay and bisexual men. The treatment described here uses the framework of CBT for social anxiety (e.g., Hope, Heimberg, & Turk, 2010) and adapts it to include substance use management in interpersonal situations and to reduce sexual risk behavior. The application of empirically supported therapy techniques to reduce both social anxiety and HIV risk behavior for gay and bisexual men is illustrated using three case examples. The present treatment is potentially appropriate for HIV-negative gay and bisexual men who present with social anxiety and who wish to remain HIV-negative by decreasing their sexual risk behavior.     

What motivates hate crimes based on sexual orientation? Mediating effects of anger on antigay aggression

The aim of this study was to examine the role of anger in response to gay men within three theoretical models of antigay aggression. Participants were 135 exclusively heterosexual men who completed a structured interview designed to assess sexual prejudice, anger in response to a vignette depicting a nonerotic male-male intimate relationship (i.e. partners saying "I love you", holding hands, kissing), and past perpetration of antigay aggression. Among identified antigay assailants, motivations for one earlier assault (i.e. sexual prejudice, peer dynamics, thrill seeking) were also assessed. Results indicated that anger fully mediated the relationship between sexual prejudice and antigay aggression, partially mediated the effect of peer dynamics on antigay aggression, and did not account for the relationship between thrill seeking and antigay aggression. These findings indicate that anger in response to gay men facilitates antigay aggression among some, but not all, antigay perpetrators.     

Money, Housework, Sex, and Conflict: Same-Sex Couples in Civil Unions, Those Not in Civil Unions, and Heterosexual Married Siblings

In this study we examined the division of finances, the division of household tasks, relationship maintenance behaviors, sexual activity, monogamy, and conflict among same-sex couples who had had civil unions in Vermont, same-sex couples who had not had civil unions recruited from their friendship circles, and married heterosexual couples recruited from among their siblings. Married heterosexuals had a more traditional, gendered division of finances, household tasks, and relationship maintenance behaviors, even though the heterosexuals were all siblings or in-laws of lesbians or gay men. Sexual orientation was a stronger predictor of the division of household tasks than was income difference within couples. Lesbians reported less frequent sexual activity than married heterosexual women, and gay men were less monogamous than married heterosexual men. Gay men in civil unions differed on a few variables from gay men not in civil unions, but there were no differences among lesbians.     

The disclosure dilemma for gay men and lesbians: "coming out" at work

This study examined disclosing sexual orientation at work for 220 gay men and 159 lesbians. Self-acceptance, the centrality of one's identity, how "out" one is to friends and family, employer policies, and perceived employer gay-supportiveness were associated with disclosure behaviors at work for gay/lesbian employees. Disclosing at work and working for an organization perceived to be more gay supportive was related to higher job satisfaction and lower job anxiety. Reactions of coworkers to gay or lesbian workers mediated the relationship between disclosure and gay/lesbian workers' job attitudes. Implications and solutions for management are discussed.     

Racialized Sexual Discrimination (RSD) in the Age of Online Sexual Networking: Are Young Black Gay/Bisexual Men (YBGBM) at Elevated Risk for Adverse Psychological Health?

Young Black gay/bisexual men (YBGBM) are a highly marginalized population across multiple health outcomes. Most research on YBGBM health has focused on HIV/sexual health, but there is a demonstrable need for research examining racism and psychosocial functioning among this population. Racialized Sexual Discrimination (RSD), also known as sexual racism, is an important but under-investigated phenomenon that may have implications for the psychological health and well-being of YBGBM. This paper provides an overview of empirical research on RSD as experienced by gay/bisexual men of color in online partner-seeking venues. First, the researchers discuss how racialized experiences are a documented online phenomenon, with a variety of manifestations, and identify the potential effects that this phenomenon may have on the psychosocial health of YBGBM, and gay/bisexual men of color as a whole. Second, the researchers synthesize the RSD literature with a broader literature examining psychological well-being across race and sexual orientation. Third, the researchers present a theoretically grounded conceptual model detailing the pathways between RSD and psychological well-being using a stress and coping framework. The paper concludes with recommendations for future research on this topic, including scale development and hypothesis testing.     

Validation of the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire in adults with a same-sex partner

Background/ObjectiveThe Interpersonal Exchange Model of Sexual Satisfaction Questionnaire (IEMSSQ) is one of the few instruments that has been developed from a theoretical model and assess sexual satisfaction. In addition, it has been successfully validated in Spanish heterosexual population. The objective of this study is to adapt and examine its psychometric properties (reliability, evidence of validity, and measurement invariance across sexual orientation and sex) in gay people in a relationship. Method: A sample of 1,820 adults, of whom 50% are gay people and 55% men, answered the Spanish version of the IEMSSQ. In addition, subjects with gay orientation answered the Massachusetts General Hospital-Sexual Functioning Questionnaire and the Dyadic Adjustment Scale. Results: When comparing by sex and sexual orientation, the IEMSSQ has a strict invariant structure. Its reliability is good, and the evidence of construct and concurrent validity is adequate. However, the components of equality are moderate. Conclusions: The IEMSSQ makes it possible to compare the sexual satisfaction between gay/heterosexual men and women, presenting good psychometric properties in gay people, constituting an useful instrument in the clinical and research field.