Stigma and Discrimatn Affects Gay and Bisexual Men's Health | CDC

Contents:

• GAY AND BISEXUAL MEN'S HEALTH ISSU
• GAY AND BISEXUAL MEN'S HEALTH
• THE GAY BOWEL SYNDROME: A MON PROBLEM OF HOMOSEXUAL PATIENTS THE EMERGENCY PARTMENT
• GAY MEN AND THEIR FATHERS: HURT AND HEALG
• WHEN TO PROSTATE NCER, 'GAY MEN ARE ERASED,' PATIENTS SAY
• SEXUAL PROBLEMS AFFECTG GAY MEN
• GAY MENTAL HEALTH: MENTAL HEALTH ISSU FACG GAY MEN
• A GAY UPLE RAN A RAL RTRANT PEACE. THEN NEW NEIGHBORS ARRIVED.
• THE HEALTH CHALLENG OF EMERGG ADULT GAY MEN EFFECTG CHANGE HEALTH CARE
• JAGS' MAXEN IS FIRST MALE AMERIN PRO SPORTS ACH TO E OUT AS GAY

GAY AND BISEXUAL MEN'S HEALTH ISSU

The term “homosexualy, ” while sometim nsired anachronistic the current era, is the most applible and easily translatable term to e when askg this qutn across societi and languag and has been ed other cross-natnal studi, cludg the World Valu Survey.

And Poland, supporters of the erng PiS (Law and Jtice), which has explicly targeted gay rights as anathema to tradnal Polish valu, are 23 percentage pots ls likely to say that homosexualy should be accepted by society than those who do not support the erng party. Acrdg to Michael Kimmel, a soclogist and expert on male sex rol, men monstrate their masculy by repudiatg all that is feme and monstratg an ever-ready willgns to engage sexual terurse wh women whenever the opportuny aris- a nutshell, to prove they are not gay.

Th is no wonr that the boys the study for my book: Comg Out, Comg Home: Helpg Fai Adjt to a Gay or Lbian Child, relled beg so reactive and fearful of the rpons of their fathers—the very people who were expectg them to receive and rry the torch of masculy. " Add to this shame and disappotment men's tenncy to be stoic about problems to avoid appearg petent or weak and one gets a sense why many fathers, like those of the boys prevly quoted, did not want to discs such a topic wh a stranger—a gay stranger, no ls. Certaly all fathers need to show that they love their sons and dghters, but fathers of gay sons need to fd ways to surmount the barrier of homophobia and socially scripted queass about gay sex to show their sons that they are ed lovable and serve the love of a good man.

GAY AND BISEXUAL MEN'S HEALTH

But the unique challeng facg gay and bisexual men wh prostate ncer have largely gone who have sex wh men (MSM) are ls likely to get regular prostate ncer screengs, and those who are diagnosed are ls likely to have faial and social support, acrdg to rearch ced by the Natnal Instut of Health. Brass’ said his sexual functn was relatively good, but stead he stggled wh ntence for weeks — g as many as ne “pads” a day and stayg wh yards of a bathroom at all you’re gay and you go to a urologist who hasn’t alt wh gay men, they’ll tell you, 'Brg your wife wh you. '"He joed a prostate ncer support group specifilly for gay and bisexual men at Mount Sai Hospal Manhattan, one of several anized by the natnal advocy anizatn wh other queer men “allowed to be very open about our feelgs — and our sexualy — and to be empathetic wh each other, ” Brass said.

“The medil muny say, ‘We don’t want to ask olr heterosexual men qutns that might upset them, ’" Simon Rosser, an LGBTQ health specialist and -thor of "Gay and Bisexual Men Livg Wh Prostate Cancer, " told NBC Rosser, PhD, MPH, is a profsor at the Universy of Mnota School of Public Health.

Universy of MnotaA profsor at the Universy of Mnota School of Public Health, Rosser has received a $3 ln grant om the Natnal Cancer Instute to put together the first prehensive rehabilatn program specifilly for gay and bisexual men wh prostate ncer. Gettg the disease, ironilly, is somethg of a luxury for a gay men of Brass’ age: Too many had their liv cut short by the AIDS epimic long before they’d typilly be diagnosed (the average age for a prostate ncer diagnosis is 66) the advent of lifavg antiretroviral dgs the mid-1990s, though, gay men are fally reachg their goln years. "In parison to their straight peers, LGBTQ+ dividuals experience unique strsors such as bullyg, harassment, fear of rejectn, ternalized homophobia, body image distrs, barriers to accsg medil and mental health treatment, and vlence, " Sydney Brour-Johnson, PhD, senr director for clil servic at the Veras Collaborative Dunwoody, Ga., told Health.

THE GAY BOWEL SYNDROME: A MON PROBLEM OF HOMOSEXUAL PATIENTS THE EMERGENCY PARTMENT

Homophobia, stigma (negative and ually unfair beliefs), and discrimatn (unfairly treatg a person or group of people) agast gay, bisexual, and other men who have sex wh men still exist the Uned Stat and n negatively affect the health and well-beg of this muny. The majory of MSM [men who have sex wh men] are highly rilient and able to pe succsfully wh many negative life strsors, such as those associated wh homophobia and discrimatn;"1 however, this don't mean that there aren't specific gay mental health challeng.

It's still a mystery, but that don't stop rearchers and laymen alike om askg if our environments are to blame, as if beg gay is an afflictn that needs to be solved like a cycle of psychologists and ex-gay therapy groups often throw the claim that gay men long for other men out of a subnsc need to nnect wh an absent or lackg father. “I have que a few gay iends, clients and a fay member, and I have patronized a gay-owned rtrant for years, ” he whether the Washers are tryg to remake The Plas to their image of Ameri — Whe, nservative, Christian — Melissa said, “I n see where you’re g om.

Though no longer makg new ntent prt or onle, the "famo pk perdil" mak sure you're 18 before enterg s webse -- which is jt as famoly featured photography and terviews wh renowned gay artists, such as German fashn signer Bernhard Willhelm, whose nu portras -- taken by Wolfgang Tillmans -- appeared the magaze's first issue May 2001. Sce then, BUTT has featured gay artists such as Casey Spooner, Michael Stipe, John Waters, Hez Peter Kn, Edmund Whe, Terence Koh, Walter Pfeiffer, and Slava 's athetic was memorable for the way sexualized men you'd fd on the street or subway; they had body hair, teeth that weren't perfect, even pnch. Even though other LGBT magaz at the time knew that sex sells - and ed that to their advantage - HERO Magaze steered clear of pornography and other sexual s foundg 1997, HERO Magaze ma mov that were clive and progrsive, as was more acceptg of upl and men over 40 than other gay publitns at the time.

GAY MEN AND THEIR FATHERS: HURT AND HEALG

Men -- which was origally named Advote Men until 1997, sce was a sister publitn of The Advote -- drew an dience by feature popular male mols like Zeb Atlas and Mark Dalton, among 2009, the publishers of the Los Angel-based magaze, Specialy Publitns, announced was movg all s gay porn magaze to an onle platform, lled, you'll e up unlucky if you try to accs the webse now; and no new issu of Men have seen the light of day sce.

WHEN TO PROSTATE NCER, 'GAY MEN ARE ERASED,' PATIENTS SAY

Origally put together by the Dghters of Bilis, the first Amerin lbian anizatn, which disband over disagreements on whether to band up wh misogynist gay male functns or jo the femist movement, several of Ladr's edors moved to the Natnal Organizatn for Women. 1–2), “homosexualy as practiced by the Athenians was not about an inty, muny, or movement; rather, was part of a larger syndrome which clud men’s ways of relatg to boys, wiv, urtans, prostut, and other sexual partners, and, a larger sense, to both the people of Athens and to the other cy-stat.

SEXUAL PROBLEMS AFFECTG GAY MEN

14-16 Inherently, beg gay is different om beg bisexual or pansexual, although the sexual behavr may be the same, the feelgs and salience n be que addn, the umbrella term LGBTQ is limed nsiratns of health and health re for this populatn recently timated to nstute approximately 4. For example, would be aquate and false to state that HIV is a health dispary that disproportnately affects the LGBTQ populatn; rather, is a health dispary the Uned Stat that overwhelmgly burns gay and bisexual men and transgenr women, 19 who are part, but not the totaly, of the LGBTQ is wh this ia md that the thors further ntextualize the ias prented the pag to follow. In particular, the thors nsir the health challeng faced by gay men who are emergg adults, regnizg that is durg this perd that a vast majory of gay men emerge to their sexual inti, 13, 20 and that this velopmental perd is often ght wh risk behavrs21 that might impact the health profile of the men the immediate and set the foundatn for health issu across the life urse.

GAY MENTAL HEALTH: MENTAL HEALTH ISSU FACG GAY MEN

22ADOLESCENCE AND EMERGING ADULTHOOD IN GAY MENThe psychologist Jefey Art (2000) nceptualized the velopmental state of emergg adulthood to differentiate the perd between adolcence and adulthood, which, Wtern dtrialized natns, enpass approximately ag 18 to 25. 28For gay men, the perd of emergg adulthood is a highly vulnerable perd which the nfluence of sexual risk takg, dg e, mental health burn, rceratn, and other risk ndns, 29-31 precipated by experienc of homophobia and discrimatn32, 33 om society at large, as well as racism and hegemonic notns of masculy wh the gay populatn, 13 promise health and well-beg that may last throughout adulthood.

38 Although the provisn of re for emergg adult gay men has improved relative to past generatns of gay men, who were pathologized due to their sexual inty beg tegorized as a mental illns, visible to health re provirs bee of fear of discrimatn, or neglected bee they were afflicted wh AIDS, the ndns are still far om ial. For stance, relative to young heterosexual men, young gay or sexual mory men are signifintly more likely to experience childhood victimizatn (eg, parental psychologil and physil abe), 45, 46 school-based/peer victimizatn, 47 low levels of parental support, 48 and forced homelsns bee of their sexualy. 49 As such, the health challeng and equali addrsed this article are not ally related to homosexualy or gayns, but, stead, are the reflectn of nox social ndns (eg, social margalizatn, excln, and stctural stigmatizatn) that work ncert to rro the health profile of young and emergg adult gay men.

For stance, a systematic review of mental health disorrs and sexual orientatn, Kg and lleagu68 documented that, across studi, gay men evinced greater risk for lifetime prevalence of suici attempts, lifetime prevalence of prsn, and lifetime prevalence of anxiety relative to heterosexuals. Although many emergg adult gay men may stggle wh adverse mental health out and rced psychologil well-beg, is cril to note that certa subpopulatns (ie, those who are multiply disadvantaged bee of tersectg margalized inti) may be more at risk than others.

A GAY UPLE RAN A RAL RTRANT PEACE. THEN NEW NEIGHBORS ARRIVED.

74 In addn to HIV and syphilis, gay men are disproportnally burned by other sexually transmted fectns (STIs), 77 such as bacterial STIs (eg, chlamydia and gonorrhea), 78 human papillomavis, 79, 80 Hepatis B and C, 81, 82 and herp simplex vis (HSV)-2. 88 Ined, adolcent gay men are signifintly more likely to engage behavrs that amplify lifetime ncer risk and have long-term physil health nsequenc relative to heterosexual men, such as smokg, nsumg alhol, g illic dgs, engagg risky sexual behavrs, reportg ltle physil activy, and nsumg a diet low us and vegetabl.

THE HEALTH CHALLENG OF EMERGG ADULT GAY MEN EFFECTG CHANGE HEALTH CARE

87 As Rosar and lleagu87 highlight, many of the health and ncer-related risk behavrs emerge early the life urse of sexual mory men (ie, adolcence), effectively creasg lifetime ncer risk among certa subpopulatns of gay men due to earlier engagement ncer-related risk addn to behavral risk factors, gay men have been documented to report lower levels of perceived physil health and higher rat of adverse physil health out. However, the precedg data offer prelimary support for the extent to which sexual orientatn may be a robt predictor of physil health out and, th, a clil foc on gay men’s physil health is CARE CHALLENGESThe myriad health challeng faced by emergg adult gay men are magnified due to hardships accsg aquate and petent health re that serv the unique needs of this populatn. Sab and lleagu108 report that implic preferenc for heterosexual people vers lbian and gay people are pervasive among heterosexual health re provirs; that implic preferenc for heterosexual women were weaker than implic preferenc for heterosexual men; and that heterosexual nurs held the strongt implic preference for heterosexual men over gay men.

90 The study participants, all of whom were emergg adult gay men, sought provirs who posssed knowledge of the specific health re needs of gay men, pecially wh regard to same-sex sexual health, which are ficient most medil school curricula113: “I fely uld’ve ed a doctor to talk to like a – yeah, a doctor to talk to jt about what’s healthy, and what’s not wh gay sex. ” The fdgs also unrsre the extant lerature regardg negative provir attus: “The doctor wasn’t knowledgeable wh the LGBT muny… She’s never really had gay patients so for her ’s kda new and her reactn was kda like oh, you’re young, right now you shouldn’t be havg anal sex…It wasn’t the reactn I was expectg. ” As a rult of such suatns, many young gay men turn to sourc outsi the medil profsn for knowledge about their health: “I’ve always gotten knowledge of gay men health and about risk and HIV and stuff through outsi sourc…I feel unfortable speakg to my doctor.

”LGBTQ health re centers such as Callen-Lor New York Cy and Fenway Health Boston provi an important service to emergg adult gay men: “When I vised the gay center, then they tght me a whole new vobulary and certa different aspects of myself that I should pay attentn to more, which helped me out.

JAGS' MAXEN IS FIRST MALE AMERIN PRO SPORTS ACH TO E OUT AS GAY

” This perspective unrsr the need for not only more robt, thorough, and tailored tn and trag on gay men’s health re for medil provirs, but also unrsr the need for health re spac and settgs that are affirmg of sexual mory addn, enomic circumstanc might pound the aforementned matters that unrme the health of gay men.

118 As nceptualized by Sger and lleagu119, 120 and adapted for gay men by Stall and lleagu, 118 the synmic paradigm postulat that multiple -occurrg epimics teract synergistilly to modify disease risk, transmissn, and progrsn, and that the synmic ndns are directed by psychosocial burns, often emanatg om experienc of homophobia and discrimatn, experienced by this populatn. 122, 123 In this view, health re servic for the LGBTQ populatn broadly, and for emergg adult gay men specifilly, mt be (1) holistic nature addrsg the multiplicy of health burns; (2) unrstood relatn to the social ndns that exacerbate the health dispari, cludg the transmissn of pathogens (ie, a bpsychosocial perspective); and (3) attend fully to sexual and genr inti the livery of re.

For emergg adult gay men who are the procs of velopg their own sexual inty and enactg strategi to disclose who they are, the addn of the 2 qutns on any and all health re forms will functn to alleviate the already undue burn of a lifetime of “g out. ”13Numero rourc and guil127, 128 have emerged recent time rponse to the mountg evince on the numero health dispari burng the liv of emergg adult gay men and the LGBTQ populatn more broadly, much rmed by the approach postulated by leadg medil provirs and advot such as Harvey Makadon and lleagu129 and anizatnally through the Natnal LGBT Health Edutn Center at the Fenway Instute. 10, 129 The efforts advance a set of domas that might impact a posive change the health re livery to emergg adult gay men: (1) addrsg and velopg polic that attend to the well-beg of LGBTQ people wh health re facili; (2) creatg health re environments that are welg; and (3) trag staff fully and thoroughly to bee more apt at addrsg the health of the populatn.