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Gu C, Bu H, Lv Z, He A. Sexual Self-Identification Offsets and Self-Stigma Moderates: Expanding the Rejection-Identification Model to Examine Stigma's Effects on Well-Being Among Gay and Bisexual Men. JOURNAL OF HOMOSEXUALITY 2024:1-20. [PMID: 38833645 DOI: 10.1080/00918369.2024.2360608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Gender and sexual minorities still face stigma-related stress from all areas of society. The rejection-identification model (RIM) proposes that some stigmatized individuals may respond to the negative effects of stigma on well-being by enhancing their self-identification. However, this does not apply to all gender and sexual minorities. Grounded in minority stress theory and the RIM, this study examined how stigma-related stressors (i.e. perceived stigma and self-stigma) and their associated mechanisms impact sexual self-identification and subjective well-being. A total of 366 Chinese gay and bisexual men were included in the study. The results showed that sexual self-identification, as a protective factor, mediated the association between perceived stigma and subjective well-being. Furthermore, the indirect effect of the mediation model was moderated by self-stigma, such that the indirect effect of perceived stigma on subjective well-being through sexual self-identification was the highest among Chinese gay and bisexual men with low self-stigma. Given that research into the mental health and well-being of Chinese gay and bisexual men is still in its infancy, our findings are important and may help in developing and improving socially and psychologically sensitive counseling services or intervention strategies for these populations.
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Affiliation(s)
- Chudan Gu
- Humanities School, Donghua University, Shanghai, China
| | - He Bu
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Zijian Lv
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Along He
- School of Journalism & Communication, Nanjing University, Nanjing, China
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Nettuno L, Mann S, Gonzales G. Sexual orientation based health disparities in Chile. PLoS One 2024; 19:e0296923. [PMID: 38271408 PMCID: PMC10810431 DOI: 10.1371/journal.pone.0296923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Numerous studies from Europe and North America have documented sexual orientation-based health disparities, but due to data limitations, very little is known about the health of sexual minorities (i.e., lesbians, gay men, bisexual individuals, and other non-heterosexual populations) in developing countries. This research note uses newly available nationally representative data from the Chilean Socio-Economic Characterization Survey (CASEN) to explore sexual orientation-based disparities in self-rated health, health insurance coverage, and healthcare utilization in Chile. Our findings indicate that sexual minority respondents report worse self-rated health and greater health care utilization, and that sexual minority men are more likely to have private health insurance relative to heterosexual men. These findings are important in facilitating continued efforts to reduce health disparities in Latin America.
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Affiliation(s)
- Laura Nettuno
- Department of Economics, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Samuel Mann
- RAND Corporation, Arlington, Virginia, United States of America
| | - Gilbert Gonzales
- Department of Medicine, Health & Society, Department of Health Policy, and Program for Public Policy Studies, Vanderbilt University, Nashville, Tennessee, United States of America
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He A, Bu H, Liao A, Mu W. What triggers depressive symptoms among gay and bisexual men? A sequential mediation model of sexual minority-related stigma and self-criticism. BRITISH JOURNAL OF SOCIAL PSYCHOLOGY 2023; 62:1097-1113. [PMID: 36594229 DOI: 10.1111/bjso.12621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 12/12/2022] [Indexed: 01/04/2023]
Abstract
A growing number of studies has shown that gay and bisexual men are more likely to experience adverse mental health status than their heterosexual counterparts. Stigma-related stress and self-criticism are believed likely to exacerbate depressive symptoms among gay and bisexual men. This research used cross-sectional findings to illustrate the mediating role of internalized self-stigma and self-criticism in the association between perceived public stigma and depressive symptoms. A total of 317 Chinese gay and bisexual men (267 gays and 50 bisexuals with a mean age of 25.29) were invited to participate in this study from October to November 2021. Sociodemographic characteristics, perceived public stigma, internalized self-stigma, self-criticism and depressive symptoms were measured through self-reported online questionnaires. The results indicated that the association between perceived public stigma and depressive symptoms was sequentially mediated by internalized self-stigma and self-criticism. The findings indicated that public stigma, as a distal stressor, was perceived and internalized as self-stigma by gay and bisexual men. This self-stigma may pose a risk for depressive symptoms via self-criticism (a maladaptive consequence of their attempts to reduce cognitive dissonance). These results highlight the necessity of reducing sexual minority-related stigma and self-criticism to reduce depressive symptoms. Our findings appeal to society to further decrease prejudice and stigma, increase tolerance, and focus on the negative mental health status of gay and bisexual men.
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Affiliation(s)
- Along He
- School of Journalism & Communication, Nanjing University, Nanjing, China
| | - He Bu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Ankang Liao
- School of Foreign Studies, Nanjing University, Nanjing, China
| | - Wenlong Mu
- School of Journalism and Communication, Wuhan University, Wuhan, China
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Bahamondes J, Barrientos J, Guzmán-González M, Garrido-Rojas L, Gómez F, Espinoza-Tapia R. The negative effects of internalized homonegativity on sexual satisfaction: dyadic effects and gender-based differences in Chile. JOURNAL OF LESBIAN STUDIES 2022; 27:22-40. [PMID: 36103623 DOI: 10.1080/10894160.2022.2122197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Heterosexism is not only expressed through sexual prejudice as an external stressor, but also as an internalized rejection toward one's own (and others') sexually diverse identity. That is, lesbian women and gay men themselves internalize negative societal attitudes toward their sexual orientation and identity-a phenomenon called internalized homonegativity. A wealth of research shows that internalized homonegativity negatively affects the health and social adjustment of gay and lesbian people. However, the literature has documented this trend from an individual (over a dyadic) perspective, and largely among gay (over lesbian) samples. To address this oversight, we analyzed data from 210 gay and lesbian couples in Chile to examine both actor and partner effects of internalized homonegativity on their sexual satisfaction. Results from moderation analyses from an actor-partner interdependence model (APIM) approach show that partners' internalized homonegativity negatively affects actor sexual satisfaction, a pattern significantly moderated by gender; that is, only observed among lesbian couples. Our results further demonstrated that these effects hold above and beyond the actor and partner effects of age and relationship satisfaction, as well as relationship length. These results are consistent with the broader literature, which discusses the specific features of internalized homonegativity in lesbian women, characterized-among other aspects-by restrictive social demands over their sexuality. Accordingly, our findings highlight the deleterious relational consequences of internalized homonegativity and offer a relevant empirical contribution to the understanding of specific minority stress dynamics among lesbian women.
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Affiliation(s)
- Joaquín Bahamondes
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Jaime Barrientos
- Escuela de Psicología, Universidad Alberto Hurtado, Santiago, Chile
| | | | | | - Fabiola Gómez
- Escuela de Psicología, Pontificia Universidad Católica, Santiago, Chile
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Liu F, Ye Z, Chui H, Chong ES. Effect of perceived public stigma on internalized homophobia, anticipated stigma, shame, and guilt: Outness as a moderator. ASIAN JOURNAL OF SOCIAL PSYCHOLOGY 2022. [DOI: 10.1111/ajsp.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Fangsong Liu
- School of Psychology Jiangxi Normal University Nanchang China
| | - Zilan Ye
- Department of Educational Psychology, Faculty of Education The Chinese University of Hong Kong Hong Kong Hong Kong
| | - Harold Chui
- Department of Educational Psychology, Faculty of Education The Chinese University of Hong Kong Hong Kong Hong Kong
| | - Eddie S.K. Chong
- Department of Social Work and Social Administration The University of Hong Kong Hong Kong Hong Kong
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Operario D, Sun S, Bermudez AN, Masa R, Shangani S, van der Elst E, Sanders E. Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men. Lancet HIV 2022; 9:e574-e584. [PMID: 35750058 PMCID: PMC7613577 DOI: 10.1016/s2352-3018(22)00076-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/27/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
In this Series paper, we review evidence on the co-occurring and synergistic epidemics (syndemic) of HIV and mental health problems worldwide among men who have sex with men (MSM). The multilevel determinants of this global syndemic include structural factors that enable stigma, systematic bias, and violence towards MSM across geographical and cultural contexts. Cumulative exposure to these factors over time results in population-level inequities in the burden of HIV infections and mental health problems among MSM. Evidence for this syndemic among MSM is strongest in the USA, Canada, western Europe, and parts of Asia and Latin America, with emerging evidence from sub-Saharan Africa. Integrated interventions are needed to address syndemics of HIV and mental health problems that challenge the wellbeing of MSM populations worldwide, and such interventions should consider various mental health conditions (eg, depression, anxiety, trauma, and suicidality) and their unique expressions and relationships with HIV outcomes depending on cultural contexts. In addition, interventions should identify and intervene with locally relevant structural factors that result in HIV and mental health vulnerabilities among MSM.
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Lin HC, Chang CC, Chang YP, Chen YL, Yen CF. Associations among Perceived Sexual Stigma from Family and Peers, Internalized Homonegativity, Loneliness, Depression, and Anxiety among Gay and Bisexual Men in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106225. [PMID: 35627760 PMCID: PMC9141414 DOI: 10.3390/ijerph19106225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to examine the moderating factors of the association between perceived sexual stigma from family and peers and internalized homonegativity, as well as to compare the effects of perceived sexual stigma from family and peers and internalized homonegativity on loneliness, depression, and anxiety in gay and bisexual men. In total, 400 gay and bisexual men participated in this study. The experiences of perceived sexual stigma from family and peers on the Homosexuality subscale of the HIV and Homosexuality Related Stigma Scale, internalized homonegativity on the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, loneliness on the UCLA Loneliness Scale (Version 3), depression on the Center for Epidemiological Studies-Depression Scale, and anxiety on the State subscale of the State-Trait Anxiety Inventory were collected. The results indicated that perceived sexual stigma from family and peers was significantly associated with internalized homonegativity in both gay and bisexual men, and that sexual orientation moderated the association. Moreover, the association between internalized homonegativity and loneliness was significantly greater than that between perceived sexual stigma from family and peers and loneliness, although no significant differences were observed in their associations with depression and anxiety. Intervention programs that promote changes in the attitudes toward gay and bisexual men among the general population are needed to help prevent the development of internalized homonegativity and further loneliness, depression and anxiety.
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Affiliation(s)
- Huang-Chi Lin
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan;
- Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY 14214-3079, USA;
| | - Yi-Lung Chen
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-23323456 (ext. 20106) (Y.-L.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-23323456 (ext. 20106) (Y.-L.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
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