unmasking the gender factor in gay men's health: sex now survey 2010
DESCRIPTION
Terry Trussler, CBRC. Gay Men's Health Summit, 2010TRANSCRIPT
Unmasking the gender factor
SEX NOW Survey 2010
Sexual orientation alone may be inadequate to explain gay health disparities…
Investigate Gender Determinants
Retooling Sex Now Survey
From behavioural risk factors to
determinants of health indicators...
How are marginalization, social stress & mental wellness related? … to gay health outcomes?
i.e. suicide, depression, HIV, STI…
What social inequities elicit gay health disparities?
National Promotion
Recruitment
n=7982
Contact siteBanner adEmail blastWOMOther
RecruitmentBritish Columbia 1413 20.1%
Alberta 1019 14.5%
Saskatchewan 213 3.0%
Manitoba 291 4.1%
Ontario 3060 43.6%
Quebec 580 8.3%
New Brunswick 137 2.0%
Nova Scotia 72 2.4%
PEI 31 0.4%
Newfoundland 77 1.1%
Yukon 5 0.1%
NWT 9 0.1%
Nunavut 15 0.2%
Sample age
Mean = 43
<25 9.6%25-29 10.1%30-39 18.8%40-59 50.6%60+ 10.9%
Marginalization Indicators
Suicidal Bullied Forced Career Isolated Low mood
05
101520253035404550
Marginalization X Age
<25 25-29 30-39 40-59 60+0
10
20
30
40
50
60
SuicidalBulliedIsolatedLow mood
Marginalization X Age
<25 25-29 30-39 40-59 60+0
5
10
15
20
25
30
Forced sexCareer affected
Marginalization Indicators
Suicid
al
Bullied
Forc
ed
Caree
r
Isol
atio
n
Low m
ood
0
10
20
30
40
50
60
70
HIV+HIV-
Counseling
Psyc
holo
gist
Ther
apist
Psyc
hiat
rist
Peer
sup
port
Other
0
10
20
30
40
50
60
51% accessed counseling services
Counseling Topics
Depre
ssio
n
Fam
ily
Relat
ions
hip
Sex
Comin
g ou
t
Subs
tanc
es0
10
20
30
40
50
60
64% were satisfied with services
Care for Depression
Suicidal
Low Mood
Career
Bullied
Isolation
Forced sex
Risky sex
0 1 2 3 4 5 6
odds of being treated
Linking ideas
“Sexuality is the apparatus of power” Michel Foucault
How did that come to be?
The History of Sexuality v 1-3
Heterosexuality doesn’t exist without homosexuality to explain it.
Linking ideas
Archives of Sexual Behavior, Vol. 33, No. 2, April 2004, pp. 117–128 ( C ° 2004)
Gender Nonconformity, Childhood Rejection, and Adult Attachment: A Study of Gay Men
Monica A. Landolt, Ph.D.,1 Kim Bartholomew, Ph.D.,2;4 Colleen Saffrey, B.A. (Hons),2 Doug Oram, M.A.,2 and Daniel Perlman, Ph.D.3
Linking ideas
Public Health and Human RightsAPHA 134th Annual Meeting and ExpositionNovember 4-8, 2006
Gender nonconformity as a target of prejudice, discrimination, and violence against LGB individuals
Allegra Raboff Gordon, MPH and Ilan H. Meyer, PhD. Mailman School of Public Health, Columbia University,
Linking ideas
Psychological Bulletin American Psychological Association, Inc.2003, Vol. 129, No. 5, 674–697
Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and BisexualPopulations: Conceptual Issues and Research Evidence
Ilan H. MeyerColumbia University
“Minority Stress”
Linking ideas
Critical Public HealthVol. 18, No. 3, September 2008, 271–283
Intersectionality and the determinants of health: a Canadian perspective
Olena Hankivskya* and Ashlee Christoffersenb
“policy decisions create relational inequities in which some groups benefit and others experience more marginalization and oppression.”
Intersectionality & Gay Health Determinants
Focus on social inequities
Intersecting systems of oppression/privilege
i.e. Gender and Sexuality (+ age, income, race, social location…)
Interrogate the relationship between social categories… embrace complexity…
Social Status
Masculinities
49.7% Single 4.8% Married/man23.7% Partnered/man14.2% Married/woman 4.9% Partnered/woman 2.7% Other
Masculinities
Conforming Non-conforming
Married to woman Single
Partnered with woman Married to man
Partnered with man
Other
“MSM” “Gay”
In-gender comparison
Gay 6303 81%MSM 1490 19%
HIV+ Gay 9.2% MSM 1.1%
Common Practices
Mas-turbate
Oral Anal Leather Rough0
5
10
15
20
25
30
35
GayMSM
Varied Masculinities
Relationship
Dating
Involvement
Intensity
Intimate style
0 1 2 3 4 5 6 7 8 9
MSMGay
Varied Outcomes
Couns
elin
g
Depre
ssio
n
Fam
ily
Partn
er Sex
C' Out
Subs
tanc
e0
10
20
30
40
50
60
Gay MSM
Minority Stress Indicators
Counseling
Depression
Family
Relationship
0 0.5 1 1.5 2 2.5
MSMGay
Marginalization Indicators
Bullied Suicidal Forced sex
Career Isolated Low Mood
0
10
20
30
40
50
Gay MSM
Odds of Marginalization
Low mood
Isolated
Suicidal
Career affected
Bullied
0 1 2 3 4 5 6 7 8 9
MSM Gay
Transmission Risk
Top Bottom Any0
5
10
15
20
25
30
35
GayMSM
Outcomes
Chlam
ydia
HPV
Gonor
rhea
Syph
ilis
Herpe
s
Hep C
0
0.5
1
1.5
2
2.5
3
3.5
GayMSM
Disparities
HIV
Syphilis
Gonorrhea
Herpes
Chlamydia
HPV
Hep C
0 1 2 3 4 5 6 7 8 9
MSMGay
Varied Masculinities
Low attachment
Web Contact
High Income
Preoccupation/sex
Adventurous style
0 1 2 3 4 5 6 7 8 9 10
MSMGay
Summarizing Disparities
Conforming Non-conforming
Income Marginalization
Marginalization Mental distress
Mental distress Sexual risk
Sexual risk HIV
HIV STI
STI
“MSM” “Gay”
Summarizing Ideas
Marginalization strongly associated with treatment for depression
Youth and HIV+ men experienced highest rates of marginalization
Gay men experienced higher rates of marginalization, depression, HIV and STI than MSM
Gender non-conformity helps explain gay health disparities
Practice ImplicationsCritical Public HealthVol. 18, No. 1, March 2008, 87–96
The social construction of gay oppression as a determinantof gay men’s health: ‘homophobia is killing us’
Jeffrey P. AguinaldoDepartment of Sociology, Wilfrid Laurier University, Waterloo, Canada
“The problem is not the oppressed it is the oppressor.”
Observe and count all the subtle andobvious ways heterosexism occurs and goes unchallenged and uncontested…
Next Steps
Determinants Survey 2011
Young Gay Investigator Team - YGIT
Measuring Marginalization and Resilience
How is “gay oppression” being done?
Distribute the evidence gathering…
Acknowledgements
Questionnaire Development: Carl Bognar, Bill Coleman, Olivier Ferlatte, Jody Jollimore, Mike Kwag, Rick Marchand
Survey Promotion: Justin Go, Glenn Doupe & CDC Internet Team
Technical Assistance: Sean Lytle, Rachel Thompson
Knowledge Transfer & Translation: Public Health Agency of Canada
Dissemination: Province of British Columbia