Internalized homophobia, mental health, sexual behaviors, and outness of gay/bisexual men from Southwest China

Abstract

BackgroundSocial attitudes toward male homosexuality in China so far are still not optimistic. Sexual minorities in China have reported high levels of internalized homophobia.MethodsThis Internet-based study examined the associations among internalized homophobia, mental health, sexual behaviors, and outness among 435 gay/bisexual men in Southwest China from 2014 to 2015. Latent profile analysis, confirmatory factor analysis, univariate logistic regression, and separate multivariate logistic regression analyses were conducted.ResultsThis descriptive study found the Internalized Homophobia Scale to be suitable for use in China. The sample demonstrated a high prevalence of internalized homophobia. Latent profile analysis suggested a 2-class solution as optimal, and a high level of internalized homophobia was significantly associated with greater psychological distress (Wald = 6.49, AOR = 1.66), transactional sex during the previous 6 months (Wald = 5.23, AOR = 2.77), more sexual compulsions (Wald = 14.05, AOR = 2.12), and the concealment of sexual identity from others (Wald = 30.70, AOR = 0.30) and parents (Wald = 6.72, AOR = 0.49).ConclusionsThese findings contribute to our understanding of internalized homophobia in China, and highlight the need to decrease gay-related psychological stress/distress and improve public health services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-017-0530-1) contains supplementary material, which is available to authorized users.

Internalized Homophobia, Depressive Symptoms, and Suicidal Ideation Among Lesbian, Gay, and Bisexual Adults in South Korea: An Age-Stratified Analysis

“…26,27 Furthermore, they may have had fewer opportunities to develop effective coping strategies that could help them deal with mental health issues than older LGB adults. 28,29 Consistent with findings reported in studies conducted elsewhere, [4][5][6][7][8] there was a statistically significant association between IHP and depressive symptoms among Korean LGB participants. In the age-stratified analyses, IHP was associated with depressive symptoms in older LGB people, particularly LGB adults aged 40-69 years.…”

“…2,3 The literature has indicated that IHP is related to mental health problems, including depressive symptoms and suicidal behaviors. [4][5][6][7][8] A meta-analysis of 31 empirical research studies investigating the association between IHP and mental health suggested that age could be an effect modifier in the association between IHP and negative mental health outcomes. 7 The aforementioned study revealed that the association of IHP with poor mental health became stronger as the participants' age increased.…”

Potential HIV transmission risk among spouses: marriage intention and expected extramarital male-to-male sex among single men who have sex with men in Hunan, China

“…Generally, Chinese MSM experience high levels of sexual and gender minority stress. Our study indicated that the average score of internalised homophobia among our participants was significantly higher than the average scores seen in studies outside of China 24 25. Those men with internalised homophobia might believe that homosexuality is ethically wrong or psychologically abnormal, that homosexual behaviours are shameful, or that gay relationships are more likely to be unsuccessful 26.…”

Minority stress, depression, and cigarette smoking among Chinese gay versus bisexual men: A two-group structural equation model analyses

“…However, other research has documented significant relationships between mental distress and smoking among sexual minority men globally. [44][45][46][47] There might be some contextual factorssuch as tobacco-free policy in our campus-based venues, peer influences, and social or cultural norms -confounding or buffering the effect of minority stressors on cigarette use in this study population.…”