Journal of Homosexuality最新文献

COVID-19 shelter-in-place orders were critical in preventing the spread of SARS CoV-2 virus but may have disrupted care for people living with HIV, including access to antiretroviral treatment (ART). Understanding how COVID-19 restrictions affected ART adherence is a public health concern. Neighborhoods, Networks and HIV (NNHIV) is an ongoing longitudinal cohort study evaluating the impact of neighborhoods and networks on HIV care engagement among gay, bisexual, and other men who have sex with men (GBMSM) living in New York City (NYC). During follow-up visits between April 2020 and January 2021, pandemic impact was assessed, including health care/medication access concerns. Using multivariate logistic regression models, correlates of self-reported persistent ART adherence (≥85%) were assessed. 131 participants provided complete data. Over follow-up, half (50%) attended in-person medical appointments, just over a quarter (27.3%) attended in-person HIV-related lab appointments. In multivariable models, homelessness was associated with lower odds of being consistently adherent (aOR = 0.11, 0.10-0.98. Higher levels of HIV treatment self-efficacy (aOR = 1.05, 1.03-1.07), COVID-19 related increases in substance use (aOR = 3.75, 1.02-13.75) and higher levels of medical mistrust (aOR = 1.05, 1.03-1.52) were all associated with increased odds of being persistently adherent. Although COVID-19 public health restrictions did impact the daily lives of GBMSM living with HIV in the NNHIV cohort, ART adherence remained consistently high, even among those who reported difficulty accessing care during the restrictions. This suggests that local healthcare infrastructure adapted in the face of COVID-19 to meet the changing needs of this cohort of men.

Drawing upon the Generations Study, a longitudinal U.S. national probability survey, we examine sexual fluidity among 894 sexual minority adults over three waves of survey data. We find that plurisexual individuals (i.e. attracted to more than one gender) are more sexually fluid than are monosexual individuals, and those who hold more emergent sexual identities (e.g. asexual, same-gender loving, pansexual, and queer) are more sexually fluid than those with more traditional sexual identities (gay, bisexual, and lesbian). We also find that, although sexual minority men are less fluid than sexual minority women, men's sexual fluidity is tied to more individual and contextual characteristics than is women's fluidity. Finally, we examine how sexual identity fluidity is related to select health-related outcomes and established social determinants of health for sexual minorities. We find no differences based on sexual fluidity for sexual minority men, but sexually fluid sexual minority women fare better than non-fluid sexual minority women on measures of alcohol consumption and social support from friends. These findings suggest that sexual fluidity might be more positively linked to some health-related indicators for women when shifts are primarily occurring between sexual minority identities, rather than between heterosexual and more stigmatized identities.

It is well established that people of LGBTQIA+ communities suffer more often from mental illness and encounter greater barriers to accessing mental health services compared to hetero/cis people. Moreover, this community faces an increased risk of experiencing negative effects during therapy. As such, it is important to evaluate to what extent psychotherapists have the necessary awareness and knowledge to work with LGBTQIA+ clients. Furthermore, it is important to assess how this topic is currently addressed in psychotherapy training. We conducted an online survey sent to all registered psychotherapists in Austria. To assess attitudes, the Ally Identity Measure (AIM) was translated into German and validated as part of the current study, since to our knowledge no similar scales existed in German. The German version indicated good construct, convergent and discriminant validity and test-retest reliability. Of the 492 participants, only 5% felt they definitely had enough training on LGBTQIA+ topics and 2% received obligatory training during their studies. Additional training and self-education on the theme were positively associated with AIM scores (all p < 0.01). These results highlight that psychotherapists in Austria feel underprepared to work with LGBTQIA+ clients. This has important implications for health equity in gender and sexual minorities.

This paper explores the bereavement experience of aging queer men in Czechia through the lenses of the sociology of death, dying, and bereavement, as well as critical studies on men and masculinities. It examines how their coming-out connects to caregiving, and how taking care of a close person and then losing them impacts their life. To do this, the study is grounded in the concepts of biographical disruption and disenfranchised grief, with a focus on care. Drawing on nine interviews and using interpretative phenomenological analysis, three themes emerged: 1) the non-acceptance of coming out and its connection to caregiving, 2) taking on a role of a caregiver as a source of biographical disruption, and 3) the loss of a close person as a source of both biographical disruption and disenfranchised grief. The findings suggest that communication partners who faced non-acceptance of their coming out tend to provide care for others while refusing to seek it for themselves, and that biographical disruption is a useful concept when applied to caregivers themselves who also face the possibility of disenfranchised grief after the passing of their close person.

This study examines the relationship between workplace bullying and mental health outcomes among gay and bisexual (GB) male workers in Japan, based on the minority stress framework. Prior research has shown that lesbian, gay, bisexual, transgender, queer, and other populations with diverse sexual orientations are more vulnerable to mental health problems and suicide, yet few studies have focused specifically on workplace bullying as a distal stressor. Using an anonymous web-based survey conducted in 2020, data were collected from 1,202 employed GB men aged 20-69. Logistic regression analyses, including Firth's penalized likelihood method for rare events, assessed associations between bullying and psychological distress, suicidal ideation, and suicide attempts, adjusting for sociodemographic, employment, and workplace factors. Results showed that 8.8% of respondents reported bullying due to sexual orientation. Bullying was significantly associated with higher odds of psychological distress, suicidal ideation, and suicide attempts. These associations remained significant after controlling for confounders. The findings indicate workplace bullying is not only linked to psychological distress but also extends to suicide-related behaviors. This highlights the urgent need for organizational interventions, legal protections, and inclusive workplace cultures in Japan. Future research should adopt longitudinal designs and address intersectionality to strengthen empirical evidence and policy relevance.

Although same-sex marriage and adoption have been legally recognized in Mexico through several rulings by the Supreme Court of Justice of the Nation, public attitudes toward these rights remain contested. Despite gradual increases in support, empirical studies in Mexico examining macro-social and individual factors shaping public opinion are still limited. Using data from the CNEP 2024 post-electoral survey (N = 1,205), this study analyzes the effects of sociodemographic, political, and media-related variables on support for both rights. Results show that being female, younger, more educated, having a lower income, voting for Jorge Álvarez Máynez, and active social media use were positively associated with support for both rights. In contrast, religiosity and voting for Claudia Sheinbaum affected only support for adoption. The findings partially align with theoretical expectations about gender roles, modernization, and network contagion, while contradicting others, such as the role of income and the limited influence of religiosity. The results are discussed within the broader theoretical framework that informs this area of research.

The phenomenon of gender identity detransition broadly speaking happens when someone re-identifies with their assigned-sex after transitioning their gender identity. There is a growing body of evidence exploring the prevalance of detransition yet few studies have sought to understand the lived experience of gender detransition, and those who also retransition. Five participants were recruited from an NHS GIC and interviewed about their experience of detransition. Interview transcripts were analyzed using interpretative phenomenological analysis. There were four main themes: (a) a sense of difference from childhood is experienced; (b) gender transition is challenging in multiple ways; (c) conflicts are experienced; and (d) stopping transition has challenges and benefits. Gender identity transition and detransition is a varied experience and people have multiple needs.

Lesbian, gay, bisexual, trans*, and other queer (LGBTQ*) patients in German primary healthcare face discrimination and minority stress, contributing to health challenges. To provide comprehensive care, doctors need to be aware of their patients' sexual orientation. However, there is few evidence on how gay men in German-speaking contexts want to communicate their sexuality with their General Practitioners (GPs). This qualitative study used 19 episodic interviews with gay men from rural and urban Germany recruited by voluntary response sampling. Framework Analysis was used for data analysis, supported by MAXQDA software. Three disclosure types emerged: (1) Open, (2) ambivalent, and (3) reserved. While some participants proactively shared their sexual orientation, others disclosed only when necessary, and some avoided disclosure altogether. Fear of discrimination, past negative experiences, and lack of visible support shaped these decisions. Disclosure-or the lack thereof-had significant consequences, including delayed care, self-management of health issues, and actively seeking sensitized GPs. Participants emphasized the value of inclusive signals (e.g. in language, symbols, forms) and LGBTQ*-competent care. This study concludes that sexual orientation should become a routine part of communication in general practice. This might encourage more open health communication, reduce fear of stigmatization, and ultimately improve care.

Understanding health staff perceptions of LGBTQ+ individuals is crucial for improving healthcare quality and addressing health disparities. Discriminatory attitudes and lack of knowledge can negatively impact patient outcomes. This systematic review aims to gain a comprehensive understanding of the perceptions of health staff regarding LGBTQ+ individuals. The PICO framework was used to guide the search strategy. Qualitative studies were systematically searched across online databases, including PubMed, Embase, Scopus, and CINAHL. Studies published from their inception to December 2024 were included. The quality assessment of the selected studies was performed using the Joanna Briggs Institute (JBI) critical appraisal tool for qualitative research. This review protocol is registered on PROSPERO under the ID CRD420250653610. A total of eight studies were included, revealing four major themes: (1) perceptions of training gaps and structural barriers, (2) perceptions of discrimination and stigma, (3) perceptions of challenges in providing LGBTQ+ inclusive care, and (4) perceptions of LGBTQ+ workplace culture and professional support. Findings highlight the urgent need for LGBTQ±inclusive healthcare policies, comprehensive training programs, and systemic reforms to enhance cultural competency, reduce disparities, and improve healthcare experiences for LGBTQ+ individuals. Addressing these challenges is essential to fostering inclusive, affirming, and equitable healthcare environments.

Research on transgender travelers remains dominated by Western frameworks that overlook how cultural values shape the experience of minority stress. This study extends Minority Stress Theory (MST) using hiya, a native cultural value rooted in shame, propriety, and relational accountability, as a mechanism that mediates both psychological distress and coping among transgender tourists. Drawing on interviews and focus group discussions with 35 transgender travelers in the Philippines, we show how hiya functions as both a stressor, intensifying self-surveillance, identity concealment, and travel avoidance, and a coping device that guides individuals toward affectively safer spaces where temporary self-expression becomes possible. Rather than viewing culture as background context, we argue that values like hiya actively structure how minority stress is felt, negotiated, and relieved. By theorizing hiya-informed stress and adaptation, this study offers a culturally grounded extension of MST and calls for tourism research to reframe trans travel through a non-Western lens.