Psychosocial Health Disparities Among Black Bisexual Men in the U.S.: Effects of Sexuality Nondisclosure and Gay Community Support
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This thesis explores the subjectivities of females practicing same-sex sexuality in Mexico City. These subjectivities are here viewed in relationship to recent economic transformations in Mexico and to ideas on gender and sexuality produced by diverse actors such as the gay and lesbian and feminist movements, government programs, the media, and the Catholic Church. While the individual subject is constructed through different dominant ideas, female same-sex sexuality in Mexico, offers an interesting case because most dominant ideas suggest that it cannot exist. Analyzing dominant ideas is, then, not sufficient to understand how subjectivities are constructed. Hegemonic ideas are pieced together to form subjectivities, but meanings on gender and sexuality are also produced by subjects that are here viewed as possessing a creative potential. Subversive ideas are not only considered reactive responses to hegemonic ideals but rather as an active shaping of life to make the everyday experience possible. The presentation of subjectivities here focuses on three main themes: Gender and sexual self-representation; love and sexuality; and, life with the family. The second part of the thesis presents three testimonies that have the potential of challenging fixed definitions of these women's identities and realities. This thesis contributes to the understanding of gender and sexuality in Mexico City from the unexplored location of female same-sex sexuality, and to the understanding of the effects on sexualities and subjectivities of the social and economic changes that have taken place in Mexico during the past decades.
Representation
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This chapter considers some aspects of gender and sexuality in Latin America.
In doing so, it seeks to explore how gender and sexuality interact and to give
some historical context. It examines different expressions of female and male
sexuality in the region and how certain ideas of being a ‘proper man’ or
‘proper woman’ are reproduced. To understand such issues, it is important to
consider how ideas of gender and sexuality have changed, as well as how
political and historical factors have shaped understandings of gender and
sexual identities. Despite appearances, gender identities, and even sexuality,
are not fixed. Rather they reflect a myriad of different influences which affect
how an individual understands and acts upon her/his notion of gender and
sexual identity. The content and meaning of such identities vary across time,
geography, class, ethnicity, age and so forth: for example, being a middle-class,
professional, white woman in her thirties in Buenos Aires is quite distinct from
being a poor, black woman in her fifties from north-east Brazil. It is also
important to remember that sexuality is not a descriptor merely for what one
does, but also for how one identifies: in Latin America men who have sexual
relations with men do not necessarily consider themselves gay or bisexual, as
the discussion below highlights.
Sexual identity
White (mutation)
Affect
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Individual health is affected not only by characteristics and behaviors of the individual, but also by the environment in which the individual lives. Although neighborhood effects are well-established in the health literature, whether these effects are different for sexual minority populations is unknown. There is evidence that the neighborhoods in which sexual minorities reside are distinct from those in which heterosexuals reside, which could give rise to differential neighborhood effects. This research uses restricted data from the National Center for Health Statistics Research Data Center-which include neighborhood identifiers-to investigate health-relevant differences between the neighborhoods in which heterosexuals and sexual minorities reside. We also provide preliminary evidence on whether neighborhood effects explain any or all the disparities in health behaviors or health outcomes between sexual minority and heterosexual populations or mediate or moderate the effects of other covariates in explaining these disparities.
Health statistics
Heterosexuality
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Cultural Studies
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One of the four overarching goals of Healthy People 2020 is to achieve health equity, eliminate health disparities, and improve the health of all groups, including the health of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) populations. In 2011, the Institute of Medicine (IOM) released a report that drew attention to the unique health disparities experienced by sexual minorities and underscored the need for a comprehensive approach to sexual minority health research. This article proposes a new model of LGBTQ health to help measure, explore, explain, and predict the impact of sexual minority status on health outcomes. The Intersectional Ecology Model of LGBTQ Health (IEM) demonstrates how the relentless hypervigilance of LGBTQ individuals in a heteronormative society impacts health outcomes through the primary vehicles of stigma and chronic, elevated stress. The purpose of the IEM is to guide future research and enhance public health practice for LGBTQ populations.
Minority Stress
Stigma
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In this chapter, we introduce readers to emerging research on sexual and gender minority (SGM) health disparities. First, we provide a brief background on SGM populations, including how SGM populations are defined, the different measures that have been used to operationalize sexual orientation and gender identity, and what is currently known and unknown about SGM health disparities. Second, we discuss research on the causes of SGM health disparities, with a particular focus on stigma. We take a multilevel, multimethod approach that considers how various research methods and designs – including surveys, daily diary studies, experiments (e.g., field and quasi-experiments), and interventions – have been successfully used to evaluate stigma as a determinant of SGM health disparities. Third, we outline methodological and ethical challenges confronted by researchers in this field and discuss future directions that are needed to advance research on SGM health disparities.
Stigma
Sexual identity
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Background: Many documented disparities associated with health behaviors and access to health care impact the health outcomes of sexual and gender minorities (SGM). The current study aimed to gain insight into the health dispari-ties experienced by SGM adults living in Ohio to obtain data to plan future health-related programs. Methods: A secondary data analysis was conducted using 2018 Ohio Behavior Risk Factor Surveillance System (BRFSS) data. Health behaviors, health care access, and health outcomes were analyzed by sexual orientation (n=11 301) and gender identity (n=11 426) to determine health disparities faced by sexual minority males, sexual minority females and transgender individuals. Results: Significant SGM health disparities in Ohio are related to substance use (ie, binge drinking, current smoking status, e-cigarette use, and marijuana use); poor physical and mental health status; lack of health care coverage; and experiencing COPD, emphysema, or chronic bronchitis (all p < 0.001). In addition, fewer sexual minority females reported being within recommended breast cancer screening guidelines than heterosexual females (p < 0.05). Conclusion: Sexual and gender minority adults in Ohio report disparities associated with several health behaviors and access to health care. These findings may be due to factors at the patient level (eg, experiencing minority stress), provider level (eg, implicit bias), system level (eg, discrimination), and/or society level (eg, lack of legal protections). Study results will be used to plan health campaigns and programs targeted to SGM adults and providers to achieve health equity for the SGM population in Ohio.
Minority Stress
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Cultural Studies
Gender Relations
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