Gay Men’s Health and Inty: Social Change and the Life Course - PMC

Contents:

• GAY MEN’S HEALTH AND INTY: SOCIAL CHANGE AND THE LIFE COURSE
• PHYSIL, BEHAVRAL, AND PSYCHOLOGIL TRAS OF GAY MEN INTIFYG AS BEARS
• SEXUAL AND ETHNIC INTY DEVELOPMENT AMONG GAY/BISEXUAL/QUTNG (GBQ) MALE ETHNIC MORY ADOLCENTS
• THE RISE AND FALL OF GAY: A CULTURAL-HISTORIL APPROACH TO GAY INTY VELOPMENT
• THE EXTCTN OF GAY INTY
• THE HIDN GAY LIV FALLY BEG UNVERED
• 6 - INTY AND POLICS A “POSTMORN” GAY CULTURE
• TURNS OUT, BARBIELAND ISN'T AS GAY AS S QUEER FANS HAD HOPED
• A BRIEF HISTORY OF LBIAN, GAY, BISEXUAL, AND TRANSGENR SOCIAL MOVEMENTS
• GAY CULTURE: ANCIENT WONR OR MORN CREATN?

GAY MEN’S HEALTH AND INTY: SOCIAL CHANGE AND THE LIFE COURSE

Published fal eded form as:PMCID: PMC5903851NIHMSID: NIHMS882333AbstractDue to signifint historil change the late twentieth and early twenty-first century related to both health and cultural attus toward homosexualy, gay men of distct birth horts may diverge nsirably their health and inty velopment. Keywords: gay men, health, homosexualy, life urse, inty, history, HIV/AIDS, PrEPIn an early fom on the emergence of pre-exposure prophylaxis (PrEP; see Grant et al., 2010) for HIV preventn held at San Francis’s LGBT Center wnsed by the first thor, an argument epted the dience between a group of young men their twenti and a group of men their fifti. In all likelihood, they uld relate to men of both generatns, havg veloped their sexual liv as gay men wh ndom e as a strong muny norm but havg lost few to heated exchange between the two generatns of men at the PrEP fom reveals the way which social inti and health practic are dynamic and ground historil time and place.

It th n gui scholars to rearch qutns, practic, and advocy strategi more clearly aligned wh the lived experience of gay men diverse cultural and historil ntexts, wh the aim to both unrstand and enhance gay men’s this article, we illtrate the utily of a life urse paradigm the study of gay men’s health and inty velopment and propose empiril work that embodi this paradigm.

PHYSIL, BEHAVRAL, AND PSYCHOLOGIL TRAS OF GAY MEN INTIFYG AS BEARS

We foc on the cultural ntext of the Uned Stat (US) orr to provi an exemplar for adaptatn other natnal settgs which distct historil events will be also regnize that wh the US signifint diversy exists among men who intify as gay owg to the tersectns of other inti such as race, class, genr inty, and other social inti (e.

In other words, although we do not expect uniformy the way which diverse gay men experience historil events, we do expect monaly and th propose salience of certa historil events likely to affect a diversy of gay ias we velop this article may be relevant to bisexual and other same-sex attracted men. Health is th ncerned wh more than the absence of pathology body and md; is ncerned wh the state of dividual and social well-beg (World Health Organizatn, 1948) a larger ntext of stigma and strs for sexual mori (Meyer, 2003) Men’s Health and the Life Course: Key PrciplThe life urse paradigm do not simply gui to a foc on gay men at different pots their dividual velopment (e. A brief samplg of major historil events that have occurred over the past half-century ll our attentn to how the urse of gay men’s liv the US might radilly diverge across generatns—the Stonewall rts of 1969, the emergence of the AIDS epimic the 1980s, the disvery of highly active anti-retroviral therapy (HAART) to manage HIV 1996, the US Supreme Court’s cisn Lawrence v.

A life urse paradigm is clive of the plex aspects of velopment sochistoril ntext and their relevance for the inti and health of gay men (Mart & D’Augelli, 2009) Generatns of Gay Men the USDefg the GeneratnsThe qutn of how to fe a generatn has been a ncern of life urse theory and the soclogy of agg for some time (e. Our goal was to velop hypoth about hort differenc that n be tted future rearch and th to stimulate more quiry that foregrounds the ncept of generatn-hort as a meangful social inty for gay men’s health and inty intifyg hort-fg events, we were terted both discrete happengs and the broar social ntext of how gay men have been “spoken about” (Fouult, 1982) cultural disurse at particular historil moments. Fally, the equaly era (approximately 2003-prent) is characterized by the gradual but now wily held regnn of sexual mory inti and muni as legimate and worthy of equal treatment and protectn unr the law (Keleher & Smh, 2012) the historil eras, we intified four specific hort-fg events (CDEs)—events that marked likely turng pots the llective nscns of gay men, wh implitns for their experience of inty and health (see Table 1).

SEXUAL AND ETHNIC INTY DEVELOPMENT AMONG GAY/BISEXUAL/QUTNG (GBQ) MALE ETHNIC MORY ADOLCENTS

The distct labels we have selected for each generatn reflect the domant disurse of male homosexualy durg cril perds of velopment: sickns, liberatn, AIDS, and 1Generatn-horts of gay men alive, 2017GeneratnApproximatebirth yearsAge at CDE1(Stonewall, 1969)Age at CDE2(AIDSdisvery, 1981)Age at CDE3(HAARTdisvery, 1995)Age at CDE4(Lawrence, 2003)Age 2017Context of velopment1Sickns1930s30s40s50s60s70s–80sHomosexualy strongly pathologized durg childhood and adolcence; early adulthood wh birth of gay and lbian movement; many closeted until later life and sufferg more psychologil distrs about sexualy2Liberatn1940s20s30s40s50s60s–70sExperienced puberty as gay and lbian movement was iatg but not wily visible; early adulthood wh creased visibily and formatn of strong muni urban centers; strongly impacted by AIDS wh loss of works and partners3AIDS-11950s–1960s10s (puberty)20s30s40s50s–60sExperienced puberty at height of visibily for gay and lbian movement; experienced early adulthood at height of AIDS, trma of substantial aths muny; midlife wh major health advanc and civil rights gas4AIDS-21970s–1980s010s10s20s30s–40sExperienced puberty at height of AIDS, ls personal loss than member of AIDS-1 but equatn of gay sex wh ath; benefted om Inter durg adolcence; early adulthood durg treatment advanc and greater equaly5Equaly1990s00<1010s20sExperienced puberty and emergg adulthood after treatment advanc for HIV tablished, civil rights victori, creasg equalyThe Sickns GeneratnFor most of the twentieth century, same-sex sire was classified as a sickns, reprentg a diagnosable mental illns the Diagnostic and Statistil Manual (DSM) of the Amerin Psychiatric Associatn (see Hammack et al., 2013).

THE RISE AND FALL OF GAY: A CULTURAL-HISTORIL APPROACH TO GAY INTY VELOPMENT

Yet prr to the natnal visibily for the gay and lbian civil rights movement realized by the Stonewall rts of 1969 and the removal of homosexualy om the DSM 1973, the domant disurse about homosexualy was that homosexualy and of self nstuted a disease (Hammack et al., 2013; Herek, 2010) men who veloped durg this era likely viewed their sexual sir, practic, and inti through the prism of disease and abnormaly, eply ternalizg stigma (see Cohler, 2007; Hammack & Cohler, 2011; Loughery, 1998). We regnize that this label may be an unfortable one for men of this generatn, yet we employ precisely to pture the extent to which societal disurse and cultural attus so strongly equated homosexualy wh pathology at the time, likely leadg to formidable early psychologil men of the Sickns Generatn were born approximately the 1930s and experienced childhood, adolcence, and early adulthood wh the domant disurse of homosexualy as illns (see Table 1). Rearch that foc specifilly on the experienc of men of lor of this generatn is sential to unrstand the impact of “double stigma” they likely experienced at cril perds their of the Sickns Generatn alive today would have experienced several eras of gay and lbian history, livg long enough to wns the major social and polil gas of the most recent equaly era (2003-prent).

In addn, the experience of health re and other service stutns as hostile to the unique ncerns of gay men may rema a legacy for men of this generatn, as they ntue to report lack of accs to supportive re (Fredriksen-Goldsen & Mura, 2010) or fears of discrimatn health ntexts (Jackson, Johnson, & Roberts, 2008). Stonewall exposed gay and other same-sex attracted men throughout the US to the size and signifince of the larger sexual mory muny, although this exposure was likely more pronounced for men who rid or near major urban sizeable gay and lbian muni had already formed major US ci after World War II (D’E, 1983; Sadownick, 1996), they existed more clanste forms until the 1970s. Visibily of the muni creased dramatilly durg this liberatn era (Hirshman, 2012), and the erosn of the sickns narrative of homosexualy gave way to monstratns of pri and muny ruals such as the emergence of Gay Pri (origally lled Christopher Street Liberatn Day) as an annual celebratn of the Stonewall rts (Duberman, 1993).

THE EXTCTN OF GAY INTY

Open exprsn of same-sex sire beme possible some muni, pecially big ci wh “gay ghettos” (Leve, 1979), along wh a social and polil culture wh a more unified gay muny that enuraged challenge of the stat quo (Armstrong, 2002) men who me of age the US durg this era (1969–1981) had opportuni, unparalleled before, to immerse themselv to gay and lbian muni urban settgs, likely creasg possibili for enhanced psychologil and social well-beg pared to prr generatns. Like men of the subsequent generatn, though, their experience of the hort-fg event of AIDS at the peak of their adulthood likely troduc major challeng for their health and inty experience of gay men of this generatn was far om uniform, however, and likely diverged acrdg to factors such as race and ethnicy.

In one of the only studi of men of lor of this generatn, Woody (2014) found that Ain Amerin men reported feelgs of alienatn om the Ain Amerin muny, havg to nceal their same-sex sir, but also an aversn to labels of the largely whe LGB AIDS-1 GeneratnThe social and polil succs of the liberatn era were cshed by the emergence of the AIDS epimic 1981, which by the end of the 1980s had killed nearly 75, 000 gay men (Centers for Disease Control and Preventn, 2005).

The AIDS era was characterized not jt by the vastatn of the disease self but also the acpanyg disurse of the antigay “relig right” and “moral majory” that went so far as to claim that AIDS was punishment for the “immoraly” of gay sex, creatg a major ntext of stigma for all same-sex attracted men and for people wh AIDS (Herek & Glunt, 1988) and leadg to gay men’s practic and bodi beg subjects of ntamatn durg this era. AIDS-related stigma beme pervasive, wh extraordary public anxiety about the disease, part bee of s associatn wh homosexualy (Herek & Glunt, 1988) the 1980s, the state of gay men’s health beme a “public health and psychologil emergency” (Batchelor, 1984), and gay men beme targets of prejudice and wispread cultural fear for their ntamatn (Batchelor, 1988; Herek & Glunt, 1988).

THE HIDN GAY LIV FALLY BEG UNVERED

Though other generatns of men of lor might have shared this experience, this hort was the first for which the experienc were clearly AIDS-2 GeneratnWe distguish between gay men who were early adulthood at the hort-fg event of AIDS 1981 (members of the AIDS-1 Generatn) and men who were childhood or early adolcence at the time and th ls likely to have been sexually active and socially embedd wh the gay muny. Sce s emergence, the Inter has bee a signifint ntext for gay men’s sexual and social experience (Grov, Brlow, Newb, Rosengerberger, & Bermeister, 2014; Harper, Bce, Serrano, & Ja, 2009; Mtanski, Lyons, & Garcia, 2011), and s availabily for men of the AIDS-2 Generatn at a cril velopmental moment (i.

Th there is evince of diversy among same-sex attracted men of lor their health and inty velopment, and tersectg inti create variable velopmental trajectori for all same-sex attracted men of Equaly GeneratnWh the emergence of highly effective treatments and preventn strategi for HIV/AIDS me a gradual shift the disurse about gay men om ntamated to worthy of equal treatment unr the law, and the AIDS epimic may have e to humanize gay men ways prevly unrealized.

In addn, wh the emergence of new highly effective HIV preventn optns such as PrEP, views about sex, sexual practic, and sexual health have likely e to more closely remble men who me of age the liberatn era, wh gay sex ls likely to be viewed as herently of the Equaly Generatn may also be more likely to hold multiple, ncurrent sexual inti or prefer not to intify wh a sexual inty label. Even the US, the majory of rearch on gay men has not taken to acunt the unique experienc of bisexual men and of men of lor or men livg far om urban centers, so the prent amework mt be open to men other natns and non-whe US gay men may not have experienced the same events wh the same timg and social ntext as the men the generatns proposed here. We hope that rearchers who study sexual and genr inty diversy other cultural settgs will adapt a life urse paradigm for e those sexualy rearchers, a life urse paradigm challeng the notn that gay men nstute a “speci” whose practic and norms n be charted wh lawful regulary by llg attentn to variabily (see Hammack et al., 2013; Sav-Williams, 2005).

6 - INTY AND POLICS A “POSTMORN” GAY CULTURE

This approach may be at odds wh the sexual subjectivi of younger horts of gay men, who not only did not experience the AIDS epimic but also do not view HIV as a lethal advot for gay men and their health, the life urse paradigm illtrat how health is not jt a matter of dividual functng and adaptatn; is closely lked to the polil and historil ntext of shared membership a generatn-hort. Bee there is a arth of general rearch regardg this muny, and no studi to date that e quantative methods, we cid to explore this muny quantatively—g an Inter-nvenience sample, followed by a purposive suggted, the Bear culture exhibs and valu a greater sense of domant (but not necsarily domeerg) “thentic masculy” parison to other subcultur wh the gay muny (e. G., uratn, fistg, voyrism, exhibnism) (Grov, Parsons, & Bimbi, 2010) to the active existence of the Bear muny and regnn of this subculture by the larger gay/bisexual male culture, more rearch is need to explore the gree to which the prevly mentned physil, behavral, and psychologil differenc actually exist.

Consirg the likely prevalence of a Bear inty may be held (wh varyg tenaci) by about 14–22% of gay men, the rults provi addnal evince for the manift and latent heterogeney of gay and bisexual rults regardg body tras and partner selectn nfirm, for the first time a systematic manner, fdgs documented prev terview and ethnographic studi.

A study that answers the rearch qutns would provi further evince to support the heterogeney hypothis: Not only is the mastream gay muny culturally heterogeneo, but so are the sexual health behavrs and problems wh last suggtn for future rearch would be to tt some of the theori generated by the current data. It won the 2019 Digal Publishg Award for bt digal lumn that this is the 100th edn of this lumn and that we're nearg the fal days of my first full wrg about all thgs gay on the regular, I figured why not go all out and unt down the queer pop culture moments that fed an absolutely extraordary for LGBTQ excellence? Scht's CreekArguably the most popular Canadian televisn export sce The Kids and the Hall (if not ever), CBC's very own Scht's Creek gave both everyone's favoure pansexual sweater enthiast David Rose (seri -creator Dan Levy) and the fictnal utopia we all serve: a world where homophobia don't seem to exist and David's sexualy is simply accepted by all the show's characters whout qutn.

TURNS OUT, BARBIELAND ISN'T AS GAY AS S QUEER FANS HAD HOPED

Pedro Almodóvar's Pa and GloryAnother masterfully realized reflectn on gay agg is currently still cemas: Pedro Almodóvar's Pa and Glory, a semi-tobgraphil look at a filmmaker whose hope and health is fadg, portrayed by longtime Almodóvar me Anton Banras sentially playg Almodóvar  a reer-bt performance (give him an Osr nomatn, please). Kate McKnon and Bowen Yang on Saturday Night LiveTwo of the few unniably great thgs about a very uneven for Lorne Michaels's 45-season-and-untg Saturday Night Live were the addns of two tremendoly talented gay edians: Kate McKnon (who joed 2012 and has been the bt thg about SNL ever sce) and Bowen Yang (who me on as a wrer 2018 and st member  2019). Lady Gaga took a song wh lyrics like "Don't be a drag, jt be a queen" and "No matter gay, straight, or bi / Lbian, transgenr life / I'm on the right track, baby / I was born to survive" and phed as far to the mastream as possible, sellg over 8 ln pi worldwi of the track alone and performg at the 2017 Super Bowl halftime show for 117.

A BRIEF HISTORY OF LBIAN, GAY, BISEXUAL, AND TRANSGENR SOCIAL MOVEMENTS

However, when Dube and Sav-Williams (1999) examed the timg of sexual inty velopment ton for lbian, gay, and bisexual (LGB) youth (such as “age of awarens of same-sex attractns, ” “disclosure of sexual inty to others, ” and “first same-sex sexual enunter”), they found that regardls of ethnicy, all participants met their sexual inty velopment ton at velopmentally appropriate ag, wh differenc noted the ag of their first sexual experienc and intifitn as LGB. Addnally, the LGB iends provid participants wh social support, eher explicly givg advice to the participant, or beg posive role the youth of lor navigated venu and peer works which varied their ethnic posn, youth nsired the diverse multiple geographil areas as part of their personal “gay muny.

One participant stated that his grandmother’s history survivg opprsn durg the civil rights movement ma him nnect wh his ethnic inty, but also impacted his own rilience toward current experienc of Inty Concerng nnectn wh their sexual inty, CBOs assisted youth wh learng how to succsfully navigate gay, Whe, and ethnic muni as a GBQ person of lor. Some youth were able to safely navigate their burgeong sexual inty and velop nnectns to other GBQ dividuals through the ter, which served as an anonymo venue to explore their procs of vtigatg one’s sexual inty is markedly different om prev theori of sexual inty velopment (Cass, 1979; Coleman, 1982; Troin, 1989), which suggt that dividuals lk wh more adult-oriented gay or lbian venu, such as bars and clubs.

GAY CULTURE: ANCIENT WONR OR MORN CREATN?

I’ll be fascated to see what dienc make of this mpy, tty portra of a group of gay men who talk , traffic secrecy and have rved out somethg separate that is not exactly play is a postrd om an era that we have thankfully moved past, a pot of reference for our hard-won succs over the last half-century and our arrival an fely better place.

But there had been enough progrs toward the acceptance and tegratn of gays by 2005 that Andrew Sullivan wrote an say The New Republic tled “The End of Gay Culture, ” which he imaged would “expand to such a diverse set of subcultur that ‘gayns’ alone will cease to tell you very much about any dividual. That same year, the so-lled "Alan Turg law" offered pardons to 49, 000 Brish gay men who’d been nvicted of homosexual acts – followg a mpaign arguably bolstered by the greater awarens brought about by The Imatn Game, the h film that picted the nvictn and chemil stratn of the Enigma-breakg puter scientist.