Gay and Bisexual Men's Health
Stigma and Discrimination
Homophobia, stigma (negative and usually unfair beliefs), and discrimination (unfairly treating a person or group of people) against gay, bisexual, and other men who have sex with men still exist in the United States and can negatively affect the health and well-being of this community.
These negative beliefs and actions can affect the physical and mental health of gay, bisexual, and other men who have sex with men, whether they seek and are able to get health services, and the quality of the services they may receive. Such barriers to health must be addressed at different levels of society, such as health care settings, work places, and schools to improve the health of gay and bisexual men throughout their lives.
The Effects of Negative Attitudes on Gay, Bisexual, and Other Men Who Have Sex with Men
Some people may have negative attitudes toward gay, bisexual, and other men who have sex with men. These attitudes can lead to rejection by friends and family, discriminatory acts and violence, and laws and policies with negative consequences. If you are gay, bisexual, or a man who has sex with other men, homophobia, stigma, and discrimination can:
- Affect your income, whether you can get or keep a job, and your ability to get and keep health insurance.
- Limit your access to high quality health care that is responsive to your health issues.
- Add to poor mental health and poor coping skills, such as substance abuse, risky sexual behaviors, and suicide attempts.
- Affect your ability to have and maintain long-term same-sex relationships that lower your chances of getting HIV & STDs.
- Make it harder for you to be open about your sexual orientation, which can increase stress, limit social support, and negatively affect your health.
Homophobia, stigma, and discrimination can be especially hard for young men who are gay, bisexual, and other men who have sex with men. These negative attitudes increase their chance of experiencing violence, especially compared with other students in their schools. Violence can include behaviors such as bullying, teasing, harassment, physical assault, and suicide-related behaviors.
Gay and bisexual youth and other sexual minorities are more likely to be rejected by their families. This increases the possibility of them becoming homeless. Around 40% of homeless youth are LGBT. A study published in 2009 compared gay, lesbian, and bisexual young adults who experienced strong rejection from their families with their peers who had more supportive families. The researchers found that those who experienced stronger rejection were about:
- 8 times more likely to have tried to commit suicide
- 6 times more likely to report high levels of depression
- 3 times more likely to use illegal drugs
- 3 times more likely to have risky sex
Reducing the Effects of Stigma and Discrimination
Gay and bisexual men and their family and friends can take steps to lessen the effects of homophobia, stigma, and discrimination and protect their physical and mental health. One way to handle the stress from stigma and discrimination is by having social support. Studies show that gay men who have good social support—from family, friends, and the wider gay community—have
- higher self-esteem,
- a more positive group identity, and
- more positive mental health.
What Can Parents and Guardians Do?
Parents of a gay or bisexual teen can have an important impact on their child’s current and future mental and physical well-being. Parents should talk openly with their teen about any problems or concerns and watch for behaviors that might show their child is being bullied or is experiencing violence. If bullying, violence, or depression is suspected, parents should take immediate action working with school staff and other adults in the community.
In addition, parents who talk with and listen to their teens in a way that invites open discussion about sexual orientation can help their teens feel loved and supported. Parents should have honest conversations with their teens about safer sex, STDS, and HIV prevention. Parents should also talk with their teens about how to avoid risky behavior and unsafe or high-risk situations.
Parents also should develop common goals with their teens, such as being healthy and doing well in school. Many organizations and online information resources exist to help parents learn more about how they can support their gay and bisexual teen, other family members, and their teens’ friends.
Read more about Positive Parenting Practices.
What Can Schools Do?
Schools can also help reduce stigma and discrimination for young gay, bisexual, and other men who have sex with men. A positive school environment is associated with less depression, fewer suicidal feelings, lower substance use, and fewer unexcused school absences among LGBT students. Schools can help create safer and more supportive environments by preventing bullying and harassment, promoting school connectedness, and promoting parent engagement. This can be done through the following policies and practices:
- Encourage respect for all students and not allow bullying, harassment, or violence against any students.
- Identify “safe spaces,” such as counselors’ offices, designated classrooms, or student organizations, where gay and bisexual youth can get support from administrator, teacher, or other school staff.
- Encourage student-led and student-organized school clubs that promote a safe, welcoming, and accepting school environment (such as gay-straight alliances, which are school clubs open to youth of all sexual orientations).
- Make sure that health classes or educational materials include HIV and STD information that is relevant to gay and bisexual youth too, making sure that the information uses inclusive words or terms.
- Encourage school district and school staff to create and publicize trainings on how to create safe and supportive school environments for all students, regardless of sexual orientation or gender identity and encourage staff to attend these trainings.
- Make it easier for students to have access to community-based providers who have experience providing health services, including HIV/STD testing and counseling, and social and psychological services to gay and bisexual youth.
You can also help by reporting discrimination, especially while seeking and receiving healthcare services. This could also have a positive impact on the environment for other gay and bisexual men. Hospitals can’t discriminate against people based on sexual orientation and gender identity. Hospitals that receive funding from the Centers for Medicaid and Medicare are required to have nondiscriminatory hospital visitation policies, so that same-sex partners and other family members can visit loved ones in the hospital.
Whether you are gay or straight, you can help reduce homophobia, stigma, and discrimination in your community and decrease the negative health effects. Even small things can make a difference, such as supporting a family member, friend, or co-worker.
- Parents’ Influence on LGB Teens
- "It Gets Better Project" for LGBT Youth
- Sexual Orientation and Homosexuality (American Psychological Association)
- For a Better Understanding of Sexual Orientation & Homosexuality (American Psychological Association)
- Gay, Lesbian & Straight Education Network
- Gay-Straight Alliances Network
- Creating Safe Space for GLBTQ Youth: A Toolkit (Advocates for Youth)
- PFLAG-Parents, Families, Friends and Loved Ones of Lesbians and Gays
- Bouris A, Guilamo-Ramos, Pickard A, Shiu C, Loosier PS, Dittus P, Gloppen K, Walmiller JM. A systematic review of parental influences on the health and well-being of lesbian, gay, and bisexual youth: Time for a new public health research and practice agenda. Journal of Primary Prevention 2010; 31:273-309.
- Espelage DL, Aragon SR, Birkett M. Homophobic teasing, psychological outcomes, and sexual orientation among high school students: What influence to parents and schools have? School Psychology Review 2008; 37:202-216.
- Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health outcomes in white and Hispanic/Latino lesbian, gay, and bisexual young adults. Pediatrics 2009; 123:346-352.