“You Could Tell I Said the Wrong Things”: Constructions of Sexual Identity Among Older Gay Men in Healthcare Settings

Older gay men commonly conceal their sexual identity in healthcare settings due to past experiences and expectations of encountering stigma and discrimination in these contexts. Although insights on how older gay men construct their sexual identity in healthcare may help contextualize this phenomenon, this question remains under-explored. Accordingly, we present the findings of a secondary grounded theory analysis of individual interview data, which we originally collected to examine the healthcare experiences of 27 gay men ages 50 and over, to explore constructions of sexual identity among the group. Our findings broadly reveal that older gay men’s varying exposure to intersecting systems of oppression, together with their perceptions of different healthcare settings, may be critical in shaping their constructions of sexual identity in these contexts. Our research supports the need for healthcare policies and practices that address stigma and discrimination as salient barriers to sexual identity disclosure among older gay men.

Lack of Sexual Identity Disclosure in China May Distort Efforts to Combat STI Epidemics

Background. To evaluate whether Chinese men who have sex with men (MSM) select an STI test (rectal vs urethral) appropriate for their sexual behavior (insertive and/or receptive role in anal sex). Methods. We studied uptake of gonorrhea and chlamydia testing among Chinese MSM (N=431) in a multi-site RCT (December 2018 to January 2019). We collected socio-demographics, relevant medical and sexual history, and disclosure of sexual identity (outness). We estimated the decision to test and test choice, and the extent to which disclosure plays a role in decision-making. Results. Among 431 MSM, mean age was 28 years (SD=7.10) and 65% were out to someone. MSM who indicated the versatile role and were out to someone had a 26.8% (95%CI=6.1, 47.5) increased likelihood for selecting the rectal test vs the urethral test, compared to those versatile and not out. Versatile MSM out to their health provider outside of the study context had a 29.4% (95%CI=6.3, 52.6) greater likelihood for selecting the rectal STI test vs the urethral test, compared to versatile MSM not out to their health provider. Conclusions. Anal sex role and identity disclosure may affect gonorrhea and chlamydia testing provision. Apart from clinicians, community-based efforts may reduce stigma-based barriers to testing.

Social Science Research on Heterosexual Relationship Dissolution and Divorce Where One Parent Comes Out as LGB

Lesbian, gay, and bisexual (LGB) parenthood post-heterosexual relationship (PHR) dissolution was the focus of much of the early social science research on sexual minority parenting from the 1980s onward, and remains relevant today. The initial legal cases contesting LGB parenting involved mainly lesbian mothers seeking custody of their children PHR. Yet the focus of most research on LGB parenting and legislation in the twenty-first century has been on children brought up in planned LGB-parent families. This chapter highlights the key issues of sexual identity disclosure and identity intersection for LGB parents PHR. It considers family transition through single parenthood, nonresidential parenting, and stepfamily formation that might particularly marginalize LGB parents and their children PHR. The review focuses on studies of LGB parents, new same-gender partners, and children in these families. When relevant, it considers how family law relates to sexual minority identity empowerment and disempowerment PHR.