“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.

No country for old gay men: Age and sexuality category intersection renders older gay men invisible

Four studies analyzed how sexual orientation (heterosexual vs. gay) and age categories (young vs. elderly) referring to men are cognitively combined. In Study 1, young gay men were judged as more prototypical of gay men than adult or elderly gay men, while young, adult, and elderly heterosexual men were perceived as equally prototypical of heterosexual men. In Study 2, gay men were stereotyped more by young rather than elderly stereotypical traits, while heterosexual men were not stereotyped in terms of age. In Study 3, elderly men were stereotyped more by heterosexual than gay-stereotypical traits, while young men were not stereotyped in terms of sexual orientation. In Study 4, gay men were judged to be young rather than elderly, while elderly men were judged to be heterosexual rather than gay. Overall, elderly gay men were overlooked when processing their constituent categories, “gay” and “elderly” men. Implications for models of intersectionality are discussed.

Primary and secondary supportive partnerships among HIV-positive and HIV-negative middle-aged and older gay men

This study describes the primary and secondary partnerships of aging gay men participating in the Understanding Patterns of Healthy Aging Among Men Who Have Sex with Men substudy of the Multicenter AIDS Cohort Study and examines differences in the prevalence of these relationship structures by HIV status while adjusting for age, education, and race/ethnicity. Relationships were compared within the following structural categories: “only a primary partnership”, “only a secondary partnership”, “both a primary and secondary relationship”, or “neither a primary nor secondary relationship”. There were 1,054 participants (51.9% HIV negative/48.1% HIV positive) included in the study. Participants had a median age of 62.0 years (interquartile range: 56.0–67.0) and most reported being non-Hispanic white (74.6%) and college educated (88.0%). Of the 1,004 participants with available partnership status data, 384 (38.2%) reported no primary or secondary partnerships, 108 (10.8%) reported secondary-only partnership, 385 (38.3%) reported primary-only partnership, and 127 (12.6%) reported both primary and secondary partnerships. Of participants who reported primary partnerships only, the prevalence rates (PRs) were lower among those 62 years and older, HIV positive, black non-Hispanic and Hispanics. Of participants who reported only having a secondary partnership, the PRs were higher among those 62 years and older and HIV positive. Of participants who did not report having either a primary or secondary partnership, the PRs were higher among those 62 years and older, HIV positive, and black non-Hispanic compared with their respective referent groups. There was no significant difference in PRs of having both primary and secondary partnerships by age category, HIV status, race/ethnicity, and education. This study aimed to fill a knowledge gap in the literature regarding both primary and secondary supportive partnerships among aging HIV-positive and HIV-negative gay men.

Identity Collision: Older Gay Men Using Technology

This study examines identity work among older gay men in relation to Information and Communication Technology (ICT). It draws on the notion of IT identity—the extent to which individuals experience technology as integral to their sense of selves—to explore how their homosexuality and advanced age shape their relationships with technology. Applying thematic analysis to 17 semi-structured, in-depth interviews with gay male users aged 66–81, we show that while homosexuality and technology enable and reinforce one another, the relationship between technology and advanced age can be better defined by alienation and estrangement. Consequently, we argue that technology constitutes a crossroads at which the gay and elder identities intersect and collide. In this sense, technology is similar to other cultural constructs, like sexuality, that challenge the merger of advanced age and homosexuality, rendering the older gay identity almost impossible.

Looking Ahead: Intersecting Influences on Older Gay Men Living With HIV

Older HIV-positive gay men live at the intersection of multiple inequalities—with cascading effects on their present and future lives. This qualitative study explored how they plan for their future, with a focus on Advance Care Planning—the process of reflecting/communicating preferences and values for future health and end-of-life care. Seven French-speaking gay men aged 55+ in Montreal, Canada participated in a focus group that was audio-recorded, transcribed and thematically analyzed in four steps. Findings suggest the intersection of sexual orientation and HIV-positive status exacerbated self-disclosure issues; the further addition of age led to preoccupation with day-to-day living and rendered these men vulnerable to social isolation. These tensions not only interfered with their capacities to talk about future care, but also created barriers to thinking about future care. These findings describe the multiple layers and compounding consequences of inequality among older gay men living with HIV.