Mental health of LGBTQ+ people during the COVID-19 pandemic: a scoping review

Citation:

Christopher Dietzel, Bamidele Bello, Brittany O’Shea, Jessie Cullum & Matthew Numer (2023): Mental health of LGBTQ+ people during the COVID-19 pandemic: a scoping review, Advances in Mental Health, DOI: 10.1080/18387357.2023.2248299

Abstract

Objective: The purpose of this study was to analyse available literature on the mental health of LGBTQ+ people during the

COVID-19 pandemic.

Methods: For this scoping review, six electronic databases were searched in three broad topic areas (the COVID-19 pandemic,

LGBTQ+ people, mental health) in April 2022. The search yielded 4,285 studies, and after screening them, 61 studies were included

in the final review, which were thematically analysed.

Results: Results were organised according to four themes: comparative effects of the pandemic on LGBTQ+ and

heterosexual cisgender people’s mental health; mental health impacts; differences in the mental health among LGBTQ+ people;

and protective and risk factors. LGBTQ+ people’s mental health was disproportionately impacted by the pandemic, particularly

when compared to heterosexual and cisgender people. Some sub-populations of LGBTQ+ people were impacted more than

others, such as bisexual, transgender, non-binary, and gender-diverse people. Depression, anxiety, and stress/distress were the

most salient mental health issues, though loneliness, suicidal ideation, self-harm, and COVID-related fears were also prevalent.

LGBTQ+ people used substances, social media, dating apps, and pornography to cope with the pandemic.

Discussion: Gaps in the literature and study limitations are

identified, and recommendations for policy, health services, and

future research are offered.

Read the full-paper Here

Embracing a New Day: Exploring the Connections of Culture, Masculinities, Bodies, and Health for Gay Men through Photovoice

Citation

Joy, P., Numer, M., Kirk, S., Aston, M. (2021). Embracing a New Day: Exploring the Connections of Culture, Masculinities, Bodies, and Health for Gay Men through Photovoice. Journal of Bodies, Sexualities and Masculinities

Abstract

The construction of masculinities is an important component of the bodies and lives of gay men. The role of gay culture on body standards, body dissatisfaction, and the health of gay men was explored using poststructuralism and queer theory within an arts-based framework. Nine gay men were recruited within the city of Halifax, Nova Scotia, Canada. Participants were asked to photograph their beliefs, values, and practices relating to their bodies and food. Semi-structured interviews were conducted, using the photographs as guides. Data were analyzed by critical discourse analysis and resulted in three overarching threads of discourse including: (1) Muscles: The Bigger the Better, (2) The Silence of Hegemonic Masculinity, and (3) Embracing a New Day. Participants believed that challenging hegemonic masculinity was a way to work through body image tension.

Link: https://www.berghahnjournals.com/view/journals/jbsm/2/2/jbsm020203.xml

Assemblages of Excess Pleasure and Connection: The sociosexual uses of virtual and chemical technologies among men who have sex with men

Citation

Numer, M., Hammond, C., Holmes, D. (2021). Assemblages of Excess Pleasure and Connection: The Sociosexual Uses of Virtual and Chemical Technologies Among GBMSM. Nursing Philosophy.

Abstract

Chemicals have penetrated everyday lives of men who have sex with men as never before, along with new online and mobile technologies used to seek pleasures and connections. Poststructuralist (including queer) explorations of these new intensities show how bodies exist in the form of (political) surfaces able to connect with other bodies and with other objects where they may find/create a function (e.g., reproduce or disrupt hegemonies). This federally funded netnographic study explored how a variety of chemicals such as recreational drugs, pharmaceuticals and steroids are contributing to the construction of gay, bisexual and other men having sex with men (GBMSM) communities and their interactions with idealized masculinities in the age of increasing technology. Five major thematic categories emerged from our analysis: (1) assembling bodies and technologies, (2) becoming orgiastic, (3) experiencing stigma, (4) becoming machinic and (5) negotiating practices. Our analysis explores how and why GBMSM pursue excesses of pleasure and connection through the assemblages they make with sexualized drug use, online platforms and other men.

Link: https://onlinelibrary.wiley.com/doi/full/10.1111/nup.12370?casa_token=1djpweLw7KkAAAAA%3Ai3D3FAFaapkrG6IgyGFFUNsLPheNnvkUDbjkbZi4RioZ3yMVSFb1yYX6yqj-KGTH2H1vef-qZ_-77Q

Assembling Bodies and Technologies: A Nethnographic Account of Sexualized Drug Use Among Gay, Bisexual, and other Men Who Have Sex with Men

Citation

Holmes, D., Numer, M., Hammond, C., Joy, P., Sinno, J. (2021). Assembling Bodies and Technologies: A Nethnographic Account of Sexualized Drug Use Among Gay, Bisexual, and other Men Who Have Sex with Men. Gender, Technology and Development. DOI: 10.1080/09718524.2021.1940437 

Abstract

The identities and communities of gay, bisexual, and other men who have sex with men (GBMSM) are undergoing reconfiguration through two technologies: the digital spaces of social networking and hookup apps, and the sexualized use of chemicals such as recreational and illicit drugs, pharmaceuticals, and steroids. These technologies are creating spaces for GBMSM to indulge in excesses and extremes of pleasure, generating what has been described as an online chemculture. We approached this topic from a poststructuralist queer perspective, attending to the ways in which the fluid assemblages between GBMSM bodies and technologies produce sexual relations that resist heteronormative and other oppressive social structures. Using discourse analysis, this mixed method study (questionnaires and semi-structured interviews) of 50 GBMSM explored how they talked about their sexualized uses of digital and chemical technologies. Data collection occurred in three Canadian cities (Halifax, Ottawa, and Vancouver). The results identify the technologies most frequently employed in the sexual encounters of GBMSM, as well as participants’ self-identified purposes for using these technologies and the effects they have on GBMSM identities and communities. This study suggests that there is some potential, though not without some tension, in GBMSM using digital and chemical technologies to realize queer desires.

https://doi.org/10.1080/09718524.2021.1940437

Sexualized Drug Use and Online Technologies: Examining the negotiations and practices of gay, bisexual, and men who have sex with men

Citation

Joy, P., Hammond, C., Holmes, D., Sinno, J., Numer, M. (2021). Sexualized Drug Use and Online Technologies Examining the Negotiations and Practices of Gay, Bisexual, and Men Who Have Sex with Men. AWRY: Journal of Critical Psychology.

Abstract

Within the health literature for gay, bi, and trans men sexualized drug use is often positioned as only a sexual health risk. This research utilized netnography to examine the ways men use technologies to negotiate SDU and their sexual health. Participants were recruited from three Canadian cites to participate in semi-structured interviews. Fifty interviews were completed. Foucauldian discourse analysis was used to analyze data. Participants described negotiating practices, through the ethics and politics of sex, communicating pleasures, and reducing harm. Findings suggests that sexualized drug use is more than just a sexual health risk. Implications for service providers are explored.

Link: https://awryjcp.com/index.php/awry/article/view/38

Compassionate Bodies, Compassionate Practice: Navigating Body Image Tensions among Gay Men

Citation

Joy, P., Goldberg, L., Numer, M., Kirk, S., Aston, M., & Rehman, L. (2021). Compassionate Bodies, Compassionate Practice: Navigating Body Image Tensions among Gay Men. Canadian Journal of Dietetic Practice and Research. 

Abstract

Our purpose in writing this Perspective in Practice is to create awareness about the role of compassion within dietetic practice, particularly the role of compassion for body image tensions. Nine self-identifying gay men were recruited to a photovoice research study that explored their beliefs, values, and practices relating to food and their bodies. Compassion was found as one way to navigate body images tensions. It is not the intent of this article to review all aspects of this research study but to use it as an example to illustrate compassion in dietetics. We suggest that our findings reveal the strength of using compassionate practice within the dietetic profession. In doing so, we call upon dietitians to incorporate compassion into their clinical and client care practices to foster health and healing for all communities, especially among those who struggle with body image tensions.

Link: https://dcjournal.ca/doi/abs/10.3148/cjdpr-2021-012

Reflections in comics: The views of queer artists in producing body imagine comics and how their work can improve health.

Citation

Joy, P., Gauvin, S., Aston, M. & Numer, M. (2020). Reflections in comics: The views of queer artists in producing body imagine comics and how their work can improve health. Journal of Graphic Novels and Comics. DOI: 10.1080/21504857.2020.1806891.

Abstract

Comics are an innovative way to translate health knowledge and research to service providers and communities. A theoretical framework intertwining poststructuralism and queer theory was used to explore the experiences of queer artists in the creation and production of body image comic anthology entitled Rainbow Reflections: Body Image Comics for Queer Men. The aim was to examine the beliefs of the artists about the potentiality of comics to address body image concerns for queer men. Body image concerns may create negative health experiences, isolation, loneliness, and sexual intimacy concerns. Nineteen self-identifying queer artists participated in the study. Discourse analysis revealed five threads of discourse that bring understanding on how comics can improve body image, and the health and well-being of both the artists through the act of creation and the reader through the act of consumption. Theses threads of discourse include: 1) Creating a unique language, 2) Revealing and healing themselves, 3) Exploring cultural influences, 4) Expanding spaces for queer men and their bodies, and 5) Connecting men. The findings reveal that comics can create knowledge and stimulate discussions about body image and has the potential to positively influence the health of queer men.

https://doi.org/10.1080/21504857.2020.1806891

Gay men’s sexual health promotion in virtual space: Exploring stakeholders’ attitudes and approaches to outreach on mobile apps in Nova Scotia.

Citation

Thompson, R., Joy, P., Numer, M., & Holmes, D. (2018). Gay men’s sexual health promotion in virtual space: Exploring stakeholders’ attitudes and approaches to outreach on mobile apps in Nova Scotia. The International Journal of Community Diversity, 18(3-4), 17-29.

Abstract

HIV infections are still are a concern for many gay men in Canada despite prevention efforts. Social networking applications (SNAs) have predominantly been where gay men meet for sexual encounters. Grindr is the most common app used, which is a GPS-enabled SNA that was released in 2009. In Nova Scotia, there is a culture of silence in the gay community surrounding HIV/AIDS discourses. It is suggested that the perspective of professional stakeholders in sexually transmitted and blood borne infections (STBBI) prevention is needed to enhance prevention efforts. The purpose of this qualitative study is to explore the perspectives of service providers regarding STBBI risk on one SNA for gay men. Key stakeholders in this current study were sexual health service providers working in Nova Scotia. Four stakeholders were interviewed as part of a larger study. Secondary thematic analysis was employed to examine this data for this research project. The interviewed stakeholders experienced outreach challenges because of the “changed landscape” of online partner finding. Stakeholders have an interest in accessing these spaces for prevention and suggest that online forums such as Grindr can be used for sexual health prevention aimed at gay men. Further, leaders in the gay men’s community may be able to help service providers understand the implications and potential contributions of sexual health promotion efforts.

http://hdl.handle.net/10222/75936

Constituting the ideal body: A poststructural analysis of “obesity” discourses among gay men.

Citation

Joy, P., & Numer, M. (2018). Constituting the ideal body: A poststructural analysis of “obesity” discourses among gay men. Journal of Critical Dietetics, 4(1), 47-58. (open access)

Abstract

Ideal bodies are constituted through various social and cultural discourses. One such discourse that constitutes bodies is the “obesity” discourse. The term obesity is a contested and medicalizing term that constitutes a view of fat people as unhealthy, immoral, and undesirable. Obesity discourses, therefore, also constitute notions of the bodies and body types that are thought to be healthy, acceptable, and attractive. The effects of obesity discourses can be prominently observed in gay men’s culture where muscular, white, thin bodies are glorified. This paper employs a poststructural framework to examine how desired bodies are constituted in gay culture. This paper also explores how some gay men resist dominant obesity discourses. A critical review of the literature on fatness, body dissatisfaction, and the influence of gay culture on eating practices among gay men informs this work. Various studies have shown that gay culture can constitute experiences of body dissatisfaction, rejection, and isolation for many men, especially for those that fall outside the idealized version of male bodies or who are labelled as “obese”. Implications for critical dietitians who are working with gay men are discussed.

This paper is open access. Read it here.

Queering educational practices in dietetics training: A critical review of LGBTQ inclusion strategies.

Citation

Joy, P., & Numer, M. (2018). Queering educational practices in dietetics training: A critical review of LGBTQ inclusion strategies. Canadian Journal of Dietetic Practice and Research, 79, 1-6. DOI: 10.3148/cjdpr-2018-006

Abstract

Lesbian, gay, bisexual, trans, and queer people (LGBTQ) have unique concerns regarding their nutritional health while experiencing disparities within the Canadian healthcare system. Dietetic training programs often do not provide adequate knowledge or skills to students to be competent in meeting the needs of this population. Drawing from literature from other health programs, this paper outlines key strategies to the integration of LGBTQ curriculum into dietetic training programs. LGBTQ training can help students gain cultural competencies, knowledge and understanding of the LGBTQ communities, and the nutritional concerns within them.

http://dx.doi.org/10.3148/cjdpr-2018-006

HIV/AIDS and the public health paradox: A poststructural discourse analysis of the impact of HIV Messaging on gay men in Nova Scotia.

Citation

Numer, M., Gahagan, J., Brown, M., & Atkinson, S. (2017). HIV/AIDS and the public health paradox: A poststructural discourse analysis of the impact of HIV Messaging on gay men in Nova Scotia. The International Journal of Health, Wellness and Society, 7(3), 91-104. DOI: 10.18848/2156-8960.

Abstract

Three decades of public health and health promotion policies and programs, in Nova Scotia, have aimed to reduce the rate of new HIV infections. Yet, gay men in this province continue to experience the highest rates of HIV transmission and have the highest proportion of people living with this disease in Canada. In this paper, the authors employ a Foucauldian conceptual framework and a qualitative post-structural discourse analysis to examine the role of public health in HIV messaging and how this has shaped our knowledge and understanding of gay men in the modern age of HIV/AIDS. Seventeen HIV activists in Nova Scotia were interviewed, and the transcripts are the textual source of the discourse analysis. An investigation of local public health efforts can illustrate the impact of the often-unseen dimensions of power and also the unintended consequences of health messaging on target populations. The findings suggest that public health efforts aimed at HIV prevention and stigma reduction are neither apolitical nor neutral. Rather, while these public policy efforts are aimed at HIV prevention, by attempting to regulate sexual subjectivities, they have become a form of discourse that has entered into the subject experience of gay men. This paper explores some of the ways in which public health HIV discourse impacts the subject experience by examining the effects of mainstreaming HIV messaging, sanitizing messaging for public consumption, and avoiding candid discussions about gay men’s sexual practices in the context of public health.

https://doi.org/10.18848/2156-8960/CGP/v07i03/91-104

The sexual health of gay men in the post-AIDS era: Feminist, post-structuralist and queer theory perspectives.

Citation

Numer, M., & Gahagan, J. (2009). The sexual health of gay men in the post-AIDS era: Feminist, post-structuralist and queer theory perspectives. International Journal of Men’s Health, 8(2), 155-168. DOI: 10.3149/jmh.0802.155

Abstract

This article discusses feminist, post-structuralist and queer theories as a framework for masculinities research on sexual health promotion efforts targeting gay men, particularly in relation to HIV prevention. The theories discussed have the potential to challenge the social categories associated with gender, sex, sexual identity and sexual orientation which often determine identities and subjectivities. Recognizing masculinity as a gender "performance" rather than a fixed identity enables health researchers to more fully investigate gendered sexual behaviors which are imbued with social, political and economic meaning. A combined feminist, post-structuralist and queer theoretical framework provides a way to understand how concepts of masculinity organize social interactions and how these in turn shape and inform the sexual health behaviors of men. The purpose of this article is to offer an approach for use by gay men's health researchers working on health promotion.

http://dx.doi.org/10.3149/jmh.0802.155

The sexual health of gay men: Exploring the intersections of identity, masculinities and sexual health promotion.

Citation

Numer, M. (2008). The sexual health of gay men: Exploring the intersections of identity, masculinities and sexual health promotion. The International Journal of Diversity in Organisations, Communities and Nations Annual Review, 8(3), 249-254. DOI 10.18848/1447-9532/CGP/v08i03/39611

Abstract

This paper will explore the implications of traditional masculinity in relation to public health discourse aimed at the sexual health of gay men. The examination of gay men as gendered subjects who perform gender acts in relation to sexual health practices is critical to addressing issues of diversity in this sector of health care, particularly in relation to HIV/AIDS. Despite the growing attention given to the theory and practice associated with gay men’s sexual health behaviors, there remains a gap in the literature and a lack of understanding of dominant or hegemonic masculinity as it influences the sexual health practices of gay men. Traditionally, there is a paradoxical relationship between gay men and the notions of masculinity. While gay men theoretically hold a subordinate position in the hierarchy of heterosexual hegemonic masculinity, there exists a similar masculine hierarchy within the gay male community which in turn has an erotic association. That is, gay men are often ranked according to their ability to “measure up”, both in relation to other men and as sexual objects, to the standard of hegemonic masculinity which entail power, dominance, invulnerability and more. This situation, along with the recent theorizing of men’s practices of masculinity being associated with their poorer health, leads to the logical conclusion that gay men’s sexual health practices can be linked to a systemic hegemonic masculinity. If the full breadth and depth of sexual health among young gay men are to be considered in the development of health policy and health promotion, the intersections of gender, sex and sexuality must be explored. The aim of this argument is to present issues of diversity within the category “men”, and to illustrate the multiplicities and intersections of identity within the category “gay men”.

https://doi.org/10.18848/1447-9532/CGP/v08i03/39611