Abstract
Background: Same-sex marriage is currently not legalized in China, despite the considerably large number of homosexual and bisexual Chinese populations. At the same time, their holistic health status remains unclear. This is the first scoping review conducted to comprehensively examine all the available literature and map existing evidence on the holistic health of homosexual and bisexual Chinese.Methods: This scoping review used the framework of Arksey and O'Malley and followed the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR). A comprehensive search strategy was carried out across 20 English (EN) and Chinese (both traditional and simplified) electronic databases from January 1, 2001, to May 31, 2020. Two reviewers conducted the reference screening and study selection independently and consulted a third senior reviewer whenever a consensus must be achieved. Data extraction was conducted using a structured data form based on the Cochrane template, after which a narrative synthesis of the findings was performed.Results: A total of 2,879 references were included in the final analysis, with 2,478 research articles, 167 reviews, and 234 theses. Regarding the study populations, the vast majority of studies centered on men only (96.46%), especially men who have sex with men (MSM). Only 1.32% of the studies targeted female sexual minorities. The geographical distribution of all research sites was uneven, with most of them being conducted in mainland China (95.96%), followed by Hong Kong (2.05%), Taiwan (2.02%), and Macau (0.06%). Regarding the specific study focus in terms of the health domain, around half of the studies (45.93%) focused on sexual health only, and an additional quarter of the studies (24.15%) investigated both sexual health and social well-being. Meanwhile, the studies focusing on mental health only accounted for approximately 15% of the total.Conclusions: This scoping review revealed that previous research focused more on male than female sexual minorities, on disease-centered surveys than person-centered interventions, and investigations on negative health conditions than positive health promotion. Therefore, investigations centered on the female sexual minorities and corresponding person-centered interventions are highly needed.Review Registration: The protocol of this review has been registered within Open Science Framework (https://osf.io/82r7z) on April 27, 2020.
Highlights
Homosexuality and bisexuality have long existed worldwide, but the recognition of same-sex marriage in many countries has only gradually occurred in recent years
This review aims to comprehensively examine the literature to explore the breadth of current knowledge relating to the holistic health of homosexual and bisexual Chinese, identify potential knowledge gaps, and inform future in-depth research on how to improve the health of this particular population
Following the overarching review question: “What is the holistic health status of Chinese homosexual and bisexual adults?” some detailed review questions are as follows: 1) “What health-related variables have been investigated about homosexual and bisexual Chinese?” 2) “What types of research have been conducted and which disciplines were most involved in carrying out studies targeting this population?” and 3) “What are the differences among the sample populations in terms of sexual orientation and gender?”
Summary
Homosexuality and bisexuality have long existed worldwide, but the recognition of same-sex marriage in many countries has only gradually occurred in recent years. In 2001, homosexuality was no longer classified as a pathology under the Chinese Classification of Mental Disorders [2], marking a historical turning point in the progress of homosexuality in China. Despite such developments, in contemporary China, the mainland government still recognizes neither legal same-sex marriage nor civil unions, and the situations in Hong Kong and Macau are similar. Homosexual and bisexual Chinese from the above Cross-Straits Four-Regions have experienced similar cultural and policy backgrounds in the past two decades Research on this population is of historical significance in such an era.
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