Internalized Homonegativity Research Articles

Exploring Sexual Satisfaction in Lesbian and Bisexual Women from a Minority Stress Perspective

Sexual health among lesbian and bisexual (LB) women has largely been studied in the context of sexual health behaviors. Less is known about aspects of sexual health such as sexual satisfaction and minority stress processes as possible predictors of sexual satisfaction. This study explored sexual satisfaction and minority stress in LB women. Single and partnered cisgender LB women (N = 627) were compared on measures of sexual satisfaction and proximal minority stress (i.e., internalized homonegativity and outness/concealment). The proximal minority stress variables were tested as predictors of sexual satisfaction in a regression analysis. Multigroup analyses were also conducted to explore differences between lesbian and bisexual women in the regression analysis. Participants were recruited through LGBT+ websites and other social media platforms in Norway. Results showed that lesbian women were more open about their sexual orientation, reported greater identification with the LGBT+ community, and were more sexually satisfied than bisexual women. Those with a steady partner were also more sexually satisfied than those who were single. Being younger, partnered and experiencing less internalized homonegativity (IH) predicted greater satisfaction in LB women overall, and no differences in the predictors across sexual orientation were found in the multigroup analysis.

Internalized Homonegativity is Indirectly Associated with Smoking Status through Somatic Anxiety.

In this study, we examined how internalized homonegativity (IH), a non-adaptive cognitive response to lesbian, gay, and bisexual (LGB) minority stressors, related to the manifestation of somatic anxiety symptoms and reduced the likelihood of being a former smoker. Participants (N = 77) smoked ≥ 100 cigarettes in their lifetime, some of whom successfully quit their use (N = 23 former smokers). The Lesbian, Gay, and Bisexual Identity Scale and the State-Trait Inventory for Cognitive and Somatic Anxiety were used to assess IH and somatic anxiety. Current smokers experienced higher IH rates than former smokers (former = 0, current = 1; b = .65, p < .05). IH was positively associated with somatic anxiety (b = .17, p < .001), and the association between IH and smoking status was mediated through somatic anxiety (b = .17; CI = [.0002, .6539]). One's experience with IH may be a risk factor for psychological distress and continued smoking. Current findings can aid in the development of future longitudinal or experimental studies to examine the causality between IH and somatic anxiety and include confounding variables.

Internalized homonegativity moderates the association between attachment avoidance and emotional intimacy among same-sex male couples.

The present study aimed to examine dyadic associations between attachment insecurity and emotional intimacy in same-sex male couples, and to investigate whether and how each partner's internalized homonegativity (IH) moderated these associations. The sample included 138 same-sex male couples. Both dyad members completed self-report measures of attachment insecurity, emotional intimacy, and IH. The actor-partner interdependence model with moderation analysis was applied. Indicated that higher levels of actor's and partner's attachment anxiety and attachment avoidance were associated with lower actor's emotional intimacy. IH moderated the partner effects of attachment avoidance on emotional intimacy. The partner's higher attachment avoidance was associated with one's own lower emotional intimacy at low (but not high) levels of one's own IH and at high (but not low) levels of the partner's IH. Findings suggest that the partner's attachment avoidance may differently affect one's own emotional intimacy depending on the IH levels of both dyad members. Helping partnered sexual minority men decrease attachment insecurity while recognizing their own and their partners' IH may promote relationship quality.

Impact of Migration and Acculturation on Turkish Men Who Have Sex with Men in Germany: Results from the 2010 European MSM Internet Survey.

To examine the impact of migration and acculturation of Turkish men who have sex with men (MSM) to Germany, using data from the European MSM Internet Survey (EMIS-2010), on measures of acculturation including circumcision status, internalized homonegativity (IH), HIV/STI knowledge, sexual orientation, outness, HIV-testing, and sexual behaviors. We compared four groups of MSM: MSM born and residing in Germany who had completed the questionnaire in German (n = 38,915), MSM born and residing in Germany, with a father or mother born in Turkey (n = 97), MSM residing in Germany who were born in Turkey or whose parents were born in Turkey (n = 262), and MSM who were born and residing in Turkey and who completed the questionnaire in Turkish (n = 1,717). Data showed that there were significant dose-response curves between level of migration and several outcome variables. As exposure to Germany increased, MSM had lower IH, higher HIV/STI knowledge, increased outness, and were less likely to be circumcised. There were similar significant findings with regard to sexual HIV risk behavior (condomless anal intercourse with partners of unknown (or sero-discordant) HIV status). Data were consistent with acculturation over generations in immigrant groups in MSM migrating from Turkey to Germany. Integration includes both cultural aspects (circumcision) and integration into a more homopositive gay environment (IH, outness, increased HIV/STI knowledge), and sexual HIV risk behavior. Migration and associated acculturation may constitute a risk change for HIV/STI and mental health issues associated with IH and outness.

Unpacking the Internalized Homonegativity-Health Relationship: How the Measurement of Internalized Homonegativity and Health Matter and the Contribution of Religiousness.

Internalized homonegativity (IH) is widely recognized to negatively influence the health of lesbian, gay, bisexual, and queer/questioning (LGBQ +) individuals. It is not clear, however, the role that religiousness may play in the relationship between IH and health or how differing conceptualizations of IH or health may influence this relationship. We conducted a multi-level meta-analysis of 151 effect sizes from 68 studies to examine the relationship between IH and health as well as what may moderate this relationship. Results suggested that IH was consistently and negatively related to health (r = - .28). Analyses suggest that IH was most strongly related to mental health and well-being, evidencing a relatively weaker (though still negative) relationship with physical or sexual health. Analyses of different ways to measure IH suggest that scales that conceptualize IH to include distress (e.g., the Internalized Homonegativity Inventory) report stronger relationships with health than scales that conceptualize IH orthogonally from distress (e.g., the Internalized Homonegativity scale of the Lesbian, Gay, Bisexual Identity Salience Scale [LGBIS]). We failed to find significant moderation effects for religiousness, though it was hard to evaluate this relationship due to the poor quality of most measures of religiousness. We encourage researchers to use measures of IH that conceptualize IH orthogonally from distress (e.g., the LGBIS) and to use more nuanced measures of religiousness (e.g., religious belief, religious activity). We also encourage researchers to focus on how IH impacts less-often studied measures of health (e.g., physical health, suicidality).

Associations between sexual stigma, enacted HIV stigma, internalized HIV stigma and homonegativity, and depression: testing an extended minority stress model among men who have sex with men living with HIV in India

ABSTRACT Limited data is available on the associations between intersectional stigmas and mental health outcomes among men who have sex with men living with HIV (MSMLH) in India. The minority stress model postulates that sexual stigma contributes to depression through proximal stressors like internalized homonegativity (IHN). Using cross-sectional survey data from 119 MSMLH in 2015/16, we tested whether: (1) sexual stigma and enacted HIV stigma (EHS) are associated with depression; (2) their effects on depression are mediated through IHN and internalized HIV stigma (IHS); and (3) their effects on IHN are mediated through IHS. Significant direct associations were observed between scores on sexual stigma and IHS (β = .49, 95% CI .27, .70), EHS and IHN (β = .19, 95% CI .03, .36), and IHS and IHN (β = .07, 95% CI .03, .12). IHS scores mediated the associations of sexual stigma with depression (β = .17, 95% CI .07, .27) and IHN scores (β = .04, 95% CI .004, .07). EHS was not found to be significantly associated with depression or IHN. The findings partially support the minority stress model among MSMLH and highlight the importance of addressing both sexual and HIV-related stigmas to improve mental health of MSMLH, especially by screening for and reducing IHS, IHN and depression.

Comparison of the Influence of Internalized Homonegativity on Sexual Risk Behavior of Men Who Have Sex with Men in Spain and Turkey

Objectives: This study aimed to understand how the association between internalized homonegativity (IH) and sexual risk behavior differed in Spain (N = 3,336) and Turkey (N = 550). Methods: We used multigroup structural equation modeling. Results: HIV and pre-exposure prophylaxis (PrEP) knowledge mediated the relationship between IH and sexual risk behavior among MSM in Spain, but not among men in Turkey. Higher HIV/PrEP knowledge was associated with higher sexual risk behavior among MSM in Spain, while among MSM in Turkey the association was in the opposite direction. Conclusions: The meaning of safe-sex may differ across contexts, and this should be taken into consideration when tailoring HIV prevention programs.

Sexual Shame and Emotion Dysregulation: Key Roles in the Association between Internalized Homonegativity and Sexual Compulsivity

ABSTRACT Sexual minority men (SMM) are at increased risk for mental health problems due to effects of sexual minority stigma (e.g., internalized homonegativity (IH)). Both IH and emotion dysregulation are contributors to sexual compulsivity; however, the role of feelings of sexual shame have not been examined in this association. A sample of 982 HIV-negative SMM completed online surveys (Mage = 42.4, SD = 13.74). Path analyses indicated significant direct effects of IH on sexual shame (β = 0.44, p < .001), emotion dysregulation (β = 0.19, p < .001), and sexual compulsivity (β = 0.22, p < .001). Modeled simultaneously, the association between sexual shame and sexual compulsivity (β = 0.26, p < .001) was significant, as was the association between emotion dysregulation and sexual compulsivity (β = 0.27, p < .001). Finally, an indirect effect of IH on sexual compulsivity through both sexual shame (p < .001) and emotion dysregulation (p < .001) was significant, and the association between IH and sexual compulsivity was reduced to non-significant (β = 0.01, p = .74). Targeting feelings of sexual shame and emotion dysregulation in clinical interventions may help reduce the negative health impact of sexual compulsivity among SMM.

Is Conservative Religiousness Inherently Associated with Poorer Health for Sexual Minorities?

Results of path analysis involving sexual minority participants (N = 1317) from diverse sociopolitical contexts revealed health outcomes to be associated with internalized homonegativity and the resolution of conflict between religious and sexual minority identities. Contrary to expectations, several markers of religiousness were not directly associated with either improved or worsened health outcomes for depression or anxiety. However, religious activity moderated the influence of internalized homonegativity (IH) on depression such that IH was less strongly related to depression among individuals who frequently attended religious services than among individuals who infrequently attended religious services. These findings have special salience for advancing a more accurate understanding of conservatively religious sexual minorities and directing culturally sensitive research, clinical services, and public policy.

Sex Differences in the Romantic Relationships of Same-Gender Couples: The Role of Visibility Management.

Although internalized homonegativity (IH) in lesbian, gay, or bisexual people (LGBs) predicts adverse relationship satisfaction, this association has typically only been examined on an individual level. Moreover, studies often ignore potential mechanisms that underlie sex differences. One of these mechanisms is related to visibility management (i.e., the careful, planned decisions about whether or not to disclose one's sexual orientation). Therefore, in this study we investigate dyadic sex-specific associations between IH, visibility management, and relationship satisfaction. Our sample includes 254 LGB couples (139 female and 115 male same-gender dyads) in Flanders, Belgium. Data were analyzed with the Actor-Partner Interdependence Mediation Model (APIMeM). Results indicated that there were small to medium significant correlations among IH, visibility management, and relationship satisfaction. We also found support for mediated actor effects: individuals low in IH maintain less restrictive visibility management strategies. These in turn lead to higher relationship satisfaction, but only in female same-gender couples. Our findings contribute to the understanding of mechanisms that underlie the harmful effects of sexual minority stressors for same-gender relationship satisfaction.

Reducing Internalized Homonegativity: Refinement and Replication of an Online Intervention for Gay Men

ABSTRACT We refined and replicated an efficacious brief intervention to reduce internalized homonegativity (IH) with a sample of gay and exclusively same-sex attracted men recruited from outside of LGBT community networks using Amazon Mechanical Turk. We sought to 1) determine if levels of IH differed between the original study's community-based sample and our non-community-based sample, 2) examine the efficacy of the replicated intervention, and 3) assess for longitudinal effects of the intervention at a 30-day follow-up. Four hundred eighty-four participants completed either the intervention or a stress management control condition. Mean levels of IH were higher in the current sample compared with the earlier study's community sample. The intervention was efficacious at reducing global IH, reducing personal homonegativity, and increasing gay affirmation. Ninety-six participants completed the follow-up; follow-up results were not significant and may have been affected by high rates of attrition. Implications for research and practice are discussed.

Internalized Homonegativity and the Challenges of Having Same-Sex Desires in the Lebanese Context: A Study Examining Risk and Protective Factors

ABSTRACT Internalized homonegativity (IH) has received increased attention in the literature on sexual minorities. Nevertheless, there is a lack of research on IH in conservative Arab cultures like Lebanon. The present study aimed to cover this gap by exploring risk and protective factors of IH in Lebanese sexual minorities. A hierarchical multiple regression (N = 210) revealed that religiosity, parental rejection (actual or anticipated), and legal discrimination were significant risk factors of IH, while sense of belonging to the LGBT community was a strong protective factor. Although self-compassion did not emerge as a predictor, it had interesting interactions on the bivariate level. Results, limitations, clinical implications, and recommendations for future research and policy making are discussed.

Effects of Internalized Homonegativity and Face Visibility on HIV-Risk-Taking Behaviour in Gay Men Who Had Casual Sex Using Online-Dating Applications

Objective: To examine how internalized homonegativity (IH) and face visibility on online-dating applications relate to HIV risk-taking in gay men. Methods: Gay men (n = 277) completed an online survey measuring IH, face visibility on online-dating profile(s), and frequency of unprotected sex. Results: Higher IH related to more unprotected receptive (but not insertive) anal intercourse with their casual sex partner(s). In gay men with low face visibility, higher IH related to the higher frequency of unprotected sex. Conclusions: IH and face visibility together may influence HIV-risk-taking behavior among gay men seeking casual sex through online-dating applications.

The impact of religiosity on the psychological well-being of LGBT Christians

Individuals who identified as LGBT and Christian were administered measures of religiosity, their religious organization’s view of homosexuality, internalized homonegativity (IH), and psychological well-being, including eudaimonic well-being (an approach to well-being that focuses on meaning, self-realization, and optimal functioning rather than pleasure attainment and pain avoidance), depression, stress, and anxiety. Religiosity was associated with higher levels of eudaimonic well-being and lower levels of depression, anxiety, and stress. Compared to participants who rated their church as rejecting of homosexuality, participants who rated their church as accepting of homosexuality had lower levels of depression and IH and higher levels of eudaimonic well-being. Moderation analyses indicated that church attendance moderated the relationship between religiosity and psychological well-being at moderate to high levels of church attendance, suggesting that church attendance plays a more important role than other religious practices in the relationship between religiosity and psychological well-being. Analyses indicated that IH and attendance did not mediate, nor did church type moderate, the relationship between religiosity and psychological well-being. Implications of findings are discussed.

Internal homonegativity among men having sex with men: a comparative cross-national study

The paper studies internalized homonegativity (IH) and its predictors among men who have sex with men (MSM) in 12 countries of Eastern Europe and Central Asia (EECA). Internalized homonegativity (sometimes called internal homophobia) is a negative attitude to own same-sex attractions. It arises when gays and other people with homosexual attractions interiorize predominant negative attitudes and assumptions about homosexuals and homosexuality. Internalized homonegativity is a significant factor of poorer health (including vulnerability to HIV infection), and lower inclusion in the community in Western countries. It remains highly understudied in post-Soviet countries, although there is a sufficient ground to suppose its higher prevalence here. Cross-sectional online survey of MSM was conducted in August–October, 2017. Convenience sample was recruited via dating apps and websites, other partner sites, and MSM-service organizations. Analytical sample size was 8239 respondents from Russia, Ukraine, Belarus, Kazakhstan, Kyrgyzstan, Estonia and Lithuania (which were merged), Armenia, Georgia, Azerbaijan, Macedonia, and Moldova. IH was measured by the 8-item Short Internalized Homonegativity Scale (SIHS) in all main languages of the countries. According to results of Cronbach’s a test and multi-group confirmatory factor analysis, adaptation of SIHS showed satisfactory to good reliability, and partial scalar invariance across EECA. IH was not predominant in all countries’ samples. However, average IH was significantly different by countries. That could be attributed to both sampling design and differences in societal homophobia. Results of structural equation modeling of SIHS predictors also varied between countries. However, in most countries IH was lower among self-identified gays, those who were more open about own homosexual attractions, and was less religious. The unexpected findings included negative associations between IH and higher education, and contradictory associations with age in some countries. Results showed that internalized homonegativity is a common and comparable phenomenon among MSM in Eastern Europe and Central Asia. Its prevalence is presumably different across the countries. IH relates, first of all, to own sexual orientation (gay, bi- etc.), and acknowledgement of own same-sex attractions. Also, the SIHS measure is good enough for use in further studies of male health and possibilities for LGBTIQ mobilization in the region.

Predictors of internalized homonegativity in Norwegian men who have sex with men (MSM)

The aim of this study was to explore the relationship between internalized homonegativity (IH) and individual, psychological, and social factors in a self-selected sample in Norway of men who have sex with men (MSM). To investigate this relationship, a cross-sectional, online survey study was carried out in 2012 among a self-selected sample of 529 MSM. The following three dimensions of IH were investigated: “Personal comfort with a gay identity”, “Social comfort with gay men,” and “Public identification as gay.” When controlling for the effect of psychological and social factors, there was no relationship between individual factors and dimensions of IH. Openness about one’s sexual orientation was the best predictor for all IH dimensions. In addition, MSM who had a less negative affect, felt fewer social consequences, and experienced less shame related to sexual compulsiveness had less IH related to “Personal identity as a gay man” than others. Respondents who were open about their sexual orientation and had a positive affect status had less IH related to “Social comfort with gay men” than others. Finally, MSM who were open about their sexual orientation and had higher sexual self-esteem had less IH related to “Public identification as gay.”

Structural Validation and Multiple Group Assessment of the Short Internalized Homonegativity Scale in Homosexual and Bisexual Men in 38 European Countries: Results From the European MSM Internet Survey

Internalized homonegativity (IH) is the internalization of negative attitudes and assumptions about homosexual people by homosexual people themselves. To measure IH, Smolenski, Diamond, Ross, and Rosser (2010) and Ross, Rosser, and Smolenski (2010) revised the Reactions to Homosexuality Scale (RHS) to develop the Short Internalized Homonegativity Scale (SIHS) with eight items. Using the European Men Who Have Sex With Men Internet Survey (EMIS) data, with an analytic sample of 130,718 gay and bisexual men in 38 European countries, we confirmed the validity of the SIHS scale in both training and validation data, in strata of Ross, Berg, et al.’s (2013) three “homosexual discrimination” country clusters, of age, and of education level. However, the performance was less adequate in comparison of gay versus bisexually identified individuals. The latent SIHS structure contains only minor variations across these three strata. The seven-item scale performed as well as the eight-item scale. The SIHS is a promising candidate for standard IH measures, which is invariant across cultural, age, and educational strata.

Migration and Assimilation of Turkish Gay and Bisexual Men in Germany

To examine the impact of migration and assimilation of Turkish Men-who-have-Sex-with-Men (MSM) to Germany, using data from the European MSM Internet Survey (EMIS-2010), on measures of acculturation including circumcision status, internalized homonegativity (IH), HIV/STI knowledge, sexual orientation, outness, HIV-testing and sexual behaviours. We compared MSM born and residing in Germany and completing the questionnaire in German (n=38,915), MSM whose father or mother were born in Turkey residing in Germany (half Turkish migration background, n=97), MSM with both parents born in Turkey, or born in Turkey themselves (full Turkish migration background, n=262) and men born and residing in Turkey and who completed the questionnaire in Turkish (n=1,717). Data showed that there were significant dose-response curves between level of migration and circumcision, outness, IH and HIV/STI knowledge showing the impact of culture change with decreased circumcision, lower IH, higher HIV/STI knowledge, and increased outness in German MSM as exposure to Germany increased. There were similar significant findings with regard to HIV sexual risk behaviour (unprotected anal intercourse with partners of unknown (or sero-discordant) HIV status).

The buffering effect of peer support on the links between family rejection and psychosocial adjustment in LGB emerging adults

Lesbian, gay, and bisexual (LGB) emerging adults often seek support from their peers if they lack support from their family of origin. We predicted that peer social support would moderate the link between negative family relationships and psychosocial adjustment, such that in the context of family rejection, experiencing more peer support would predict lower levels of anxiety, depression, and internalized homonegativity (IH) and higher self-esteem. Sixty-two (27 females) LGB individuals (ages 17–27, M = 21.34 years, SD = 2.65) reported on their families’ attitudes toward homosexuality, experiences of family victimization, peer social support, anxiety and depression symptoms, IH, and self-esteem. Results showed that peer social support moderated the link between negative family attitudes and anxiety and also moderated the link between family victimization and depression. The moderating effects suggest that having a supportive peer group may protect against mental health problems for LGB emerging adults who lack support from their family of origin.

HIV Vulnerability and Coexisting Psychosocial Health Problems amongTanzanian Men who have Sex with Men from the Perspective of an African Syndemic Model

This study, conducted among men who have sex with men (MSM) in sub-Saharan Africa (SSA), sought to replicate the syndemic effects of psychosocial health problems on HIV risk by using data collected from a sample of 300 MSM and bisexuals from Tanzania. We also sought to test the utility of syndemic theory by replicating the effects of the number of syndemic conditions on HIV risk behavior in that population. Five psychosocial health problems (i.e., the syndemic factors), acronymized as SAVID, were examined: substance use while having condomless sexual intercourse, childhood and adolescent sexual abuse, experience of anti-gay violence, internalized homonegativity (IH), and depression. Nine of the 10 odds ratios (ORs) generated from analysis of the bivariate associations between these syndemic factors were found to be statistically significant and positive; the tenth was marginally significant and positive. These results indicate not only a high degree of coexistence of the syndemic factors but also suggest that possible interactions between these factors may have additive effects on the behavioral health outcomes of the study participants. Such additive effects were confirmed by finding a A¢Â€Âœdose-responseA¢Â€Â� relationship between HIV risk-associated sexual behavior and the number of the five syndemic factors reported by each participant. After controlling for demographic and contextual factors, we found that the SAVID syndemic variable significantly increased the odds of engaging in condomless sexual intercourse (OR, 1.48). This substantiates the central tenet of syndemic theory, which is that those participants who were exposed to a greater number of the psychosocial health problems also engaged in higher-risk sexual behavior. Multivariate regression analyses revealed not only the effect of two of the syndemic conditions (substance use during sex and IH) on HIV risk-related sexual behavior but also confirmed how one demographic variable (younger age) and one culturally structured factor (being gay but still having a meaningful sexual relationship with women) uniquely contributed to syndemic conditions among Tanzanian MSM. These results suggest that a multifaceted HIV intervention grounded in syndemic theory should be considered as an effective approach to mitigating the risk environment that potentiates the vulnerability to HIV among Tanzanian MSM.