Attitudes toward gay men and lesbians and related factors among nurses in Southern Taiwan

OBJECTIVES: The aims of this study were to explore different dimensions of the attitudes toward gay men and lesbians among nurses in southern Taiwan and to examine the association between attitudes and intention to provide care to homosexual individuals. The factors related to attitudes towards gay men and lesbians by nurses were also examined. METHODS: In total, 1824 nurses from a medical centre and two regional teaching hospitals in southern Taiwan were recruited into this study. We used the Attitudes Toward Homosexuality Questionnaire (ATHQ) to examine four-dimensional concepts toward homosexuality among nurses. The association of attitudes with the intention of taking care of homosexual patients was examined. Correlations of attitudes toward homosexuality with demographic and occupational data, sexual orientation, knowledge about homosexuality, and experiences of having contact with gay men and lesbians were examined using a stepwise multiple linear regression. RESULTS: Participants had the most negative attitude toward homosexuality in the 'contact' and 'stereotypes' dimensions, followed by the 'morality' dimension and then the 'condemnation/tolerance' dimension. Nurses with more negative attitudes toward homosexuality had lower intentions of taking care of patients with a homosexual orientation. Nurses who had friends or relatives with a homosexual orientation, had a higher educational degree, and had provided care to homosexual patients were more likely to have positive attitudes toward homosexuality. In contrast, nurses who had worked for a longer period, labelled themselves as being absolutely heterosexual, and were religious were more likely to have negative attitudes toward homosexuality. CONCLUSIONS: The factors related to attitudes toward homosexuality identified in this study have to be taken into consideration when intervening for nurses' attitudes toward gay men and lesbians.     

“Sex-role preference” as an explanatory variable in homosexual behavior

Sex-role preference is an important neglected variable in statistically controlled studies of homosexual behavior. This variable must accompany controls for degree of psychopathology of respondents and degree of heterosexual and homosexual behavior experienced by respondents. Cross-cultural differences exist. Mexican males have rigidly defined insertor-insertee roles, with earlier life events serving as predictors of these sex-role preferences. Greece is comparable to Mexico. In Turkey, stigmatization accompanies passive homosexuality. Role playing may be age graded, as in the Southwest Pacific. In lower socioeconomic classes of the United States, sex roles for homosexual males are more stereotypically and unequivocably defined. Chicanos generally have strong sex-role preferences when involved in homosexual encounters; their attitude is similar to that found in Mexico. Among middle-class Anglo-American males, few or no sex-role feelings are associated with types of sex acts by most homosexually behaving males. This may be related to a focus on oral-genital rather than anal sex acts. The sharply dichotomized gender roles and the cultural formulation linking effeminacy and homosexuality appear to provide the necessary conditions for the development of sex-role preferences in many societies.Presented to Symposium on Ethnosexuality, Annual Meeting of the Southwestern Anthropological Association, San Francisco, April 1976.     

An Involvement and overtness measure for lesbians: Its development and relation to anxiety and social zeitgeist

The relationships among anxiety, degree of overtness in homosexuality, involvement in homosexuality, and occupational status were investigated to test prevalent hypotheses relating homosexuality and neuroticism. Sixty-three acknowledged lesbians completed the Manifest Anxiety and Defensiveness Scale (MAD), the Lesbian Degree of Involvement and Overtness Scales (DIOS), and a biographical data sheet. Reliability and validity indices for the DIOS are presented. Some findings were that anxiety was not related to degree of involvement in homosexuality, that anxiety was related to degree of overtness in low- but not in highstatus lesbians, and that the social Zeitgeist at the time of first lesbian activity was related to degree of overtness but not to degree of involvement in homosexuality. The results are discussed in terms of the relationship between social desirability and a hostile society. Additionally, comparisons of anxiety levels in homosexual and heterosexual women are presented and discussed. The results are interpreted as lending support to the emerging view of the homosexual as nonneurotic.     

Adolescent homosexuality and concerns regarding disclosure

Development of sexual identity in middle childhood and early adolescence is a natural process. However, it is more stressful for homosexual adolescents. Society continues to stigmatize and marginalize homosexuality. To avoid rejection and hostility, homosexual adolescents are pressured to hide their sexual identities. This fact compounds the anticipated normal developmental concerns of adolescence, and can create unique problems for the homosexual adolescents. Homosexuality can place them at risk for social stigmatization, isolation, depression, suicide, abuse, and rejection by their families and friends. During this exceptionally stressful time, both adolescent students and their families need anticipatory guidance and support. In providing anticipatory guidance, this article discusses critical roles played by professionals who work with adolescents in community or school settings. Included are insights into development of this normal variant of sexual attraction and orientation, risks that homosexual adolescent students may face as well as their disclosure concerns, and possible reactions families may have following disclosure. Supporting homosexual adolescents and their families is emphasized with regard to sensitively providing information, disclosure decisions, coping with stigmatization, and resiliency factors.     

Cultural factors affecting urban Mexican male homosexual behavior

Some aspects of the mestizoized urban culture in Mexico are linked to male homosexuality in support of the theory that cultural factors play an important role in the kind of life styles and sex practices of males involved in homosexual behavior. The following factors are considered relevant: the sharp dichotomization of gender roles, dual categorization of females as good or bad, separate social networks maintained by males before and after marriage, proportion of unmarried males, and distribution of income. One result of the sharp dichotomization of male and female gender roles is the widely held belief that effeminate males generally prefer to play the female role rather than the male. Effeminacy and homosexuality are also linked by the belief that as a result of this role preference effeminate males are sexually interested only in masculine males with whom they play the passive sex role. The participation of masculine males in homosexual encounters is related in part to a relatively high level of sexual awareness in combination with the lack of stigmatization of the insertor sex role and in part to the restraints placed on alternative sexual outlets by available income and/or marital status. Males involved in homosexual behavior in Mexico operate in a sociocultural environment which gives rise to expectations that they should play either the insertee or insertor sex role but not both and that they should obtain ultimate sexual satisfaction with anal intercourse rather than fellatio. In spite of cultural imperatives, however, individual preferences stemming from other variables such as personality needs, sexual gratification, desires of wanted partners, and amount of involvement may override the imperatives with resulting variations in sexual behavior patterns.Presented to Symposium on Homosexuality in Crosscultural Perspective, 73rd Annual Meeting of the American Anthropological Association, Mexico City, November 23, 1974.     

Stigmatization,discrimination and fear of aids in Greece: Implications for health policy

A prospective health‐education research project about AIDS knowledge and attitudes towards AIDS was conducted in Athens and nine adjacent municipalities in west Attica, Greece. Socioeconomic and demographic data, AIDS knowledge, and attitudinal information were collected from 1552 respondents and analysed treating the attitudes of stigmatization, discrimination and fear towards AIDS as the dependent variable. Statistically significant correlations were found between each of the three attitudinal variables and the independent ones; specifically, age, place of residence, marital status and level of AIDS knowledge. Our working hypothesis—that the higher the level of AIDS knowledge, the lower the level of discrimination and stigmatization—was supported by our data. The relationship between AIDS knowledge and fear was less clear. Fear probably inhibits a rational approach to screening for HIV, and more empirical research is needed about fear and its interaction with stigmatizing and discriminatory attitudes and behaviours. Such research should be aimed at identifying population groups ‘at risk’ of expressing high levels of negative social attitudes about AIDS so that educational programmes can be appropriately designed.     

Sexual orientation and eating psychopathology: the role of masculinity and femininity

OBJECTIVE: Previous research suggests that eating disorders are related to homosexuality in men, although links with female sexual orientation are less clear. Appearance factors have generally been implicated in this relationship. However, previous studies have failed to consider the role of femininity, even though evidence suggests that this is a more critical factor than sexual preference. The aim of this study was to consider the relationship between gender-role orientation and eating psychopathology in nonclinical men and women of different sexual orientations. METHOD: One hundred university students (40 homosexual; 60 heterosexual) completed the Bem Sex Role Inventory and the Eating Attitudes Test. RESULTS: For the group as a whole, there were links between femininity and high levels of eating psychopathology, whereas masculinity was associated with relatively healthy eating-related attitudes and behaviors. When considering the role of sexual orientation, these links were specific to homosexual men and women. CONCLUSIONS: In relation to homosexual men and women, the results support a model where femininity might be seen as a specific risk factor for eating disorders, whereas masculinity is likely to be a protective factor. Methodological and conceptual implications are discussed.     

Gender Atypicality and Anxiety Response to Social Interaction Stress in Homosexual and Heterosexual Men

Gender non-conforming behavior and a homosexual sexual orientation have both been linked to higher levels of anxiety. This study examined the independent and interactive effects of gender atypicality and sexual orientation on levels of state anxiety immediately following a stressful social interaction task among a sample of homosexual and heterosexual Israeli men (n = 36). Gender atypicality was measured via both self-report and observer ratings. State anxiety was measured via both self-report immediately subsequent to the stressful social interaction task and pre- to post task changes in salivary cortisol. Results showed that self-reported gender atypicality and heterosexual sexual orientation predicted higher levels of self-reported social interaction anxiety, but not changes in cortisol. There were no sexual orientation by gender behavior interactions and there were no significant effects for observer rated gender atypicality. These findings suggest that gender atypicality, not homosexuality, place individuals at risk for increased anxiety.     

Suicidality and Sexual Orientation: Differences Between Men and Women in a General Population-Based Sample From The Netherlands

Homosexuality has been shown to be associated with suicidality and mental disorders. It is unclear whether homosexuality is related to suicidality, independently of mental disorders. This study assessed differences in lifetime symptoms of suicidality (death ideation, death wishes, suicide contemplation, and deliberate self-harm) between homosexual and heterosexual men and women, controlling for lifetime psychiatric morbidity. Interaction effects of age and the role of perceived discrimination were also examined. Data were collected on a representative sample of the Dutch population aged 18–64 years. Classification as heterosexual or homosexual was based upon reported sexual behavior in the preceding year. Of those sexually active, 2.8% of 2,878 men and 1.4% of 3,120 women had had same-sex partners. Homosexual men differed from their heterosexual counterparts on all four suicide symptoms (OR ranging from 2.58 to 10.23, with higher ORs for more severe symptoms), and on the sum total of the four symptoms; homosexual women only differed from heterosexual women on suicide contemplation (OR=2.12). Controlling for psychiatric morbidity decreased the ORs, but among men all associations were still significant; the significance for suicide contemplation among women disappeared. Younger homosexuals were not at lower risk for suicidality than older homosexuals in comparison with their heterosexual counterparts. Among homosexual men, perceived discrimination was associated with suicidality. This study suggests that even in a country with a comparatively tolerant climate regarding homosexuality, homosexual men were at much higher risk for suicidality than heterosexual men. This relationship could not only be attributed to their higher psychiatric morbidity. In women, there was no such clear relationship.     

On the question of homosexuality in actors

There is a belief that a high percentage of male actors are homosexual. The specific linking of actors and homosexuality seems to have first appeared in the Elizabethan Puritan condemnations of the theater. Psychoanalytic theory has tended to further promulgate the linkage between effeminacy, homosexuality, and acting. An analysis of the relevant existing empirical literature indicates that few studies have addressed themselves to evaluating this relationship. Those studies supporting the effeminacy-actor relationship were seriously flawed both in design (e.g., use of indirect measures to infer homosexuality) and interpretation of the data. Only one study used direct measures of sexual orientation. Even though that study had methodological problems, its results indicated that the percentage of homosexuality among actors was not verifiably greater than that found in the general population. It is felt that the current belief of greater homosexuality in actors, as compared to the general population, is a product of our Puritan heritage, the actors's unconventionality, and of public flaunting of the homoerotic behavior of that portion of actors that are homosexual.     

Familial Aspects of Male Homosexuality

Research has generally supported the existence of familial–genetic factors for male sexual orientation, but has not shed much light on the specific nature of those influences. Gay men with gay brothers provide the opportunity to examine several hypotheses. Sixty-six men, representing 37 gay male sibling pairs, completed questionnaires assessing behavior on various measures including childhood and adult gender nonconformity, timing of awareness of homosexual feelings, self-acceptance, and the quality of family relationships. Consistent with prior findings using twins, gay brothers were similar in their degree of childhood gender nonconformity, suggesting that this variable may distinguish etiologically (e.g., genetically) heterogeneous subtypes. The large majority of gay men with brothers knew about their own homosexual feelings before they learned about their brothers' homosexual feelings, suggesting that discovery of brothers' homosexuality is not an important cause of male homosexuality.     

Psychosocial development of heterosexual,bisexual, and homosexual behavior

Relationships with overt adult Kinsey Scale scores (K) indicate that early sexual experiences are most closely related to K, followed in order by gender related and familial variables. A developmental model emphasizing social learning is presented. Interviewees were 7669 American white males and females.Elevated K (more homosexual scores) was found for females who had few girl companions at age 10 and few male companions at 16, had learned to masturbate by being masturbated by a female, had intense prepubertal sexual contact with boys or men, found thought or sight of females, but not males, arousing by age 18, had homosexual contact by age 18, higher K at 17, and higher first-year homosexual behavior frequency.Elevated K (more homosexual scores) was found for males who reported poorer teenage relationships with their fathers, had more girl companions at age 10, fewer male companions at 10 and 16, avoided sports participation, learned of homosexuality by experience, learned to masturbate by being masturbated by a male, had intense prepubertal sexual contact with boys or men, had neither heterosexual contact nor petting to orgasm by age 18, found thought or sight of males, but not females, arousing by age 18, had homosexual contact by age 18, higher K at ages 16 and 17, and had higher first-year homosexual behavior frequency.Behavioral bisexuals, those scoring between 2.0 and 4.0 on the K scale on the basis of overt behavior (0.7% of females, 1.2% of males), reported more arousal to heterosexual stimuli than did exclusive heterosexuals.     

Rural School Nurses'Attitudes about AIDS and Homosexuality

ABSTRACT: The AIDS epidemic has spread to rural areas of the United States. Conservative rural communities are facing the challenge of having children with HIV entering school. School nurses, as the only health care providers in the schools, are in a strong position to facilitate the education of children with HIV and to provide AIDS education to students, faculty, and parents. School nurses' knowledge and attitudes about AIDS and people with AIDS influence their effectiveness in prevention activities and care of HIV-infected children. This study examined the relationship between specific demographic, practice, and cultural variables and rural school nurses' attitudes about AIDS and homosexuality. Sixty-nine school nurses responded to a mailed questionnaire as part of a larger study of rural nurses. Results indicate attitudes about homosexuality were related to nurses' homosexual knowledge and religious beliefs while attitudes about AIDS were related to nurses' willingness to care for people with AIDS and feeling prepared to do so.(J Sch Health. 1997;67(8):341–347)     

Sex hormones and male homosexuality in comparative perspective

Animal research has demonstrated the modifiability of sex-dimorphic mating behavior by hormone and brain manipulation, especially in subprimate mammals, and has led to radical attempts at treating human homosexuality by psychosurgery and to the suggestion of preventing homosexuality by prenatal hormone manipulation. This article reviews psychoendocrine studies of human homosexuality — the effects of hormone treatments on sexual orientation, the association of clinical endocrine syndromes with homosexuality, sex hormone measurements in homosexual subjects, and the issue of prenatal endocrine influences on human sexual orientation. The available studies, often deficient in methodology, have produced conflicting and largely negative results as to a hormonal theory of human homosexuality. Unfortunately, there is hardly any overlap between psychoendocrine studies on sexual orientation in man and on sex-dimorphic mating behavior in subhuman mammals that would allow systematic comparisons. A major alternate theory of human homosexuality has been derived from learning theory, and this position has been strengthened by the recent development of partially successful behavior therapy approaches to the change of sexual orientation. There is currently a lack of animal experimentation that could assist in formulating a learning-based etiological theory of human homosexuality. Since the influence of hormones relative to learning on sexual behavior appears to diminish along the evolutionary scale, animal models need to include manipulation of both hormonal and learning conditions.     

Condemnation of homosexuality in the black community: A gender-specific phenomenon?

While it is commonly accepted that homosexuality finds less tolerance in the black community, little or no research has addressed this issue empirically. In the context of an epidemiological investigation of AIDS-related attitudes, 2006 state employees were surveyed to compare the condemnatory orientation of blacks and whites towards homosexuality. One item measured endorsement of a hostile proposition concerning the deleterious impact of AIDS on the homosexual population. Greater relative endorsement was found of the proposition by blacks confirming the hypothesis that less social tolerance of homosexuality exists in the black community. Analyses of gender, educational achievement, religious preference, and marital status revealed that the racial difference in condemnation of homosexuality was derived almost exclusively from a difference in attitude between black and white females. The primary source of this difference may stem from the black female perception that homosexuality exacerbates the developing problem of a decreasing pool of available black males already affected by integration, racially disproportionate incarceration rates, and relatively high rates of premature death among black males from heart disease, cancer, AIDS, substance abuse, and violence.The research reported here was partially supported by a contract with the Tennessee State Department of Health and Environment, Nashville, Tennessee.     

The prevalence of homosexual behavior and attraction in the United States,the United Kingdom and France: Results of national population-based samples

Researchers determining the prevalence of homosexuality in nationally representative samples have focused upon determining the prevalence of homosexual behavior, ignoring those individuals whose sexual attraction to the same sex had not resulted in sexual behavior. We examine the use of sexual attraction as well as sexual behavior to estimate the prevalence of homosexuality in the United States, the United Kingdom, and France using the Project HOPE International Survey of AIDS-Risk Behaviors. We find that 8.7, 7.9, and 8.5% of males and 11.1, 8.6, and 11.7% of females in the United States, the United Kingdom, and France, respectively, report some homosexual attraction but no homosexual behavior since age 15. Further, considering homosexual behavior and homosexual attraction as different but overlapping dimensions of homosexuality, we find 20.8, 16.3, and 18.5% of males, and 17.8, 18.6, and 18.5% of females in the United States, the United Kingdom, and France report either homosexual behavior or homosexual attraction since age 15. Examination of homosexual behavior separately finds that 6.2, 4.5, and 10.7% of males and 3.6, 2.1, and 3.3% of females in the United States, the United Kingdom, and France, respectively, report having had sexual contact with someone of the same sex in the previous 5 years. Our findings highlight the importance of using more than just homosexual behavior to examine the prevalence of homosexuality.     

The relationship between suicide risk and sexual orientation: results of a population-based study.

OBJECTIVES: This study examined the relationship between sexual orientation and suicide risk in a population-based sample of adolescents. METHODS: Participants were selected from a cross-sectional, statewide survey of junior and senior public high school students. All males (n = 212) and females (n = 182) who described themselves as bisexual/homosexual were compared with 336 gender-matched heterosexual respondents on three outcome measures: suicidal ideation, intent, and self-reported attempts. Logistic regression analyses were used to examine the association between sexual orientation and outcome measures with adjustment for demographic characteristics. RESULTS: Suicide attempts were reported by 28. 1 % of bisexual/homosexual males, 20.5% of bisexual/homosexual females, 14.5% of heterosexual females, and 4.2% of heterosexual males. For males, but not females, bisexual/homosexual orientation was associated with suicidal intent (odds ratio [OR] = 3.61 95% confidence interval [CI = 1.40, 9.36) and attempts (OR=7.10; 95% CI=3.05, 16.53). CONCLUSIONS: There is evidence of a strong association between suicide risk and bisexuality or homosexuality in males.     

Sexual Orientation and Gender: Stereotypes and Beyond

In this essay, I explore empirical research about the relationship between sexual orientation and gender. Both concepts have multiple meanings, which hinder an unequivocal understanding of the relationship between the two concepts. One of the first studies assumed to establish a relationship between male homosexuality and femininity was conducted by L. M. Terman and C. C. Miles (1936). The study actually gives a much more complicated picture of the relationship. Terman and Miles actually found two groups of homosexual men with, respectively, extremely high masculinity and extremely high femininity scores. Subsequently, various other studies examined the relationship between sexual orientation and gender, introducing the concept of androgyNY. While these studies were executed, major changes took place in the homosexual world, which have been characterized as the masculinization of culture. It is unclear how these changes relate to the masculine and feminine properties of the men involved. Various suggestions are made for further research on the relation between gender and sexual orientation. This essay is based on the Presidential Address, International Academy of Sex Research, Bloomington, Indiana, July 16–19, 2003.     

The Cognitive, Behavioral, and Personality Profiles of a Male Monozygotic Triplet Set Discordant for Sexual Orientation

The neurohormonal theory of sexual orientation proposes that homosexual men and homosexual women are exposed prenatally to a hormonal environment that is similar to that of the other sex. Prenatal exposure to an opposite-sex hormonal environment may lead the nervous system to develop in a manner consistent with the opposite sex. If this cross-sex exposure occurs, one prediction would be that the cognitive ability profile of homosexual men would be similar to that of heterosexual women. This study examined a set of male monozygotic triplets, aged 21 years, discordant for sexual orientation: 2 of the triplets were heterosexual, 1 was homosexual. The triplets were administered measures of 23 domains of cognitive ability, as well as measures of sexual orientation and masculinity/femininity. On the measures of cognitive ability, the triplets performed similarly, yet consistent differences were found between the 2 heterosexual triplets and the 1 homosexual cotriplet. Differences having the same pattern were found for the number of Schafer homosexuality signs on the Rorschach, and on a homosexuality scale derived from items on the Minnesota Multiphasic Personality Inventory--2 (MMPI-2). Responses from the homosexual triplet were in a more feminine direction than responses from his 2 heterosexual cotriplets on measures of masculinity-femininity, which included measures derived from Rorschach responses, the MMPI-2 Masculinity-Femininity scale, the Bem Sex Role Inventory, and the Boyhood Gender Conformity Scale. Responses to the 16 Personality Factor Questionnaire also distinguished the 1 homosexual triplet from the 2 heterosexual cotriplets. These findings support the view that the prenatal hormonal environment may have enduring effects on selected behavioral traits.