GBTQ2MSM Health 

1970’s

GBTQ2MSM Health emerges. Major setback with GRID (Gay-Related Immune Deficiency), the first name of HIV (not a different virus).

1980s-1990s

General health care for GBTQ2MSM ​ took a backseat to HIV and HIV/AIDS politics. The shame and stigma associated with HIV/AIDS alienated men from health care, further closeting their sexuality and reducing their ability to have their health care needs met appropriately.

2000s

Improvements in HIV testing, care and treatment help support a shift in focus to the broader health needs of GBTQ2MSM such as primary care, mental health and wellness and general health promotion. In BC, this work was supported by the provincial STOP HIV/From Hope to Health strategy.

Today

HIV still disproportionately impacts GBTQ2MSM, but there is broad recognition that GBTQ2MSM health care encompasses significantly more than avoiding HIV infection.

 

NOTE: Gay rights and gay liberation, as it emerged in the 1970s, also led to conversations about gay men's and lesbian health as well as trans health. The organizations that popped up laid the infrastructure for what eventually would be AIDS organizations.

Factors Impacting GBTQ2MSM Health 

Structural stigma operates at multiple levels (self or internalized stigma; hate crimes such as gaybashing; community norms and institutional policies)

Sexual minorities living in communities with high levels of anti-gay prejudice experience higher hazard of mortality than sexual minorities living in low-prejudice communities:

Data shows that GBTQ2MSM experience higher rates of:

  • HIV & STIs (HPV, Syphilis, Hepatitis C, Gonorrhea, Chlamydia)

  • Alcohol & Substance Use

  • Smoking

  • Eating Disorders & Body Image

  • Mental Health/Violence/Trauma

 

Presumably, these outcomes are increased for GBTQ2MSM  who are also Indigenous, people of colour, and Trans/Two-Spirited/Non-Binary as well. Those folks with multiple intersecting marginalized identities are at a significantly greater risk for negative health outcomes. Additionally, the highest rate of mortalities is in Indigenous communities.

Protective Factors Among GBTQ2MSM  

 

  • Levels of protective factors higher among bisexual than among gay and lesbian respondents

  • Family connectedness, teacher caring, other adult caring, and perceived safety at school (for younger men)

  • Sense of coherence

  • Social support and self-efficacy

  • Many GBTQ2MSM have experienced isolation and rejection, leading them to create social supports outside of traditional family, and becoming more self-reliant.

  • Social network size

  • Many GBTQ2MSM have large social networks that are maintained well into their adult lives providing great social support.

  • For trans people, having at least one legal ID with sex designation matching lived gender, as well as having strong social and parental support for their gender, would positively impact their lives and decrease rates of suicide amongst trans populations.

  • For trans people who need to undergo full transition, access to complete medical transition would positively impact their lives and decrease rates of suicide amongst trans populations

What can we do to support GBTQ2MSM individuals to experience positive health and wellness?

  • Use inclusive language to encourage your patients to disclose their identify to you

  • Mirror the terms that they have used for themselves (unless it's a reclamation word such as 'queer')

  • Apply/Demonstrate an understanding of trauma-informed practice when dealing with GBTQ2MSM

  • Understand the generational impacts of trauma and generational differences amongst GBTQ2MSM populations

  • Listen to them! be transparent, use informed consent, be affirming of their identities, make it clear that you see their identity as part of the normal spectrum of human diversity

  • Avoid discussing gender or sexuality in terms of stereotypes and don’t reinforce toxic masculinity/male stereotypes i.e. ‘man’s man’, ‘flamboyant’, ‘boys will be boys’ etc.