Sarah ChownLorraine Hailnka Malcoe

CHALLENGES AND OPPORTUNITIES:

UNDERSTANDING RESILIENCE IN THE GAY

MEN’S HEALTH LITERATURE

10 First Nations lived on and from this land prior to the beginning of colonization in the mid 1800s

INDIGENOUS LANDS - VANCOUVER

Gay men includes cis and trans* men who are primarily att racted to men, and identify as gay, queer, two-spirit, homosexual

This presentation does not speak to experiences of bisexual and heterosexual men who have sex with other men

GAY, NOT MSM

“GOING BEYOND THE BUZZWORD”

Shift to resilience began in the 1980s

Alternative to pathologizing gay men

WHERE IT ALL BEGAN…

Web of Science Citation report, results from keyword searches for gay men and resilience in October 2012

“…we want to transform the ways in which we think about and evaluate gay men, shift ing […] into a model which recognizes the tenacity, survival-skills, and overall resilience of our cultures and communiti es. What would it mean to understand openly gay men as the resilient porti on of our community, that porti on which has suff ered […] yet emerged emoti onally intact and spiritually strong? What would it mean to understand our gender play, kinship networks, and sexual cultures […] as adapti ve survival strategies which have served us well?”

–Eric Rofes, 1999

CALL FOR RESILIENCE

“Individuals’ mental health in the face of adversity, and why some individuals are able to experience adversity without negati ve ongoing physical and mental health outcomes and others aren’t.”

-Herman et al, 2011

RESILIENCE

Systemati c searches in CINAHL, Medline, PsycINFO and Social Work Abstracts (n=245) Gay: queer, two-spirit, ‘men who have sex with men’ (MSM), down

low, ibbi, yoos, radical faeries Man: trans, male, man, boy Resilience: resilien*, protective factors, strengths-based approaches

131 arti cles specifi cally used the concept of resilience in relati on to gay men 21 (16%) of 131 articles provided explicit definitions of

resilience

METHODS

Most literature is quantitative or reviews

People living with HIV and youth were the most common populations Studies reported demographic breakdowns of

their samples, but rarely included analysis of how or why the demographics they report matter

THE LITERATURE

Most arti cles used a non-specifi c concept of resilience Subtypes: couple, ego, family, educational, emotional and

psychological resilience

Three characteristi cs were common across defi niti ons of resilience: Outcome of a dynamic process About individuals adapting or responding to adversity Results in a researcher-defined positive outcome

THE LITERATURE

adversity

RESILIENCE = DYNAMIC PROCESS

Resilience

Individual

Social environmentResources

Adaption or responseBehavioural, social or psychological

Acute adverse eventSuicidality, HIV diagnosis, loss of partner

Chronic adversitySystems of oppression, potential for HIV infection

ADAPTING/RESPONDING TO ADVERSITY

Thriving despite adversity

Getti ng through

Bouncing back

Growing from exposure to adversity

“POSITIVE” OUTCOMES

Successfully negotiating coming out

Individual, constitutional factors

Social support across the lifecourse

Multiple experiences of oppression

HOW GAY MEN BUILD RESILIENCE

DISCUSSION

Strength in some contexts, heightens vulnerability in others

Unparalleled expectati on of resilience amongst gay men

Depoliti cizes gay men’s needs

Narrow defi niti on

CONCERNS FROM COMMUNITY

Multiplicity and simultaneity of individual identities

Diversity within the ways these identities are experienced

Analyses of the processes through which difference is ascribed on the basis of social locations that create and construct difference and inequities (Dhamoon, 2011, p. 236)

INTERSECTIONALITY

Measures of resilience are oft en Eurocentric and based on “mainstream” values

Systems of oppression that people are resilient to oft en left unexamined

Rarely, if ever, is resilience studied at the community level

LIMITATIONS OF DEFINITIONS

Recognizing the simultaneity of risk and resilience

Preventing adverse conditions that create resilience

Creating space for diversity within healthy gay communities

Imagining healthy gay men and healthy gay communities

MOVING BEYOND THE DEFINITIONS

Variety of definitions, measures and operationalizations of resilience

Concerns advanced in academic and non-academic forums regarding the social and health equity implications of resilience

SUMMARY

Incorporati ng literature on resilience amongst indigenous people and other groups experiencing minority stress

Expanding this analysis to arti cles with implicit defi niti ons

Discussing relati onships between protecti ve factors and resilience

NEXT STEPS FOR MY WORK

ACKNOWLEDGEMENTS

QUESTIONS & COMMENTS

Despite these concerns, resilience has been identified as a priority for gay men’s health research moving forward both in this report and elsewhere. The question the report poses is, “What are the components of assets and resilience among gay and bi men and how do they influence behaviour? (What keeps gay men healthy, versus what makes them sick?)” (p. 20).

NEW DIRECTIONS

People living with HIV and youth were the most common populations Studies reported demographic breakdowns of

their samples, but rarely included analysis of how or why the demographics they report matter

Many calls for greater attention to within-group variation

WITHIN-GROUP DIVERSITY