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Gay Men’s Health and Identity
from a Life Course Perspective
Phillip L. Hammack
University of California, Santa Cruz
Gay = AIDS = Death
+

①

Gay men’s health: 2013

②

Gay men and the life course: 3 principles

③

Gay men and the life course: 5 generations

④

Implications for research, practice, and advocacy
+

Gay men’s health: 2013
HIV prevalence among gay
men, 2008 (%)
00

19
HIV+
HIV81

Source: NHSB Report, CDC, 2008
+

Gay men’s health: 2013
Major depression
prevalence, ages 50-69 (%)
00
17
Major
depression

83

Source: Institute of Medicine, 2011
+

Gay men’s health: 2013
Prevalence of suicide
attempts, ages 18-59 (%)
00

15.6
Suicide attempt

84.4

Source: Institute of Medicine, 2011
+

Gay men’s health: 2013


Minority stress processes


Victimization and harassment



Stigma experiences and expectations



Internalized homophobia



Effects of these processes on the body



Eating disorders



Substance abuse



Cancer
+

Gay men’s health: 2013
Primary health research focus, 2013

16.67%
HIV/RSB

Substance Abuse

7.14%

Mental and Physical Health/WellBeing

8.33%

67.86%

Other (e.g., Stigma, Relationships,
SelfImage, Identity, Disclosure, Spirituality
, Homophobia, Minority Stress)

Source: Hammack et al., in preparation (84 published or in-press empirical studies in 2013; key words
gay men, health)
+

Gay men’s health: 2013

HIV prevalence among
gay men, 2008 (%)

Primary health research
focus, 2013

00
19

16.67%

HIV+
HIV81

HIV/RSB

7.14%
8.33%
67.86%
+

Gay men’s health: 2013
Population focus, 2013

US-White Majority (>50% White)
26.34%

26.30%

US-Multiracial (<50% White)

Australian

13.16%

34.20%

Source: Hammack et al., in preparation (84 published or in-press empirical studies in 2013; key words
gay men, health)
+

Gay men’s health: 2013

HIV prevalence among
gay men, 2008 (%)

Primary health research
focus, 2013

00
19

16.67%

HIV+
HIV81

HIV/RSB

7.14%
8.33%
67.86%
“…you are asking to die….”
“…we can’t
carry the burden
of everyone who
died before
us….”
+

①

Gay men’s health: 2013

②

Gay men and the life course: 3 principles

③

Gay men and the life course: 5 generations

④

Implications for research, practice, and advocacy
+

The life course paradigm
+

Gay men and the life course:
3 principles
1.

Historical time and place
+

Gay men and the life course:
3 principles
2.

Linked lives
+

Gay men and the life course:
3 principles
3.

Human agency
+

①

Gay men’s health: 2013

②

Gay men and the life course: 3 principles

③

Gay men and the life course: 5 generations

④

Implications for research, practice, and advocacy
+

Gay men and the life course:
5 generations
1.

The Stigma Generation
• Born in the 1930s
• Today in their 70s and 80s
• Gay and Lesbian Civil Rights Movement
• Declassification of homosexuality as
mental illness
• AIDS epidemic
+

Gay men and the life course:
5 generations
2.

The Stonewall
Generation

• Born in the 1940s
• Today in their 60s and 70s
• Gay and Lesbian Civil Rights Movement
at the height of adulthood
• Gay culture in the 1970s
• AIDS
+

Gay men and the life course:
5 generations
3.

The AIDS 1 Generation
• Born in the 1950s and 1960s
• Experienced adolescence and early
adulthood post-Stonewall
• Today in their 40s, 50s, and early 60s
• Hardest hit by AIDS
• Significant cultural trauma
+

Gay men and the life course:
5 generations
4.

The AIDS 2 Generation
•

Born in the 1970s

•

Childhood and adolescence during AIDS

•

Gay identity = gay sex = death

•

Health and mental health support

•

Emergence of Internet

•

Treatment advances for HIV

•

From AIDS to marriage equality

•

Today in our 30s and 40s
+

Gay men and the life course:
5 generations
5.

The Post-AIDS/Marriage
Equality Generation

•

Born in the 1980s and 1990s

•

Today in their teens and 20s

•

Lawrence v. Texas (2003)

•

Gay sex ≠ death

•

Cultural support for sexual orientation
diversity

•

GSAs and Modern Family
+

①

Gay men’s health: 2013

②

Gay men and the life course: 3 principles

③

Gay men and the life course: 5 generations

④

Implications for research, practice, and advocacy
+

Implications for research, practice &
advocacy
 Reconsider

surveying our
practices and charting our “norms”

 Reconsider

the standard scientific

paradigm
 “Thick

description” and
interpretation, not surveillance

 Whose

voices?
+

Implications for research, practice &
advocacy


Historical sensitivity and reflexivity



Health-related attitudes and practices in
generational perspective



Awareness of one’s own generational position
and its impact on practice
+

Implications for research, practice &
advocacy
+

Acknowledgments


Terry Trussler, Rick Marchand & Olivier Ferlatte



At UC Santa Cruz: James E. Lykens



At UCLA: Ilan Meyer



At Columbia University: David Frost



In memoriam: Bertram J. Cohler (1938-2012)

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Day 2 1100 - phillip hammack

  • 1. + Gay Men’s Health and Identity from a Life Course Perspective Phillip L. Hammack University of California, Santa Cruz
  • 2.
  • 3.
  • 4. Gay = AIDS = Death
  • 5.
  • 6.
  • 7.
  • 8. + ① Gay men’s health: 2013 ② Gay men and the life course: 3 principles ③ Gay men and the life course: 5 generations ④ Implications for research, practice, and advocacy
  • 9. + Gay men’s health: 2013 HIV prevalence among gay men, 2008 (%) 00 19 HIV+ HIV81 Source: NHSB Report, CDC, 2008
  • 10. + Gay men’s health: 2013 Major depression prevalence, ages 50-69 (%) 00 17 Major depression 83 Source: Institute of Medicine, 2011
  • 11. + Gay men’s health: 2013 Prevalence of suicide attempts, ages 18-59 (%) 00 15.6 Suicide attempt 84.4 Source: Institute of Medicine, 2011
  • 12. + Gay men’s health: 2013  Minority stress processes  Victimization and harassment  Stigma experiences and expectations  Internalized homophobia  Effects of these processes on the body  Eating disorders  Substance abuse  Cancer
  • 13. + Gay men’s health: 2013 Primary health research focus, 2013 16.67% HIV/RSB Substance Abuse 7.14% Mental and Physical Health/WellBeing 8.33% 67.86% Other (e.g., Stigma, Relationships, SelfImage, Identity, Disclosure, Spirituality , Homophobia, Minority Stress) Source: Hammack et al., in preparation (84 published or in-press empirical studies in 2013; key words gay men, health)
  • 14. + Gay men’s health: 2013 HIV prevalence among gay men, 2008 (%) Primary health research focus, 2013 00 19 16.67% HIV+ HIV81 HIV/RSB 7.14% 8.33% 67.86%
  • 15. + Gay men’s health: 2013 Population focus, 2013 US-White Majority (>50% White) 26.34% 26.30% US-Multiracial (<50% White) Australian 13.16% 34.20% Source: Hammack et al., in preparation (84 published or in-press empirical studies in 2013; key words gay men, health)
  • 16. + Gay men’s health: 2013 HIV prevalence among gay men, 2008 (%) Primary health research focus, 2013 00 19 16.67% HIV+ HIV81 HIV/RSB 7.14% 8.33% 67.86%
  • 17.
  • 18.
  • 19.
  • 20. “…you are asking to die….” “…we can’t carry the burden of everyone who died before us….”
  • 21. + ① Gay men’s health: 2013 ② Gay men and the life course: 3 principles ③ Gay men and the life course: 5 generations ④ Implications for research, practice, and advocacy
  • 22. + The life course paradigm
  • 23. + Gay men and the life course: 3 principles 1. Historical time and place
  • 24. + Gay men and the life course: 3 principles 2. Linked lives
  • 25. + Gay men and the life course: 3 principles 3. Human agency
  • 26. + ① Gay men’s health: 2013 ② Gay men and the life course: 3 principles ③ Gay men and the life course: 5 generations ④ Implications for research, practice, and advocacy
  • 27. + Gay men and the life course: 5 generations 1. The Stigma Generation • Born in the 1930s • Today in their 70s and 80s • Gay and Lesbian Civil Rights Movement • Declassification of homosexuality as mental illness • AIDS epidemic
  • 28. + Gay men and the life course: 5 generations 2. The Stonewall Generation • Born in the 1940s • Today in their 60s and 70s • Gay and Lesbian Civil Rights Movement at the height of adulthood • Gay culture in the 1970s • AIDS
  • 29. + Gay men and the life course: 5 generations 3. The AIDS 1 Generation • Born in the 1950s and 1960s • Experienced adolescence and early adulthood post-Stonewall • Today in their 40s, 50s, and early 60s • Hardest hit by AIDS • Significant cultural trauma
  • 30. + Gay men and the life course: 5 generations 4. The AIDS 2 Generation • Born in the 1970s • Childhood and adolescence during AIDS • Gay identity = gay sex = death • Health and mental health support • Emergence of Internet • Treatment advances for HIV • From AIDS to marriage equality • Today in our 30s and 40s
  • 31. + Gay men and the life course: 5 generations 5. The Post-AIDS/Marriage Equality Generation • Born in the 1980s and 1990s • Today in their teens and 20s • Lawrence v. Texas (2003) • Gay sex ≠ death • Cultural support for sexual orientation diversity • GSAs and Modern Family
  • 32. + ① Gay men’s health: 2013 ② Gay men and the life course: 3 principles ③ Gay men and the life course: 5 generations ④ Implications for research, practice, and advocacy
  • 33. + Implications for research, practice & advocacy  Reconsider surveying our practices and charting our “norms”  Reconsider the standard scientific paradigm  “Thick description” and interpretation, not surveillance  Whose voices?
  • 34. + Implications for research, practice & advocacy  Historical sensitivity and reflexivity  Health-related attitudes and practices in generational perspective  Awareness of one’s own generational position and its impact on practice
  • 35. + Implications for research, practice & advocacy
  • 36. + Acknowledgments  Terry Trussler, Rick Marchand & Olivier Ferlatte  At UC Santa Cruz: James E. Lykens  At UCLA: Ilan Meyer  At Columbia University: David Frost  In memoriam: Bertram J. Cohler (1938-2012)