Citation

Ortiz-Hernández L. Salud Ment. (Mex) 2005; 28(4): 49-65.

Copyright

(Copyright © 2005, Instituto Mexicano de Psiquiatria)

DOI

unavailable

PMID

unavailable

Abstract

Bisexuals, lesbians, and homosexuals (BLH) face diverse forms of social exclusion because their sexual orientation (SO) is viewed negatively in most societies. Studies performed in industrialized countries have shown that prejudices faced by the BLH population may have a deleterious effect in their mental health because, in comparison with heterosexuals, they present a higher prevalence of consumption of alcohol and other drugs, suicide attempts, suicide ideation and mental disorders. Meyer has pointed out in those studies that comparing BLH and heterosexual morbidity may only allow for the documentation of the existence of negative effects of heterosexism and homophobia on BLH health. Although this means a substantial advance, it does not allow for the exploration of mechanisms through which oppression leads to higher morbidity in the BLH population. It must be added that most of these studies are not guided by a conceptual framework which explains in detail the differences in mental morbidity between heterosexuals and BLH. Despite the fact that in Latin America increasingly more academics and politicians are worried by these problems, knowledge about health and disease conditions in BLH is still incipient. In a literature review it was evinced that almost all the researches performed in Latin America have been centered in the HIV/AIDS infection and other sexually transmissible diseases or traumatisms derived from certain sexual practices in homosexual and bisexual males. It was concluded that more studies are necessary about mental health in the BLH population in which bisexual and lesbian women are included, because they have been studied with less frequency than homosexual and bisexual males. Considering the above, the objective of this study was to analyze the effects of internalization of oppression on the risk of presenting mental health damages in the BLH population. The oppression of BLH is caused by three dominant norms deriving from the gender system: a) Heterosexism, which is the ideological system that denies, derides and stigmatizes any form of behavior, identity, relation or community different from the heterosexual ones. b) The adherence to gender stereotypes, according to which males must be masculine and women must be feminine. Culturally, homosexuality is equaled to the transgression of gender stereotypes (TGS): homosexual males are thought of as feminine and lesbians as masculine, although in reality this does not always the case. That is why many BLH have suffered diverse forms of violence because in infancy and adolescence they were feminine males or masculine women. c) Androcentrism consists in the subordination or inferiority of feminine before masculine, that is, the features, attitudes and values considered as masculine are evaluated positively and the individuals who have them possess a superior status, while the symbols defined as feminine are scorned. Androcentrism explains why homosexuality is more punished in males than in females. BLH, just like heterosexuals, grow up and live in a society structured in terms of the dominant norms of the gender system. This causes that BLH internalize the dominant values of the gender system. To understand how BLH incorporate oppression in their subjectivity, one may recover the concept of habitus which is defined as a system of categories of perception, thought and action. To be able to evaluate the habitus of the oppressed in BLH it is proposed to "deconstruct" it in three concepts: internalized homophobia, perception of the homosexual stigma and hiding. Internalized homophobia occurs when BLH incorporate in their self-esteem the negative meanings, the prejudices and stereotypes accrued to homosexuality and TGS, which causes them to have negative attitude towards their own homosexuality, the homosexuality of others, towards their TGS and that of others. Due to the symbolic link between TGS and homosexuality, it is important to incorporate the negative attitude towards TGS in the definition of internalized homophobia. The perception of the stigma due to homosexuality refers to the expectations of BLH about possible attitudes and reactions that other persons may have due to their SO. By hiding, BLH modify their physical appearance and their behavior with the goal to make invisible their homosexuality or the expressions considered TGS. An observational, cross-sectional and analytical study was performed. Between September and November of 2001, a questionnaire was applied to 506 BLH attending various organizations and institutions in Mexico City visited by different "sub-groups" of BLH. A part of the population was contacted through personal networks of the author and a list of e-mail addresses of a socialization group. The questionnaire was completed by the subjects themselves. Through the questionnaire, the three forms of internalized oppression were evaluated (internalized homophobia, perception of stigma and hiding) and five risks to health perception of the health status, suicide ideation, in the number of schoolmates or co-workers who knew the SO was related with a lower risk of alcoholism. Avoiding showing affection to their partner of the same sex was related with a higher risk or presenting alcoholism. The risks of suicide ideation, suicide attempts and mental disorders were higher in the persons that did all they could to hide their SO. BLH who avoided TGS had a higher probability of presenting suicide ideation, mental disorders and alcoholism. The results of the study showed that BLH population have important health problems such as suicide ideation and suicide attempts and alcoholism in the case of the LB women. Further, although there are differences between homosexual and bisexual males and lesbian and bisexual females regarding the most frequent type of internalized oppression, the three forms of internalized oppression (internalized homophobia, perception of the stigma due to homosexuality, and hiding) were associated with a higher risk of presenting suicide ideation, suicide attempts, mental disorders and alcoholism. These findings may be recovered to prevent health damages in the BLH population. The actions directed by governments towards the BLH population have been basically HIV/AIDS research and prevention programs in homosexual and bisexual males. These actions are the result of the magnitude of the problem and not because the existence of these sub-groups is recognized. However, this research has evidenced that besides the HIV/AIDS problem, BLH present other health problems such as suicide ideation and suicide attempts, mental disorders and alcoholism. Therefore, it is required that government institutions broaden the scope of the welfare and health programs directed towards the BLH population. Evidently, long term measures must be taken to eliminate prejudice against homosexuality and TGS, which may only be possible through modifications in the social institutions.

Language: es

Keywords

human; Mexico; mental health; Stigma; Mental health; prevalence; sex difference; suicide attempt; suicidal behavior; alcohol consumption; article; homosexuality; mental disease; sexual orientation; bisexuality; Human immunodeficiency virus infection; social aspect; social disability; child development; health status; acquired immune deficiency syndrome; guilt; Internalized homophobia; lesbian; sexually transmitted disease; Oppression; South America; Bisexuals; Central America; Gays; Homosexuals; Lesbians