Birth Cohort Differences in Sexual Identity Development Milestones Among HIV-Negative Gay and Bisexual Men in the United States

Abstract

The coming-out process for gay and bisexual men (GBM) involves crossing sexual identity development (SID) milestones: (1) self-awareness of sexual attraction to the same sex, (2) self-acceptance of an identity as gay or bisexual, (3) disclosure of this sexual identity to others, and (4) having sex with someone of the same sex. We examined trends in SID milestones by birth cohort in a 2015 U.S. national sample of GBM (n = 1,023). Birth cohort was independent of when men first felt sexually attracted to someone of the same sex (median age 11 to 12). However, with the exception of age of first same-sex attraction, older cohorts tended to pass other milestones at later ages than younger cohorts. Latent class analysis (LCA) of SID milestone patterns identified three subgroups. The majority (84%) began sexual identity development with same-sex attraction around the onset of puberty (i.e., around age 10) and progressed to self-identification, same-sex sexual activity, and coming out—in that order. The other two classes felt same-sex attraction during teen years (ages 12.5 to 18.0) but achieved the remaining SID milestones later in life. For 13% of men, this was during early adulthood; for 3% of men, this was in middle adulthood. Findings highlight the need to monitor ongoing generational differences in passing SID milestones.

Funding and Acknowledgments

One Thousand Strong was funded by NIH/NIDA (R01 DA 036466: Jeffrey T. Parsons and Christian Grov). H. Jonathon Rendina was supported by a National Institute on Drug Abuse Career Development Award (K01-DA039030). We would like to acknowledge other members of the One Thousand Strong Study Team—Dr. Tyrel Starks, Dr. Ana Ventuneac, Demetria Cain, Mark Pawson, Ruben Jimenez, Brett Millar, Chloe Mirzayi, Raymond Moody, and Thomas Whitfield—and other staff from the Center for HIV/AIDS Educational Studies and Training—Andrew Cortopassi, Chris Hietikko, Doug Keeler, Chris Murphy, Carlos Ponton, and Brian Salfas. We would also like to thank the staff at Community Marketing Inc.—David Paisley, Thomas Roth, and Heather Torch. Finally, special thanks to Dr. Jeffrey Schulden at the National Institute on Drug Abuse (NIDA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.