The Relationship Between Homosexuality, Internalized Homo-Negativity, and Mental Health in Men Who Have Sex with Men

ABSTRACT

Whether homosexuality or internalized homo-negativity is the critical variable affecting the mental health of men who have sex with men has long been debated. As part of a larger study, 422 Midwestern homosexual men completed questionnaires examining degree of homosexuality, internalized homo-negativity, and depression. Logistic regression modeling identified internalized homo-negativity, but not degree of homosexuality, as significantly associated with greater adjustment depression (OR = 1.5), major depression (OR = 2.6), dysthymia (OR = 1.5), and likelihood of being in therapy (OR = 1.4). Internalized homo-negativity was also negatively associated with overall sexual health, psychosexual maturation, comfort with sexual orientation, “outness,” and peer socialization. Internalized homo-negativity, not homosexuality, appears associated with negative health outcomes. Providers should promote sexual health and avoid interventions that reinforce internalized homo-negativity.

KEYWORDS:

• Homosexuality
• sexual orientation
• internalized homo-negativity
• homophobia
• sexual health
• mental health
• depression
• gay men

This research was funded partly under a grant from the Minnesota Department of Health, AIDS/STD Prevention Services Section as part of an HIV prevention initiative: Grant Number: 1742-634-9012/9013, and in part by an evaluation grant from the Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention–Intervention, Research and Support: Grant Number: U62-CCU513272-01. All research was undertaken with approval of the University of Minnesota Institutional Review Board, human subjects' committee, #9204S05165 and the CDC Institutional Review Board, #1679. Participants were required to sign a two-page informed consent document detailing objectives, risks and benefits prior to participation in the study.