Jagiellonian University Medical College, Faculty of Medicine, Department of Psychiatry, Sexology Lab, Krakow, Poland.
Jagiellonian University, Faculty of Philosophy, Institute of Sociology, Centre for Evaluation and Analysis of Public Policies, Krakow, Poland.
J Sex Med. 2022 Jul;19(7):1090-1097. doi: 10.1016/j.jsxm.2022.04.012. Epub 2022 May 31.
Only a minority of men experiencing sexual problems will seek professional help and the proportion of gay or bisexual men can be even lower.
To investigate if sexual identity and minority stress are related to professional help-seeking in Polish gay and bisexual men.
Sexual identity was measured with the standard question: "Do you consider yourself to be heterosexual, gay, or bisexual?" Men who provided a complete set of answers to the study tools and replied "yes" to the question: "Have you ever had a problem with sexual functioning that lasted at least several months?" were included (N =644, N = 203, N = 324, N = 117). A simple question on help-seeking was: "Did you seek professional assistance then?" Other data were gathered with the use of a self-constructed questionnaire. Minority stress processes, that is, internalized homophobia, expectations of rejection, and identity concealment, were measured with the subscales of the Sexual Minority Stress Scale. Bivariate analyses and multivariate logistic regressions were performed to test the statistical significance of sexual identity and minority stress processes as predictors of professional help-seeking.
Contacting a specialist when experiencing a sexual problem.
A total of 84.5% of all men did not seek professional help. Gay identity (OR = 0.58, P = .045), as opposed to bisexual identity, was significantly related to reduced odds of consulting a specialist. Age (OR = 1.03, P = .005), number of doctor's visits per year (OR = 1.51, P < .001), and a psychiatric diagnosis (OR = 1.65, P = .043) were positively related to help-seeking behaviors. Identity concealment significantly decreased the likelihood of consulting a specialist (OR = 0.94, P = .017).
Specialists need to be aware that gay identity and identity concealment may prevent a proportion of men from seeking their help and thus should be publicly explicit about their inclusive and nonpathologizing approach to sexual diversity.
The major strengths of the study include the use of a relatively large sample size and data from the little recognized Polish context characterized by a predominantly hostile anti-LGBT social climate, and exploration of a neglected topic of substantial significance at the public and individual levels. The major limitations are the use of nonprobability sampling, cross-sectional self-report design, and a single question to capture the presence of sexual problems with no measurement of associated distress.
Gay men are at risk of avoiding help-seeking when experiencing sexual problems because of identity concealment. Grabski B., Kasparek K., Koziara K., et al. Professional Help-Seeking in Men Experiencing Sexual Problems - The Role of Sexual Identity and Minority Stress. J Sex Med 2022;19:1090-1097.
只有少数有性问题的男性会寻求专业帮助，而同性恋或双性恋男性的比例可能更低。
调查性身份和少数群体压力是否与波兰男同性恋和双性恋者寻求专业帮助有关。
性身份通过标准问题来衡量：“你认为自己是异性恋、同性恋还是双性恋？” 那些对研究工具提供了完整的答案并回答“是”的人，“你是否曾经有过持续至少几个月的性功能问题？” 被纳入研究（N=644，N=203，N=324，N=117）。寻求帮助的简单问题是：“你当时寻求专业帮助了吗？” 其他数据是通过自制问卷收集的。少数群体压力过程，即内化的恐同、被拒绝的期望和身份隐瞒，是通过性少数群体压力量表的子量表来衡量的。进行了双变量分析和多元逻辑回归，以检验性身份和少数群体压力过程作为专业帮助寻求的预测因素的统计学意义。
所有男性中共有 84.5%没有寻求专业帮助。与双性恋身份相比，同性恋身份（OR=0.58，P=.045）与咨询专家的几率降低显著相关。年龄（OR=1.03，P=.005）、每年看医生的次数（OR=1.51，P<.001）和精神科诊断（OR=1.65，P=.043）与寻求帮助的行为呈正相关。身份隐瞒显著降低了咨询专家的可能性（OR=0.94，P=.017）。
专家需要意识到，同性恋身份和身份隐瞒可能会阻止一部分男性寻求他们的帮助，因此他们应该公开明确自己对性多样性的包容和非病理化的方法。
