Okasawara Diogo Sussumu, Boffi Letícia Carolina, Oliveira-Cardoso Érika Arantes, Santos Manoel Antônio Dos
Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
Cad Saude Publica. 2025 Jul 25;41(7):e00228324. doi: 10.1590/0102-311XEN228324. eCollection 2025.
This paper presents a systematic review and meta-synthesis to synthesize and reinterpret findings of primary qualitative studies on older cisgender gay men's experience of sexuality and seeking healthcare services. Following the SPIDER search strategy and PRISMA guidelines, bibliographic search was conducted on the CINAHL, LILACS, Oasisbr, APA PsycInfo, PubMed/MEDLINE, Scopus and Web of Science databases. Two independent researchers screened and selected the articles, collected data and elaborated a thematic synthesis. Of the 2,382 studies identified in the databases, 30 articles met the inclusion and exclusion criteria and were selected, totaling 849 gay men between 50 and 95 years old. Analysis produced four descriptive themes: (1) Living history: perceptions on the impact of historical and cultural development on experiencing sexuality; (2) Aging as a gay man: understandings on becoming and being a new body and self; (3) Caring for a social network: severing, building and maintaining bonds; (4) Handling health and professional care. From it were developed three analytical themes: (1) (Un)doing gay men through a dehumanizing gaze; (2) Oldness as performance; (3) To care is to care about. The discriminatory manner society perceives older gay men produces specific isolation from public life, gay communities, and health care services. Punitive laws against their sexuality, negative media representation, lack of proper care and family, community, and spiritual support interfered with their self-care and care seeking habits. Culturally sensitive future measures in policymaking and healthcare services are needed to properly care for this population.
本文进行了一项系统综述和元综合分析，以综合并重新解读关于老年顺性别男同性恋者性经验及寻求医疗服务的质性研究的主要发现。遵循SPIDER检索策略和PRISMA指南，在CINAHL、LILACS、Oasisbr、美国心理学会心理学文摘数据库、PubMed/MEDLINE、Scopus和科学网数据库中进行了文献检索。两名独立研究人员筛选并选择文章、收集数据并进行了主题综合分析。在数据库中识别出的2382项研究中，有30篇文章符合纳入和排除标准并被选中，共有849名年龄在50至95岁之间的男同性恋者。分析产生了四个描述性主题：（1）生活史：对历史和文化发展对性经验影响的认知；（2）作为男同性恋者的衰老：对成为并拥有新身体和自我的理解；（3）维护社交网络：切断、建立和维持联系；（4）应对健康和专业护理。由此发展出三个分析性主题：（1）通过非人化的凝视“（不）塑造”男同性恋者；（2）衰老即表演；（3）关爱就是关心。社会看待老年男同性恋者的歧视性方式导致他们在公共生活、同性恋社区和医疗服务中被特定地孤立。针对他们性取向的惩罚性法律、负面的媒体报道、缺乏适当的护理以及家庭、社区和精神支持，都干扰了他们的自我护理和寻求护理的习惯。在政策制定和医疗服务中需要采取对文化敏感的未来措施，以妥善照顾这一人群。
