The gay population, or homosexual individuals, is a marginalized group with several lifestyle choices. The first lifestyle choice is sexual-partner preference. Homosexuality, or people who identify as gay, are individuals who prefer same-sex relations, “whose attractions and behaviors focus exclusively or mainly on members of the same sex” (Institute of Medicine, 2011). Secondly, the gay population will generally not have children (as it is impossible to conceive between members of the same sex; though this is changing through adoptions services and alternate birth methods) and have more income to spend on leisure. Children are an added expense to a household and Buford writes “the absence of children in the vast majority of gay households means that these households… do have dramatically more discretionary income (2000). Due to the lack of children and arguably more discretionary income, gay consumers consume more. Buford continues to write that “gay … consumers are more likely to have time for leisure activities, and are thus especially interesting prospects for products and services… [which] includes entertainment and travel and all the industries they encompass, such as movies, premium TV channels, airlines, cruise companies, resorts, and so on” (2000). Fourth, gay lifestyle has high rates of substance consumption of cigarettes and alcohol. Since “gay culture has traditionally centered around the gay bar; companies with products consumed in bars, such as spirits, beer, and cigarettes, saw this marketing opportunity early on” (Buford, 2000). Fourthly, another gay lifestyle choice is physical activity, most especially in the gym. Holleran writes about the “direct connection between the gym and the baths for gay men… At the gym one was doing something beyond sex, something pure and idealistic: fashioning a body, disciplining a self (2016). Lastly, another part of gay lifestyle is that they are “urban, style-conscious” individuals and though that sounds like a stereotype, Schneider writes that “that sounds more like the popular image of gay men, and perhaps there’s even a grain of truth to the stereotype of gay men as fashion-minded city dwellers” (2010). In an article by Stokes, she writes “Fashion design is an occupation where women far outnumber men… [and] gay men are the most successful,” demonstrating the fashion influence on gay lifestyle (2015).
One health need/problem that gay men face is the high risk for HIV infection. The Vanderbilt University School of Medicine identify that gay men, “continue to be at increased risk for HIV infection (2014). Practicing safe sex with the use of condoms is proven to be effective in transmission risk reduction of the virus (Vanderbilt University School of Medicine, 2014). Secondly, gay men are at increased risk for contracting hepatitis. The Vanderbilt University School of Medicine suggest that “men who have sex with men should be immunized against Hepatitis A & B” and also to practice safe sex to prevent transmission of the hepatitis C virus (2014). Thirdly, it has been documented that “gay men abuse substances at higher rates compared to others” which includes a variety of substances such as “poppers,” amphetamines, marijuana, cocaine, cigarettes, and ecstasy (Vanderbilt University School of Medicine, 2014). Substance use in itself is already detrimental but with the judgment impairment associated with it, risks increase exponentially for risky behavior such as unprotected sex, more illicit drug use, and recklessness. Fourth, in addition to HIV risk, gay men have a much higher risk for contracting sexually transmitted diseases. Due to having more partners and risky sexual behaviors, men who have sex with men are at risk for gonorrhea, syphilis, chlamydia, HIV, hepatitis A, B, and C, and HPV. (Vanderbilt University School of Medicine). Lastly, gay men are at risk for depression and anxiety issues. Vanderbilt University School of Medicine writes that this issue is amplified in “men who are closeted or don’t have adequate social support… [and] as a result, gay teenagers and young adults have an increased risk of suicide” (2014). In a society that generally frowns upon gay men, being ostracized and rejected, the risk for depression and anxiety persists.
Marginalized groups encounter specific healthcare disparities and discriminatory practices. One disparity that the gay population must endure is the urgency to remain “hidden.” Often, for fear of judgment, rejection, and even violence, gay men will not disclose to providers their sexual orientation, which has an effect of health practices. In fact, there are twenty states in the United States of America who have sanctions against same-sex activity, with “widespread discrimination directed at people who have revealed their identity, many sexually diverse individuals feel that “coming out” is dangerous—even coming out to health care providers. (Gay and Lesbian Medical Association and LGBT health experts, 2001). Secondly, another discriminatory practice with respect to the gay population involves healthcare providers not recognizing the unique social structures in gay relationships. The Gay and Lesbian Medical Association and LGBT health experts contend, “providers not accepting wont allow family or caretakers to have a part” (2001). It is not the traditional family unit of man and woman and sometimes healthcare providers will not recognize partners of gay men as care providers, excluding a vital support person for a patient. Thirdly, insurances discriminate on gay relationships by not recognizing their partnerships. The Gay and Lesbian Medical Association and LGBT health experts write:
“Gay men and lesbians in committed relationships are at a disadvantage in obtaining insurance compared to married heterosexual couples since many insurance companies and employers do not provide domestic partner benefits (2011).
Due to these circumstances, the gay population may have trouble navigating insurance benefits, creating an unfair disparity for this group. Fourthly, Bogart, Revenson, Whitfield, and France make an excellent point in the fact that most of our knowledge regarding gay health is focused only on HIV modalities, and “as a consequence… this research has overshadowed other LGBT research and led to a conceptualization of LGBT health that is focused on risk and disease” (2014). Due to the narrow studies focusing mainly on the HIV subject, there are disparities and holes in sound research regarding other issues that involve gay health, creating a lack of all-encompassing study in this population. Lastly, another health related disparity involves policies that discriminate against gay population and their behavior that influence health decisions. For example, as mentioned earlier, several states have discrimination law and policies with regards to gays, and Hatzenbuehler and colleagues revealed that a “recent United Nations report found that at least 76 countries have discriminatory laws against same-sex sexual behavior” (as cited by Bogart, Revenson, Whitfield, and France, 2014). To add to these discriminatory practices, there are also local laws that exist to “allow police to use possession of condoms as evidence that a person is involved in sex work; as a result, many sex workers, particularly those who are transgender, have decided not to carry condoms,” which will increase their risk for STDs and HIV (Bogart, Revenson, Whitfield, and France, 2014). The societal constraints have a direct impact on the health of the gay population, making law/policy a health-related problem for this marginalized group.
