The San Diego Paper
Colorado Paper ('97) - - Banff Paper ('95) - - 1997-98 Papers
The Paper (written in collaboration with Professor Ramsay, Faculty of Social Work, University of Calgary) was Presented by Pierre Tremblay at The 11th Annual Sociological Symposium: "Deconstructing Youth Suicide," San Diego State University - March 17, 2000. A part of the present updated version of the paper was presented at the Gay Men's Health Summit in Boulder, Colorado - July, 2000 (Cover Page).
2004 Updated Interim Version Of This Paper.
Table of Content: Major Sections Listed.
of Content: Major Section / Subsections/ Highlights Listed and Linked.
Title: The Social Construction of Male Homosexuality and Related Suicide Problems: Research Proposals for the Twenty First Century.
Sexual Orientation: Binaries and Definition Problems.
Male Homosexuality: From Common to a Rarity.
Male Youth Suicide Problems: Worsening Since 1950, Higher Rates for Homosexually Oriented Males, and Greater Risk for Suicide.
Homosexually Oriented Male Youth: Ongoing Suicide Problems?
Feminine Males: A Social Construction of Suicide Problems.
Research Proposals For The Twenty First Century.
Current definition(s) of "sexual orientation" and gender-based binaries. Note 1: Contemporary concepts of "sexual orientation" are being challenged. Note 2: Bisexuality has been ignored or condemned as a part of binary politics.
Heterosexualities, bisexualities, homosexualities, and asexualities best describe human sexualities. Warnings about research based on current definitions of sexual orientation.
The research which produced the postulated "the gay gene" concept in 1993 was soon placed in question as it had been predicted. Serious problems are related to what is meant by "sexual orientation." It is an unstable concept.
was very common in the ancient world, sometimes being the rule (Ancient
Greece). Some contemporary individuals are said to have the utopian
vision: the world may return to bisexuality.
up in a world where most adolescent males are relating sexually with each
other (as the author did) versus growing up with similar same-sex desires
and thinking no one else is like oneself. Note
3: Kinsey et al. (1948) reports that homosexuality more common
in working-class males compared to upper-class males, by a factor of 200
to 500 percent. The
Dowsett (1994) report on homosexuality in the working-class city of Nullangardie,
The modern situation for boys with same-sex desires: feeling like a freak as opposed to being part of the majority. Note 4: Growing up in a word where adolescent boys are being 'told' by Catholic priests that their homosexual activities are minor sins: something like telling a lie.
During the first half of the twentieth century in the United States and in other countries, many apparently heterosexual males were relating sexually with males. An explanation for why so many young adult males stopped being homosexually active. Note 5: Male homosexuality appears to have been extremely common in British Navies where some practices were similar to the ones reported to have existed in male prisons. About 25 percent of young adult males are sexually assaulted in Australian prisons.
Not long ago, many males did not perceive themselves to be homosexual if they were not sexually passive when having sex with other males. The Kinsey et al. (1948) study reported high incidences of male homosexuality (about 40%) existing during the first half of the twentieth century. Homosexuality was very common in male prisons and American career delinquents sold their sexual services to homosexual males in society.
The incidence of male homosexuality greatly declined in the last 50 years. Methodologically flawed studies report 1 to 2 percent of males engaging in same-gender sexual activities. Bagley and Tremblay (1998) report incidences of 9.2% for young adult males "being currently homosexually active" in Calgary, Alberta. These results are consonant with the results reported for the CARDIA Cohort study of young adult males as noted later in the paper.
Bagley and Tremblay (1998) suggest that great underestimating errors (200 to 800%) exist in recent demographic studies based on sexual orientation, the reason for this being "seriously flawed methodology." The Turner et al. (1998) study confirms this fact for adolescent males (age 15 to 19 years) who were asked questions about their homosexual activities using pencil-and-paper methodology compared to using computer technology. Underestimating errors average 400%.
the early 1940s, psychiatrists are actively teach the idea that homosexually
active males are seriously ill, very dangerous, and a great threat to society.
Psychiatry used the "mental disorder" label, and legislators used the decree
that all male homosexual activities were criminal acts, to help society
wage a major war against male homosexuality. The
current definition of the word "fag" or "faggot," or "gay," as learned
and rendered by North American adolescents."
The male youth (15- to 24-years-old) suicide rate has increased 3-fold since the 1950s, but the increase was 5-fold for 15- to 19-year-old males, and the most information about gay/bisexual male suicide problems now exists for males in this age group. Related data in Table 1. Males account for 92% of the additional male and female youth deaths from suicide since 1950. Therefore the increase in youth suicides is almost all a male problem.
Tremblay (1995) proposes that up to 50% of male youth suicides, but this idea has been negated by mainstream suicidologists. Bagley and Tremblay (1997) propose that maybe more than 50% of male youth suicides involve homosexually oriented males.
Homosexually oriented male adolescents at much greater risk for suicide attempts than their heterosexual counterpart by a factor of 6 to 7 times. For homosexually oriented female adolescents, the greater risk factor is 1.5 to 2 times compared to heterosexually oriented females.
Homosexually oriented adolescents are at greater risk for the more serious suicide behaviors, compared to heterosexually oriented adolescents: Table 2. The risk factors would be much greater for males if the results were available for males only. Maybe by a factor of 14-times as reported by Bagley and Tremblay (1997) for the most serious forms of suicide attempts. Note 6: The relative incidence of suicide attempters in the Garofalo et al. (1998) study would be 33% versus 5.1% for GBN males compared to heterosexual males. GBN adolescent males, forming 4.6% of the males sampled, represent 25% of the adolescent male suicide attempters. Note 7: A need for researcher to differentiate between a "suicide attempt" and acts of "self-harm" often classified to be suicide attempts.
The Remafedi et al. (1991) study of GB male youth: The males are at great risk for serious suicide attempts with a significant risk of resulting deaths. The high proportion of homosexually oriented male adolescents who attempt suicide places them at higher risk for an eventual suicide either as adolescents or later in life.
Table 3: For six American studies of gay and bisexual male youth, about 30% report having attempted suicide. Of these, 44% attempted suicide at least one more time.
Tremblay (1995) suggested that a mean spirited objective had motivated the production of the 1995 Suicide and Life Threatening Behavior special issues on "Sexual Orientation" edited by Muehrer, Moscicki, and Potter (1995) who are from the National Institute of Mental Health (NIMH) and the Centers for Disease Control (CDC).
The CDC still does not show by example that "sexual orientation" information should be solicited from adolescents who participate in Youth Risk Behavior Surveys. Rare YRBS studies which have solicited "sexual orientation" information, however, do report that homosexually oriented male adolescents are at much greater risk for a suicide attempt than their heterosexual counterparts.
probability that homosexually oriented male youth account for at least
50 percent of suicide attempters, and the fact that these males are more
at risk than heterosexual males for the more serious suicide behaviors,
such as more serious forms of suicide attempts, leads to the informed proposition
that more than 50 percent of male youth suicides (maybe up to 75 percent)
involve males for whom homosexuality issues are, or have been, a significant
factor in their lives.
Bell and Weinberg (1978) reported that 22% of first time suicide attempts occurred after the age of 25 years. About 43 percent of all first time suicide attempts associated with homosexuality issues were related to problems in a homosexual relationship. Suicide reattempting rates have remained high over the last 50 years, and may have risen a little, from 39% to 44%. Note 9: Not all suicide attempt by homosexually oriented males are related to homosexuality issues, and a significant number - about 35% - are not related to negative events such as "coming out" events or "negative homosexuality-related self-perception" issues.
The Remafedi et al (1991) data indicates that gay/bisexual male youth who have engaged in prostitution, been sexually abused, have been runaways, and have been arrested have elevated suicide attempt rates. There is also a general "suicide attempt" risk decrease from males being "feminine," to males being "masculine," the former having a 4.4 times greater likelihood for having attempted suicide than their "masculine" counterparts (48% vs 11%).
Problems often associated with suicide behaviors are likely ongoing for many gay and bisexual youth after they make more formal contact with gay communities. The suicide problems of boys involved in prostitution: seeking to be loved by an older male. Other young males also seeking love from older males are often just used and may be at risk for suicide problems.
Some problems of males who self-identify as gay or bisexual in early adolescence to middle adolescence: highest risk for suicide behaviors often associated with high risk for family problems, being runaways or throwaways, becoming street youth, being sexual abused after beginning to seek sexual partners often via public / anonymous sex venues, and substance abuse.
ongoing substance abuse problems of homosexually oriented adolescents equals
greater risk for suicide problems. Note
10: Youth Risk Behavior Surveys report much higher rates of varied
substance use and abuse by homosexually oriented adolescents.
In the recent history of homosexuality in the western world, there has been an association between males who identify as homosexual or gay and high levels of femininity. Bell et al. (1981) reported that gender nonconformity was the single most statistically significant difference between predominantly homosexual males and predominantly heterosexual males.
Table 4: Degrees of femininity reported by Bell and Weinberg (1981) for predominantly homosexual males before they became adults are similar to the sex role femininity ratings reported by Remafedi et al. (1991) for gay and bisexual male adolescents. "Feminine" gay and bisexual male youth are at much greater risk for suicide attempts than are their "masculine" counterparts.
Gay bisexual male youth with enough "femininity" to result in their classification outside the "masculine" sex role category is associated with a 3-times greater likelihood of reporting a suicide attempt compared to "masculine" gay and bisexual males.
Mandel (1996) reports that boys are still learning to greatly devalue femininity which reflects their misogyny learned at a very young age: Unlike the ways in which girls can and do value masculinity, boys do not and cannot value femininity."
Boney (1996) reports having done to himself what the many variations of the anti-sissy bullies had not managed to do: make him become acceptably 'masculine'. This is very much related to the common anti-feminine male attitude of gay communities.
About 80 percent of gay or bisexual identified adolescent males and young adults venturing into gay communities have varying levels of often detectable "femininity," with about 25 percent being "feminine" (Remafedi et al., 1991).
One of the ways gay males lie, of the many ways listed in four major categories and 34 subcategories, is via in their appearance, and "muscles" headed the list of eleven ways gay males lie physically. Result of the de Luze (1990) ethnomethodology study done in Paris France.
The issue of gay stereotypes in Australia's Here for Life' Youth Sexuality Project. Note 13: Information related to the Australian Final Report of the 'Here for Life" Youth Sexuality Project. Graham Brown is a contact for anyone wishing to address issues related to gay stereotypes and problems which may develop with gay and lesbian youth groups.
Is the suicide problems a "sexual orientation" issue, or it is really a "sissy" (i.e. gender nonconformity) issue? And if "we" do not tackle that issue, can we honestly say that we are addressing the GB adolescent male suicide problems?
Community attachments may not be positive for all gay and bisexual males. Male prostitution is often the first community attachment a significant number of adolescent gay and bisexual males have with gay communities.
14: Gay youth are reported
to be at risk for sexual assault / rape after they venture into gay communities.
Psychiatric Problems for Gay and Bisexual Males:
(Major Depressive Disorder), Substance Abuse, Personality Disorders, Effects
of Minority Stress. 'At Risk' Subpopulations. The
Remafedi (1999) research proposals.
The questions related to "sexual orientation" which have been asked to date in some YRBS studies. Table 5: The available YRBS Data Sets.
The association of higher risk for suicide problems with harassment based on the the assumption that one is homosexual (Seattle, 1995 YRBS, and other studies) has not yet been reported in peer reviewed studies. Table 6: Suicide Attempt Results Based on Sexual Identity and Being / Not Being Targeted for Anti-Gay Abuse in the Seattle (1995) Youth Risk Behavior Survey.
(1995) YRBS Study:
"The Homosexuality Factor" (includes anti-gay harassment) is associated
with about 30 percent (29%) of adolescent suicide attempters, and almost
40 percent (37.3%) of suicide attempters reporting that receiving medical
attention was associated with their suicide attempts.
Sexual Behavior (For the previous 5 Years, the previous 12-months, including the number of sex partners of either gender.)
Suicide Behaviors (Previous 12-month period, with questions exploring the severity of suicide attempt, hospitalization and resulting therapy, and intent to die.) The questions are intended to answer the unknowns listed in Table 2.
Behaviors (Similar questions for the period preceding the last 12-Month
period. This data will produce a lifetime incidence for suicide attempts
when combined with results for the previous 12-month period.)
A proposal to carry out a YRBS study
using computer technology as opposed to pencil-and-paper methodology to
establish the magnitude of error between the two methodologies. The Turner
et al. (1998) study reported that, on average, for males aged 16 to 19
years, the pencil-and-paper methodology produced an average underestimate
of 400% for males acknowledging having engaged in various forms of same-gender
sexual activity. Bagley and Tremblay (1998) generated data indicating that
methodologies other than computer technology had been producing underestimating
errors ranging from 200% to 800% in the reporting of varied adult male
Birth Cohorts (New Zealand). This cohort was used by Fergusson et al. (1999) to confirm that, by the age of 21, homosexually oriented males and females had been at great risk for a suicide attempt and other problems. Note 15: Another study from New Zealand based on the Dunedin Multidisciplinary Health and Development Study (DMHDS) cohort is being prepared for peer review.
Cohorts selected when individuals were five or six years of age have also been used in research. Such a sample was used by Reinherz et al. (1995) who reported that gender nonconformity in preschool ("behaviors that are counter to typical gender norms, such as aggressive behavior in females and dependence in males") was one of the "early gender-specific risks for suicidal ideation."
Cohort Study began as a sample of young adults: Demography results
based on sexual orientation (Table
7). The result replicate the Bagley and Tremblay (1998) demographic
results for young adult males.
Vietnam Era Twin Registry sample was used by Herrell et al. (1999) who reported that homosexually oriented males were at greater risk for suicide attempts in their lifetime than their heterosexual counterparts.
Community Based Samples: Obtained a subset of individuals for study from random sampling is often expensive and community based samples of these individuals are used to explored a number of factors related to their lives. Examples: Remafedi et al. (1991), and most studies of gay and bisexual individuals have been in this category.
Samples in Special Communities: Male Homosexuality may be studied in other special populations, such as male psychiatric populations. Examples given of homosexuality results from studies of predominantly schizophrenic and schizoaffective males which have produced results indicating that about 19% of these males report being homosexually active, and significant number (10 to 50 percent) report being involved in prostitution.
Populations in Studies of Suicide: Homosexual males are overrepresented
the population with a history of having received a psychiatric diagnosis.
One study reported that 33% of suicides in a psychiatric population was
associated with homosexually oriented individuals. As a rule this factor
is ignored in studies of suicide in psychiatric populations, as it is studies
of suicidality in mainstream populations.
C. Ethnomethodology Studies Needed to Better Understand Gay Community Attributes: Racism, Public Sex Arena, Lying, Biphobia, Effects of Community 'Norms', Etc.. The objective is to explore what may be the community realities which may not coincide with the appearances.
Theory Data Intake Methodology is needed to explore realities possibly
not yet recognized to have major associations with certain problems such
as high risk for suicide in gay and bisexual male youth populations. Other
factors than correlated variables may be most implicated in human problems.
It is noted that in a Calgary SPAN
(Suicide Prevention Advocacy Network), five parents had teenage sons who
had committed suicide. I eventually discovered that two of the older suicide
victims (17 and 19 years of age) were homosexually oriented, and the two
in their lower teens (14 years of age) had a history of being "sissies"
and being abused accordingly. Three of these teenage male suicide victims
had committed suicide in 1995 and were from the greater Calgary area. On
the basis of the evidence, it is concluded that about 50 percent of all
youth suicides (male and female) may involved homosexually oriented males.
Note 1: Contemporary concepts of "sexual orientation" are being challenged.
Note 2: Bisexuality has been ignored or condemned as a part of binary politics. A 'collaboration' seems to have existed between apparent heterosexual people and homosexual (gay- and lesbian-identified) people in this respect.
Note 3: Kinsey et al. (1948) reports that homosexuality more common in working-class males compared to upper-class males, by a factor of 200 to 500 percent. The Dowsett (1994) report on homosexuality in the working-class city of Nullangardie, Australia.
Note 4: Growing up in a word where adolescent boys are being 'told' by Catholic priests that their homosexual activities are minor sins: something like telling a lie.
Note 5: Male homosexuality appears to have been extremely common in British Navies where some practices were similar to the ones reported to have existed in male prisons. About 25 percent of young adult males are sexually assaulted in Australian prisons.
Note 6: The relative incidence of suicide attempters in the Garofalo et al. (1998) study would be 33% versus 5.1% for GBN males compared to heterosexual males. GBN adolescent males, forming 4.6% of the males sampled, represent 25% of the adolescent male suicide attempters.
Note 7: A need for researcher to differentiate between a "suicide attempt" and acts of "self-harm" often classified to be suicide attempts, even in mainstream suicidology.
Note 8: The OR (Odds Ratio for engaging in self-harm and attempting suicide) are given for the Bagley and Tremblay (1997) study related to the suicidality of homosexually oriented males compared to heterosexually oriented males.
Note 9: Not all suicide attempt by homosexually oriented males are related to homosexuality issues, and a significant number - about 35% - are not related to negative events such as "coming out" events or "negative homosexuality related self-perception" issues.
Note 10: Youth Risk Behavior Surveys report much higher rates of varied substance use and abuse by homosexually oriented adolescents.
Note 11: The OR (Odds Ratio for engaging in self-harm and attempting suicide) are given for the Remafedi et al. (1991) data for gay and bisexual male youth with any significant degree of femininity compared to gay and bisexual male youth classified to be "masculine."
Note 12: French excerpts from de Luze (1990) translated by author in the paper.
Note 13: Information related to the Australian Final Report of the 'Here for Life" Youth Sexuality Project. Graham Brown is a contact for anyone wishing to address issues related to gay stereotypes and problems which may develop with gay and lesbian youth groups.
Note 14: Gay youth are reported to be at risk for sexual assault / rape after they venture into gay communities.
15: Another study from
New Zealand based on the Dunedin Multidisciplinary Health and Development
Study (DMHDS) cohort is being prepared for peer review.
Table 1: American Youth Suicide Rates: 1950 to 1990 Increasing Youth Suicides: A 90% Male Problem.
Table 2: GLB Youth: Increasing "At Risk" Status For The More Serious Suicide Problems: Youth Risk Behavior Survey Results.
Table 3: G(L)B Youth Lifetime "Suicide Attempt" DATA Published Studies (American).
Table 4: Bell, Weinberg, and Hammersmith (1981) Femininity / Masculinity Self-Rating Childhood to Age 17.
Table 5: Youth Risk Behavior Surveys / Other Surveys: Available Data Sets.
Table 7: Cardia Cohort: Lifetime Same-Sex Partners (Totals - Weighted Results)
Two Hundred References (Approximately).
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