In its ongoing attempt to expand the conversation about gay health beyond HIV, the ninth annual BC Gay Men’s Health Summit focused on the directions gay lives take overall, and how they’re shaped by where they live and when they were born.
“We’re now seeing the wider scope,” co-organizer Terry Trussler, from the Community Based Research Centre, told summit participants who gathered at Vancouver’s SFU Harbour Centre, Nov 7-8.
In addition to the personal factors that affect gay men’s health, it’s important to look at how they relate to society, culture, the people around them, where they live and which age group they’re part of, Trussler explained.
Studying the full course of gay men’s lives — their actual lived experiences — is “vital,” Phillip Hammack, an associate professor at the University of California Santa Cruz, echoed in his keynote presentation.
Hammack stressed the importance of intergenerational dialogue, and recalled a particularly interesting exchange from a community forum on HIV prevention that he attended last year in San Francisco.
“The older men were chastising the younger men who admitted they chose not to use condoms regularly since they perceived that condoms were a barrier to the intimacy they sought in sex,” he said. “One of the older men said in response to this that ‘every time you do that you are asking to die.’
“So one of the younger men countered, ‘we can’t keep being afraid of sex because you were. We can’t carry the burden of everyone who died before us.’
“Now, members of my generation in our 30s and 40s — let us call the AIDS 2 generation — we were notably silent during the exchange. We were all sort of looking at each other saying, ‘Oh wait, what are we supposed to say here?’
“We could relate to both generations.”
Several presenters suggested that a gay man’s ability to connect with community and find social support is at least partially contingent on his age.
Andrew Shopland says many of the young men who he works with at Mpowerment long for community.
Although the YouthCo project is geared towards gay and bisexual men under 30 to expand their HIV awareness through workshops and ongoing peer support, Shopland says very few people come to his groups for health information.
“I would say it’s so easy to get communication to all of us but that’s not what guys want… Really what we’re looking for is connection and acceptance,” he told the summit. “And at Mpowerment we can create those things.
“One of the things I found most surprising was, I thought as a facilitator, I would have to, like, pull teeth to get guys to talk about their feelings and open up about stuff. But it’s actually quite the opposite. As soon as there’s any sort of space for that, it just comes pouring out. There’s such demand for it.”
“What about senior gay guys versus young gay guys?” asked researcher Robert Ablenas, who interviewed older gay men in Kelowna, Prince George, Vancouver and Victoria. “Compared to younger gay men, 60-plus gay men have more challenges to developing and sustaining social support networks based on chosen family.”
Ablenas says many gay men over 60 have “outlived many of their potentially supportive peers lost during the early years of AIDS, and are at risk of withdrawal and into social isolation.”
Ablenas found that the sexual, mental and social health of older gay men is improved or at least maintained through social support and quality support networks such as participation on a sports team, time with friends, or help with day-to-day tasks.
“There’s greater likelihood these adults can maintain their independence and self-determination into a later age,” he said. “And at the same time you can view this as a form of community capacity building if we're looking after our seniors in this regard, in that they have the potential to teach the rest of us through what they’ve learned through their personal histories, what can be taught through that, as well the type of mentoring they can provide to folks in subsequent generations who are following in their footsteps and tracing out amazing new paths.”
Nathaniel Lewis, a geography lecturer at the University of Nottingham, argued that gay men’s health outcomes are also linked to where they live.
“I think life course — especially in terms of the social experiences that we experience at different points in life — is absolutely central in understanding some of the key issues that are experienced disproportionately by gay men, including isolation, depression, anxiety, substance use and sexually transmitted infection including HIV/AIDS,” he said.
The connection between gay health and community is at a crossroads right now, he said.
“On one hand we see the sort of celebratory narrative that over time our rights have been won and things like gay villages are a relic of the past,” he explained. “And while this might be very true for a very specific set of metropolitan, privileged and usually white men, we also need to think about how community and care are accessed among, for example, the kid from southwestern Ontario who was kicked out of his house and shows up on a bus in Ottawa, or the new immigrant from the Dominican Republic or the Philippines who might not know what being gay means in a North American context and how to negotiate that. “
Lewis noted that gay men and lesbians who moved to large American cities in the ’70s and ’80s often left behind communities that were advancing less quickly and, in doing so, created the institutions that facilitated their coming out and community development.
Today’s messaging within the gay community seems to place less emphasis on shared infrastructure and support, and more burden on individuals, he said, pointing for example to the It Gets Better campaign.
“The message is not only wait it out until you get older but also that you can make it better for yourself by moving to a city, travelling and fitting into a normative lifestyle, which again only a certain segment of the population is privileged enough to do,” he said.