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PubMed1984

On the mechanism of thrombocytopenic purpura in sexually active homosexual men.

Thrombocytopenic purpura has recently been noted in sexually active homosexual men. To elucidate the pathogenesis of thrombocytopenic purpura in this population, we compared the disorder in 33 homosexual men with that in 23 patients (15 women and 8 men) thought to have classic autoimmune thrombocytopenic purpura. The homosexual group had 3.8-fold higher levels of platelet-bound IgG and 4.2-fold higher levels of platelet-bound complement than the patients with autoimmune thrombocytopenic purpura. Eluates from the platelets of only 1 of 10 homosexual patients reacted in vitro with normal platelets, as compared with those from the platelets of 12 of 15 patients with autoimmune thrombocytopenic purpura. Twenty-one of 24 homosexual patients (88 per cent) had elevated serum levels of immune complexes that were capable of binding to platelets, whereas none of 5 patients with autoimmune thrombocytopenic purpura had circulating immune complexes. The IgG fraction of positive serum samples from three homosexual patients did not bind to normal platelets, whereas that from the positive serum of two patients with autoimmune thrombocytopenic purpura and one woman in whom isoimmune antiplatelet antibody developed during pregnancy (studied as a positive control) did bind to normal platelets. We conclude that, whereas classic autoimmune thrombocytopenic purpura involves antiplatelet IgG directed against platelet antigenic determinants, the thrombocytopenic purpura that occurs in sexually active homosexual men is usually caused not by antiplatelet IgG but probably by the nonspecific deposition of complement and immune complexes on platelets.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Glandular politics. Experimental biology, clinical medicine, and homosexual emancipation in fin-de-siècle central Europe.

Focusing on the work of the physiologist Eugen Steinach and the clinician and activist Magnus Hirschfeld, this essay explores the complex interplay of experimental biology and medical discourse in the construction of a male homosexual identity in early twentieth-century Central Europe. Hirschfeld's collaboration with Steinach, the essay demonstrates, was not simply an instance of the imposition of a biomedical model of sexuality on the homosexual community by a hegemonic medical profession. Hirschfeld, a physician who was also a leader of the German movement for homosexual emancipation, used Steinach's theory to anchor a new biological model of homosexuality, claiming that male homosexuals were neither diseased nor depraved but formed a distinct, autonomous group of organically feminized men. The redefinition of homosexuality resulting from Steinach's and Hirschfeld's research, the essay argues, was not related exclusively to the specific politics of homosexual emancipation but also to more general debates, anxieties, and contestations over the cultural meanings of masculinity and femininity.

Biology↗

PubMed1995

Lower prevalence and incidence of HIV-1 syncytium-inducing phenotype among injecting drug users compared with homosexual men.

OBJECTIVE: To study the prevalence, incidence and predictive value for progression to AIDS of the HIV-1 syncytium-inducing (SI) phenotype in HIV-infected injecting drug users (IDU) compared with HIV-infected homosexual men. DESIGN: Two prospective cohort studies on HIV-1 infection among IDU and homosexual men. METHODS: HIV-infected IDU (n = 225) and homosexual men (n = 366) without AIDS were studied from March 1989 through December 1993. Data on laboratory markers, including the presence of SI variants, demographics, behavioural characteristics and clinical events were collected at every visit. RESULTS: At baseline, SI variants were detected in 4% of IDU and 17% of homosexual men. During the study period 18 IDU and 68 homosexual men switched from non-SI to SI phenotype (4-year cumulative incidence, 14.6 and 28.4%, respectively) before AIDS diagnosis. Among participants with a documented date of HIV infection the cumulative incidence of SI was lower among IDU than homosexual men (4-year cumulative incidence, 6.2 and 20.7%, respectively). At AIDS diagnosis, 21% of all AIDS cases among IDU had the SI phenotype compared with 54% among homosexual men. In both risk groups an accelerated CD4 decline was found after the non-SI-to-SI switch. The SI phenotype appeared to be a predictor of AIDS (multivariate relative hazard, 5.33), independent of CD4 cell count and p24 antigen at baseline. In the multivariate time-dependent analysis, the relative hazard of SI phenotype decreased considerably, which is consistent with the hypothesis that the effect of SI phenotype on progression to AIDS is mediated by CD4 cell count. CONCLUSION: The SI phenotype is associated with accelerated CD4 decline and progression to AIDS in both risk groups. The remarkable lower prevalence and incidence of the SI phenotype among IDU may implicate a difference in pathogenesis and natural history of HIV infection linked to transmission group.

Adult↗

PubMed2004

Nursing staff and nursing students' emotions towards homosexual patients and their wish to refrain from nursing, if the option existed.

Studies have reported that homosexual patients fear they will not receive adequate care if they openly show their sexual orientation, for example, when introducing their partner. The aims of this study were to investigate the emotions of nursing staff and nursing students, and possible relations to cultural background and gender, towards homosexual patients; whether nursing staff and nursing students would choose to refrain from nursing homosexual patients, if the option existed; and, if so, how they express their wish to refrain from nursing this group of patients. All participants received verbal and written information before the study started. Returning a completed questionnaire indicated a participant's tacit consent. Approval was obtained from the heads of departments and persons in charge of nursing and nursing assistant programmes. The study had a descriptive, comparative design, and an Affect Adjective Checklist (AAC) and specially designed Nursing Behaviour Questionnaire (NBQ) were used. The participants included nurses and assistant nurses from an infectious disease clinic, and students enrolled in a university nursing programme and upper secondary assistant nurses' training, all in central Sweden. The findings showed that both professional nursing staff (response rate 67%, n = 57), and students (response rate 62%, n = 165), expressed emotions of homophobic anger, homophobic guilt and delight. Groups with a cultural background other than Swedish expressed more homophobia. No gender differences were indicated for homophobic emotions. In the professional group, 36% would refrain from nursing for homosexual patients if given the option. The corresponding figure for the students was 9%. The limitations were that the sample was small and not randomly selected, and as participation was anonymous no follow-up could be done. It was concluded that the emotional factors of homosexual anger and homosexual guilt might be of value in helping to explain and predict attitudes towards homosexuals.

Adult↗

PubMed1993

The impact of training on school professionals' knowledge, beliefs, and behaviors regarding HIV/AIDS and adolescent homosexuality.

The impact of training on secondary school professionals' knowledge, beliefs, and behaviors regarding HIV/AIDS and adolescent homosexuality was examined. Subjects (79 introductory and 50 advanced trainees) and 58 controls (no prior training) were systematically sampled from professionals in a statewide demonstration program to prevent HIV transmission among gay and bisexual youth. Subjects completed mailed, self-administered surveys based on the curriculum. The overall response rate was 79%. Trainees scored significantly higher than controls on knowledge pertaining to HIV and adolescent homosexuality. They also reported using greater numbers of strategies to teach students about homosexuality and to improve the mileu for homosexual students. Training at any level was independently associated with constructive behaviors, while controlling for demographic characteristics. Advanced learners were most knowledgeable and least reliant on informal sources of information. They were more likely than others to teach about homosexuality and to refer homosexual students to community services. Findings supported the hypothesized benefits of the intervention. Schools that mandate AIDS education should help staff confront the difficult issue of adolescent homosexuality.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Adolescent homosexuality and concerns regarding disclosure.

Development of sexual identity in middle childhood and early adolescence is a natural process. However, it is more stressful for homosexual adolescents. Society continues to stigmatize and marginalize homosexuality. To avoid rejection and hostility, homosexual adolescents are pressured to hide their sexual identities. This fact compounds the anticipated normal developmental concerns of adolescence, and can create unique problems for the homosexual adolescents. Homosexuality can place them at risk for social stigmatization, isolation, depression, suicide, abuse, and rejection by their families and friends. During this exceptionally stressful time, both adolescent students and their families need anticipatory guidance and support. In providing anticipatory guidance, this article discusses critical roles played by professionals who work with adolescents in community or school settings. Included are insights into development of this normal variant of sexual attraction and orientation, risks that homosexual adolescent students may face as well as their disclosure concerns, and possible reactions families may have following disclosure. Supporting homosexual adolescents and their families is emphasized with regard to sensitively providing information, disclosure decisions, coping with stigmatization, and resiliency factors.

Adaptation, Psychological↗

PubMed1984

Syphilis, hepatitis A, hepatitis B, and cytomegalovirus infection in homosexual men in Antwerp.

In a homosexual communication centre in Antwerp 196 homosexual men were screened for seromarkers of syphilis, hepatitis A (HAV), hepatitis B (HBV) and cytomegalovirus (CMV). A comparison group consisted of 118 heterosexual men attending a venereal disease clinic in Antwerp. Treponemal antibodies were found in 7.1% of homosexual men, of whom half gave no history of past or present infection. Anti HAV was present in 43.3%, HBV seromarkers in 34.4%, and CMV antibodies in 71.2% of homosexual men. Hepatitis B surface antigen (HBsAg) was detected in eight homosexual men, but not in the heterosexual control group. Prevalence rates of infections other than HAV were significantly higher in homosexual men than in heterosexual men. Answers to a questionnaire were used to evaluate risk factors for different diseases, which were: duration of active homosexuality for all infections, promiscuity (greater than or equal to 10 partners in the past six months) for syphilis and hepatitis B, and anal intercourse for hepatitis B. Visiting saunas and travelling for sexual contacts also indicated a higher risk for STD, but were an indirect expression of promiscuity.

Adolescent↗

PubMed1980

Social and psychological functioning of the ageing male homosexual.

The stereotype of the older male homosexual is one of disengagement from the homosexual world, loneliness, rejection, depression and unhappiness. This typical picture of the ageing homosexual is not supported by the findings from 478 homosexual men in Australia with diverse backgrounds. There are no age differences in psychological well-being and involvement in the gay community. The older homosexual does believe he has less control for his sexual orientation and attempts to hide his homosexuality more than his younger counterparts. These latter findings appear to be generational differences. Implications for professionals working with homosexuals and their parents are briefly discussed.

Adolescent↗

PubMed1991

[Systems analytical investigation of the effect of countermeasures against the AIDS epidemic among homosexuals].

In Japan, the AIDS (Acquired Immunodeficiency Syndrome) epidemic among haemophiliacs has been the most urgent issue, because of the large number of haemophiliacs with AIDS. However, after governmental approval of the production of heated coagulating agents in 1985 and 1986, the prime object of prevention against the AIDS epidemic shifted from transmission through coagulation agents to that through sexual contacts. In order to investigate the most appropriate countermeasures against the AIDS epidemic among homosexuals in Japan, the numbers of HIV (Human Immunodeficiency Virus)-infected cases and AIDS cases in the future were estimated, and changes of the future numbers of HIV-infected persons and AIDS cases by behavior of homosexuals were compared using a systems analytical method. The methods of estimation and comparison are similar to those of R. M. Anderson and others, using numerical analysis of a mathematical model consisting of differential equations. They assumed a closed homosexual group whose members seldom have contact with members of other homosexual groups, but we assumed an open homosexual group whose members are being infected by other groups, because this assumption was more appropriate to the situation of homosexual society in Japan. The results showed that the prevalence number of HIV-infected cases would be about 1,800, that the prevalence number of AIDS cases would be about 100 among 100,000 homosexuals at 20 years after the beginning of the AIDS epidemic, and that the most effective countermeasure was reducing the frequency of sexual contacts among members or taking prophylactic measures during sexual contacts. These prevalence numbers of HIV-infected cases and AIDS cases would be reduced to between 1/4 and 1/2 of the above-mentioned calculated values by promotion of that countermeasure.

Acquired Immunodeficiency Syndrome↗

PubMed1976

Differences in psychological sex, adjustment, and familial influences among homosexual and nonhomosexual populations.

The present study investigated differences in psychological sex, present and past adjustment, and parental influences among homosexual cross-dressers, homosexual non-cross-dressers, applicants for sex change surgery, and heterosexuals. The homosexual non-cross dresser and heterosexual groups were found to have the most masculine gender role, with the sex change group having the most feminine gender identity. The two homosexual groups were most accepting of homosexuality, with the sex change group having the least acceptance of homosexuality. Support was not found for the prediction that the sex change group would have the worst present and past adjustment followed by the homosexual cross-dressers with the poorest past adjustment. As predicted, however, fathers were perceived as more nurturant in the heterosexual group than among the remaining three groups. These findings suggest that variations in sexual-life-style can be understood as manifestations of different combinations of the components of psychological sex and that a nurturant father is important in the development of a heterosexual life-style.

Adaptation, Psychological↗

PubMed1981

The Bell and Weinberg study: future priorities for research on homosexuality.

The Bell and Weinberg Homosexualities study attempts to subject important prior studies on homosexuality to systematic large-sample retests and also to break new ground in our positive understanding of homosexuality. In this article, defects in prior studies are surveyed, and then the adequacy of Bell and Weinberg's work is subjected to methodological evaluation. Issues discussed include the validity of the MMPI Mf scale, questions of sample representativeness, whether "straights" can do adequate research on homosexuality, differences in heterosexual and homosexual sexuality, the role of subculture acculturation in homosexual psychological adjustment, and the use of cluster-analysis to generate typologies of homosexualities.

Female↗

PubMed1984

Homosexual men and women who served their country.

The present work examines the effectiveness of United States military policies in excluding homosexual men and women from the armed forces by comparing percentages of homosexuals who have served in the armed forces with matched samples of heterosexuals. Interview data on 1,456 respondents from 1969 and 1970 are reported. The data show that homosexual and heterosexual men seem equally likely to have served in the military, while lesbians were more likely than heterosexual women to have served. The data also indicate that the policies of excluding homosexuals from the services are ineffective. The explanation for this may be that many homosexuals may not be aware of their homosexuality at time of entry into the service, and, hence, cannot readily be identified either by themselves or others. It is also suggested that certain draft criteria have in fact increased the percentages of homosexuals serving in the military.

Adolescent↗

PubMed1987

Recent challenges to traditional assumptions about homosexuality: some implications for practice.

During the last decade there has been a change in professional attitudes toward homosexuality reflected in the development of new models of treatment. Rather than offering a cure the aim is to help homosexuals adjust positively to their orientation. Such attitudinal change on the part of the practitioners has not, in the main, questioned the fundamental assumptions of theories which seek to explain homosexuality. Recent theoretical inquiry into homosexuality, however, has done this, posing an important challenge to the traditionally held view that people have an essential sexuality that is either homosexual or heterosexual and which remains fixed and unchanging throughout their lives. This paper addresses some of the more important clinical implications of these recent developments, in particular, the suggestion that "the homosexual" as a certain type of person is an "invention." In addition, the therapeutic value and difficulties associated with an acknowledgement that sexual preference and identity may change over time are considered. Finally, there is consideration of what the goals should be in the case of the person who seeks professional help in changing from a homosexual to a heterosexual orientation.

Adaptation, Psychological↗

PubMed1987

Non-ghetto gays: a sociological study of suburban homosexuals.

This ethnographic study is focused upon the lifestyles of white, suburban, middle-class homosexuals. Interview data on some two dozen individuals obtained in the spring of 1982 was increasingly supplemented and supplanted by continued field observation and other techniques of data-gathering through the summer of 1985. The data on the coming-out experiences were largely congruent with models of homosexual identity formation, especially those of Plummer (1975) and Troiden (1979). As expected, older subjects generally progressed through coming-out stages at a slower pace than their younger counterparts. The middle-class orientation and the suburban socio-cultural environment were also seen as inhibiting homosexual identity formation. The advent of AIDS seemed to have little obvious impact on behavior until the last months of the study. Suburban homosexuals in this study were strongly oriented to their work and career-building, to suburban home ownership, and to obtaining a long-term love relationship with another male. Suburban homosexuals were also strongly individualistic and assimilationist, rather than oriented towards collective action or organizational membership based on shared sexual identity. While the fortunes of the two friendship groups differed, friendship bonds among suburban homosexuals compare favorably with male friendships in the general population. The findings in this study suggest that suburban homosexuals, like many other Americans, are finding suburban life increasingly attractive and that the lure of large cities and gay ghettos has faded.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Homosexuality, class and the church in nineteenth century England: two case studies.

This article seeks to reconstruct and contrast two episodes in the nineteenth century Church. Both involved churchmen, Bishop Percy Jocelyn and Dean Charles Vaughan, in homosexual incidents. The second episode, that of Dean Vaughan, has been reconstructed for the first time using the Broadlands Manuscripts of Lord Palmerston. The most interesting aspect of these events is the response of the "establishment" to homosexuality. There seems little doubt that attitudes of the "establishment" were determined largely by class. The "establishment" would not officially condone homosexual behaviour, but in both cases (to varying degrees) it seems to have acted toward these men with latitude. One was able to evade justice, the other denied a mitre but otherwise allowed advancement in the Church. Both incidents provide evidence that persecution of homosexuals was something confined to the lower orders; and that the discreet middle class or aristocratic homosexual could rely on his class for protection. Perhaps integral to this tolerance was a Victorian taste for self-denial. The homosexual who treated his sexuality as a curse and a source of tragedy was more likely to attract the tolerance of his peers than the homosexual who acknowledged his sexuality to the full.

Attitude↗

PubMed1995

Homosexuality and the Left in the Netherlands: 1890-1911.

The attitudes of the Dutch socialist left toward homosexuality are examined, drawing upon a wide range of sources. At the end of the nineteenth century, a political debate on prostitution heightened social interest in sexuality in its diverse forms. Medical literature on sexual perversion was another starting point for the growing discussion of homosexuality. These debates were joined by Dutch socialists of divergent opinions. Whereas some of them wanted to acknowledge the right of homosexuals who were born that way to express themselves, only one exceptional author defended the right to homosexual sex. But most socialists were prejudiced against homosexuality and generally endorsed Frank van der Goes's proposal to eliminate homosexual behavior while accepting the notion of an inborn homosexual orientation.

History, 19th Century↗

PubMed1996

Homosexual inmates in the Buchenwald Concentration Camp.

The treatment of homosexual inmates in Nazi concentration camps is a subject which was largely ignored by historians in both West and East Germany after the war. Not until the 1980s, when research began to focus on some of the lesser-known victims of Nazi terror, did attention shift to the fate of homosexuals. This process can be seen clearly at the Buchenwald Memorial in the former GDR, the site of the persecution and also the death of considerable numbers of prisoners identified by the pink triangle on their clothing. The persecution of homosexuals in Nazi Germany began in 1933, even before Buchenwald was built in 1937. The Nazis aimed to eradicate homosexuality, which they saw as a threat to the survival of the German people. Incarceration in concentration camps like Buchenwald marked a stage in the radicalization of Nazi policy against homosexuals. There they were subjected to the harshest conditions and treated as the lowest of the low in the camp hierarchy. They were continually exposed to the terror of the SS but also the latent prejudices of the rest of the camp population. The culminating points of their maltreatment in Buchenwald were the use of homosexuals in experiments to develop immunization against typhus fever and the attempt by an SS doctor to "cure" homosexuality through the implantation of sexual hormones.

Concentration Camps↗

PubMed1996

Police discourses of homosexual men in New Zealand.

The present study examined the discourses of homosexuality in the police, using the discourse analytic method developed by Potter and Wetherell (1987). The study asked how police officers constructed gay men using their discourses and why gay men should or should not be employed by the police. Eight police officers were interviewed. Analysis revealed officers drew on three distinct discourses to construct gay men. The effeminate discourse associated homosexuals with effeminate behaviors. The deviant discourse associated homosexuals with behaviors that are morally and legally prescribed, and the discourse of conditional acceptance was used by officers to positively present, while voicing reservations about homosexuals. These discourses formed the linguistic resources officers used to construct types of homosexuals that were subsequently rejected as potential police officers. Several arguments were used to justify the conclusion that homosexuals were unsuited to the police. These related to the internal and external pressures impinging on the department with regard to the employment of homosexuals. The implications of the discourses are discussed with reference to gay men, the police, and the ideologies of heterosexism and gender.

Homosexuality, Male↗