Should Homophobia be Treated?

"Homophobia" refers to the fear of homosexual people. It may span a range of feelings from mild, private feelings of discontent to raging hatred affecting public policies and social institutions such as marriage.

When homophobia is internalized, it can affect the behavior and decision-making of the homophobic person significantly, so much so, that people may go to large extents to avoid being perceived as homosexual. While trying to separate out "metrosexuals" and "bromance" from homosexuality can at times seem defensive, the effects of this "turf battle" are usually not so glaringly detrimental. However, a recent study has shown that a fundamental trait of internalized homophobia can have disastrous consequences, leading to denial and disabilities that can profoundly affect their lives.

Shoptaw and colleagues recently published a study in the Journal of Urban Health, in which they examined how internalized homophobia correlated with sexual behavior and HIV status. Their findings were quite revealing and concerning. There were two major implications: (1) Men who identified as straight (they may have been bisexual) who looked down upon homosexuality had more sexual partners than those who did not; (2) Also, greater internalized homophobia was highest in a subgroup of men who had sex with men and women who had never tested themselves for HIV. Of these men, 26% - more than a quarter- were HIV positive. What are the implications of these findings?

This study shows that homophobia can be a barrier to HIV testing and may also lead to a false level of feeling protected against HIV, thereby leading to multiple sexual partners and a greater risk of AIDS. It is notable that this study did not include men who had sex exclusively with women, but it did include people who self-identified as straight. In fact, it is notable that men who self-identified as straight despite having had sex with men were in danger of denial of the adverse effects of their sexual practices. What are the possible reasons for this?

One obvious reason is that the "straight" men in this study were petrified of examining the complexity of their sexuality, and in an effort to "block off" a real part of their lives, also blocked off a real concern about their own health. Having more sexual partners may also be a way to avoid being boxed into a category of sexuality, but it does pose a greater risk for not being tested and then, actually having HIV. In part, because of the strong associations of HIV with homosexuality, these men may not take the risk of HIV seriously. This points to the terrible effect of the anxiety of homophobia and a reason to pay attention to this. Clearly, there is some exaggerated sense of immortality that is created as a defense against examining the real risks of promiscuous sex.

In the US, Puerto Rico, for example, had the second highest rate of HIV infection, and 37% of people were likely infected during high-risk heterosexual contact. Sexual behaviors among heterosexual men and women are also evolving. In fact, between 2001 and 2006 in a study done in Seattle, New Orleans and St. Louis, 37% of heterosexual adults had had anal intercourse with only 26% of women reporting condom use during the last anal intercourse and 45% of men reporting condom use. In this respect, women were less protected than men. These and other data point to the real risk of HIV infection in heterosexual contexts and the absence of safe sexual behavior in this population.

With that many people having unprotected sex, the dangers of promiscuity pose a real tension for the sexual explorer-homosexual or heterosexual. Furthermore, a false unconscious association between HIV and homosexuality may make people avoid HIV testing, or not even think of it. Unfortunately, when the infection strikes, it is too late to do anything about this.

Clearly, we cannot make assumptions about safe sexual practices in the heterosexual community either, despite appearances. While education about the risk of STDs and safe sexual practices could be helpful the problem seems to be more deeply rooted in denial, but even more so, in the perceived "need" for sex regardless of risk. Sex is notorious for blocking off thinking, and in fact its appeal is based on this very effect, but the answer to the ever-present public health hazards of HIV is not facilitated by homophobia-this fear and anxiety seems to paralyze self-preservation as well. One wonders how much of this homophobia is rooted in self-hatred.

While society has done well to remove some policy prejudices against groups such as women and people of color, with still more that has to be done, it is notable that people still feel protected by the fact that they cannot "become" a woman (unless they go through several conscious procedures) or a black person, for example. However, this same level of assurance does not appear to exist for homosexuality and the resulting homophobia clearly sets up an irrational set of thoughts and beliefs that have a huge impact on health.

With homophobia therefore affecting quality of life in terms of HIV awareness, the question arises: how different is this from social phobia or spider phobia or any other phobia? I would argue that homophobia, like these other phobias, can reach proportions where it is disabling to a person's health, and should be addressed by primary care physicians or psychiatrists so as to protect people from their own fears and beliefs.

Follow Srinivasan Pillay on Twitter: www.twitter.com/srinipillay

Comments

[Malkin71]

If you are a man and you have sex with men, you are not straight. I don't care what you want to self identify as, words have meaning.

This article, in all fairness to homophobes (I wonder if that sentence has ever been typed before) this article is not talking about homophobia.

It's talking about denial and self hatred being externalized as faux homophobia by bisexual men.

[mergina]

I don't think you can treat it. You certainly cannot treat the Religious Fundamentalism that is a self inflicted horror story.

[avicenna]

What if high-risk behaviour and "novelty seeking" - such as promiscuous "straight" men who have experimented sexually with same-sex individuals - is a behaviour that is associated with a polymorphism in a gene (or group of genes) - like the dopamine receptor? This would imply that this type of behaviour may be as "innate" as homosexuality - and fear or intolerance towards it may be as ineffective as homophobia or any other xenophobia. The only thing that can ease our ability to deal with this abundance of diversity is to accept that there are "different strokes for different folks" - and the only one that is going to ensure your physical and mental health is in good shape is yourself.

[Srinivasan Pillay - Huffpost Blogger]

thank you for your comment.

most genetic contributions to cause are partial. that is, they do not account for all of most phenomena. so, if homophobia is genetic (which we don't know it is yet), i suspect that there are probably many psychological and social contributions to its cause. also, apparently "innate" causes of prejudice have been shown to be amenable to cognitive intervention. besides, it appears that homophobic men are putting themselves at risk for HIV due to this fear.

we don't say that "the only one that is going to ensure your physical and mental health is in good shape is yourself" when it comes to social, spider or airplane phobias. why would we do this for homophobia?

[JohnFromCensornati]

"I would argue that homophobia, like these other phobias, can reach proportions where it is disabling to a person's health, and should be addressed by primary care physicians or psychiatrists so as to protect people from their own fears and beliefs."

Their homophobia should be addressed by primary care physicians or psychiatrists so as to protect *other* people from the behaviors caused by the homophobic fears and beliefs.

What is fear of homophobes called?

[kwinter]

For you, living in Kentucky, I'd call it a healthy fear!

And you make a good point.

[Srinivasan Pillay - Huffpost Blogger]

thanks for the comment. i think that is a goof point. but somehow, people are more amenable to adjusting their prejudices if they recognize that they are hurting themselves.

[SouthJerseySteve]

I have a phobia of large bugs! I don't kill people over my phobia.

If your phobia of gay people makes you a violent person, maybe a class in Anger Management would help before you reach for that baseball bat.

[Romulus]

But do you kill large bugs? :-D

[SouthJerseySteve]

Well, yeah, but it's a bug, you can't go to jail for arachnophobia. :-8

[PlaceboStudman]

you're absolutely right, Mr Pillay, fear is fear, and all phobias should be treated as such. The difficult part becomes defining what exactly IS homophobia. Many people will not admit to being homophobic, and many more are not homophobic as such, yet possess beliefs and values that manifest themself in what appears to be homophobia. You should come and read some of the Gay Rights blogs sometime, and you'll see what i mean. The first step to solving a problem is admitting we have one, but in the case of homophobia, admitting such a thing is often seen worse than holding onto and expressing those fears, when others who have those same fears are all too often afraid of losing their homophobic peers

[BobLablah]

I believe that homophobia is genetic and should be treated as any other disability.

[RadicalRepublican]

Excellent rejoinder!

[JohnFromCensornati]

So, then you're not a radical Republican at all. You're a run-of-the-mill, homophobic Republican.

[Ohioan730]

My childhood friend confessed to me that he used to go downtown with another friend and they used to brutally attack gay men off guard. He said they would casually pass them on the sidewalk and clothesline or sucker punch them for no reason. It makes him teary eyed when he talks about it. He's clearly disturbed and haunted by it.

I knew him when he used to do that and he never once mentioned it to me until 20 years later. He had a sense that what he was doing was wrong but he kept doing it because he thought he would score points with God because the bible said God makes no provisions for the LGBTs.

His favorite female cousin was clearly a lesbian and everyone could see it but him. Even I could see it when I was a dumb kid. She LIVED with a woman and they only had ONE bedroom--HELLO? He said when the truth finally sunk in, he avoided her and was angry with her.

He told me what "cured" him of homophobia and other ignorance was watching me read books when we were children. Because we were such good friends, he wanted to do what I did. We lost touch until recently but since then he went onto college and is completely different.

Education is essential to tolerance and living in a peaceful society. Time after time it is proven.

[Srinivasan Pillay - Huffpost Blogger]

this is actually research done to prove that you are correct. our prejudices do arise from ignorance. almost all people i know have some prejudice. the idea, as you point out, is to be open about them, and to educate ourselves about them so that we act in accordance with what we feel is right when it matters. thanks for your comment.