An Exploration of Northern Gay Men’s Health

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Despite the progress being made in Canada as it relates to the consideration of Lesbian, Gay, Bisexual, Transgender, Queer, and Two-Spirit + (LGBTQ2S+) health issues, the health and well-being of gay men in a northern Canadian context remains a difficult topic with which to grapple. A small pilot study that I conducted during my undergraduate degree looked at the health of gay men in the Northern Health region of British Columbia using two simultaneous approaches. First, through a targeted literature review and second, by carrying out four interviews with men of various ages and demographics who grew up in northern BC. 

As per the literature review, resources for gay men are more accessible in urban centres in southern BC and include targeted mental and physical health services which are known to create inclusive social and recreational resources (Health Initiative for Men, 2019). However there tends not to be the same level of supportive resources within rural and remote municipalities (City for All Women Initiative, 2020). For the men I interviewed, their treatment growing up in northern BC was not often friendly, and some had even experienced discrimination by healthcare providers. Optimistically, those who still live there today largely expressed that attitudes have begun to shift.

Despite this shift, data from the interviews made it clear that northern gay men have felt a lack of support and a lack of safety throughout their lives, particularly in the context of schools and workplaces. Similar themes stood out in all interviews around feeling uncomfortable or even powerless in these settings. These feelings would arise due to, for example, a principal not condemning a homophobic act against one of the men when he was a student, or a teacher refusing to support a Gay-Straight Alliance group.

Between the four interviews, another major commonality pertaining to life growing up as a gay man in the north was that gayness was not something that was discussed or generally socially accepted. For example, there were stories shared by some participants that mirrored a type of ‘don’t ask, don’t tell’ policy at work, wherein the expectation for employees was to remain silent on their sexual orientation or any other element related to their identity as a gay or queer person.

Interview findings demonstrated the need for a continued cultural shift within certain northern and rural areas in order to increase feelings of safety for gay men. Respondents who grew up or lived in these regions were subject to both blatant and subtle acts of homophobia, and in some cases, the discrimination continues to this day. Lifting up the voices and experiences of northern gay men in a respectful way will help ensure they are heard and that they are in a better position to ask for support. This could also help to create a cultural shift in workplaces, schools, and medical facilities.

Sadly, a couple of the men I interviewed expressed that previous research that had attempted to engage them had done so in belittling, disrespectful, or trivializing ways. An intersectional lens must be applied when reaching out to gay men or to other people in the LGBTQ2S+ community. This involves an approach that acknowledges the multiple, overlapping barriers that may prevent them from being reached, wanting to participate, or having the ability to do so (Canadian Women’s Foundation, n.d.).

Accessible opportunities for participation must also take into account the underlying factors that may discourage potential participants from taking part. According to the Gender-Based Analysis Plus (GBA+) framework used by the Canadian Institutes of Health Research, these factors interact to create a person’s identity - anything ranging from sex and gender, to age, ethnicity, and (dis)ability status (Status of Women Canada, 2017; Canadian Women’s Foundation, n.d.). Furthermore, as per O’Neill et al.’s PROGRESS framework, services not available to a person due to their place of residence can “be considered unfair” and therefore also facilitate health inequities (O’Neill et al., 2014). Overall, the sense I got from my interviews was that recognizing the complexity of individuals’ identities beyond limiting and harmful stereotypes will help to ensure that research participants do not feel like a number or a statistic.

There is great reason and opportunity within public health research to consider how to heal and move forward from past wrongs, which is made evident by the targeted literature review and participant data from participant interviews. In the process, we should re-envision research opportunities to ensure that they are accessible to people of previously neglected demographics. These research areas could relate specifically to gay men or to other LGBTQ2S+ individuals, or could be areas of interest to the general population. What is important is that efforts are made to target individuals and groups who have been marginalized through tact, sensitivity, and by demonstrating that the individuals’ well-being is at the heart of the research effort.

Brian Portner, BSc Health Sciences (Honours) graduate, Simon Fraser University

References
Canadian Institutes of Health Research. (2020). Gender-Based Analysis Plus (GBA+) at CIHR. 
Retrieved from https://cihr-irsc.gc.ca/e/50968.html
Canadian Women's Foundation. (n.d.). The Facts about Intersectional Feminism in Canada. 
Retrieved from https://canadianwomen.org/the-facts/intersectional-feminism/
City for All Women Initiative. (2020). Women and Cities. Retrieved from 
https://www.cawi-ivtf.org/equity-inclusion/women-and-cities
Health Initiative For Men. (2019). Your Mind Matters. Retrieved from https://checkhimout.ca/
O'neill, J., Tabish, H., Welch, V., Petticrew, M., Pottie, K., Clarke, M., . . . Tugwell, P. (2014). 
Applying an equity lens to interventions: Using PROGRESS ensures consideration of 
socially stratifying factors to illuminate inequities in health. Journal of Clinical 
Epidemiology, 67(1), 56-64. doi:10.1016/j.jclinepi.2013.08.005
Status of Women Canada. (2017). GBA+ Research Guide. Retrieved from 
https://cfc-swc.gc.ca/gba-acs/guide-en.html