Overcoming adversity: a grounded theory of health management among middle‐aged and older gay men

Abstract

This article presents findings from a grounded theory study in which we explored how self-identifying gay men between 40 and 76 years of age manage their health in the context of homophobia, heteronormativity and discrimination. Data were collected with 25 men over a 6-month period in a large urban setting in Western Canada. A preliminary theory of health management is discussed, consisting of the central phenomenon of overcoming adversity. Three thematic processes are considered that illustrate how adversity and health management are situated within the interrelationships of historical and ongoing discrimination inclusive of and external to the healthcare encounter, the complexity of men's illnesses, and the temporal aspects of HIV epidemics and treatments that occurred throughout their lives. These themes include: advocating for health needs, knowing about health issues and treatments, and engaging in health promoting practices. These findings help to address a gap in knowledge concerning health management among older gay men and support that initiatives aimed at health care with gay men must appreciate the systemic role of discrimination, while supporting men's individual efforts in actively managing their health.

Processes underpinning survival in gay men living with HIV and a history of suicidality

“…The findings from this investigation contribute to a process of normalising help‐seeking by showcasing the proclivity of gay men to help‐seek, as evidenced by others (Handlovsky et al., 2018, 2020a, 2020b; Siegel & Meyer, 1999). Inherent to men's willingness to help‐seek was a desire to support others in similar circumstances and is recognised as central to the efficacy of peer navigation efforts particularly in the context of HIV supports (Dickinson & Adams, 2014; Harper et al., 2014).…”

Older, self‐identifying gay men's conceptualisations of psychological well‐being (PWB): A Canadian perspective

“…Although many older gay men may not experience the intensity of stigma/discrimination as it was during the HIV/AIDS crisis, researchers have highlighted, for example, contemporary health settings to be sites of persistent subjugation for this group of men (Kia et al, 2019, 2020). There is a growing body of literature focused on how older gay men actively resist discrimination to support PWB (Emlet et al, 2017; Ferlatte et al, 2015, 2017; Handlovsky et al, 2020). There is little information, however, regarding insights into how PWB is defined and understood.…”

“…There is a growing body of literature focused on how older gay men actively resist discrimination to support PWB (Emlet et al, 2017;Ferlatte et al, 2015Ferlatte et al, , 2017Handlovsky et al, 2020). There is little information, however, regarding insights into how PWB is defined and understood.…”