Terry Trussler, CBRC Presented at the Gay Men's Health Summit, 2010.

1. Unmasking the gender factorSEX NOW Survey 2010

2. Sexual orientation alone may be inadequate to explain gay health disparities… Investigate Gender Determinants

3. Retooling Sex Now Survey From behaviouralrisk factors to determinantsof health indicators... How are marginalization, social stress & mental wellness related? … to gay health outcomes? i.e. suicide, depression, HIV, STI… What social inequities elicit gay health disparities?

4. National Promotion

5. Recruitment

6. Recruitment

7. Sample age

8. Marginalization Indicators

9. Marginalization X Age

10. Marginalization X Age

11. Marginalization Indicators

12. Counseling 51% accessed counseling services

13. Counseling Topics 64% were satisfied with services

14. Care for Depression

15. Linking ideas “Sexuality is the apparatus of power” Michel Foucault How did that come to be? The History of Sexuality v 1-3 Heterosexuality doesn’t exist without homosexuality to explain it.

16. Linking ideas Archives of Sexual Behavior, Vol. 33, No. 2, April 2004, pp. 117–128 ( C ° 2004) Gender Nonconformity, Childhood Rejection, and Adult Attachment: A Study of Gay Men Monica A. Landolt, Ph.D.,1 Kim Bartholomew, Ph.D.,2;4 Colleen Saffrey, B.A. (Hons),2 Doug Oram, M.A.,2 and Daniel Perlman, Ph.D.3

17. Linking ideas Public Health and Human Rights APHA 134th Annual Meeting and Exposition November 4-8, 2006 Gender nonconformity as a target of prejudice, discrimination, and violence against LGB individuals Allegra Raboff Gordon, MPH and Ilan H. Meyer, PhD. Mailman School of Public Health, Columbia University,

18. Linking ideas Psychological Bulletin American Psychological Association, Inc. 2003, Vol. 129, No. 5, 674–697 Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence Ilan H. Meyer Columbia University “Minority Stress”

19. Linking ideas Critical Public Health Vol. 18, No. 3, September 2008, 271–283 Intersectionality and the determinants of health: a Canadian perspective OlenaHankivskya* and Ashlee Christoffersenb “policy decisions create relational inequities in which some groups benefit and others experience more marginalization and oppression.”

20. Intersectionality & Gay Health Determinants Focus on social inequities Intersecting systems of oppression/privilege i.e. Gender andSexuality (+ age, income, race, social location…) Interrogate the relationship between social categories… embrace complexity…

21. Social Status

22. Masculinities

23. In-gender comparison HIV+ Gay 9.2% MSM 1.1%

24. Common Practices

25. Varied Masculinities

26. Varied Outcomes

27. Minority Stress Indicators

28. Marginalization Indicators

29. Odds of Marginalization

30. Transmission Risk

31. Outcomes

32. Disparities

33. Varied Masculinities

34. Summarizing Disparities

35. Summarizing Ideas Marginalization strongly associated with treatment for depression Youth and HIV+ men experienced highest rates of marginalization Gay men experienced higher rates of marginalization, depression, HIV and STI than MSM Gender non-conformity helps explain gay health disparities

36. Practice Implications Critical Public Health Vol. 18, No. 1, March 2008, 87–96 The social construction of gay oppression as a determinant of gay men’s health: ‘homophobia is killing us’ Jeffrey P. Aguinaldo Department of Sociology, Wilfrid Laurier University, Waterloo, Canada “The problem is not the oppressed it is the oppressor.” Observe and count all the subtle and obvious ways heterosexism occurs and goes unchallenged and uncontested…

37. Next Steps Determinants Survey 2011 Young Gay Investigator Team - YGIT Measuring Marginalization and Resilience How is “gay oppression” being done? Distribute the evidence gathering…

38. Acknowledgements Questionnaire Development: Carl Bognar, Bill Coleman, Olivier Ferlatte, Jody Jollimore, Mike Kwag, Rick Marchand Survey Promotion: Justin Go, Glenn Doupe & CDC Internet Team Technical Assistance: Sean Lytle, Rachel Thompson Knowledge Transfer & Translation: Public Health Agency of Canada Dissemination: Province of British Columbia