Lesbian, Gay, Bisexual and Transgender. Over the past decade, LGBT people have gained more and more tolerance and acceptance in India, especially in large cities.

Nonetheless, most LGBT people in India remain closeted, fearing discrimination from their families, who might see homosexuality as shameful. Discrimination is still present in rural areas, where LGBT people often face rejection from their families and forced opposite-sex marriages.

People in the LGBT community are fighting for equal rights and acceptance. Trans people, especially, face a lot of difficulty in finding acceptance. People in the LGBT community are looked down upon all the time. This is a major issue because discrimination against the LGBT community is highly prevalent.

People’s prejudices lead them to think that LGBT people are odd and very different. Today, homosexuality and queer identities may be acceptable to more Indian youths than ever before but within the boundaries of families, homes and schools, acceptance still remains a constant struggle for LGBT people. I have heard of people coming out of the closet and declaring to their families that they are not the person their family expected them to be.

Being L,G,B or T is not a ‘problem’, nor is it a ‘choice’ as such. LGBT individuals are merely individuals who have sexual preferences that differ from what would appear to be the ‘norm’, due to differing learned behaviours and, you know, having a personal perspective and mindset that differs from everyone else’s. Saying that it’s objectively wrong for people to have sexual preferences that differ from the norm is objectively wrong itself.

Article 15 of our Indian Constitution Article 15, 1949

15. Prohibition of discrimination on grounds of religion, race, caste, Sex or place of birth.

If normal men and women have the right to live in this society with respect then why not a person who belongs to LGBT can live in this society with respect. It’s not about what our religion says it’s about what humanity says…If we talk about religion as per the Hindu aspects Lord Rama had given a boon to hijras for their loyalty that’s why the curse or boon of hijras means a lot to the normal beings.

I think everyone who is living in this world, either normal or abnormal has equal rights to live in this society with full respect..!!

Abstract

Factors associated with the well-being of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth were qualitatively examined to better understand how these factors are experienced from the youths’ perspectives. Largely recruited from LGBTQ youth groups, 68 youth participated in focus groups (n = 63) or individual interviews (n = 5). The sample included 50% male, 47% female, and 3% transgender participants. Researchers used a consensual methods approach to identify negative and positive factors across 8 domains. Negative factors were associated with families, schools, religious institutions, and community or neighborhood; positive factors were associated with the youth's own identity development, peer networks, and involvement in the LGBTQ community. These findings suggest a pervasiveness of negative experiences in multiple contexts, and the importance of fostering a positive LGBTQ identity and supportive peer/community networks. Efforts should work towards reducing and eliminating the prejudicial sentiments often present in the institutions and situations that LGBTQ youth encounter.

Keywords: gay, lesbian, well-being, youth

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth have greater vulnerability to a wide range of health, mental health, and social problems such as eating disorders, sexually transmitted diseases, school difficulties, forced sex, homelessness, violence and suicide (Austin et al., 2009; Blake et al., 2001; Bontempo & D'Augelli, 2002; Cochran, Stewart, Ginzler, & Cauce, 2002; Garofalo, Wolf, Kessel, Palfrey, & Durant, 1998; Perdue, Hagan, Thiede, & Valleroy, 2003; Russell, Driscoll, & Truong, 2001; Thiede et al. 2003). These negative outcomes are not inevitable as a result of a sexual minority status (Diamond, 2003) but their occurrence may increase due to the discrimination, marginalization, and isolation that are often associated with being LGBTQ (Remadefi, 2008; Savin-Williams, 1995). Despite the increasing acceptance of LGBTQ persons in the US, being a young person who is a sexual minority can still be difficult in a society largely oriented toward heterosexuality (Meyer, 2003).

Sexual minority youth can experience difficulties in multiple contexts. In families, for example, some LGBTQ youth have described their relationships with parents as distant or strained due to their sexual orientation (Floyd, Stein, Harter, Allison, & Nye, 1999), a fear of victimization from family members (D'Augelli, 2006), and a lack of acceptance from socially conservative parents (Newman & Gerard, 1993). In school, sexual minority youth report negative experiences such as bullying and antigay victimization by other students (Birkett, Espelage, & Koenig, 2009; D'Augelli, Pilkington, & Hershberger, 2002; Kosciw, Greytak, & Diaz, 2009), or having their property damaged or stolen (Garofalo et al., 1998). While religion may sometimes be a source of support and a protective factor against health risks, it may be less so for LGBTQ youth than for their heterosexual counterparts (Rostosky, Danner, & Riggle, 2007). In particular, religion may be a source of distress and contribute to internalized homophobia if religious beliefs are irreconcilable with one's sexual identity (Ream & Savin-Williams, 2005). Finally, the larger social environment may affect the well-being of LGBT youth. A recent Oregon study found the risk of attempting suicide for lesbian, gay, and bisexual youth was 20% greater in social environments unsupportive of LGBTQ persons compared to LGBTQ-supportive environments (Hatzenbuehler, 2011).

The research described above has been valuable in identifying the difficulties experienced by sexual minority youth and the contexts in which these experiences take place (Birkett et al., 2009; D'Augelli, 2006; Floyd et al., 1999; Rostosky et al., 2007). However, this literature suffers from two limitations. First, many studies narrowly focus on a single domain such as school or family. Such an approach may not fully capture the extent or multiplicity of negative factors affecting the well-being of LGBTQ youth. The second limitation is the scant attention devoted to investigating positive factors that may contribute to LGBTQ youth well-being (Bouris et al., 2010; Elze, 2005; Horn, Kosciw, & Russell, 2009; Russell, 2005; Ryan, Russell, Huebner, Diaz, & Sanchez, 2010; Savin-Williams, 2001). A handful of studies have begun to examine positive factors such as parental support (Ryan et al., 2010), affirmative school environments (Espelage, Aragon, & Birkett, 2008; Russell, 2005), emotional connectedness to family and school (Saewyc et al., 2009), emotional resiliency within antigay environments (Scourfield, Roen, & McDermott, 2008), and positive role models and social support (Fenaughty & Harre, 2003; Russell, 2005). Identifying and acknowledging these positive factors balances the picture of LGBTQ youth that emerges from an overly problem-focused research literature.

An approach that contextualizes individuals within increasingly broader systems may be a useful way to describe how multiple systems affect the well-being of LGBTQ youth. For example, Brofenbrenner's (1979, 1994) ecological perspective argues that human development is largely shaped by interconnected environmental systems that include the people's immediate (e.g., family, peers, school), larger (e.g., neighborhoods, communities), and cultural/societal contexts, as well people's development in the context of historical events. Brofenbrenner further suggests this model is bidirectional and emphasizes that the individual shapes his or her microsystem or the immediate environment. Incorporating a person's influence within the immediate environment is useful for understanding adolescent development in general but may be particularly beneficial when examining the relationship between multiple contexts that may be unsupportive of same-sex sexuality and how sexual minority youth cope with and respond to these contexts. By looking at the experiences of LGBTQ youth in different contexts and exploring their positive aspects, we may capture the range and complexity of life circumstances that influence the developmental trajectories and enhance and/or diminish well-being for LGBTQ youth.

Equally important is using research methods that approximate an ecological perspective of well-being for LGBTQ youth. Qualitative research methods are appropriate for this for several reasons. First, they can provide a rich understanding of the contexts and experiences of sexual minority youth from their perspectives and in their own words. Second, qualitative research methods are useful because they allow for exploring phenomenon that are largely unknown, important here given the relative infancy of the research literature (Bentz & Shapiro, 1998) on positive life aspects of LGBTQ youth. Finally, qualitative methods offer the potential for representing human agency or how individuals express their choices and actions in the world (Reissman, 1994). This aspect of qualitative research may be particularly important when doing research with marginalized populations who may be perceived as lacking visibility and power.

Study Purpose

This study elicited descriptions of negative and positive life factors from LGBTQ youth. Using qualitative analysis methods, we describe these factors and the related contexts in which they occur. A better understanding of these factors may help to identify relevant components for effective health and mental health prevention interventions for this population. This includes identifying positive factors that can be enhanced and negative factors whose effects might be ameliorated in service of reducing the challenges faced by LGBTQ youth.

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Method

The University of Washington's Institutional Review Board approved all procedures. Parental consent was not required for participation.

Recruitment

We recruited 14 to19 year olds, who spoke English, and self-identified as gay, lesbian, bisexual, transgender, queer or questioning one's sexual or gender identity (LGBTQ). We recruited the majority of study participants from existing LGBTQ youth groups in Washington state, such as LGBTQ youth-focused community agencies and school-based Gay-Straight Alliances (GSAs). We also distributed posters, flyers, and postcards to community agencies and other venues frequented by youth, such as cafés, barbershops, music venues, and youth centers. Youth self-selected to join the study and some chose to participate even if they did not meet the core recruitment criteria (see below).

Sample

A total of 68 youth (50% female, 47% male, 3% transgender) participated in the focus groups (n = 63); some youth were unable to take part in the focus groups, but wanted to be included, so individual interviews were also conducted with 5 persons. Participants ranged in age from 14 to 24 with almost half indicating they were 16 or 17 years old. Four youth reported being over 19 and 11 youth self-identified as “straight allies” of LGBTQ youth. We chose not to exclude these individuals from participating in the focus groups because they were part of intact groups and because of their recent membership in the target age range or insightful input as allies. Forty-two percent identified as White, 35% as multiracial, and the remaining 23% were spread across other race/ethnicity categories, with 6% identifying as African American and 6% as Latina/o. Most of the youth lived with their parents (60%), friends/roommates (15%), other family members (9%), or in other living situations (10%), while 6% were homeless.

Procedures

We chose focus groups as the primary data collection method to stimulate discussion and take advantage of the dynamics of the group process. Qualitative methods such as focus groups are ideal when a large sample is not necessary and it is desirable to dig more deeply into the topic of interest, giving the researcher more insight into understanding an issue. Focus groups can be more efficient than in-depth interviews and more cost-effective than some qualitative or quantitative methods.

We conducted nine focus groups: eight were held in LGBTQ youth focused agencies and one at a Gay-Straight Alliance (GSA). The majority of focus groups were conducted in midsized cities and smaller towns outside the urban core of LGBT community programs in Seattle. We sought youth from these locations because they would not have the same level of access to community support programs as do LGBTQ youth within more resource-rich urban centers. All study participants were given $15 cash for participating, and snacks were served. Research staff read the consent information statement to participants at the beginning of the focus groups and interviews, during which youth read along on their own copies. Facilitators then gave youth the option to leave if they decided they did not want to participate, but none did. Facilitators used a semistructured interview guide that covered topics such as sexual and gender identity, and being LGBTQ in one's school, place of worship, racial/ethnic community, and family. Participants also completed a brief demographics survey at the end of a focus group or interview. All focus groups and individual interviews were digitally recorded and transcribed verbatim by a professional transcriptionist.

Analysis

We analyzed transcribed interviews in Atlas.ti, Version 5.0 using strategies from a consensual methods approach (Hill, Thompson, & Williams, 1997). The goal of the consensual methods approach is to identify core ideas contained within interview data, and to determine the representativeness of these ideas across the complete dataset. In this approach, multiple analysts are involved in an iterative process of developing and applying coding decisions to transcripts, and making decisions based on the consensus of the analysis team. First, each team member independently reviewed at least 2 transcripts and created initial codes such as “coming out,” “negative religious experiences,” and “positive associations with school.” These codes reflected general categories of topics that arose during the focus groups/interviews, based on statements made by participants. The coding team then met to review each transcript and its associated codes, and worked to develop a consensus about what set of codes should be used to represent the patterns identified within and across cases. This process of code development included the identification of discrepancies between team members, which were resolved through group discussion. Codes were revised, added, and deleted as a result of this consensual process, which resulted in codes the team agreed on in terms of their definition, relevance, and scope.

With this list of initial codes, the research team divided the remaining transcripts and coded these in pairs. This involved reading over the transcripts and attaching one or more codes to each key idea or statement made by participants. The two coders’ codes were compared and, when discrepancies in coding occurred, the pair of coders discussed these until consensus was reached. New codes that emerged from coding remaining transcripts were added to the initial code list by consensus of the research team. A senior researcher and a doctoral student audited the final coded transcripts and checked the coding for accuracy.

Analysts then compiled a comprehensive listing of codes and organized these codes into domains from the intrapersonal to the larger community level (e.g., family, school). Next, we identified codes based on their valence or whether it represented a negative (i.e., nonsupportive, dismissive, harmful) or positive (i.e., supportive, affirmative, helpful) experience. We then identified the most commonly mentioned core themes in each domain that represented either a negative or positive factor. Being identified as a common theme was based on both the number of people who discussed the topic and the number of focus groups or interviews in which the topic was independently raised. By identifying both the number of individuals and groups who discussed a theme or factor, the team was able to ascertain the intensity of a theme by looking at whether it was discussed by multiple youth across focus groups, or was the product of discussion by a handful of people in only a few groups. This approach guards against equating the number of quotes with importance, favoring instead the presence of an idea across more than one person and group as an indicator of its relative level of significance (Carey & Smith, 1994).

Results

Youth in the study discussed many negative and positive factors in their lives. The most frequently mentioned themes within each domain are summarized in Table 1. Table 1 shows the number of people (individuals) who discussed the topic (No. of IN) and the number of focus groups or interviews in which the topic was independently raised (No. of FG/I). Overall, although youth discussed both negative and positive factors across all domains, negative factors were reported most often in the domains of families, schools, religious institutions, and community or neighborhood while positive factors were mentioned most frequently in the domains of the youth's own identity, peer networks, and LGBTQ community. The number of negative and positive factors for one domain, responses to and ways to cope with a stigmatized identity, was almost equal. In Table 2, we provide examples of statements the youth made that reflected a positive and negative factor in each domain.

Identity

Youth discussed identity issues in a more positive than negative light. For example, the idea that an LGBTQ identity was flexible was apparent in almost three fourths of the groups. While a flexible identity may suggest instability or confusion, youth referred to it as a way to exercise control in how they self-identified and presented their sexual/gender identities to others. A flexible identity included not wanting or needing labels (even LGBTQ labels), using multiple terms to identify one's sexuality, being open about pronouns when referring to oneself, and using terms that reflected the complexity and fluidity of gender and/or sexual identity such as “two-spirit,” “gender queer,” and “pansexual.” Closely related to flexibility, youth also made statements about their identities that reflected having a greater sense of control. For instance, some youth discussed reclaiming derogatory terms (such as faggot or dyke) as a positive step in deflecting and reappropriating their negative connotation and usage. Finally, youth spoke about being visible as LGBTQ as a way to express a sense of pride in their identities and not conform to stereotypical gender roles. Visibility was often achieved by purposely wearing clothing and accessories to mark themselves as being different and/or LGBTQ (i.e., pink triangles), and disclosing their sexual identities to others.

In contrast, the most frequently mentioned negative factor associated with an LGBTQ identity was feeling the need to hide it from others such as teachers and from the community in general (hiding an LGBTQ identity was also common in the family—see Table 1). Youth also mentioned being concerned about being “outed” as LGBTQ (i.e., having their sexual orientation revealed without their permission) or being labeled by others. In general, these quotes reflected the perception that youth faced resistance in being able to determine the labels they wanted for themselves and the timing of disclosing their sexual identities (if at all) to others. Rigid gender roles were also mentioned as posing conflicts and limiting self-expression for some youth. For example, a Chicano male youth mentioned that males within his culture were expected to be strong family figures, making it difficult for males to identify as female or transgender persons.

Responses to and ways to cope with a stigmatized identity

The number of negative and positive responses for dealing with a stigmatized identity was almost equal. Youth reported negative factors that reflected feelings of social isolation and negative internalized feelings related to being gay. In over half of the focus groups, youth described being isolated, primarily at school. Because they were often the only gay person they knew of at school, they felt there was no one else with whom to share experiences. One youth noted that even in the LGBTQ community, there were few adults who had gone through similar situations because many older LGBTQ persons came out after leaving middle or high school. This difference made finding support within the adult community sometimes difficult. Additionally, three quarters of the focus groups included discussion about negative internalized feelings related to being LGBTQ. For instance, one youth said other people's reactions made her feel bad about herself and wonder if she was wrong to be gay. Another young woman referred to herself as “mentally disabled” by the negative interactions she has with others related to her sexuality.

In terms of positive factors, youth reported various methods and supports for coping with a stigmatized identity. In over half the groups, youth discussed two active methods for coping with stigma: fighting back and advocating for LGBTQ rights. Youth frequently reported being targeted for harassment based on how they looked or having others know or believe them to be LGBTQ. For some, these experiences resulted in the youth actively standing up for themselves or friends through verbal confrontations or physical fights with the harassers. Other youth channeled these energies into efforts to advocate for LGBTQ persons or activities, such as creating “pink proms,” organizing LGBTQ positive media campaigns at school, or talking with school officials about anti-LGBTQ attitudes and behaviors in the school. In addition to these social methods of coping, youth also discussed developing a sense of self-acceptance, which included understanding themselves as unique, and learning how to be comfortable with themselves.

Family

Negative factors were more common than positive factors when youth discussed their families. Experiencing or fearing rejection was the most common concern for LGBTQ youth in terms of negative family responses. Youth mentioned being concerned about being kicked out and denied financial support if their parents or guardians found out about their sexual identity. Youth also felt the need to hide their LGBTQ identity and were unable to openly talk about being LGBTQ with family members, particularly parents, because of previous antigay or otherwise gay-negative statements in their families. For example, one young woman reported that members of her family were “hardcore gay bashers,” while others noted that their family members encouraged them to be straight, or believed their being LGBTQ was a passing phase.

In terms of positive factors, the most frequently mentioned was being accepted as an out LGBTQ person by family members, primarily siblings. Acceptance and support ranged from conditional (i.e., youth needed to behave in a more hidden or heterosexually identified way in order to maintain their parents’ “acceptance” of their LGBTQ identity) to unconditional support where a family member was excited that the youth was LGBTQ, welcomed romantic partners, and engaged in activism. A few LGBTQ youth came from families where their parents were openly LGBTQ and they saw this as affirming for them. Youth also mentioned being able to openly discuss being LGBTQ in one's family as a positive.

Peer networks

Positive factors outnumbered negative factors in the peer network domain. Peers of LGBTQ youth were described as sources of information and help. For example, many of the LGBTQ youth or their allies said friends were a major source of social support to whom they turned when they had questions or when they needed someone to talk to. While the majority of the youth singled out peers as the most likely to provide support, they noted that support can come from many different people, including non-LGBTQ parents, siblings, teachers, and principals, for example, as well as friends.

In contrast to the support that peers provided, there were also ways that peers were the source of nonsupport or negative experiences. For example, some youth in our study found it difficult to find peers to talk to and understand what they were going through, especially in contexts where it was not safe or comfortable to be “out” to others. Sometimes, participants reported outright negative experiences. One youth reported discomfort with an overnight school field trip because she was not out and other girls on the trip made fun of and “simulated” lesbian sex to boys they were talking to on the phone. A small number of youth experienced a lack of support from their peers but at least one youth who found support among other LGBTQ peers reported pressure from these peers to be sexually active, even when the youth did not want to do so.

School

School was associated with more negative factors than positive factors. Over half of the groups discussed experiencing verbal or physical harassment at school because of being identified as LGBTQ. Youth described verbal harassment such as being called names, hearing derogatory labels or phrases such as “faggot” or “that's so gay,” being sworn at, and being told one is going to hell for being LGBTQ. Youth also reported experiencing, hearing about or witnessing physical harassment such as being pushed, bullied, beaten up, or having food thrown at them when they were identified as LGBTQ. Youth discussed the inaction of school staff such as teachers and administrators who did not intervene when youth were being harassed as another negative aspect associated with school. In addition, youth experienced resistance to starting Gay-Straight Alliances (GSAs) in their schools from students and staff. Overall, persons in the school environment who were mentioned most frequently as exhibiting antigay or otherwise nonsupportive behavior were principals, staff, or religious students and teachers.

Despite these negative experiences, some youth reported positive and supportive school environments. Participants often described this acceptance and support as the result of having peers who were open-minded, or school personnel who could be turned to when they were “hassled” by other students. They also saw GSAs as contributing to a positive school environment by providing safe spaces for LGBTQ youth and decreasing isolation. One youth stated she felt like she was “the only one and now that there's a GSA, it's a lot easier because I'm not the only one.” Along the same lines, having visible LGBTQ persons in school such as teachers or other students also helped with promoting a supportive school climate for youth.

Religious institutions

Many LGBTQ youth in our study discussed religion as a negative factor. They consistently described hearing negative messages from faith communities related to their sexual orientation. Youth stated that others in their lives had told them that they are sinners, abominations, or that God hates them and they will go to hell for being LGBTQ. Youth reported being harassed at their places of worship, and many had either left their faith communities or been forced out. Youth also heard negative messages from religious leaders in the media and, based on religious beliefs, from youth and adults at their schools that maligned them for being LGBTQ. These negative encounters also occurred in the youths’ families with some youth reporting that they were ostracized from their families for being LGBTQ due to the family's religious beliefs. Youth also mentioned being physically confronted in public spaces such as school with negative religious messages and calls to “repent.”

A smaller number of LGBTQ youth shared positive statements about religion, faith or spirituality which they experienced as a source of strength in their lives. Some youth had already sought out religious communities that were openly accepting of LGBTQ people, and others found new ones that were accepting of their sexuality. Some LGBTQ youth left nonaccepting religions and participated in spiritual traditions such as paganism and Wicca since these religious movements are typically accepting of gender and sexual diversity. Some youth were able to discuss their concerns about religion and LGBTQ issues with persons who belonged to various religious communities, even those that were relatively less LGBTQ-accepting.

Community/neighborhood

Study youth mentioned more negative encounters in their communities and neighborhoods than positive ones. Youth reported experiencing physical harassment and hearing about other LGBTQ youth being similarly victimized. For example, in Table 2, youth reported two different experiences of harassment including being spit on and getting beaten up. Besides harassment, experiencing a combination of discrimination, such as LGBTQ discrimination in conjunction with racism and sexism, were also discussed. Specifically, youth of color and young women described additional experiences of rejection that they saw as related to the ways their sexual identity overlapped with their racial/ethnic background and gender. For example, a bisexual multiracial female described the lack of safe spaces that simultaneously acknowledged her multiple identities. Finally, participants reported meeting strangers who openly voiced antigay views either to the youth themselves, or to their parents or friends.

In terms of positive factors, some youth were able to navigate their neighborhoods and communities by finding a core group, agency, or event that was not specifically LGBTQ-focused but nevertheless buffered them against negative experiences (see LGBTQ Community Involvement section for LGBTQ-specific agencies). For example, one young person found support in a writing group while another cited a community sponsored sporting event where youth were able to hang out and talk. Another positive that encompassed the larger community was the visibility of different kinds of diversity. Specifically, youth suggested that more racially diverse communities were more likely to be open to diversity in general, including sexual orientation. Youth cited their own families, ethnic communities, and role models from the media they believed promoted visibility and acceptance for racial and sexual diversity. Finally, a handful of youth believed their neighborhood or community was safe for LGBTQ people. One youth mentioned he felt safe enough in his neighborhood to hold his boyfriend's hand in public.

LGBTQ community involvement

Youth held more positive than negative views on LGBTQ organizations. LGBTQ youth organizations provided formal and informal programs for youth, a safe place for youth to go and meet other LGBTQ youth, and a place where youth felt like they can be themselves. In addition to organizations, youth also noted that they turned to LGBTQ adults for mentoring and advice. Several youth mentioned they could not attend activities at local organizations because of anti-LGBTQ sentiment in their family, but they made ready use of the internet, particularly MySpace and Facebook sites, to interact with other LGBTQ youth and community forums.

Although youth frequently mentioned the importance of LGBTQ organizations as sources of support, they were not always available. Several youth lamented the lack of opportunities for LGBTQ community involvement, particularly in rural areas, and especially the lack of places for LGBTQ youth to meet. Even in more populated areas, youth commented about problems with access at some organizations, especially those that relied on volunteers for staffing. Although not mentioned frequently, youth did report a lack of community organizations for segments of LGBTQ youth; specifically LGBTQ youth of color and LGBTQ youth between the ages of 18 to 21.

Discussion

The goal of the study was to elicit information on the current perspectives of LGBTQ youth using an ecological framework, considering both the negative and positive factors in their lives. Our findings indicate that LGBTQ youth tend to experience negative factors such as rejection and harassment in more heterocentric social environments (e.g., family, school, general community, religion) but that this is less the case in environments that tend to be more LGTBQ-supportive (e.g., peer groups, and LGBTQ community). These findings underscore the usefulness of the ecological framework as a guide to understanding how different contexts, both positive and negative, influence LGBTQ youth well-being. Our findings replicate previous research that suggests the importance of social context for sexual minority youth, and that their interactions with this context may be particularly complex and challenging (D'Augelli, 2006). Moreover, our study found evidence of youth influencing their immediate social contexts, especially in response to dealing with a stigmatized identity. This finding supports the idea of the bi-directionality of influence within the ecological model. Keeping in mind the importance of within-group variation (Diamond, 2003), these findings and provide implications for intervention and support services, future research, and policy.

It is notable that many youth viewed their sexual and/or gender identity as more of a positive factor than a negative one, and frequently described their identities as being flexible but under their control. Russell, Muraco, Subramaniam, and Laub (2009) identified “personal empowerment” as resulting from the feeling of having agency over things in one's life and feeling good about oneself. It may be that this is achieved through people feeling in control of how they describe their sexual and/or gender identity, or feeling unique and special because of not fitting into a typical “box” or rigid category. Feeling and perhaps, even embodying a sense of uniqueness because of one's LGBTQ identity may contribute to authenticity but this sense of being “different” may also be isolating for some LGBTQ youth, particularly in contexts (e.g., peer groups, school, religious institutions) where individuality may be undervalued. This dilemma suggests that identity presentation for LGBTQ youth is strategic and lends support to the importance of espousing a “flexible” identity.

Other areas where positives outnumbered negatives were related to peer networks and connection to LGBTQ community or mentors. Having friends/ allies to turn to and get support from was frequently mentioned as an asset as well as having a connection to other people in the LBGTQ community or mentors. Although connection to the LGBTQ community was an important positive resource, we did see evidence (though more rarely) that some youth experienced negative interactions with LGBTQ peers. These findings have implications for those wishing to provide helpful services to this population. It would be important to facilitate the formation of supportive networks or connections in the community, helping youth to negotiate conflict in peer relationships, especially reinforcing norms for cooperation. One way to accomplish this is to encourage development of school or community GSA's where young people can come together in a safe environment; however, this may be challenging in some environments. For example, youth in rural areas may have fewer opportunities for connecting to peer and community support, while school environments may differ in their support of LGBTQ youth. Another way to create helpful networks or connections may be facilitated by using online resources and forming online communities for LGBTQ youth. Community events and groups that are not LGBTQ-specific should also work towards being LGBTQ-friendly and welcoming of diverse backgrounds. For example, a writing group (or any youth-related group or activity) that encourages and allows authentic self-expression within a supportive environment would help LGBTQ youth.

While youth expressed various areas that were mostly positive, negative factors outnumbered those across several domains, including those usually considered places of support for youth such as family, school, and religious institutions. Two important strategies are suggested by this finding. First, efforts could be focused on determining the most effective methods for diminishing anti-LGBTQ attitudes and behaviors in these environments. For example, LGBTQ-friendly health care providers, religious leaders, and school personnel could find ways to routinely make information available regarding sexual identity development for all youth and their parents, providing empirical evidence about the durability and stability of sexual identity structures. Second, in situations where it is not possible to affect shifts in family, school or religious institutions, an important alternative service for this population would be the creation of support programs in the community, such as providing mentors and role models for LGBTQ youth.

School experiences deserve a special mention for this population. School attendance is a legally mandated activity for all youth, yet this environment may be one in which LGBTQ youth face the most frequent harassment. Efforts should be made to create positive school climates for all students; current efforts focused on intervening to prevent bullying of students should include components on diminishing the harassment and bullying of LGBTQ youth. This includes working to change negative attitudes and behaviors toward LGBTQ youth that can sometimes be fostered by students, teachers, and administrators. There is evidence that creating a more positive environment benefits the entire student body in a school, not just the sexual minority students (Birkett et al., 2009). The Gay, Lesbian, and Straight Education Network (GLSEN) may be a helpful resource for creating safer and more positive school environments for LGBTQ youth. Other long-term solutions include providing more LGBTQ-related content in teacher-training/certification courses, preparing all school personnel with diversity training, and enforcing antibullying and harassment policies.

Although there is a spectrum of attitudes towards same-sex sexuality and LGBTQ persons among religions and within individual religions over time (Swidler, 1993), many of the youth in our study felt that religion was a source of negativity in their lives, alienating them from places of worship, from other youth and adults in their communities, and perhaps most importantly from members of their family. Given these experiences, some sexual minority youth may feel compelled to distance themselves from or reject traditional religious involvements temporarily to manage the coming out process (Rostosky et al., 2007) but other youth mentioned positive religious affiliations that provided support and a sense of belonging. These youth may have successfully managed the cognitive dissonance often arising from the conflict between religious and LGBTQ identities (Rosario, Hunter, Yali, & Gwadz, 2005). Beyond referring LGBTQ youth to welcoming and accepting religious institutions and groups, LGBTQ communities and their allies could profit from seeking opportunities for constructive dialogue with places of worship, including but necessarily limited to those that are not overtly welcoming but do not promote antigay rhetoric and discrimination.

Future Research Directions and Policy Implications

The study's findings suggest several research directions and policy implications. Future research could profit from the use of a longitudinal study design. A longitudinal study would not only better follow the youths’ developmental trajectories over time but also better capture the dynamic social environment and how it impacts the well-being of LGBTQ youth. Further research on LGBTQ youth and well-being should also be conducted to better understand how other identities such as racial/ethnic background, socioeconomic status, and physical abilities intersect with sexual and gender identity to influence well-being. We touched on these intersections of identities in our study but more research is needed to better understand how multiple minority identities influence well-being for LGBTQ youth. In terms of policy implications, our findings support the need for stronger antibullying policies in sites where youth congregate or access the internet (e.g., school, social networking sites). Given the current media attention on bullying, this is an opportune time to advocate for antibullying policies that explicitly include sexual orientation and gender identity.

Study Limitations

Our findings and interpretations have several limitations. First, individuals recruited from established LGBTQ groups may have different perspectives and experiences than others, especially since they are more likely to have access to positive influences and less isolation. Perspectives from more closeted and isolated individuals are not present in these findings, and would likely increase reports of negative experiences in the study. Also, while the sample did include people from a range of communities from large to small, and conservative to liberal, it was limited to one state and may not represent other geographical areas.

Conclusions

Two overarching themes were identified in these data: the pervasiveness of the experience rejection and harassment in a multiplicity of contexts, and the youths’ own perception that they were doing relatively well in the face of these negative experiences. These overarching themes are reflected in the types of negative and positive factors mentioned in each domain. Suggested approaches at this time are to build on what can be strengthened and provide more support to individuals to ameliorate the stressors that are not easily amenable to change. Ultimately, efforts should work towards reducing and eliminating the negative sentiment often found in the institutions and situations that LGBTQ youth encounter.

Acknowledgments

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported in part by the National Institutes of Mental Health, MH075030.

Biography

Darrel Higa is currently a Senior Service Fellow in the HIV Prevention Research Branch, Division of HIV/AIDS at the Centers for Disease Control and Prevention. His research interests include HIV prevention for gay and bisexual men, and Asian and Pacific Islander populations, and engagement in HIV care for HIV-positive persons.

Marilyn J. Hoppe is a Senior Research Scientist in the School of Social Work, University of Washington. Her research interests include adolescent and young adult health risk behavior and prevention, and data collection methodology.

Taryn Lindhorst is a Carol LaMare Associate Professor of Social Work, University of Washington. Her interests include issues of victimization, LGBT health and mixed methods research.

Shawn Mincer is currently a Research Coordinator with the Department of Anesthesiology and Pain Medicine at the University of Washington, Seattle. His research interests include adverse outcomes in general anesthesia, patient-doctor shared decision-making, same-sex intimate partner violence, and LGBTQ health.

Blair Beadnell is a Senior Research Scientist in the School of Social Work, University of Washington. His research focuses on youth and adult health risk behavior, and research methodology.

Diane M. Morrison is a Professor in the School of Social Work, University of Washington. Her research focuses on sexual behavior and decision making about risky sexual behavior.

Elizabeth A. Wells is a Research Professor at the University of Washington's School of Social Work. Her research interests include adolescent relationships and sexuality and adolescent and adult substance use.

Apryl Todd is a Clinical Social Worker at Stanford Hospital and Clinics. Her research focuses on illuminating strengths of minority and at-risk youth in a variety of clinical and social contexts.

Sarah Mountz is currently a PhD Candidate in the School of Social Work, University of Washington. Sarah's research interests focus on the experiences of LGBTQ youth in the child welfare and juvenile justice systems, and among homeless youth populations, where they are overrepresented, underserved, and unsafe.

From Rainbow

This article traces the journey of the LGBT community from 1533 to today, looking at the battles for equality that were fought and legislative changes made.

The Buggery Act of 1533, passed by Parliament during the reign of Henry VIII, is the first time in law that male homosexuality was targeted for persecution in the UK. Completely outlawing sodomy in Britain – and by extension what would become the entire British Empire – convictions were punishable by death.

The Buggery Act

It was not until 1861 with the passing of the Offences Against the Person Act, that the death penalty was abolished for acts of sodomy – instead being made punishable by a minimum of 10 years imprisonment.

The Criminal Law Amendment Act 1885 however, went a step further once again, making any male homosexual act illegal – whether or not a witness was present – meaning that even acts committed in private could be prosecuted. Often a letter expressing terms of affection between two men was all that was required to bring a prosecution. The legislation was so ambiguously worded that it became known as the ‘Blackmailer's Charter’, and in 1895, Oscar Wilde fell victim.

The Criminal Law Amendment Act

Female homosexuality was never explicitly targeted by any legislation. Although discussed for the first time in Parliament in 1921 with a view to introducing discriminatory legislation (to become the Criminal Law Amendment Bill 1921), this ultimately failed when both the House of Commons and House of Lords rejected it due to the fear a law would draw attention and encourage women to explore homosexuality. It was also assumed that lesbianism occurred in an extremely small pocket of the female population.

In the post-war period, transgender identities started to become visible. In 1946 Michael Dillon published Self: A Study in Endocrinology. The book, which in contemporary terms could be described as an autobiography of the first transgender man to undergo phalloplasty surgery, recounted Dillon’s journey from Laura to Michael, and the surgeries undertaken by pioneering surgeon Sir Harold Gillies. Dillon wrote: ‘Where the mind cannot be made to fit the body, the body should be made to fit, approximately at any rate, to the mind.’

In May 1951 Roberta Cowell, a former World War II Spitfire pilot, became the first transgender woman to undergo vaginoplasty surgery in the UK. Cowell continued her career as a racing driver and published her autobiography in 1954.

Meanwhile, a significant rise in arrests and prosecutions of homosexual men were made after World War II. Many were from high rank and held positions within government and national institutions, such as Alan Turing, the cryptographer whose work played a decisive role in the breaking of the Enigma code. This increase in prosecutions called into question the legal system in place for dealing with homosexual acts.

The Report of the Departmental Committee on Homosexual Offences and Prostitution, better known as the Wolfenden Report, was published in 1957, three years after the committee first met in September 1954. It was commissioned in response to evidence that homosexuality could not legitimately be regarded as a disease and aimed to bring about change in the current law by making recommendations to the Government. Central to the report findings was that the state should focus on protecting the public, rather than scrutinising people’s private lives.

Wolfeden Report

It took 10 years for the Government to implement the Wolfenden Report’s recommendations in the Sexual Offences Act 1967. Backed by the Church of England and the House of Lords, the Sexual Offences Act partially legalised same-sex acts in the UK between men over the age of 21 conducted in private. Scotland and Northern Ireland followed suit over a decade later, in 1980 and 1981 respectively. The Sexual Offences Act represented a stepping stone towards equality, but there was still a long way to go.

In 1966 The Beaumont Society was set up to provide information and education to the general public, medical and legal professions on ‘transvestism’ and encourage research aimed at a fuller understanding. The organisation is now the UK’s largest and longest running support group for transgender people and their families.

In the wake of the Stonewall Riots in New York in June 1969 over the treatment of the LGBT community by the police the UK Gay Liberation Front was founded (GLF) in 1970. The GLF fought for the rights of LGBT people, urging them to question the mainstream institutions in UK society which led to their oppression. The GLF protested in solidarity with other oppressed groups and organised the very first Pride march in 1972 which is now an annual event.

Gay Liberation Front Manifesto

When the GLF disbanded in late 1973 the Campaign for Homosexual Equality (CHE), based in Manchester, led the fight for equality by legal reform. Age of consent equality however, did not come until 2001 in England, Scotland and Wales, and 2009 in Northern Ireland.

The fight for sexual equality however, was far from over. Section 28 of the Local Government Act 1988, introduced by the Conservative Government under Margaret Thatcher, banned local authorities from ‘promoting homosexuality’ or ‘pretended family relationships’, and prohibited councils from funding educational materials and projects perceived to 'promote homosexuality'. The legislation prevented the discussion of LGBT issues and stopped pupils getting the support they needed. Section 28 was repealed in 2003, and Prime Minister David Cameron apologised for the legislation in 2009.

In 2004 the Civil Partnership Act 2004 allowed same-sex couples to legally enter into binding partnerships, similar to marriage. The subsequent Marriage (Same-Sex Couples) Act 2013 then went further, allowing same-sex couples in England and Wales to marry; Scotland followed suit with the Marriage and Civil Partnership (Scotland) Act 2014. Northern Ireland enactment the Northern Ireland (Executive Formation etc) Act 2019, making same-sex marriage legal on 13 January 2020.

The Gender Recognition Act 2004, which came into effect on 4 April 2005, gave trans people full legal recognition of their gender, allowing them to acquire a new birth certificate – although gender options are limited to ‘male’ or ‘female’. Between July and October 2018 the UK Government consulted the public on reforming the Act. As of 1 September 2020 no report from the consultation has been published.

The Equality Act 2010 gave LGBT employees protections from discrimination, harassment and victimisation at work. The legislation brought together existing legislation and added protections for trans workers, solidifying rights granted by the Gender Recognition Act.

The LGBT community continues to fight for equality and social acceptance.

The idea of human rights rests on the central premise that all humans are equal. It follows that all humans have dignity and all humans should be treated as equal. Anything that undermines that dignity is a violation, for it violates the principle of equality and paves the way for discrimination. 

The human rights of lesbian, gay, bisexual, transgender and intersex people (LGBTI) are coming into sharper focus around the world, with important advances in many countries in recent years, including the adoption of new legal protections. The preamble to the Indian Constitution mandates justice -- social, economic, and political equality of status -- for all. The right of equality before law and equal protection under the law is guaranteed in Articles 14 and 21 of the Constitution. In April 2014, the Supreme Court of India ruled in NALSA vs Union of India that the rights and freedoms of transgender people in India were protected under the Constitution; in September 2018, the Supreme Court also decriminalized adult consensual same-sex relationships in the Section 377 judgment review. These judgments are considered a landmark both in terms of their expansive reading of constitutional rights and in empowering LGBT persons. Both judgments mark an important moment for LGBT rights that not only reversed a relic of British imperial rule but also ordered that LGBT Indians be accorded all the protections of their constitution. This was a welcome victory, but it does not necessarily mean that LGBT people in India are fully free or perceived as equal among their fellow citizens. It underscores how much work remains to be done in India and the rest of the world to overturn antiquated and repressive anti-gay laws.

India is a vast and diverse country and attitudes towards this subject and experiences of LGBTI individuals vary vastly. The disparity between urban and rural India, language, caste, class and gender add further complexities to understanding this topic more fully. But what we do know is that India’s LGBT citizens are not a “minuscule minority”. They have a voice that is strong and refuses to be silent any longer in their efforts to reclaim equality.

So with the draconian Section 377 gone, what's the way forward?. Today we celebrate the International Day Against Homophobia and Transphobia. May 17 was specifically chosen to commemorate the World Health Organization’s decision in 1990 to declassify homosexuality as a mental disorder. This day has received official recognition from several states, international institutions as the European Parliament, and by countless local authorities. Most United Nations agencies also mark the occasion with specific events.

As a transwoman from India who was one of the original petitioners in the NALSA case, I can speak to how far we have come. But there is still much that remains to be done if the civil rights of LGBT persons in India are to be protected. We have the absolute and inalienable right to define ourselves in or own terms and in our own languages. We have the right to express ourselves and our identities without fear of violence or retribution. We are human beings, holders of human rights, and we need to recognized as such within the societies we live in.

Today, homosexuality and queer identities may be acceptable to more Indian youths than ever before, but within the boundaries of family, home and school, acceptance of their sexuality and freedom to openly express their gender choices still remain a constant struggle for LGBT (lesbian, gay, bisexual, transgender) people.

In urban India, where social media and corporate initiatives have created increasing awareness of LGBT rights, the scenario looks more upbeat for gay men than for transgender people or lesbian women. While urban LGBT voices that are heard through several online and real-world platforms form an important part of LGBT activism, these expose only a small part of the diverse challenges faced by the community.

Far away from gay pride parades, meet-ups and heated discussions on Twitter, families in rural India have their own ways of dealing with LGBT individuals. In some parts, secret honour killings are planned so that the only way for a young gay man to survive is to run away in the cover of the night to some city, with no money or social support.

In other parts, lesbian women are subjected to family-sanctioned corrective rapes, which are often perpetrated by their own family members. Vyjayanti Vasanta Mogli, a transwoman LGBT activist and public policy scholar at Tata Institute of Social Sciences, Hyderabad, who has openly spoken about her abuse at school, says that lesbian women and transmen in rural areas end up at the bottom of the hierarchy when it comes to basic human rights within the unit of family and village.

She invokes B.R. Ambedkar when talking of the rural socioeconomic environment. “Ambedkar thought of the village as a unit of violence and that is most true for LGBT issues," she says. “Village medics and babas often prescribe rape to cure lesbians of homosexuality. Refusal to marry brings more physical abuse. Stories of family acceptance that you see on TV and other media are more of an urban phenomenon."

Even in educated urban India, suicides by lesbian women make headlines every year. It comes as no surprise then that a tribunal recently ruled that the only danger to lesbians in India is from their own families.

The consequences of coming out

A recent study found that one of the major factors that results in the stigmatization of LGBT people is parental reaction towards homosexuality. The study goes on to conclude that most LGBT people are acceptable to family only if they agree to behave like heterosexuals.

Prince Manvendra Singh Gohil, whose story of coming out has been well-documented in the media over the past several years, now heads several initiatives to help LGBT people, including the Lakshya Trust that works for HIV/Aids prevention in the LGBT community. He says LGBT people must not get carried away by what they see in the media.

“It was for no small reason that I was in the closet for 41 years," he says. “I know of someone who got a sudden rush of inspiration from a TV programme and decided to come out to his family. It didn’t work. He lost his home, his job, everything. I always tell people to be fully aware of their own reality. Be financially prepared. Detach a bit from your family both emotionally and financially before you plan to take this step."

Anwesh Sahoo, Mr Gay India 2016, who came out to his family at the age of 16, has a different perspective: “I would not recommend waiting for the perfect time. Staying in the closet is a huge psychological burden. If you and your family have access to information, I suggest you do it whenever you feel strongly about your identity."

Mogli, however, cautions about the widespread practice of family members forcing LGBT people to undergo “corrective" therapy. She was forced to stay at a psychiatric ward for several months after she came out. The experience has also shaped her deep distrust of the medical community.

“The psychiatric ward was like a prison complete with high walls and electric fence where I was treated like a criminal," she recalls. “I was administered psychotic drugs which pushed me into depression and confusion. The doctor conducted torturous psychosexual experiments on me by forcing me to stay with other mentally ill women. She wanted to see how I reacted to their interaction and sexual advances. This same person has now changed her practice to make it easy for people to shop for therapies that are more in fashion now. I am not saying all doctors follow unethical practices, but LGBT people and their parents must know that there are doctors who follow trends just to adjust their current practices to what will get them more clients and money."

Sakshi Juneja, founder of Gaysi, an online space for LGBT people, says one can never plan enough. “You don’t owe it to anyone to come out. So, I would say take your own time and come out to only those you are comfortable with. Financial and emotional stability are must-haves before you communicate with your family. At the end of the day, family members want nothing more than a safe and secure future for you, so it helps if you don’t come out in a state of emotional or financial breakdown."

Parmesh Shahani, head of Godrej India Culture Lab and author of the book Gay Bombay, does not know a single person whose life turned for the worse after coming out, in the long term. “Though it is challenging, I am a strong advocate of people coming out. I know of so many families that have become much closer after people decided to come out. I would say seek help of a good resource group and an LGBT-friendly counsellor if you can. When you come out, you are only sharing who you are with others. You are not seeking their approval or acceptance. Be willing to give them the time they need to process, ask questions, and accept you.

Redefining the family and its role

In a society bound by a rigid set of social and cultural norms that dictate the terms and conditions of education, career and marriage, the lack of family support can prove to be a big blow to the mental and physical health of LGBT people. Isolation and pressure to conform often lead to depression, thoughts of suicide and psychosomatic diseases. Many of them prefer to move to another city to stay away from the immense pressure to marry and start a family.

Families that accept their identities put many restrictions in the way they choose to dress and interact with their partners. In the absence of family support, online groups and social media have offered accessible alternatives to form a community outside of family. Platforms like Gaysi and Gaylaxy, and publishers like Queer Ink have helped carve out spaces for LGBT people to interact, share and collaborate.

Dhrubo Jyoti, journalist and LGBT activist, says social media offered him a semblance of belonging right from this teenage days. Through a fake Facebook profile, he met and interacted with other queer people and found an avenue to express his fears and desires.

Juneja was motivated to start Gaysi because she felt the lack of space where LGBT people could share their experiences. “I wanted to create a platform where we could connect, where we could share our life stories. When I first started Gaysi, there were hardly any avenues for lesbian women to interact and reach out to each other."

Though the lack of parental support can potentially be debilitating, it doesn’t mean the sky has fallen, says Shahani. “I know many LGBT citizens who have formed alternative support groups, or family-like units, when their own families have been less supportive. Fortunately, in urban India, at least, we have strong LGBT associations and communities in most big cities, so people are never alone," he says.

But access to safe online spaces and support groups does not always compensate for the vacuum created by disapproval from family. Gohil says in the absence of family support, many LGBT people decide to succumb to the pressure to marry. "Many lesbian women come to me with requests to find a gay man who would be ready to put up with this show of marriage. That way they don’t have to worry about coming out or sexual abuse while satisfying their family’s obsession with marriage."

It is, according to Shahani, the fundamental responsibility of any parent to accept their children’s identity. “You are not doing your child a favour by accepting her or him. You are just fulfilling your responsibility. By accepting your child you are also helping create a better society that values diversity and accepts the uniqueness of people as they are," he says.

“A queer person has multiple struggles in all aspects of life," says Jyoti. “Parents can make their children’s lives much easier if they don’t add to these struggles. The fundamental problem is that parents have a hard time accepting their children as sexual beings. So, any talk of sexuality and sexual or gender identity is thwarted and wrapped in shame. This is where the guilt and confusion begins. If children ask uncomfortable questions, most parents hush and silence them. Parents need to learn to listen and let their children open up about difficult issues."

Popular TV shows such as Satyamev Jayate and The Tara Sharma Show have helped raise awareness among parents about LGBT issues. Jyoti says some of his friends simply asked their parents to watch the episode of Satyamev Jayate that focused on alternate sexualities instead of trying to explain everything on their own.

Sahoo says TV helped him through days when he was too young to understand all that he was going through. In the absence of open communication with his family, his role models included characters from Modern Family and actor Jim Parsons (who plays Sheldon Cooper in The Big Bang Theory). He adds that TV has the biggest reach when it comes to influencing both the elder and younger generations. “My interview with ETV Oriya, a regional channel, reached out to more people than anything I have ever presented or posted on social media or elsewhere. TV wins hands down in its reach."

Jyoti recollects being inspired by appearances of filmmaker Rituparno Ghosh on TV. “On a particular episode of a talk show, he held a long conversation with a person who had repeatedly mocked him about his mannerisms. Through the conversation, he made the person understand that though he could take all the mockery, there were other people with similar identities who could be deeply affected by such behaviour. That episode made a lasting impression on me. So yes, in addition to being a point of connection and inspiration, TV has the potential to affect attitudes across generations."

Considering TV and movies are accessible to even rural populations where social media has not yet penetrated, these could prove to be the most effective tools in redefining the roles and attitudes of families through programmes and stories that not only educate and enlighten but also relay LGBT experiences in authentic and varied voices.

Working with Gen Next

It is an encouraging sign that schools and colleges have begun to take up institutionally approved LGBT activism. Rohit Revi, one of the founders of Orenda, the gender and sexuality club at IIT Gandhinagar, says without LGBT activism in educational institutions, LGBT issues largely remain “untalkaboutable".

“Our broad agenda is to make LGBT students and their struggles visible. Invisibility is the first and biggest challenge that we need to take up," he says.

Though, theoretically, most educated citizens support alternative sexualities and gender identities, when it comes to day-to-day behaviour, there is an urgent need to change the ground reality. “Bridging the gap between academic knowledge and everyday experience means we need people to question stereotypes. Say, for example, the rampant telling of homophobic jokes. We need people to pause and ask what’s so funny about such an oppressive take. We need our allies to point out that such behaviour costs us our freedom and dignity. Creating a critical mass of such an aware group is an important part of on-campus activism," says Revi.

Juneja finds today’s youth open to listening and accepting alternative identities. She shares a recent experience where Gaysi conducted podcasts about bullying of LGBT people at school: “We got an overwhelming response. When I see students open up about such deeply personal issues, I know that change is taking root."

However, Mogli is vocal about going deeper into investigating how schools can play a more robust role in supporting LGBT issues. “Currently, our educational model is based on obedience to authority and unquestioned following of rules and regulations. This must change. We have to encourage our children to question and learn from debate. Children must be taught about their basic human rights and the tools available to protect those rights," she says.

“Secondly, they must know about legal frameworks and options to challenge these frameworks. I am not talking of heavy legalese but simple legal concepts," she says.

She adds that asking young people to take individual responsibility without talking of systemic change is futile. “You can’t say you are responsible for your life so you should work positively towards your own freedom of expression. We need to talk about Section 377. We need to talk about the new transgender bill, which the vast majority of transgender people find unacceptable. Families and individuals cannot change much as long as the system supports oppression of LGBT rights."

Gohil sums up the hope of the LGBT community when he says that once educational institutions become their allies throughout the country, future generations will have a better chance of living up to the ideals of equality.

“What better way than to prepare the future leaders of our country to believe in LGBT rights. Each time a school or college decides to participate in LGBT activism, we come closer to bridging the gap between reality and a truly inclusive society," he says.

Rashmi Patel is a freelance writer based in Melbourne. Her Twitter handle is @rashmi_patel.

Across the globe, women do more unpaid domestic work than men, and men spend more time on paid work. This gender division of labor is both the cause and the consequence of persistent gender inequalities. Men accumulate more economic resources and spend more time building up their human capital through gainful employment than women do (Becker 1993; Kan 2014; Kan and Gershuny 2009). Understanding the trends and variations in the time that women and men spend on paid work and unpaid work across different societies is therefore key to devising policies to promote gender equality.

Time use researchers have argued that there have been a continual, albeit at different paces, convergence in women’s and men’s paid work and unpaid work time across different types of welfare regimes in advanced societies over last few decades (Altintas and Sullivan 2016; Kan, Sullivan, and Gershuny 2011; Sullivan, Gershuny, and Robinson 2018). At the same time, studies have reported that progress in gender equality in other domains of public and private spheres have slowed down or stalled in recent years (England 2010; England, Levine, and Mishel 2020). Recent cross-national time use research also finds that women and men have similar amounts of total work time (e.g., Sullivan, Gershuny, and Robinson 2018). Has the gender convergence in time use stalled or is it continuous? Do women and men really have an equal amount of total work? What are the roles of welfare policies and cultural contexts in trends of the gender division of labor? Past studies sought to answer these questions by using data and welfare policy typologies derived exclusively from Anglophone and European countries (e.g., Altintas and Sullivan 2016; Hook 2006, 2010; Kan, Sullivan, and Gershuny 2011; Sullivan, Gershuny, and Robinson 2018). What we have learned from past studies was hence based on theories, data, and assumptions derived from dominant Western cultural and historical backgrounds. We might have overlooked the significance of cultural and institutional factors and the possibility of alternative paths of gender constructions.

In this paper, we analyze time use data beyond the Western paradigm—from China, Japan, South Korea (hereafter Korea), and Taiwan—to revisit the gender revolution in paid work, unpaid work, and total work time. The East Asian societies mentioned above have experienced increases in education and job opportunities for women since the 1980s. They are also characterized by strong family ties and traditional gender ideologies. Our findings provide new insights into how cultural context may interact with institution and policy contexts to affect the pace and patterns of gender convergence in work time. By harmonizing and analyzing time diary data of working-age people in four East Asian countries (China, Japan, Korea, and Taiwan) and 12 Western countries (Austria, Canada, Denmark, Finland, France, Germany, Italy, the Netherlands, Norway, Spain, the United Kingdom, and the United States) from 1985 through 2016, we have found heterogeneity in gendered time use trends among East Asian societies and overwhelming evidence of stalled progress in the closing of gender gaps in paid work, unpaid work, and total work time across both East Asian and Western societies. The continuity of gender convergence in work time depends on the magnitude of the gender gaps, welfare policies, and cultural contexts. In particular, we have found that policies that depend on family ties and women’s traditional responsibility for care work hinder progress in gender equality. Furthermore, our findings are different from those of earlier studies and indicate that during the last three decades women have longer total work time than men across both East Asian and Western societies.

In what follows, we review relevant literature about welfare regimes in Western and East Asian societies, and gender and time use trends. We then present the hypotheses, followed by data and methods, findings, and conclusion.

Theoretical Background

Welfare Regimes in Western Countries

Existing research has classified welfare regimes in Western countries based on the state welfare provision, the level of social equity, and gender ideologies (e.g., Esping-Andersen 1990; Gauthier 1996; Sainsbury 1999). In non-interventionist Liberal regimes (the United Kingdom, the United States, and Canada), the state provides limited support toward the welfare of families and individuals. Social expenditure is relatively low, and welfare provision such as pensions and unemployment benefits depend on private insurance schemes. Women are expected to participate in labor market work as well as to fulfill the major domestic caring role. Childcare services are generally provided by the private market. In Conservative regimes (Austria, France, Germany, and the Netherlands), the state has a subsidiary role in the provision of social services and welfare. Social services are provided mainly through social insurance programs, which have joint contributions by the state and employers. A male breadwinner role and a female carer role are assumed in social policies, although there are also usually generous parental leave policies. In Social Democratic regimes (Denmark, Finland, and Norway), the state takes on an important role in offering services and benefits for the citizens. Social policies are devised to raise the employment rate of both women and men. High-quality public services for childcare and eldercare are provided. There are also fringe parental and paternal leave policies that aim to promote women’s participation in the labor market and a dual-earner model of the family. In Southern European regimes (Italy and Spain), social security systems are relatively less developed compared with other types of Western welfare regimes, and social policies are built on traditional family relations that reinforce gender inequalities. Childcare and eldercare rely on informal support provided by family networks.

Welfare Regimes in East Asian Societies

The welfare systems in China, Japan, Korea, and Taiwan were developed later than those of Western societies. Between the 1980s and the 2000s, the economy in the four East Asian countries were fast developing. Hence, these countries prioritized economic development over social policies (Choi 2012; Gough 2001; Holliday 2000; Y.-J. Lee and Ku 2007) and constrained the expansion and generosity of welfare systems (Jacobs 1998). In this period, the state invested relatively highly in health and education but provided relatively less in welfare, such as childcare and unemployment benefits.

The four East Asian regimes have both similarities and variations. As for common characteristics, the welfare systems are consistent with a Confucian ideology that emphasizes traditional gender responsibilities in the family (Sung and Pascall 2014). The traditional Confucian family model emphasizes strong family ties. Women are ascribed the caring and assisting role in the family. Men are expected to be the breadwinners and support the dependents in their households and extended families. These traditionally differentiated roles have resulted in a large gender gap in paid and unpaid activities in daily life (Brinton 2001; Cho 1998; S.-K. Kim 1997). Given its distinct communist history, political structure, and demographic policies, contemporary China stands apart from the other three East Asian societies, but the historical connection with the Confucian model remains strong (Raymo et al. 2015).

Yet in these East Asian countries, gender relations are changing. The female labor force participation rate has been climbing in all the East Asian countries except China, which has been characterized by a high level of female employment since the 1980s. Seventy-two percent of Chinese working-age women were in the labor market in the 1980s. Women’s labor market participation in China fell from as high as 77 percent for women ages 15 to 64 years in 2000 to 70 percent in 2010. In Japan, this rate grew from 54 percent in 1985 to 71 percent in 2018 for women ages 15 to 64 years. In Korea, the female labor force participation rate grew from 45 percent in 1985 to 59 percent in 2018 for women ages 15 to 64 years. In Taiwan, this rate rose from 44 percent in 1985 to 50 percent in 2010 (Organisation for Economic Co-operation and Development [OECD] 2021).

In the last three decades, the four East Asian countries have been transforming on different trajectories to deal with different social and demographic challenges. Among the East Asian societies in this study, Japan and Korea have a relatively longer history of welfare provision. Due to the strong emphasis on individual responsibilities for welfare in Japan and Korea, some scholars propose that the welfare regimes in these countries are similar to a non-interventionist Liberal model (Choi 2012). Japan has been suffering from economic downturns, soaring unemployment, and population aging since the 1990s. In Korea, the government worked closely with businesses and industries to develop the economy in the 1970s and the 1980s and endorsed a minimal welfare state. Like Japan, Korea has been encountering the problem of low birth rates and aging population. Since the 2010s, the Korean government has introduced a series of family policies such as paid parental leaves, subsidized childcare services, and flexible working to help women and men to balance work and life (E. J. Kim and Parish 2020). Public and social expenditure in Korea increased from five percent in 1990 to ten percent in 2012, but the figures were lower than the OECD average (OECD 2011; Sung and Pascall 2014). Yet some scholars have classified the welfare regimes in Korea and Japan as Conservative, given the fact that the governments in these countries work closely with businesses and corporations in providing social insurance and pension schemes; the result is a high degree of stratification among occupations and between the employed and the non-employed (Esping-Andersen 1990; Shizume, Kato, and Matsuda 2021). Another strand of research defines Korea and Japan as familialist countries like the Southern European regimes in Italy and Spain because of the strong emphasis on traditional family ties and social networks in their social policies (Estévez-Abe and Naldini 2016).

In Taiwan, the welfare system is market oriented, and minimal state support is assumed. There were no planned welfare policies for promoting gender equality or provide public care in Taiwan before the mid-1980s (Chiu and Wei 2011). Public preschool childcare was first introduced in 1986. Policies that promote gender equality in the labor market, such as flexible working hours and parental leave, were first introduced in 2001. Since 2010, the government has introduced several reforms in childcare provision, such as informal childcare subsidies and early childhood school vouchers (Chiu and Wei 2011).

In Korea, Japan, and Taiwan, the provision of welfare for care and family support has been increasing gradually in the last three decades. Yet public social expenditure in these three East Asian societies is still relatively low compared with Western countries (Estévez-Abe and Naldini 2016; Gauthier 2016; OECD 2011; Sung and Pascall 2014). For example, the total spending on family benefits (e.g., child allowances and income support during parental leave) in 2010 was the lowest in Korea, Japan, and Taiwan: The gross domestic product percentage contributed to family benefits was 0.43 in Taiwan, 0.90 in Korea, and 1.40 in Japan, compared with 2.65 in Scandinavian countries. But the figure in Southern European countries was also as low as 1.4 (Gauthier 2016; OECD 2011). In terms of family financial support spending, the figure was the lowest in Korea, followed by Japan, among OECD countries in 2010 (Gauthier 2016; OECD 2011).

China has a distinct socialist history. Before the 1980s, the state played a strong role in promoting gender equality in work and family. Since the 1980s, the state has led an economic reform effort and has retracted its role in mitigating women’s domestic responsibilities and enforcing gender equality in work (He and Zhou 2018; Ji et al. 2017). There has been a resurgence of the Confucian patriarchal traditions in the family and the workplace (Ji et al. 2017). The labor market participation rate of women has been declining and the gender wage gap has been increasing (Ji et al. 2017; Kan and He 2018). The economic reform in China has led to rapid economic development as well as serious social inequalities, especially between urban and rural areas. The family policies in China do not take gendered expectations in domestic labor and care into account (Ji et al. 2017). Consequently, women share the majority of domestic work and care (Ji et al. 2017; Kan and He 2018; Kan, He, and Wu 2021; Zhou, Kan, and He 2021).

In sum, welfare policies in the four East Asian societies have been developing and changing. They share common characteristics with the Western countries, as in the emphasis on family ties in the Southern European regimes. The East Asian societies share a Confucian ideology but are influenced by different political, population, and social factors. We analyze each of the East Asian societies separately rather than categorizing them into a single welfare regime cluster.

Gender, Time Use, and the Gender Revolution

Previous research has demonstrated a gradual convergence in women’s and men’s paid work time and unpaid work time in Western countries in the last four decades (for trends in European and Anglophone countries, see Altintas and Sullivan 2016; Kan, Sullivan, and Gershuny 2011; for the trend in the United States, see Bianchi et al. 2000; Sayer 2005; for the trend in Denmark, see Bonke and Jensen 2012). The convergence is largely a result of women doing more paid work and decreasing their unpaid workload. Men decrease their paid work and increase their unpaid work participation, but change in their contributions to different types of work is much smaller than the changes observed in women’s time use (England 2010; Kan, Sullivan, and Gershuny 2011).

Welfare policies influence the pace of gender convergence in paid and unpaid work. The pace of gender convergence in paid work and unpaid work time also varies according to welfare regimes (Kan, Sullivan, and Gershuny 2011) and social policies in relation to parental leave (Hook 2006, 2010).

The Gender Revolution Framework and the Multiple-Equilibrium Perspective

These findings are broadly consistent with the gender revolution framework that posits that gender equality in the division of labor will be achieved through two sequential stages (Goldscheider, Bernhardt, and Lappegård 2015). At the first stage, due to the expansion of higher education and increases in job opportunities, women increase their involvement in labor market work, and hence increase their paid work time and reduce their domestic work time. At the second stage, with broader diffusion of egalitarian gender ideology, men start participating more in domestic labor.

At the first stage of the gender revolution, women increase their labor market participation, and dual-earner families become more common. The departure from the traditional male-breadwinner/female-homemaker family model will lead to a diffusion of more egalitarian gender ideology in a society (Esping-Andersen and Billari 2015; Sullivan, Gershuny, and Robinson 2018). However, it will also cause conflicts in gender relations at home and will result in changes in family forms, including delayed marriages and fewer children (Lesthaeghe 2010; van De Kaa 2002; Zhou and Kan 2019).

Esping-Andersen and Billari (2015) propose the multiple-equilibrium perpective. They link the upheaval in family formation trends with diffusion of new gender norms, and postulate that more egalitarian gender relations will be adopted at home over time, as societies settle into a new equilibrium of gender-egalitarian family practices. However, societies may settle in varying levels of egalitarianism in gender expectations, depending on social norms and welfare policies. Having analyzed time use data from Denmark, the United Kingdom, and Spain, Esping-Andersen et al. (2013) suggest that gender relations have become egalitarian in both paid work and domestic work in Denmark; have remained gender traditional in Spain, with men being mainly responsible for paid work and women for domestic work; and have reached an “unstable equilibrium” in the United Kingdom, where traditional male-breadwinner families have declined but the domestic division of labor has remained gender unequal.

An underlying assumption of the gender revolution framework is that everyday family lives will shift toward more egalitarian gender practices. Women will do less housework and more paid work. Men will adapt to their new domestic role by taking on a more equal share of domestic work. Although the gender gap in domestic work is closing slowly, the changes focus mainly on non-routine, more gender-neutral types of domestic work, such as grocery shopping and gardening, rather than routine, traditionally feminine types of housework, such as cooking and cleaning (Altintas and Sullivan 2016; Kan, Sullivan, and Gershuny 2011). These findings imply that gender ideology plays a key role in the gender division of domestic labor and may impede progress in the closing of the gender gap in domestic work.

No studies so far have put East Asian time use trends into a comparative perspective to document the shifts in the gendered division of labor. This is an important omission because East Asian societies have long been characterized by a distinct pattern of family behaviors and gender attitudes. Attitudes toward the importance of women’s paid work compared with men’s remain considerably more conservative in China, Japan, and Korea than in other postindustrial European and Anglophone societies, including Southern European countries such as Italy and Spain (Inglehart et al. 2014). Moreover, East Asian societies score persistently low on gender equality (World Economic Forum 2020). The gap between women’s and men’s time spent on housework is large in Japan, Korea, China, and Taiwan (Hertog and Kan 2021; Kan and He 2018; Kan and Hertog 2017; Kan, Hertog, and Kolpashnikova 2019; Zhou, Kan, and He 2021).

Furthermore, research has highlighted stagnation in the progress toward more gender-egalitarian attitudes (e.g., see England 2010; England, Levine, and Mishel 2020; Knight and Brinton 2017 about the United States; see Y. Lee 2019 about Korea; see Piotrowski et al. 2019 about Japan). However, time use researchers report a more optimistic picture: There has been a continual decline in the proportion of women’s housework across welfare regimes in Western countries in the last four decades, although the pace of decline has slowed from the 2000s to 2010s (Altintas and Sullivan 2016; Sullivan, Gershuny, and Robinson 2018).

The gender revolution framework also overlooks the total work time of men and women. On the basis of qualitative interview findings on U.S. women, Hochschild (1989) suggests that increases in women’s involvement in paid work is coupled with a heavy workload in housework and care at home (a “second shift”), especially for mothers. Quantitative studies have different conclusions. Sayer (2005) examines paid work and domestic work time in the United States and reports that women have less free time than men. Other scholars, however, argue that men and women have roughly equal amounts of total work (Craig 2007; Sullivan, Gershuny, and Robinson 2018).



LGBTQIA+ immigrants face challenges when settling into U.S. society.

To protect queer migrants from harassment or assault, detention authorities often put them into solitary confinement, which can create mental health problems, Zdanowicz said.

According to a 2016 report by Human Rights Watch, some transgender women in U.S. detention facilities are denied access to medical care, including hormone replacement theory and HIV-related treatment.

Once released, an immigrant can face a daunting series of challenges before settling into society.

Founded in 2014, QDEP helps LGBTQIA+ detainees and undocumented individuals receive health, educational, legal and emotional assistance while addressing what it calls “state violence” against members of that community.

“Currently immigrants and refugees need the most help with reintegration into society and meeting basic needs,” said Zdanowicz, who said the U.S. government has “criminalized immigration.”

Last year, QDEP distributed $240,180 to 376 trans and queer immigrants living in New York City to help cover the cost of groceries, medication, utility bills, phone service, rent and mental health support.

Supporters take immigrants to doctor’s appointments, drive them to visits at detention centers and write letters of support to those in extended detention. QDEP has provided commissary funds and books to detainees at correctional facilities.

Helping transgender and queer immigrants with free legal aid

Paul White is an LGBTQIA+ immigrant held at a detention center in the state of Virginia since August of 2020. At one point, he spent more than three months in solitary confinement.

At a session hosted by the People’s Forum in Manhattan and supported by QDEP, participants wrote letters of support to White and spoke to him over the phone. QDEP has directed White towards legal assistance because, according to QDEP, he has faced retaliation from guards for speaking out against abuse.

Last year, QDEP helped 46 trans and queer immigrants in detention connect with free legal representation for asylum, parole and bond proceedings.

Also last year, QDEP ran its second Leadership Development Program teaching transgender women, cis-gender queer women and gender non-conforming immigrants how to defend immigrants’ rights.

Currently QDEP is focused on delivering groceries and medicine to members who require assistance. “QDEP wants to ensure members are not stressed about daily necessities on top of health issues because most members are immune-compromised,” Zdanowicz said.

A grassroots organization, QDEP strives to increase the public’s understanding of why the LGBTQIA+ community faces disadvantages. It tries to avoid a paternalistic approach often adopted by charities, whose donors and volunteers can see themselves as momentary saviors, by ensuring individuals in the LGBTQIA+ community are involved in strategy and activities.

As I looked more closely at QDEP’s work, my own perception of service started to change. I asked myself, “How can we engage in community service without the typical power dynamics?”

Perhaps in that subtle way, QDEP has helped spread a message of understanding beyond those in immigration detention.

THREE QUESTIONS TO CONSIDER:

1. Why can detention be most difficult for LGBTQIA+ immigrants?
2. What is one ostensible reason authorities in detention facilities offer to explain why LGBTQIA+ immigrants can be placed in solitary confinement?
3. What does the author mean by “power dynamics” at the end of the story?

Looks really nice, Ui feels fluid

What does the phrase “LGBT community” mean to you? Chances are if you don’t identify as lesbian, gay, bisexual or trans yourself, you might think about what you’ve seen on TV – so Queer as Folk, Orange is the New Black, or The L Word , to name a few TV hits. It might also bring to mind images of brightly coloured rainbow flags or Pride parades.

But just stop for a minute and think about how often you’ve heard someone talk about “the heterosexual community”? Rarely I imagine – but the term “LGBT community”, or sometimes “gay community”, is frequently used by pretty much everyone.

This might not sound like a big deal – after all it’s just a phrase used to identify a large group of people, right? But herein lies the problem, because after carrying out my latest research, which involved over 600 LGBT participants from across the UK, I’m not sure that community is a very suitable word for such a diverse group of people.

And as I explain in my new book, Exploring LGBT spaces and communities, the term “LGBT community” can be understood in many different ways, and can mean many different things to many different people.

A sense of place

In my research, people often said they experienced the “community” part of the phrase as an actual physical space. This could be a particular geographical area such as Brighton or San Francisco, or could relate to places frequented by LGBT people – such as bars and clubs – often referred to as “the scene”.

People I spoke to also reported experiencing this community aspect as part of a virtual space – such as online, or even in an imagined sense – in that LGBT people were thought to share “something”.

Gay disco: the heart of a community? Shuttertstock

People revealed how they often had fears or negative expectations of wider society. And that this is in part why they invest in the idea of an LGBT community – as somewhere where they could feel safe and understood.

But the term does not capture differences and complexities of experience. It can also wrongly suggest some form of shared experience, which for some people can be frustrating because it seems to ignore their experiences of inequality or discrimination within – or exclusion from – so-called “LGBT community”.

LGBT and beyond

Then there is also the issue of the acronym “LGBT” itself, as it excludes a lot of people – such as those who identify as queer or intersex. And it was clear in my research that some people feel less welcomed within this acronym. Even those who do feature within these four letters – notably bisexual and trans people – can often feel marginalised by lesbian and gay people, and like that they don’t really belong to such a “community”.

People also spoke about their quest to find this “community” – with many trying and failing to discover such a thing. The idea of an LGBT community suggests that people who identify in this way should feel part of something. If they don’t it can compound negative experiences.

Not everyone’s experience of sexuality or gender is the same. Shutterstock

Many participants in my research also talked about experiencing discrimination from other LGBT people relating to their age, body, disability, ethnicity, faith, HIV status, or perceived social class. So although the phrase implies that LGBT people somehow automatically belong to a ready made community – this is simply not the case.

A group of people

It is clear then that community belonging is not a given just because people share a gender or sexual identity. And this is why the notion of “LGBT community” is problematic. As someone I interviewed argued:

The idea doesn’t exist, it’s a kind of big myth – a bit like saying there’s a brown-eyed community or a blonde community.

In this way, then, the use of the term “LGBT community” could alienate some people and even risks deterring LGBT (and other) people from engaging with services aimed specifically at them. As another participant said:

I find anyone who uses this language dubious and with doubtful intention.

This is not to say that we should abandon the phrase altogether, but often using “LGBT people” would be more accurate – and would not risk alienation felt by an already (at times) marginalised group of people.

I have been trying to figure out this problem for the longest time. Does rainbow really has seven colours?

Colours are seen when optical sensors in our retina sents signals according to the electromagnetic signals reflected off of objects. But when I look at the rainbow I only see three or four colours. So what is the meaning behind it. Am I colour blind! A wise man once said 'you can't see it because you can't accept the fact that it is there'. Am I turning my eyes off the actual reality before my eyes. This was my speculation for a long time until I became a college student and learnt more about nature of light. This opened the gates to a whole new world of realisation. It made me open my eyes and see the whole picture more clearly. And yeah rainbow really has 7 colours.

WILL RUSSIA GO NUCLEAR?

Putin threatened in a February 24 speech that anyone standing in the way of his plans for Ukraine would face consequences “such as you have never seen in your entire history.”

When he said two days later that he was putting Russia’s deterrence force on “high alert,” he was referring to one that includes nuclear weapons.

The United States responded by trying to lower tensions, saying it would not change its stance of not sending troops to the fight. But even with his non-nuclear weapons, Putin can cause massive destruction.

Worse, people who study Putin believe the risk of his using nuclear weapons is real. Check out the Bulletin of the Atomic Scientists here, and its historic Doomsday Clock.

HOW CAN I GET RELIABLE UPDATES, HOUR BY HOUR?

My favorite source of news is still Reuters, where I first started working as a foreign correspondent in 1993. At the time of writing, the international news agency is keeping a timeline of events, including military deployments, maps that illustrate the territories of the countries immediately affected and imposition of sanctions against Russia.

WHERE CAN I GO TO DEBUNK MISINFORMATION I SEE ON SOCIAL MEDIA?

Many major news organizations are now in the business of debunking misinformation and disinformation because there is just so much of it and it is so damaging – even without a war.

One great source is snopes.com. Another is Reuters Fact Check.

If you want to learn in more detail about how scientists are studying disinformation, a great place to look is the Observatory on Social Media at Indiana University, where I work. Just following the Twitter feed on the center’s homepage will teach you a lot. You can also try out the center’s tools to learn how to visualize the spread of disinformation for yourself.

WHAT IS THE IMPACT BEYOND UKRAINE?

As in all wars, the biggest impact is on civilians. More than half a million refugees have fled to neighboring countries like Poland, Hungary, Romania and Moldova. You can find updates on the refugee crisis by following Filippo Grandi, the UN High Commissioner for Refugees, on Twitter @FilippoGrandi or here.

One way we know the crisis is having a lasting impact is by looking at groundbreaking decisions being made elsewhere. Germany, for example, has overturned its post-World War Two policy of not sending lethal weapons into warzones.

“We cannot leave Ukraine defenseless against the aggressor who is bringing death and devastation to this country,” Annalena Baerbock, Germany’s foreign minister, said. “If our world is different, then our politics must be different as well.”

The European Union has sent weapons into a conflict zone for the first time in its history.

Switzerland, meanwhile, has dropped its centuries-old stance of neutrality. You can read more about what that meant in this BBC travel article from 2017.

WHAT ARE THE POSSIBLE OUTCOMES?

Putin has shown that if he cannot control the whole of Ukraine, he at least wants to destabilize it. Ukrainian leaders say their future is in a democratic Europe and that they will defend their country from Russian invaders with their lives.

At the time of writing, the 50-km long Russian military convoy reportedly advancing on Kyiv raises the specter of a prolonged and deadly siege. Ukraine is accusing Putin of committing war crimes, and the International Criminal Court’s chief prosecutor said on Monday that it was opening an investigation.

We are experiencing now a kind of world war, involving Europe, the United States and other countries and engaging both the United Nations Security Council and a rare invocation of the UN General Assembly, even if we are very far from the immense loss of life of the World War Two years, devastatingly visualized in this video.

WHAT CAN I DO?

Give money, if you can, to responsible organizations helping refugees on the ground, such as those listed here by Yale historian Tim Snyder. Support and subscribe to news outlets that are providing independent and high-quality information where you live. Take a break from the news from time to time. Hug the ones you love.

QUESTIONS TO CONSIDER:

1. Do you think Russia had good reasons to invade Ukraine?
2. What do you think your government should be doing about Russia’s invasion of Ukraine? Your community? You?
3. What do you think about the fact that so far, the international community has not imposed a no-fly zone over Ukraine to prevent attacks from the air, as the Ukrainians have requested?

INTRODUCTION

Gender refers to “the array of socially constructed roles and relationships, personality traits, attitudes, behaviours, values, relative power and influence that society ascribes to the two sexes on a differential basis. Gender is relational—gender roles and characteristics do not exist in isolation, but are defined in relation to one another and through the relationships between women and men, girls and boys” (1). Simply put, sex refers to biological differences, whereas gender refers to social differences.

In the last decade, a considerable amount of research has been conducted in the area of gender and health, including gender differences in vulnerability to, and the impact of, specific health conditions. Gender has been shown to influence how health policies are conceived and implemented, how biomedical and contraceptive technologies are developed, and how the health system responds to male and female clients (2).

Gender analysis in health has been undertaken mainly by social scientists who observed that biological differences alone cannot adequately explain health behaviour. Health outcomes also depend upon social and economic factors that, in turn, are influenced by cultural and political conditions in society. To understand health and illness, both sex and gender must be taken into account.

This paper builds upon a gender framework from the field of tropical diseases (3) by examining to what extent the framework applies equally to non-communicable diseases. The framework includes the social, economic and personal/biological determinants and consequences of tropical diseases and analyzes how gender interacts with these factors to produce different outcomes for males and females. For example, the gender differences in the social determinants of tropical diseases include the different roles of men and women in the household, status within the household and community, and cultural norms affecting risks of infection. These factors influence exposure of women and men to diseases such as malaria because men are more likely to be exposed to mosquitoes in certain work environments such as forestry or mining (3). The gender differences in the consequences of tropical diseases include how illness is experienced, treatment-seeking behaviour, nature of treatment, and care and support received from the family and care providers. In the case of HIV-associated disease, for instance, the economic consequences may be worse for women who are left with families to support when husbands become infected and die, or they may not be able to earn income or support their families when they themselves are ill.

Whereas this framework previously was limited only to developing countries where tropical diseases are mainly found, this paper expands the analysis to include industrialized countries as well. The paper brings together the findings of various studies to identify how gender interacts with the determinants and consequences of health and illness. Whereas previous research based on this framework was limited to developing countries, the present analysis demonstrates that gender has an important effect on the determinants and consequences of non-communicable diseases and conditions in both developing and industrialized countries. In each section of the paper, one example of a chronic disease or condition is provided to illustrate how the gender framework can be equally applied to developing and industrialized societies.

There is no systematic body of knowledge on gender and chronic diseases, although there is a considerable literature emerging on specific diseases such as those discussed in this paper. Based on research findings on gender, several hypotheses have been proposed. Verbrugge, for example, argued that gender differences are more pronounced for prolonged, mild conditions than for acute, life-threatening or severe ones (4). However, further research on specific diseases, including tropical infectious diseases, has added new findings that need to be taken into account. Charmaz notes the importance of examining gender differences in non-communicable diseases and that the experience of illness is strongly related to gender identities (5).

The following analysis, therefore, brings together two areas of investigation—tropical infectious diseases and chronic non-communicable diseases—by showing that the framework from tropical diseases also applies to chronic diseases. It also draws out conclusions regarding gender and chronic diseases by comparing the results of the various studies of different diseases or conditions.

RESULTS

Gender differences in determinants of health and illness

This section reviews evidence of gender differences in the social, economic and biological determinants of health and illness, focusing on three non-communic-able diseases or conditions: nutrition for social determinants, mental illness for economic determinants, and longevity for biological determinants.

Gender differences in social determinants of health and illness

Social factors, such as the degree to which women are excluded from schooling, or from participation in public life, affect their knowledge about health problems and how to prevent and treat them. The subordination of women by men, a phenomenon found in most countries, results in a distinction between roles of men and women and their separate assignment to domestic and public spheres. The degree of this subordination varies by country and geographical or cultural patterns within countries, however, in developing areas, it is most pronounced. In this section, the example of nutrition will demonstrate how gender has an important influence on the social determinants of food-consumption patterns and hence on health outcomes.

Several studies have shown the positive relationship among education of mothers, household autonomy, and the nutritional status of their children (6, 7). During the first 10 years of life, the energy and nutrient needs of girls and boys are the same. Yet, in some countries, especially in South Asia, men and boys often receive greater quantities of higher quality, nutritious food such as dairy products, because they will become the breadwinners (7–15). Das Gupta argued that depriving female children of food was an explicit strategy used by parents to achieve a small family size and desired composition (13). Studies from Latin America also found evidence of gender bias in food allocation in childhood (16–18) and, correspondingly, in healthcare allocation (19).

In developing countries, most studies show preferential food allocation to males over females. Nonetheless, some studies have found no sex differences in the nutritional status of girls and boys (20–22), and others have described differences only at certain times of the life-cycle. For example, research in rural Mexico found no nutritional differences between girls and boys in infancy or preschool, but school-going girls consumed less energy than boys. This was explained by the fact that girls are engaged in less physical activity as a result of culturally-prescribed sex roles rather than by sex bias in food allocation (23).

Studies from developing countries of gender differences in nutrition in adulthood argue that household power relations are closely linked to nutritional outcomes. In Zimbabwe, for example, when husbands had complete control over all decisions, women had significantly lower nutritional status than men (24). Similarly, female household heads had significantly better nutritional status, suggesting that decision-making power is strongly associated with access to and control over food resources. Access of women to cash-income was a positive determinant of their nutritional status. In rural Haiti, the differences in nutritional status for male and female caregivers were examined for children whose mothers were absent from home during the day. Those who were looked after by males, such as fathers, uncles, or older brothers, had poorer nutritional status than children who were cared for by females, such as grandmothers or sisters (25). Ethnographic research conducted by the authors revealed, however, that, while mothers told the interviewers that the father stayed home with the children, it is probable that the father was, in fact, absent most of the day working and that the children were cared for by the oldest child, sometimes as young as five years of age.

The involvement of both men and women in nutritional information and interventions is key to their successful implementation. Unfortunately, in most developing countries, women are selected for nutritional education because they are responsible for the preparation of meals. However, they often lack access to nutritional food because men generally make decisions about its production and purchase. Similarly, men may not provide nutritional food for their families because they have not received information about nutrition. The participation of both men and women is, therefore, fundamental to changing how decisions about food are made and food-consumption patterns and nutrition families (26). The study in rural Haiti referred to above also found positive outcomes through the formation of men's groups which received information on nutrition, health, and childcare. These men, in turn, were resources for education of the whole community (25).

The gender differences are also found in the social determinants of nutrition in industrialized countries, although their manifestations are different. For example, gender plays an important role in determining risk factors for eating disorders, which influence nutritional outcomes. The most common of these are anorexia nervosa, bulimia nervosa, and binge eating (BED) (27–28). The root causes are only partly understood. Biomedical and psychological theories include hormonal imbalance, malfunctioning of serotonin in the brain, genetic explanations, and emotional problems expressed by abnormal relationships with food. Sociocultural explanations include the emphasis placed on the ‘ideal’ female body shape in western society. Experts agree that a key factor is the desire to please others. These characteristics are linked to ‘negative femininity’—behaviours associated with passivity, dependence, unassertiveness, and low self-esteem. Dieting and bingeing may be used for improving body image and self-esteem. Concern with body image is particularly strong in adolescence where the differences in calcium intake and a more sedentary lifestyle are pronounced (29). Results of a study of 1,755 adolescents in the United States also showed that, during adolescence, intake of fruits and vegetables was generally low for both boys and girls and that their consumption was related to consciousness about controlling their weight (30). Among men, dieting and bingeing seem to be more common among gay men and sports competitors than in heterosexuals (31).