Social support is an important resource that can help reduce stressful situations or buffer the impact of stressful situations for LGBTQ+ individuals. Many definitions of social support exist, but researchers often focus on emotional, informational, or practical support provided to a person. Social support is communicated by people close to a person as well as through institutional practices and policies and in communities. General trends around the world show increasing support for sexual-minority individuals—and to a lesser extent gender-minority individuals—but there are many countries still hostile to LGBTQ+ individuals. A number of individual-level and country-level variables are related to positive attitudes toward LGBTQ+ individuals.
Social support is operationalized in many ways in quantitative research on LGBTQ+ individuals, usually used as a predictor of health outcomes. Some quantitative measures look at general social support, whereas others study social support within particular settings, or very specific ways in which support is communicated. Measures of social support specific to LGBTQ+ populations have been developed, such as The Gay and Lesbian Acceptance and Support Index. Research also looks at support at the community level—the broader community (often referred to as community climate) as well as LGBTQ+ communities. Qualitative research is valuable for exploring what social support means to various groups and for understanding how different social identities interact with each other.
Many factors influence expectations and experiences of social support; thus, research should be contextualized. Rather than studying LGBTQ+ as a group, subgroups can be studied, along with intersectional research. When this is carried out, unique findings can appear. For example, lesbians in adulthood can include ex-partners and ex-lovers in their social support networks, and Black lesbian parents describe complex ways in which they interact with their families and religious communities. Different life course changes such as same-sex marriage and LGBTQ+ parenting provide opportunities to explore if and how social support is communicated to LGBTQ+ individuals. Who support is received from is also a key area of interest—families of origin, chosen families, friends, work colleagues, LGBTQ+ communities and broader communities, and so on. Later-life circumstances of LGBTQ+ individuals need focus, as these individuals often have smaller social support networks due to lifetime discrimination and cumulative life course experiences. Political situations involving elevated anti-gay rhetoric are also relevant contexts in which to study how social support can ameliorate minority stress. Research is starting to look at social support in formal organizations, many of which have developed guidelines for developing inclusive environments for sexual- and gender-minority groups.
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Social Support and LGBTQ+ Individuals and Communities
Áine M. Humble
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Minority Stress and Relationships
Robert Carroll
Minority stress for the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) and African American communities has been well documented over the past 30 years. Generally speaking, being a member of a stigmatized community can lead to alienation from social structures, norms, and institutions, all of which can have negative implications for mental health, well-being, and relationships.
When speaking about minority stress and its impact on LGBTQ+ relationships, the research is mixed. Although there are findings that show LGBTQ+ individuals face greater discrimination and more negative health impacts than heterosexual couples, other research notes the positive coping mechanisms that highlight the resilient nature of these couples. For African Americans and other racial minorities, the disparities are greater, with research showing that racial identity is linked to an increase in overall external stressors.
However, over the last few years, discrimination toward sexual and racial minorities has reached a critical tipping point. Both within the United States and worldwide, social movements are drawing attention to the historical inequalities experienced by minority groups, and demanding change. Considering minority stress research, methods, and analyses are built on the connection between an individual and their social situations, the construct is due for an evolution, one that is representative of what our world looks like today. Although conceptualizations thus far have been productive in understanding the stressors of the LGBTQ+ and African American communities, there is a need to incorporate critical concepts of intersectionality and expand understanding of what it means to be a member of a minority group.
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Queer Healthcare Communication
Nicole Hudak
Queer healthcare communication spans different literature and topic areas. The medicalization of queer bodies has historically and continues to influence how queer individuals interact and communicate within healthcare settings. Further, heterosexism is rampant within medical institutions that perpetuate the idea that all patients are heterosexual. Because of the influence of heterosexism, medical schools are designed to ignore queer bodies. If queer bodies are acknowledged, they are positioned as something exotic and not presented as a typical patient. Heterosexism is further communicated in patient and provider interactions by providers assuming their patients’ heterosexual identity and assuming all queer patients are promiscuous. In turn, queer patients may make decisions about their healthcare based on providers’ heterosexist attitudes. Providers who practice medicine have also demonstrated their limited knowledge about queer patients and how to care for them. The literature on discrimination of queer patients focuses more on how providers have used both verbal and non-verbal forms of communication. In looking at queer discrimination, queer invisibility demonstrates more covert functions of healthcare communication. Due to the invisibility of queer patients, disclosure becomes a site of interest for researchers. While some queer patients try to seek out queer-friendly providers, researchers have given recommendations on how healthcare providers can improve their queer competency. Finally, some notable topics within queer healthcare communication include queer pregnancy, HIV, and why transgender identity should be a separate topic as transgender people have their own healthcare needs.
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Sexual Orientation and Gender Identity Disclosure in the Medical Context
L. Brooke Friley and Maria K. Venetis
For individuals who identify as LGBTQ+, disclosing sexual orientation and/or gender identity can be a complex and risky conversation. However, in the medical context this conversation frequently becomes a central part of communication between patient and provider. Unfortunately, this conversation can also become a barrier that prevents patients from receiving or even accessing necessary medical care.
LGBTQ+ individuals have reported experiencing significant discrimination in day-to-day life, and more specifically in patient–provider interactions. This discrimination leads LGBTQ+ individuals to avoid seeking necessary medical care and also frequently results in unsatisfactory care and poor health outcomes. This is of concern as LGBTQ+ individuals present with significantly higher rates of health issues and overall higher risks of cancer, chronic illnesses, and mental health concerns.
Unfortunately, many medical providers are unequipped to properly care for LGBTQ+ patients and lack opportunities for education and training. This lack of experience leads many providers to operate medical offices that are unwelcoming or even inhospitable to LGBTQ+ patients, making it difficult for those patients to access inclusive care. This can be of particular concern when the patient’s sexual orientation or gender identity becomes relevant to their medical care, as they may feel uncomfortable sharing that information with a provider.
Patient self-disclosure of sexual orientation or gender identity to a medical provider not only can contribute to a more positive relationship and improved quality of care but also can improve the psychological outlook of an LGBTQ+ individual. However, potential stigmatization can lead to the concealment of sexual orientation or gender identity information. These acts of concealment serve as intentional mechanisms of impression management within the patient–provider interaction.
When LGBTQ+ patients do discuss their sexual orientation or gender identity with a provider, it is most often because the information is directly relevant to their health and disclosure, and therefore becomes essential and often forced. There are instances where LGBTQ+ patients are motivated to disclose to a provider who they believe will respond positively to information about their sexual orientation or gender identity.
Disclosure of sexual orientation or gender identity may be direct in that it is clear and concrete. It may also be indirect in that individuals may use particular topics, such as talking about their partner, to broach the subject. Participants may also use specific entry points in the conversation, such as during taking a medical history about medications, to disclose. Some individuals plan and rehearse their disclosure conversations, whereas others disclose when they feel they have no other choice in the interaction.
Increasing inclusivity on the part of providers and medical facilities is one way to promote comfortable disclosure of sexual orientation or gender identity. Additionally, updating the office environment and policies, as well as paperwork and confidentiality procedures, can also promote safe disclosure. Finally, improvements to training and education for healthcare professionals and office staff can dramatically improve interactions with LGBTQ+ patients. All of these efforts need to make integration of knowledge about how LGTBQ+ individuals can disclose comfortably and safely a central part of program design.
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African American Queer Cinema
Victor Evans
African American queer cinema was born as a reaction to the AIDS/HIV epidemic as well as the blatant homophobia that existed within the Black community in the 1980s. It began with the pioneering works of queer directors Isaac Julien and Marlon Riggs and continued during the new queer cinema movement in the 1990s, particularly including the works of lesbian queer director Cheryl Dunye. However, these works were infinitesimal compared to the queer works featuring primarily White lesbian, gay, bisexual, transgender, and queer (LGBTQ) protagonists during that time. That trend continues today as evidenced by looking at the highest-grossing LGBTQ films of all times: very few included any African American characters in significant roles. However, from the 1980s to the 2020s, there have been a few Black queer films that have penetrated the mainstream market and received critical acclaim, such as The Color Purple (Spielberg, 1982), Set It Off (Gary, 1996), and Moonlight (Jenkins, 2016), which won the 2018 Academy Award for Best Picture. The documentary film genre has been the most influential in exposing audiences to the experiences and voices within the African American queer communities. Since many of these films are not available for viewing at mainstream theaters, Black queer cinema is primarily accessed via various cable, video streaming, and on-demand services, like Netflix, Hulu, and HBO.
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Agonistic Queer TV Studies for Western Europe
Florian Vanlee
Queer TV studies have until now focused predominantly on U.S. TV culture, and research into representations of sexual and gender diversity in Western European, Asian, and Latin American programming has only recently found traction. Due to this U.S. focus, queer television in Western Europe has yet to be comprehensively documented in scholarly sources, and Western European queer television studies hardly constitute an emancipated practice. Given that U.S.-focused queer theories of television remain the primary frame of reference to study LGBT+ televisibility in Western Europe, but its domestic small screens comprise a decidedly different institutional context, it is at this time necessary to synthetically assess how the U.S. television industry has given way to specific logics in queer scholarship and whether these logics suit conditions found in domestic television cultures.
Queer analyses of U.S. TV programming rightly recognize the presence and form of non-heterosexual and non-cisgender characters and stories as a function of commerce; that is to say, television production in the United States must primarily be profitable, and whether or how the LGBT+ community is represented by popular entertainment is determined by economic factors. The recognition hereof pits queer scholars against the television industry, and the antagonistic approach it invites dissuades them from articulating how TV could do better for LGBT+ people rather than only critiquing what TV currently does wrong. While it is crucial to be attentive toward the power relations reflected and naturalized by television representations, it is also important to recognize that the discretion of prescriptive, normative interventions by queer TV scholars relates to conditions of U.S. television production.
The dominance of public service broadcasters (PSBs) and their historical role in spearheading LGBT+ televisibility highlights the distinctive conditions queer TV scholarship is situated in in Western Europe and troubles established modes of engaging the medium. Where the modest scale of national industries already facilitates more direct interaction between academics and TV professionals, PSBs are held to democratic responsibilities on diverse representation and have a history of involving scholars to address and substantiate their pluralistic mission. Consequently, Western European television cultures offer a space to conceive of an agonistic mode of queer TV scholarship, premised not only on contesting what is wrong but also on proposing what would be right. Hence, future engagements with domestic LGBT+ televisibility must look beyond established analytics and explore the value of articulating openly normative propositions about desirable ways of representing sexual and gender diversity.
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Brazilian Queer Cinema
João Nemi Neto
Brazilian cinema is born out of a desire for modernity. Moving images (movies) represented the newest technological innovation. Cinematographers brought to the growing cities of Brazil an idea—and ideal—of “civilization” and contemporaneousness. At the same time, queer identities started to gain visibility. Therefore, a possible historiography of cinema is also a potential for a historiography of queer identities.
Nonetheless, as a non-Anglo country and former colony of Portugal, Brazil presents its own vicissitudes both in the history of cinema and in queer historiography. To understand dissident identities in a peripherical culture (in relation to Europe), one must comprehend the ways ideas and concepts travel. Therefore, queer and intersectionality function as traveling theories (in Edward Said’s terms) for the understanding of a Brazilian queer cinema.
A critical perspective of the term “queer” and its repercussions in other cultures where English is not the first language is imperative for one to understand groundbreaking filmmakers who have depicted queer realities and identities on the Brazilian big screen throughout the 20th century and the first decades of the 21st century.
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Queer Comics
KC Councilor
Queer comics have been a staple of LGBTQIA+ culture, from independent and underground comics beginning in the late 1960s to web comics in the current digital age. Comics are a uniquely queer art form, as comics scholar Hillary Chute has argued, consistently marginalized in the art world. Queer comics have also principally been produced by and for queer audiences, with mainstream recognition not being their primary goal. This marginalization has, in some sense, been a benefit, as these comics have not been captive to the pressures of capitalist aesthetics. This makes queer comics a rich historical archive for understanding queer life and queer communities. Collections of queer comics from the late 1960s and onward have recently been published, making large archives of work widely available. The Queer Zine Archive Project online also houses a large volume of underground and self-published material.
There are some affordances inherent to the medium of comics which make it a distinctly powerful medium for queer self-expression and representation. In comics, the passage of time is represented through the space of the page, which makes complex expressions of queer temporality possible. The form is also quite intimate, particularly hand-drawn comics, which retain their original form rather than being translated into type. The reader plays a significant role in the construction of meaning in comics, as what happens between panels in the “gutter” (and is thus not pictured) is as much a part of the story as what is pictured within the panels. In addition to the value of reading queer stories in comic form, incorporating making comics and other creative practices into pedagogy is a powerful way to engage in queer worldmaking.
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Queer Safer Sex Communication
Kami Kosenko
Although communication scholars have been exploring the role of partner communication in sexual health promotion since the 1960s, the term safer sex, and its corollary safer sex communication, emerged in the late 1980s in the wake of the HIV/AIDS epidemic, which was and still is disproportionately affecting queer individuals. Numerous studies, along with some meta-analyses, point to the protective potential of safer sex discussions, defined here as the communicative management of health concerns with sex partners. Despite scholarly agreement regarding its importance, the term safer sex communication has received little explication, and much of what is known about it comes from studies with predominantly heterosexual samples. A review of the literature on queer safer sex communication points to some key issues related to age, race, trauma history, place, and pre-exposure prophylaxis (PrEP), and suggests important considerations for future research efforts.
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Sexual Satisfaction in LGB Relationships
Madeleine Redlick Holland
Sexual satisfaction plays an important role in the mental, physical, emotional, and relational lives of all individuals of all sexual orientations. However, the study of sexual satisfaction among lesbian, gay, and bisexual (LGB) individuals has been hampered by a number of conceptual and methodological shortcomings. Research on sexual satisfaction has largely been conducted among individuals in mixed-gender relationships, thereby developing and utilizing measures that are heteronormative, penis–vagina focused, and centered on monogamy. Although conceptualizations and operationalizations of sexual satisfaction in the lives of LGB individuals have been imperfect, some key findings related to this construct can be drawn from the literature. Sexual satisfaction is directly related to relationship satisfaction and quality of communication, and inversely related to homonegativity. It varies by relationship arrangements, commitment levels, living arrangements, individual difference variables (such as age, socioeconomic status, and religious affiliation), and sexual orientation. Research on sexual satisfaction can continue to grow by searching for core elements of sexual satisfaction that might be stable across all orientations, incorporating insights from both quantitative and qualitative methods, and being mindful of traditionally excluded populations, such as individuals who are lesbian, gay, or bisexual.
