Chemsex, Identity and Sexual Health among Gay and Bisexual Men
Abstract
:1. Introduction
- To examine both the potential motivations of gay and bisexual men who engage in this practice and its possible health consequences;
- To identify protective factors that may limit the risk of engagement in problematic chemsex.
2. Method
3. Social, Cultural and Media Representations of Chemsex
4. Public Health Approaches to Health Behavior
5. The Significance of Identity
- Assimilation-accommodation refers to the absorption of novel stimuli in the identity structure and the subsequent changes that occur within that structure to accommodate its assimilation. For instance, a gay man who learns that he is HIV-positive may absorb knowledge of his new HIV status into his identity and this may also precipitate structural changes, such as the attenuation of his family identity as an avoidance strategy especially if his family is unaccepting [9]. This can be attributed to the shame that may accompany the diagnosis, especially on HIV status disclosure.
- Evaluation refers to the meaning and value that the individual appends to identity elements, that is, pre-existing identity content as well as the newly assimilated-accommodated elements. For instance, HIV does not mean the same thing to everyone—for some, it is negatively evaluated to the extent where it may not even be acknowledged while, for others, it may be construed as a positive life event that precipitated favorable changes in one’s life [37]. To that extent, the evaluation process is subjective and will, in part, depend on the social representations (that is, versions of social reality) to which the individual is exposed and which the individual actually accepts and internalizes [38].
- Self-esteem refers to one’s personal and social worth, that is, the extent to which one values oneself and feels valued by others. Self-esteem is an important principle of identity that affects many spheres of life, including perceptions of oneself and others, decision-making and behavior. However, research shows that self-esteem is not necessarily a “prime” principle for everybody as it operates in conjunction with the other identity principles to produce a positive sense of self [39]. There is evidence that gay and bisexual men experience challenges to their self-esteem due to stressors associated with their sexuality [40]. Moreover, stigma research, for example, [41], would lead us to hypothesize that engagement in stigmatized behaviors, such as chemsex, may also undermine a person’s self-esteem.
- Distinctiveness reflects the perception that one is sufficiently differentiated from other people and that this differentiation is positively evaluated. Two key points should be made in relation to distinctiveness. First, it is possible to feel negatively distinctive, which indeed arises on the basis of a stigmatized identity element (e.g., one’s sexuality, HIV status, chemsex participation). This would not satisfy the distinctiveness principle and would in fact probably also damage a person’s sense of self-esteem. Second, it has been noted that achieving a sense of acceptance and inclusion in valued social groups (or a sense of belonging) is also an important psychological need. Thus, an “excessive” sense of distinctiveness would not satisfy the need for belonging. This balancing of distinctiveness and belonging is at the heart of the optimal distinctiveness theory [42]. Hickson [43] notes that engagement in chemsex may constitute a rejection of the normalization of homosexuality in mainstream society and, thus, provide a sense of distinctiveness.
- Continuity refers to the psychological thread that an individual establishes between their past, present and future amid inevitable personal and social change. Despite this change, the individual must continue to believe that a factor or set of factors unify their past, present and future. This will often be a major identity element, such as a particular group membership, personality trait, or physical characteristic. Uncertainty about the future can easily undermine a person’s sense of continuity as they are no longer assured that their identity will remain temporally connected. For instance, while disclosure of one’s sexual identity is generally deemed to be psychologically beneficial, it can also represent a hazard to one’s sense of continuity [44]. After all, people do not always react positively to one’s coming out and, even if they do, the nature of one’s relationships may change—for better or for worse—potentially leading the individual to lose that crucial psychological thread between past, present and future.
- Self-efficacy is the perception of control and competence in one’s life. Crucially, this does not refer to any objective sense of efficacy in life but rather to the individual’s own appraisal of their efficacy. Self-efficacy is closely linked to self-esteem in that a person who feels in control of their life tends to derive greater self-worth and indeed a person with higher self-worth tends to have greater belief in their own efficacy [45,46]. In the context of chemsex, the perception that one can do things that one would not ordinarily feel able to do when sober may transiently enhance one’s sense of self-efficacy. Conversely, the inability to disengage from chemsex when one recognizes that this is hazardous to one’s social and psychological well-being may stimulate feelings of impotence in the same way that attempting, but failing, to quit smoking might [47].
6. Exposure to Stressors
7. Coping
7.1. Intrapsychic Strategies
7.2. Interpersonal Strategies
7.3. Intergroup Strategies
7.4. The Significance of Identity Resilience in Coping
8. Putting the Pieces Together: Stressors, Identity Threat and Coping
9. The Implications of Chemsex for Sexual Health
10. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
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Jaspal, R. Chemsex, Identity and Sexual Health among Gay and Bisexual Men. Int. J. Environ. Res. Public Health 2022, 19, 12124. https://doi.org/10.3390/ijerph191912124
Jaspal R. Chemsex, Identity and Sexual Health among Gay and Bisexual Men. International Journal of Environmental Research and Public Health. 2022; 19(19):12124. https://doi.org/10.3390/ijerph191912124
Chicago/Turabian StyleJaspal, Rusi. 2022. "Chemsex, Identity and Sexual Health among Gay and Bisexual Men" International Journal of Environmental Research and Public Health 19, no. 19: 12124. https://doi.org/10.3390/ijerph191912124