Chronic illness in non-heterosexual contexts: towards a critical LGBTQ health psychology

In this thesis, I contribute to the expansion of lesbian, gay, bisexual, trans and queer (LGBTQ) psychology by examining chronic illness within non-heterosexual contexts. Chronic illness, beyond the confines of HIV/AIDS, has been a neglected topic in LGBTQ psychology and sexual identity is often overlooked within health psychology. When the health of lesbian, gay and bisexual (LGB) people has been considered there has been an over-reliance on quantitative methods and comparative approaches which seek to compare LGB people?s health to their heterosexual counterparts. In contrast, I adopt a critical perspective and qualitative methods to explore LGBTQ health. My research brings together ideas from LGBTQ psychology and critical health psychology to explore non-heterosexuals? experiences of chronic illness and the discursive contexts within which LGB people live with chronic health conditions. I also highlight the heteronormativity which pervades academic health psychology as well as the „lay? health literature. The research presented in this thesis draws on three different sources of qualitative data: a qualitative online questionnaire (n=190), an online discussion within a newsgroup for people with diabetes, and semi-structured interviews with 20 LGB people with diabetes. These data are analysed using critical realist forms of thematic analysis and discourse analysis. In the first analytic chapter (Chapter 3), I report the perspectives of LGB people living with many different chronic illnesses and how they felt their sexuality shapes their experiences of illness. In Chapter 4, I examine heterosexism within an online discussion and consider the ways in which sexuality is constructed as (ir)relevant to a diabetes support forum. In Chapter 5, I analyse LGB people?s talk about the support family and partners provide in relation to their diabetes and how they negotiate wider discourses of gender, sexuality and individualism. In Chapter 6 I explore how diabetes intersects with gay and bisexual men?s sex lives. In the concluding chapter, I discuss the contributions of my research for a critical LGBTQ health psychology and identify some possible areas for future research.

Chronic illness in non-heterosexual contexts: an online survey of experiences

In this article we contribute to the expansion of lesbian, gay, bisexual, transgender and queer (LGBTQ) health psychology beyond the confines of sexual health by examining the experiences of lesbian, gay and bisexual people living with non-HIV related chronic illness. Using a (predominantly) qualitative online survey, the perspectives of 190 LGB people with 52 different chronic illnesses from eight countries were collected. The five most commonly reported physical conditions were arthritis, hypertension, diabetes, asthma and chronic fatigue syndrome. Our analysis focuses on four themes within participants’ written comments: (1) ableism within LGBT communities; (2) isolation from LGBT communities and other LGB people living with chronic illness; (3)heteronormativity within sources of information and support and; (4) homophobia from healthcare professionals. We conclude by suggesting that LGBTQ psychology could usefully draw on critical health psychology principles and frameworks to explore non-heterosexual’s lived experiences of chronic illness, and also that there remains a need for specifically targeted support groups and services for LGB people with chronic illnesses.

Relationship status and identity construction in heterosexual women:A discourse analytic and personal construct study

This thesis reports the findings of three studies examining relationship status and identity construction in the talk of heterosexual women, from a feminist and social constructionist perspective. Semi-structured interviews were conducted with 12 women in study 1 and 13 women for study 2, between the ages of twenty and eighty-seven, discussing their experiences of relationships. All interviews were transcribed and analysed using discourse analysis, by hand and using the Nudist 6 program. The resulting themes create distinct age-related marital status expectations. Unmarried women were aware they had to marry by a ‘certain age’ or face a ‘lonely spinsterhood’. Through marriage women gained a socially accepted position associated with responsibility for others, self-sacrifice, a home-focused lifestyle and relational identification. Divorce was constructed as the consequence of personal faults and poor relationship care, reassuring the married of their own control over their status. Older unmarried women were constructed as deviant and pitiable, occupying social purgatory as a result of transgressing these valued conventions. Study 3 used repertory grid tasks, with 33 women, analysing transcripts and notes alongside numerical data using Web Grid II internet analysis tool, to produce principle components maps demonstrating the relationships between relationship terms and statuses. This study illuminated the consistency with which women of different ages and status saw marriage as their ideal living situation and outlined the domestic responsibilities associated. Spinsters and single-again women were defined primarily by their lack of marriage and by loneliness. This highlighted the devalued position of older unmarried women. The results of these studies indicated a consistent set of age-related expectations of relationship status, acknowledged by women and reinforced by their families and friends, which render many unmarried women deviant and fail to acknowledge the potential variety of women’s ways of living.

On the utility of alternative amino acid scripts

In this work we propose the hypothesis that replacing the current system of representing the chemical entities known as amino acids using Latin letters with one of several possible alternative symbolic representations will bring significant benefits to the human construction, modification, and analysis of multiple protein sequence alignments. We propose ways in which this might be done without prescribing the choice of actual scripts used. Specifically we propose and explore three ways to encode amino acid texts using novel symbolic alphabets free from precedents. Primary orthographic encoding is the direct substitution of a new alphabet for the standard, Latin-based amino acid code. Secondary encoding imposes static residue groupings onto the orthography of the alphabet by manipulating the shape and/or orientation of amino acid symbols. Tertiary encoding renders each residue as a composite symbol; each such symbol thus representing several alternative amino acid groupings simultaneously. We also propose that the use of a new group-focussed alphabet will free the colouring of amino acid residues often used as a tool to facilitate the representation or construction of multiple alignments for other purposes, possibly to indicate dynamic properties of an alignment such as position-wise residue conservation.

A 'sexy space' for women? Heterosexual women's experiences of a male strip show venue

The rise of male strip shows marketed towards heterosexual women has called into question the idea that only men can 'gaze' or be 'sexual scrutinizers' in public leisure spaces. This paper details the findings of an ethnographic study of a male strip event 'Cheeky's',1 located in the Midlands, England. Utilising observation, informal interviews and photography, the paper describes the physical environment and the atmosphere of the event, and analyses interview data with female customers. The paper questions what spaces such as Cheeky's mean for female sexualities, sexual roles and desires. The findings are twofold. On the one hand the club was a relatively novel sexual space, as some women spectators experienced it as an 'empowering' space in which they could be 'sexually aggressive'; on the other hand, the character of the club was actively and adeptly manufactured by the Master of Ceremonies (MC), and male dancers, so as to encourage - and even to coercively elicit - extrovert behaviour from women customers. Despite shifting normative gendered expectations of women's sexual behaviour to some extent, ultimately the club structured women's sexual experiences around traditional heterosexist lines. The club did not encourage women's autonomous sexual expression, and many women claimed they had not found it a very 'sexy space'. © 2011 Taylor & Francis.

Discourses of friendship between heterosexual women and gay men:mythical norms and an absence of desire

Gay men and heterosexual women may share some common interests in critiquing hetero-patriarchy. However feminism and gay liberationist politics do not always coincide and the role of individual subjectivities in recognising oppressive discourses of normativity remains debated. Interviews were conducted with seven friendship dyads of heterosexual women and gay men. Transcripts were subjected to discourse analysis, which suggested extensive management of heterosexist norms in the friends' accounts of friendship. The analysis highlighted ambiguity over the 'male' status of gay men, a concern with constructing the friendships as legitimately asexual, and the use of parody in the face of homophobia to disrupt normative assumptions. Although we primarily considered the role of heterosexist discourses, there is also evidence that other dimensions of non-normativity (for example, gender and ethnicity) are implicated in friendships constructed around shared otherness and mutual non-normativity. © 2010 SAGE.

Renegotiating sexual intimacy in the context of altered embodiment:the experiences of women with breast cancer and their male partners following mastectomy and reconstruction

OBJECTIVE: Breast cancer diagnosis and treatments can have a profound impact upon women's well-being, body image, and sexual functioning, but less is known about the relational context of their coping and the impact upon their intimate partners. Our study focuses upon couples' experiences of breast cancer surgery, and its impact on body image and sexual intimacy. METHOD: Utilizing a dyadic design, we conducted 8 semistructured individual interviews, with 4 long-term heterosexual couples, after the women had undergone mastectomy with reconstruction. Interviews explored both partners' experiences of diagnosis, decision-making, and experiences of body image and sexual intimacy. Interpretative phenomenological analysis (IPA) was adopted; this is a qualitative research approach characterized by in-depth analysis of the personal meaning of experiences. RESULTS: Findings illustrate the positive acceptance that partners may express toward their wives' postsurgical bodies. They illuminate ways in which gendered coping styles and normative sexual scripts may shape couples' negotiations of intimacy around "altered embodiment." Reciprocal communication styles were important for couples' coping. The management of expectations regarding breast reconstruction may also be helpful. CONCLUSIONS: The insights from the dyadic, multiple perspective design suggest that psychologists must situate the meaning of supportive relationships and other protective factors in the context of complex life events and histories, in order to understand and support people's developing responses to distress. (PsycINFO Database Record

Intergroup relations in action: questions asked about lesbian, gay and bisexual issues in diversity training

This paper focuses on the questions which heterosexual trainees ask about lesbian, gay and bisexual (LGB) experience within diversity training about LGB issues. Drawing on a data corpus of 162 questions asked by trainees in 13 tape-recorded training sessions, questions were coded into six categories: (1) general understanding questions; (2) questions about the trainer's life, experience and practices; (3) professional practice questions; (4) questions about lesbian and gay related legislation, policies and procedures; (5) questions about specific people and projects and (6) questions about the meanings, derivations and correct use of terms and symbols. Real questions are compared with the decontexualized questions (and answers to them) that are provided in training manuals and it is demonstrated that these questions differ markedly from how questions actually get asked and how they actually get answered. Recommendations are provided for improving training and the argument made for turning towards analyses of the real world in action, especially when considering intergroup relations. Copyright © 2008 John Wiley & Sons, Ltd.

Contraception and heterosex: an intimate relationship

Whilst the importance of contraception within heterosex has long been accepted, particularly in relation to the prevention of HIV/AIDS, the way in which the use, or non-use, of contraception re/constructs heterosexual encounters themselves has had far less attention. The embodied nature of both the risk of pregnancy, and most contraceptive technologies leads women to assert a right to bodily autonomy. Yet this assertion conflicts with their expectation of equitable coupledom within heterosexuality and their routine consideration of men’s preferences. This article will argue that the use of contraception is an intricate part of heterosexual practices, and shows how normative ideas about heterosexuality leave men as appearing as an absent presence within women’s contraceptive decisions.

Who are you sleeping with? The construction of heteronormativity in stories about sleep in British newspapers

In popular British understanding the terms 'sleeping' or 'slept' are often used to mean sex, and (hetero)sex is seen as crucial to sustaining intimate relationships. This study of UK newspapers coverage shows that stories about sieep and sleeping arrangements can be seen to (re)produce heteronormativity through focusing on the (heterosexual) 'marital bed'. The 'marital bed' is constructed as both the physical and symbolic centre of successful heterosexual relationships. Moreover, the maintenance of this symbolic space is gendered with women given primary responsibility. The focus on the 'marital bed' helps to exclude non-heterosexuals from the idea of intimate relationships, by effectively silencing their experiences of sleep and sleeping arrangements. Normative ideas about male and female (hetero)sexualities are drawn on to undermine women's right to refuse sex within the martial bed. In addition, the term 'sleep-sex' is used to reconceptualise stories of rape, minimising the victim's experiences and absolve the perpetrator from full responsibility for the assault. By exploring these articles we can see both how the representation of the organisation of sleep is produced through heteronormativity, as well as how heteronormativity determines whose accounts of sleeping are prioritised. © Sociological Research Online.

Surveying sexualities: Internet research with non-heterosexuals

In this article we describe and evaluate the process of conducting online survey research about the legal recognition of same-sex relationships (key findings from which we have reported elsewhere, see Harding and Peel, 2006). Our aim in so doing is to contribute to the growing generic literature on internet-based research methods (Nosek et al., 2002; Rhodes et al., 2003; Stern, 2003; Strickland et al., 2003; Thomas et al., 2000) to the research methods literature within lesbian, gay, bisexual, trans and queer (LGBTQ) psychologies (Fish, 2000; Morris and Rothblum, 1999; Meezan and Martin, 2003; Mustanski, 2001) and also to extend the germinal literature focusing on internet research with non-heterosexual groups (Elford et al., 2004; Ellis et al., 2003; Ross et al., 2000). We begin by discussing the process of developing the online survey tool, before outlining the experience of the survey ‘going live’ and providing details of who completed the survey. We conclude by exploring some of the positives and pitfalls of this type of research methodology.

Sex and diabetes:a thematic analysis of gay and bisexual men's accounts

Around 50 per cent of men with diabetes experience erectile dysfunction. Much of the literature focuses on quality of life measures with heterosexual men in monogamous relationships. This study explores gay and bisexual men's experiences of sex and diabetes. Thirteen interviews were analysed and three themes identified: erectile problems; other 'physical' problems; and disclosing diabetes to sexual partners. Findings highlight a range of sexual problems experienced by non-heterosexual men and the significance of the cultural and relational context in which they are situated. The personalized care promised by the UK government should acknowledge the diversity of sexual practices which might be affected by diabetes.

Pregnancy loss in lesbian and bisexual women: An online survey of experiences

Background: Although pregnancy loss is a distressing health event for many women, research typically equates women’s experiences of pregnancy loss to ‘married heterosexual women’s experiences of pregnancy loss’. The objective of this study was to explore lesbian and bisexual women’s experiences of miscarriage, stillbirth and neonatal death. Methods: This study analysed predominantly qualitative online survey data from 60 non-heterosexual, mostly lesbian, women from the UK, USA, Canada and Australia. All but one of the pregnancies was planned. Most respondents had physically experienced one early miscarriage during their first pregnancy, although a third had experienced multiple losses. Results: The analysis highlights three themes: processes and practices for conception; amplification of loss; and health care and heterosexism. Of the respondents, 84% conceived using donor sperm; most used various resources to plan conception and engaged in preconception health care. The experience of loss was amplified due to contextual factors and the investment respondents reported making in impending motherhood. Most felt that their loss(es) had made a ‘significant’/‘very significant’ impact on their lives. Many respondents experienced health care during their loss. Although the majority rated the overall standard of care as ‘good’/‘very good’/‘outstanding’, a minority reported experiencing heterosexism from health professionals. Conclusions: The implications for policy and practice are outlined. The main limitation was that the inflexibility of the methodology did not allow the specificities of women’s experiences to be probed further. It is suggested that both coupled and single non-heterosexual women should be made more visible in reproductive health and pregnancy loss research.

Mundane heterosexism: understanding incidents of the everyday

In this article, discourse analysis, combined with lesbian feminist politics, are used to explore subtle forms of heterosexism in language, a social phenomenon that I have termed "mundane heterosexism," because of its everyday nature. Drawing on feminist understandings of subtle sexism and discursive psychology I analyse three forms of mundane heterosexism derived from (predominantly) tape-recorded antiheterosexism training session data: (1) prejudice against the heterosexual, (2) nonheterosexuality as a deficit and (3) refusing diversity. Two levels for challenging mundane heterosexism are discussed. interactional counterarguments, and broader societal campaigns. I conclude by advocating the necessity of further detailed analyses of the construction of mundane heterosexism, and stress the importance of heterosexism for feminist research. © 2001 Elsevier Science Ltd. All rights reserved.

Queer enough? Contested terrains of identity deployment in the context of gay and lesbian public activism in Poland

Gay and lesbian prides and marches are of crucial relevance to the way in which non-heterosexual lives are imagined internationally despite regional and national differences. Quite often, these events are connected not only with increased activist mobilisation, but also with great controversy, which is the case of Poland, where gay and lesbian marches have been attacked by right-wing protesters and cancelled by right-wing city authorities on a number of occasions. Overall, the scholars analysing these events have largely focused on the macro-context of the marches, paying less attention to the movement actors behind these events. The contribution of this thesis lies not only in filling a gap when it comes to research on sexual minorities in Eastern Europe/Poland, but also in its focus on micro-level movement processes and engagement with theories of collective identity and citizenship. Furthermore, this thesis challenges the inscription of Eastern European/Polish movements into the narrative of victimhood and delayed development when compared to LGBT movements in the Global North. This thesis is grounded in qualitative research including participant observation of public activist events as well as forty semi-structured interviews with the key organisers of gay and lesbian marches in Warsaw, Poznan and Krakow between 2001 and 2007, and five of these interviews were further accompanied by photo-elicitation (self-directed photography) methods. Starting from the processes whereby from 2001 onwards, marches, pride parades and demonstrations became the most visible and contested activity of the Polish lesbian and gay movement, this thesis examines how the activists redefined the meanings of citizenship in the post-transformation context, by incorporating the theme of sexual minorities' rights. Using Bernstein's (1997, 2002, 2005, 2008) concept of identity deployment, I show how and when movement actors use identity tactically, depending on their goals. Specifically, in the context of movement-media interactions, I examine the ways in which the activists use marches to challenge the negative representations of sexual minorities in Poland. I also broaden Bernstein's framework to include the discussion of emotion work as relevant to public LGBT activism in Poland. Later, I discuss how the emotions of protests allowed the activists to inscribe their efforts into the "revolutionary" narrative of the Polish Solidarity movement and by extension, the frame of citizenship. Finally, this thesis engages with the dilemmas of identity deployment strategies, and seeks to problematise the dichotomy between identity-based gay and lesbian assimilationist strategies and the anti-identity queer politics.