A+Picture+is+Worth+a+Thousand+Words

Tutor: Jey Rodgers
**The Artefact** This series of photos was created by a blogger as an appropriation of an United Nations (UN) ad campaign about gender inequality. This series of photographs consists of a portrait of a male and an Internet search bar. The search bar is shown to represent the "auto-complete" feature that is present in most popular Internet search engines, which returns search terms based on topics that are the most commonly searched worldwide. As a result, the images are supposed to reflect the multitude of negative views associated with those who identify as being gay.

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 * The original series of photos created by the United Nations. **

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 * The appropriation of the idea **

**The Public Health Issue** The choice of this artefact is aimed to bring attention to the abuse and discrimination that gay men face. As a result of the negative behaviour this minority typically encounters, studies have demonstrated that there are major disparities between gay men and their heterosexual counterparts. Major health issues include greater levels of mental health disorders, and greater levels of substance abuse, which all lead to poorer physical health status.The presence of these disparities is the reason why this is an important issue to cover.

** Literature review ** Many lesbian and gay individuals experience direct and indirect discrimination on the basis of sexuality or gender identity. In 2004, the data identified that 33% of same sex attracted young people reported experiencing unfair treatment, 44% experienced verbal abuse and 16% experienced physical abuse. Even though there is an emerging awareness of sexual orientation and gender identity as a key social determinant for health in international studies, this awareness has yet to be incorporated into mainstream health policy and the design and delivery of programs and services. Recently, researchers have returned to study mental health of LGB populations. Evidence from this research suggests that compared with their heterosexual counterparts, gay men suffer from more mental health problems including substance use disorders, affective disorders and suicide (Gilman et al., 2001).

In a review by Meyer (2003) it was concluded that lesbian and gay individuals had a higher prevalence of mental health disorders. The research identified that individuals attributed the development of certain disorders as a result of increased levels of stress from their social environments. D’Augelli et al. (2003) identified that a large number of LGB individuals reported either witnessing or experiencing victimisation in high school and as a result the individuals were less open to sharing their sexual orientation. High school victimisation was correlated with mental health symptoms in general and also with the further development of post traumatic stress symptoms. The more that individuals experienced harassment the higher the chances that they would develop internalised homophobia. This internalised homophobia increased the chances of personal Homonegativity, which was found to significantly increase stress and anxiety (Cochram, 2001).
 * Mental health **

Several decades of research has shown that LGB individuals are at a higher risk for substance use and substances use disorders (Centers for Disease Control and Prevention, 2010). Recent evidence suggests that many of these higher rates may have their origins in adolescence, identifying that on average lesbian and gay youth drug usage was 190% higher than heterosexual youth (Cochram, 2004). Lampinen et al. (2006) identified that there was a higher risk of reported “club” drug usage among gay and lesbian high school students compared to heterosexual students.
 * Substance abuse **

Factors such as verbal and physical harassment, negative experiences relating to “coming out” (including level of family acceptance), substance use, and isolation all contribute to higher rates of suicidal attempts and completions among gay men and youth compared to the rest of the population (Berg, Mimiaga & Safran, 2008). Results from an anonymous survey carried out in 33 health care sites across the United States showed that sexual orientation was associated with higher levels of emotional stress and other types of mental health disorders (Remafedi, 1991). A further study found that LGB individuals who were “out” experienced more emotional stress as teenagers and were 2 and 2.5 times more likely to experience suicidal ideation in the past 12 months. Meanwhile, those women who were not “out” were more likely to have attempted suicide than heterosexual women (Koh and Ross, 2006)
 * Suicide **

Researchers have attributed the high levels of substance abuse to the large influence bars and clubs have on LGBT culture. As a community these minorities have often found that bars and clubs were a safe haven from the abuse of the ignorant population. The result of gathering in such locations leads to higher chances that an individual would be exposed to illicit drugs and alcohol (Lampinen, et al, 2006). The high prevalence of mental disorders among LGB individuals can be attributed to the stressful social environments that are created by prejudice and discrimination (Meyer, 2003). These determinants and negative experiences all contribute to the increased prevalence of suicide and suicidal ideation among those that identify has being either gay or lesbian.
 * Explanation **

The majority of the research done was based on systematic reviews of past journals and results. This allowed for an objective analysis of the information. The conclusions drawn from these reviews were that lesbian and gay populations experienced much greater levels of mental health disorders, substance abuse and suicidal ideations compared to those of the heterosexual population. Structured interviews were also carried out in the research. The interviews were often anonymous to allow for effective subjective data to be collected. The results from these studies would again undergo meta-analysis. All studies would be compared to each other and thoroughly peer reviewed.
 * Methodologies **

The methodologies of the articles identified in this literature review had a few limitations. One of these limitations includes the fact that some of the meta-analyses was made of journal article studies conducted more than ten years ago, despite the review itself being published recently. This can be a limitation as the results of more recent generations may produce higher variation compared to those a decade ago. A limitation of some of the studies that used interviews or anonymous surveys is that some of the researchers stated that LGB individuals were more inclined to admit having experienced mental health issues compared to their heterosexual counterparts.
 * Limitations of the methodologies **

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**Cultural and Social Analysis** LGBT youths also experience heterosexism on a daily basis. That is the assumption that everyone is and should be heterosexual and that gender identity issues do not exist. The effect of such attitudes often reinforces feelings of guilt, social isolation, not being normal and the invisibility of LGBT peoples in the general community. This discrimination is the major contributor to the stress and anxiety that individuals experience from social environments. Homophobia is a form of heterosexism and may be found in many manners of people in society, heterosexual and homosexual. However, among the heterosexual population, homophobia contributes to the occurrence of moral panic.
 * Heterosexism **

Heteronormativity is a term that was made popular in 1991 to describe any of a set of lifestyle norms that hold that people fall into distinct and complementary genders (man and woman) with natural roles in life. It also makes the assumption that heterosexuality is the normal sexual orientation, and states that sexual and marital relations are most (or only) fitting between a man and a woman. Consequently, a heteronormative view is one that involves alignment of biological sex, sexuality, gender identity, and gender roles (Weiss, 2001). The impact of heteronormativity on the lesbian and gay communities is that it not only singles out those that do not fit what is considered the “standard”, but it causes LGBT individuals to grow up believing that there is only one way in which a person can start a family.
 * Heteronormativity **

As an individual grows up they constantly look to examples of how they could live their lives. For LGB individuals it is sometimes difficult to conceptualise a future because the individual’s ideals are not always accommodated by the examples portrayed in the media. As the media is a large form of exposure, what the media shows will always have large influences on an individual’s upbringing. The lack of exposure to homosexual content in the media results in many LGB individuals developing an internalised hatred for being different. The fact that most schools are based on heteronormative ideals means LGB individuals will always find it difficult to accept themselves for who they are in early stages of development. This internalised hatred leads to the development of a variety of mental health issues.

Heteronormative ideologies have a direct impact on how an LGB individual's mindset is formed. As a result of the internalised homophobia gay men have been reported as having a negative attitude to effeminate men. These individuals identify as being masculine and therefore believe that they are accepted in heteronomative society. This internalised dislike towards identifying as being homosexual causes individuals to discriminate against other gay men. As a result, effeminate gay men experience discrimination not only from certain heterosexual individuals, but from those that they thought were the same.

**Analysis of the artefact and your own learning reflections** The first time I came across this artefact I felt emotionally affected. It provoked feelings of sadness as well as annoyance. Reading through the text that was depicted in the search bars in the images reminded me that all of these issues would impact myself one day. These issues affected me because of how I choose to identify. I believe this is an effective artefact in promoting the awareness of LGBT discrimination because it is simple and socially relevant, with a clear message. These photos could easily be used as a form of advertisement to promote awareness. As a result of studying this topic, I believe I have learnt more about the origin of how lesbian and gay culture has developed over the years. I have been able to understand why so many people have a negative opinion towards the LGBT community.

This artefact has a large impact on myself as a result of past experiences. In the past I have experienced what it is like to feel rejected from society. I understand the feeling of isolation from friends and even family. The thoughts that there is nowhere a person like myself will fit. I attempted to learn more about LGBT communities and the culture, but never felt as though I fit them myself. As a result, I have spent several years attempting to live with the fact that I was not accepted and that I was different. These issues are difficult to live with, but year after year and also as a result studying this course, I feel as though there is always someone you can turn to for help.

**Reference list** Berg, M. B., Mimiaga, M. J., & Safren, S.A. (2008). Mental health concerns of gay and bisexual men seeking mental health services. Journal of Homosexuality, 54(3), 293–306.

Burgess, D., Tran, A., Lee, R., & Van Ryn, M. (2008). Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons. Journal of LGBT Health Research, 4(1), 43.

Bostwick, W.B., Boyd, C.J., et al. (2009). Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. American Journal of Public Health, 100(3), 468–475. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2820045/?tool=pubmed

Centers for Disease Control and Prevention. (2010). CDC fact sheet, substance abuse among gay and bisexual men. Retrieved from http://www.cdc.gov/msmhealth/substance-abuse.htm

Cochran, S. D. (2001). Emerging issues in research on lesbians’ and gay men’s mental health: Does sexual orientation really matter? American Psychologist, 56(1), 931–947.

Cochran, S. D., Ackerman, D., Mays, V. M., Ross, M. W. (2004) Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction, 99(1), 989–98.

Cochran, S. D., Mays, V. M., et al. (2007). Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults. Journal of Consulting and Clinical Psychology, 75(5), 785–794.

D'Augelli, A. R., Pilkington, N. W., Hershberger, S. L. (2002). Incidence and mental health impact of sexual orientation victimization of lesbian, gay, and bisexual youths in high school. School Psychology Quarterly, 17(2), 148-167. doi: 10.1521/scpq.17.2.148.20854

Evans, K. (1999). "“Are you married?”: Examining heteronormativity in schools". Multicultural perspectives, 1 (3), p. 7.

Gilman, S. E., Cochran, S. D., et al. (2001). Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. American Journal of Public Health, 91(6), 933–939.

Koh, A. S., & Ross, L. K. (2006). Mental health issues: A comparison of lesbian, bisexual and heterosexual women. Journal of Homosexuality, 51(1), 33–57.

Lampinen, T. M., McGhee, D. Martin, I. (2006). Increased risk of “club” drug use among gay and bisexual high school students in British Columbia. Journal of Adolescent Health, 38(4) 458-461.

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697. doi: 10.1037/0033-2909.129.5.674

<span style="font-family: Arial,Helvetica,sans-serif;">Ostrow, D. G., Stall, R. (2008). Alcohol, tobacco, and drug use among gay and bisexual men. In Wolitski, R. J., Stall, R., & Valdiserri, R. O., (Ed.) Unequal opportunity: Health disparities affecting gay and bisexual men in the United States. New York: Oxford University Press.

<span style="font-family: Arial,Helvetica,sans-serif;">Remafedi, G. (1991). Risk factors for attempted suicide in gay and bisexual youth. Pediatrics (Evanston), 87 (6), p. 869.

<span style="font-family: Arial,Helvetica,sans-serif;">Weiss. J. T, (2001). The Gender Caste System: Identity, Privacy, and Heteronormativity. Law of Sexuality, 123 (10) 123-182

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 * Reflection and Feedback**

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