Abstract
Masculine identified Gay, Bisexual, Transgender, Queer, and Two-spirited (GBTQ2+) persons are at significant risk of mental health problems such as depression and suicidal ideation because of the combination of discrimination, lower social support, internalized oppression, and varying degrees of alignment with traditional masculinities. This project plans to utilize both quantitative and qualitative research methods to: 1) develop and implement a survey that may determine the most effective tools to identify depression among GBTQ2+ men in population-based survey methods; and 2) engage a small group of GBTQ2+ men with depression in a focus group to explore the impact of masculinities on their mental health.
Background
Current commonly used survey tools for depression fail to capture the heterogeneity of men’s depression and this is seriously affecting the ability of population-based research to identify the true burden of depression in men, and among groups of men strongly aligned with traditional conceptualizations of masculinity in particular (Oliffe & Phillips, 2008; Rice, Fallon, Aucote, & Möller-Leimkühler, 2013). Canadian population survey results suggest that men experience about half the burden of major depression (MD) and Lifetime Suicidal Ideation (LSI) compared to women; however, these data have been questioned by those studying men’s depression because the performative nature of masculinities may influence men’s presentation and reported accounts of depression (Brownhill, Wilhelm, Barclay, & Schmied, 2005; Kellett, 2017; Oliffe & Phillips, 2008; Spendelow, 2015). Perhaps the most compelling evidence to question these depressions statistics is that Canadian men die from suicide at approximately three times the rate of women, and suicide is the seventh leading cause of death in men (Statistics Canada, 2012, 2015). Since depression frequently precedes suicide, the incongruence of these results suggest that we may be failing to recognize the true burden of depressive illness among men in society. While several masculine depression scales demonstrate promise in identifying the “masked” form of depression among men (Magovcevic & Addis, 2008; Rice et al., 2013; Zierau, Bille, Rutz, & Bech, 2002), no previous studies have examined the effectiveness of these tools in terms of identifying depression in gay, bisexual, transgender, queer, and two-spirited (GBTQ2+) men. As these men may occupy marginalized masculinities in society, they may have varying degrees of investment in traditional hegemonic masculinities (Connell & Messerschmidt, 2005). Therefore, this study proposes to explore both traditional depression scales and masculine depression measures in terms of their effectiveness in identifying depression in these populations.
In an analysis of Canadian Community Health Survey data spanning 2009 to 2012, Kellett (2017) calculated the annual prevalence of major depression (MD) in gay men to be 12.5% (SD=2.36) while bisexual men demonstrated a rate of 10.2% (SD=2.80). These rates were at least double the 5.1% (SD=.25) reported among heterosexual men (Kellett, 2017). While these The rate of suicidal ideation and attempts among Canadian GBTQ2+ men is also shockingly high with 1 in 4 (25.1%, SD= 4.76) gay men and 23.8% (SD=6.06) of bisexual men reporting lifetime suicidal ideation, compared to 8.8% (SD=.41) of heterosexual men (Kellett, 2017). Among trans-persons, the burden of depression and suicide is even greater, since the Ontario based TRANS Pulse study identified that more than half of their trans-respondents had depressive symptoms consistent with clinical depression, and 43% had a history of attempting suicide (Bauer & Scheim, 2015). The results of the Canadian Trans Youth Survey for Alberta also identify mental health issues aa a key concern with nearly three-quarters of respondents reporting self-harm in the past year, 67% of younger youth and 63% of older youth reporting suicidal ideation in the past year, and 2 in 5 has attempting suicide (Wells et al., 2017). Research suggests that the lack of social support and exposure to discrimination represent significant predictors of poor mental health in GBTQ2+ populations (Bauer & Scheim, 2015; De Silva, McKenzie, Harpham, & Huttly, 2005; Irwin, Coleman, Fisher, & Marasco, 2014; Kellett, 2017; Wang, Cai, Qian, & Peng, 2014; Williams et al., 2017).
GBTQ2+ men occupying a socially marginalized masculine location are clearly a population at significant risk for depression and other mental health problems; therefore, there is an urgent need to find the best ways possible to not only identify depression in these populations, but also to develop treatment strategies that assist these men to contextualize and reconstruct their masculinity in a manner that assists them to cope with the discrimination and marginalization that they experience.
Team Members for this project include:
Peter Kellett MN (Population Nursing) PhD (Demography) RN – Primary Investigator
Marie Damgaard B.A. (Psychology and Philosophy), MEd. (Counselling Psychology) – Co-Investigator
Morgan Magnuson BN MPH RN – Team Member
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