Thursday, June 13, 2024
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New study examines the effect of discrimination on older gay Asian men

A new cross-sectional study explores discrimination, social acceptance, and its impact on the psychological well-being of older men who have sex with men in China, Taiwan, and Hong Kong.

The study, published with BMC Public Health, looks at the impact of discrimination and social acceptance on the psychological well-being of older men who have sex with men (MSM) as a critical area of study within the broader field of LGBTQ+ research. As we know, this demographic, situated in the older spectrum of the population, faces unique challenges that intersect age, sexual orientation, and societal attitudes.

Read the full report here.

A cross-sectional survey was administered among older MSM residing in the People’s Republic of China (PRC), Hong Kong, and Taiwan.

Findings showed that participants in the study had a moderate level of psychological distress , experienced discrimination in their everyday lives, and had a moderate level of perceived social acceptance. These results suggested that discrimination and social acceptance differ among older MSM in different areas in PRC, Hong Kong, and Taiwan.

This study showed that MSM had higher rates of anxiety, depression, and substance use disorders stemming from their fear of coming out.

Discrimination, prejudice, and stigma against individuals based on their sexual orientation can lead to social isolation, which is one of the significant contributors to poor mental health outcomes among this population. The impact of social isolation is even more profound among older men who have sex with men (MSM), as they may face additional barriers related to aging and related health concerns.

The current study seeks to fill the gap in available research by exploring the impact of social acceptance and isolation on the psychological well-being of older MSM. This study investigates the factors that contribute to social isolation and examine the impact of discrimination on the psychological well-being of this population. Understanding the barriers faced by older MSM can help identify effective strategies to address these challenges and promote positive mental and emotional well-being.

This study aimed to address the following research questions regarding older men who had sex with men MSM in Hong Kong, Taiwan, and PRC: to what extent did perceived discrimination correlate with psychological well-being; how did the level of social acceptance relate to psychological well-being; and what was the nature of the association between social isolation and psychological well-being? Grounded in these inquiries, our a priori hypotheses posited that heightened perceived discrimination would exhibit an inverse association with psychological well-being, while anticipating a positive correlation between social acceptance levels and psychological well-being in the specified regions. Moreover, we hypothesized that increased social isolation corresponded to poorer psychological well-being within this population across the designated geographical areas.

For the investigation into the association between social isolation and psychological well-being in Hong Kong, Taiwan, and PRC, logistic regression analysis was employed. In line with our a priori hypothesis, increased social isolation corresponded to poorer psychological well-being within the studied population across the designated geographical areas.

As part of the methodology, researchers collaborated with LGBTQ + Non-Governmental Organizations (NGOs) operating in Hong Kong, Taiwan, and the PRC. These organizations served as vital conduits for reaching potential participants, fostering community engagement, and ensuring a sensitive and respectful approach to recruitment.

The recruitment specifically targeted men aged 60 years and above, ensuring a focus on the unique experiences of older individuals within the MSM community. Eligible participants were required to self-report a history of engaging in sexual intercourse with males and possess the capability to provide written informed consent for their participation in the online questionnaire.

Findings suggested that higher levels of perceived social acceptance from sources such as the father and friends are associated with better psychological health. Family vary significantly across the three cities. Participants in Hong Kong have better general mental health compared to participants in PRC and Taiwan. Participants in Hong Kong appeared to experience less discrimination compared to participants in PRC and Taiwan.

These findings suggest that there are notable variations in psychological well-being, experiences of discrimination, and perceived acceptance among older MSM in different regions. The statistically significant differences underscore the importance of considering regional context and cultural factors when studying and addressing the mental health and well-being of this population. Further analysis and exploration could help shed light on the underlying reasons for these variations and guide the development of targeted interventions and support systems for older MSM in different regions.

The results indicated that age, marital status, mental illness, and economic activity status are significant predictors of the psychological well-being of older MSM, whereas religion, educational attainment, living, and personal income are not significant predictors.

The findings are consistent with prior research that has shown the negative effects of discrimination on the mental health of sexual minorities. It suggests that policies and interventions aimed at reducing discrimination and promoting acceptance of sexual minorities could have a significant positive impact on the psychological well-being of older MSM.


The study found that older MSM experience discrimination and lower levels of social acceptance, particularly in the PRC and Taiwan, which can lead to poor psychological well-being. Specifically, it found that the participants reported lower general health, higher levels of discrimination, and lower levels of perceived acceptance, particularly from family members. These findings suggest that discrimination and lack of social acceptance can contribute to social isolation and poor mental health among older MSM. It highlights the need for interventions aimed at reducing stigma and improving social acceptance and support for this vulnerable population. Health and social services should be tailored to meet the specific needs of older MSM, particularly in the areas of mental health and social isolation. Ultimately, creating a more inclusive and supportive environment for older MSM is crucial in promoting their well-being and quality of life.

It is crucial to understand the challenges faced by older MSM as they are a growing segment of the aging population, with estimates suggesting that the number of older adults who identify as LGBTQ + will double by 2030. Additionally, as the global population ages, it is essential to understand the unique challenges and barriers that older MSM face, which can negatively impact their physical and mental health.

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