“My perspective is that gay male culture and identity is a subject for thick description and interpretation, not surveillance,” Hammack said. “Researchers become better advocates for gay men’s individual and collective well being when they understand the intentional world gay men have constructed to navigate stigma, subordination and contamination.”
Gay men’s health is closely linked to the era in which they were born and raised and which generation of gay they belong to, says an associate professor in psychology at the University of California, Santa Cruz.
“How gay men think about themselves, their bodies and their desires is a product of social and historical time,” Phillip Hammack told the ninth annual BC Gay Men’s Health Summit in his keynote address on Nov 8.
Hammack says the health and wellness of gay men is tied both to the historical time in which they came of age and to the experiences they shared with their generational peers at the time.
In their examination of scientific papers about gay men’s health in peer-reviewed academic journals, Hammack and his colleagues discovered that nearly 70 percent of the 84 studies published or in press this year are primarily concerned with HIV and sexual risk behaviour associated with HIV transmission. Only six studies, he said, focus on gay men’s mental or physical well-being apart from HIV.
“There are numerous other health and mental-health concerns about which we have basically insufficient data with regard to prevalence,” he said. “But we know they certainly affect gay men. These include minority stress processes such as victimization and harassment, stigma, experiences and expectations, internalized homophobia and the effects of these processes on the body, including problems like heart disease.”
Hammack argued that the lives of individuals, including gay men, are inseparable from larger historic events and trends, and defined five generations of gay men who are alive today.
Gay men of the stigma generation were born in the 1930s and experienced adulthood in the early years of the gay civil rights movement prior to the “tipping point” of the movement, as symbolized by the 1969 Stonewall riots in New York. Hammack said these men, now in their 70s and 80s, witnessed the transformation of gay identity from a diagnosable mental illness to a legitimate social identity.
“They’ve been witness to the entire AIDS epidemic and, of course, lost many to the disease, but they have survived,” he said. “They carry with them the psychological and physical legacy of these experiences. They navigated cultural stigma, the hostility of health and mental health practitioners.
“They are our gay elders and we hear their voices far too little from my perspective.”
Hammack said that members of the Stonewall generation, who were born in the 1940s and are today in their 60s and 70s, benefited from experiencing gay liberation in their early adulthood.
“Unlike the members of the stigma generation, they experienced a longer period of their life course free from stigma and, in fact, criminalization of gay sex,” he said. “But also, like the stigma generation, they experienced the devastation of AIDS and the major setbacks to the movement that it brought with it, as well as a complete reframing of gay culture.
“You think gay sexual liberation in the 1970s and then AIDS, and then this generation has to basically make a huge cognitive shift in what gay sex actually means or is about and what kinds of practices they can engage in.”
Hammack described gay men who were born in the 1950s and 1960s as the AIDS 1 generation because they were “probably the hardest hit by AIDS, given that they were at the peak of their sexually active lives when it was emerging.”
He noted that some of the major stories of this generation were told in the 2011 documentary film We Were Here, which chronicles the early days of the AIDS epidemic in San Francisco. “As one of those interviewed for the documentary film We Were Here indicates, it was like living in a war zone for this generation, with outwardly healthy and attractive men in their 20s and 30s falling ill and dying in a matter of weeks.”
Hammack placed himself and other gay men born in the 1970s in the AIDS 2 generation. He said members of this group experienced childhood and adolescence at a time when the AIDS epidemic was often conflated with gay sex, disease and death. They did not, however, experience the same personal losses as members of the AIDS 1 generation.
“So we grew up in a time when we worried enough about AIDS to certainly be vigilant about condom use,” he said. “We saw the internet emerge to open up entirely new possibilities to ourselves and the next generation. And we saw the emergence of treatment advances that gradually transformed our collective consciousness of HIV/AIDS from a lethal illness to a chronic, manageable health condition.”
He said the AIDS 2 generation witnessed the discourse shift from AIDS to issues such as marriage equality and human rights protections. “So now, approaching mid-life, we no longer see our life course as inevitably abbreviated,” he said. “We are not sentenced to a premature death. Members of my generation are finally starting to realize we may actually live to an older age. This could happen!”
Hammack said members of the post-AIDS or marriage equality generation, born in the 1980s and ’90s, are now growing up in a “radically different” social and political context than members of the AIDS 1 generation.
“They are the first generation to now experience their same-sex desires absent the same fear of AIDS that consumed members of my generation when we were beginning to have sex,” he said, noting they are coming of age as gay rights and visibility reach unprecedented heights.
“But we’re only beginning to hear the voices of men of this generation on their own terms rather than through the lens of paradigms constructed with gay men of prior generations,” he added.
Hammack’s presentation was based on an emerging research project that examines the generational patterns and differences in identity, minority stress and health. The study is being conducted in collaboration with Ilan Meyer, of the University of California at Los Angeles, who delivered a keynote presentation on the link between homophobia and the physical and mental health of queer people at the 2011 summit, as well as scholars from Columbia University, the University of Arizona and the University of California, San Francisco.