Black LGBT Health in the United States by Follins Lourdes Dolores; Lassiter Jonathan Mathias; Abreu Roberto L

Author:Follins, Lourdes Dolores; Lassiter, Jonathan Mathias; Abreu, Roberto L.
Language: eng
Format: epub
Publisher: Lexington Books

Chapter 8

Status Quo

Intersectionality Theory, Afrocentric Paradigms, and Meeting the Healthcare Needs of Gay and Bisexual African American Men

Dante’ D. Bryant

Gay and bisexual African American men occupy a unique space within the American healthcare system. On the one hand, as racial and sexual minorities, they are more likely than European American men, regardless of sexual orientation, to experience issues related to suicide, substance abuse, co-occurring disorders, and HIV/AIDS infection and mortality (Centers for Disease Control and Prevention [CDC], 2014; Feldman, 2010; Fleming & Karon, 2002; Institute of Medicine [IOM], 2011; Millet, Peterson, Wolitski, & Stall, 2006; O’Donnell, Meyer, & Schwartz, 2011). On the other hand, gay and bisexual African American men are less likely than European American heterosexuals to access healthcare resources, receive adequate care, report positive experiences with healthcare practitioners, or exhibit positive healthcare outcomes (Komaromy et al., 1996; Phillips & Malone, 2016; Smedley, Stith, & Nelson, 200). Although there is a growing body of medical research that explores the access to care, quality of care experiences, and healthcare outcomes of gay and bisexual African American men, it has largely focused on a series of variables (e.g., economic barriers, social practices, cultural differences, sexual orientation) that are external to the healthcare system (Commission on Social Determinants of Health, 2008; Williams & Purdie-Vaughns, 2016). Researchers such as Cole (2009) have argued that the tendency to focus on individual variables may be attributed to each field’s—particularly psychiatry and psychology—desire to simplify models for the sake of parsimony (Betancourt & López, 1993; Silverstein, 2006).

Although this particular approach offers significant insights into the various problems confronting these communities, it lacks the complexity necessary to resolve them. In addition, limiting the conversation to variables which are external to the healthcare system reinforces current biased and inequitable healthcare practices and reinforces the status quo. In an effort to develop a more comprehensive understanding of the healthcare challenges confronting gay and bisexual African American men, researchers must also examine the actual healthcare system. More specifically, there is a need to investigate the relationship between our healthcare system’s ideological assumptions of health, the historical treatment of African Americans as patients, and their cumulative impact on the healthcare outcomes for gay and bisexual African American men. In an effort to address this gap in the literature, the following chapter examines how these varying aspects of the healthcare system intersect and inform the treatment, healthcare experiences, and health outcomes of gay and bisexual African American men. To accomplish this task, Intersectionality Theory (IT) and Afrocentric paradigms are applied in an effort to identify and promote a more comprehensive, culturally appropriate response to the healthcare needs of gay and bisexual African American men.

This chapter is divided into four sections. Section 1: Setting the stage, explores the healthcare system’s ideological assumptions and historical treatment of African Americans and sexual minorities. Section 2: Theoretical Overview, provides a brief description of IT and Afrocentric paradigms. Section 3: Analysis, examines the relationship between social identifiers, the historical treatment of African Americans and sexual minorities, treatment practices, and healthcare experiences and outcomes for gay and bisexual African American men.

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