Coming Out - The Occupational Impact For Gay Men

Dominican Scholar
Collected Faculty and Staff Scholarship Faculty and Staff Scholarship
2013
"Coming Out": The Occupational

Impact for Gay Men
Karen McCarthy
University College Cork, Ireland, [email protected]
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Recommended Citation
McCarthy, Karen, ""Coming Out": The Occupational Impact for Gay Men" (2013). Collected Faculty and Staff
Scholarship. 251.
https://scholar.dominican.edu/all-faculty/251
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"COMING OUT": THE
OCCUPATIONAL IMPACT FOR
GAY MEN
Dr. Karen McNulty, [email protected]
Co-Researchers: Katie Kisor, Kathleen Smith, Sarit Barlev, Miriam Ressler-Levy, Dr. Susan McNulty
“Out”line
 Occupation and sexual identity
 Coming out process
 Research findings
 Role of OT
Occupation and Identity
 Understanding Meaning (Williamson, 2000;

Jackson, 1995)
 Identity (Taylor, 1999; Jackson, 1995)
 Transition (Birkholtz, 1999)
Coming out process
 Historical background:
 DSM, WHO
 8% LGB, 3% Unsure (My World Survey, 2012)
 Heterosexism and Homophobia (homonegativism)

 The Coming out process
 not viewed as a single event but as a process that evolves
over time (Savin-Willaims, 1990; Troiden, 1988)
 acceptance of one’s gayness as a positive aspect of self
(Kus, 1985)
 Strategic Outness (Williamson, 2000)
Research in OT
 “Coming Out” and it’s impact on women’s occupational behaviour- a

discussion paper (Birkholtz & Blair, 1999)
 “My Secret Life”: The emergence of one gay man’s authentic identity
(Walsh & Crepeau, 1998)
 Football and tin cans: A model of identity formation based on sexual
orientation expressed through engagement in occupations
(Williamson, 2000)
 Sexual orientation: It’s relevance to Occupational Science and the
practice of Occupational Therapy. (Jackson, 1995);
 Understanding the experience of noninclusive Occupational Therapy
clinics: Lesbians’ perspectives (Jackson, 2000)
 Sexual identity and human occupation: A qualitative exploration.
(Devine & Nolan, 2007)
Research methods
 Qualitative study
 Phenomenological approach
 Semi-structured interviews, approx. 1 hour each
 Participants:
 Seven men in their 20’s who self-identified as gay
 Experienced some of the process of coming out
 Los Angeles and San Diego area
 Purposive and snowball sampling

Research findings
 Theme 1: Hidden Identity
 Motivations to hide identity:
 External Pressures from Family,
Religious and Societal Values
 The art of hiding their identity:
 Using occupations and “impression
management” (Goffman, 1959)
 Effects of hiding their identity:
Mental health implications
Research Findings
 Theme 2: Social Support
 Friends
 Family members
 Media
 Gay support Groups

Research Findings
 Theme 3: Freedom to Explore Occupations
 New occupations-
 self care, leisure, sexual activity, substance use
 Environment shift
Summary of findings
In the Closet:
Environment (heterosexism, homophobia)
Increased Fear
Hidden Identity and use of occupations to stay in the closet
Possible mental health concerns
Coming Out:
finding support, freedom to explore new occupations, and a
change of environment
Perception of Healthcare providers
Mayock et al, 2009
 76.9% felt healthcare providers need to have more
knowledge and sensitivity to LGBT issues
 Healthcare providers typically presumed that their
patients were heterosexual, leading to reluctance on the
part of respondents to disclose their LGBT identity
 Healthcare providers were only aware of respondents
LGB identity in 44% of cases
 Only 40% felt respected as an LGBT person by their
healthcare provider
 45% of respondents actively seek out LGBT-friendly
healthcare professionals because of bad experiences
they had with providers in the past
Role of OT
 Communication with healthcare provider

 Power of language
 OT Intervention:
 Holistic Care
 Worlds of meaning– (Jackson, 1995)
 Clinical Reasoning
 Coming out as a process, strategic outness (Orne, 2011)
 Advocacy:
“Occupational therapy is the art and science of enabling engagement
in everyday living, through occupation; of enabling people to perform
the occupations that foster health and well-being; and of enabling a
just and inclusive society so that all people may participate to their
potential in the daily occupations of life” (Townsend& Polatajko,
2007, p. 372).
References
 Birkholtz, M. & Blair, S. (1999). ‘Coming out’ and its impact on women's occupational behaviour ‐ a discussion paper, Journal of Occupational Science,
6:2, 68-74.
 Devine, R. & Nolan, C. (2007). Sexual Identity & Human Occupation: A Qualitative Exploration, Journal of Occupational Science, 14:3, 154-161.
 Flowers, P. & Buston, K. (2001). ‘I was terrified of being different’: exploring gay men’s accounts of growing-up in a heterosexist society. Journal of
Adolescence, 24(1), 51-65.
 Goffman, E. (1959). The presentation of self in everyday life. Garden Ciry, NY: Doubleday
 Jackson, J. (1995). Sexual orientation: Its relevance to occupational science and the practice of occupational therapy. American Journal of Occupational
Therapy: 49(7)|, 669-679.
 Jackson, J. (2000). Understanding the experience of noninclusive occupational therapy clinics: Lesbians’ perspectives. American Journal of Occupational
Therapy, 54, 26–35.
 Kus, R. (1985). Stages of coming out: an ethnographic approach. Western Journal of Nursing Research 7(2), 177-198.
 Mayock, P., Bryan, A., Carr, N., Kitching, K. ( 2010 ). Supporting LGBT Lives: A Study of the Mental Health and Well-being of Lesbian, Gay, Bisexual
and Transgender People.
 Orne, J. (2011). You will always have to “out” yourself: Reconsidering coming out through strategic outness. Sexualities. 14: 681-703.
 Rosario, M., Hunter, J., Maguen, S. Gwadz, M. & Smith, R. (2001). The coming-out process and its adaptational and health-related associations among
gay, lesbian, and bisexual youths: Stipulation and exploration of a model. American Journal of Community Psychology, 29 (1), 133-160.
 Taylor, B. (1999 ). ‘Coming out’ as a life transition: homosexual identity formation and its implications for health care practice. Journal of Advanced
Nursing, 30(2), 520-525.
 Troiden, R.R.,(1989). The formation of homosexual identities. Journal of Homosexuality, 17(1), 43-73.
 Walsh, A. & Crepeau, E. (1998). “My secret life”: The emergence of one gay man’s authentic identity. American Journal of Occupational Therapy, 55
(7), 563-569.
 Williamson, P. (2000). Football and tin cans: A model of identity formation based on sexual orientation expressed through engagement in occupations.
British Journal of Occupational Therapy, 63(9), 432–439.
Resources
 Glen.ie : Gay and Lesbian Equality Network
(Resources- Mental Health and Well Being)
 Supporting LBBT lives: Key Findings Report
 Guide to practice for health care professionals
 HSE report: Look After Yourself, Look After Your Mental

Health
 Older persons: Visible Lives
 Lgbt.ie; National LGBT Helpline: 1890 929 539

 Belongto.org
Discussion Questions
 What is the role of OT when someone is coming out?
 How does coming out impact occupations social, leisure ,
school, work)?
 Can OT work specifically with LGBT population? Or
how can knowledge of coming out influence traditional
OT practice areas?
 Is there a need for a guide for OT in working with LGBT
population?
 How can OT address heterosexism/ homophobia and
advocate for LGBT population?
Thank you! Questions?

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Dominican Scholar

Collected Faculty and Staff Scholarship Faculty and Staff Scholarship

"Coming Out": The Occupational

Survey: Let us know how this paper benefits you.

 Understanding Meaning (Williamson, 2000;

 Heterosexism and Homophobia (homonegativism)

 “Coming Out” and it’s impact on women’s occupational behaviour- a

 Los Angeles and San Diego area

 Purposive and snowball sampling

 Gay support Groups

 Communication with healthcare provider

 HSE report: Look After Yourself, Look After Your Mental

 Lgbt.ie; National LGBT Helpline: 1890 929 539

Thank you! Questions?

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