Health Education Research, Vol. 15, No. 1, 97-107, February 2000
© 2000 Oxford University Press
School of Behavioural Studies, Nene University College Northampton, Park Campus, Boughton Green Road, Northampton NN2 7AL, UK
This paper investigates the concept of internalized homophobia in both theory and research relating to lesbian and gay health. It offers a contemporary and critical review of research in this area, and discusses a range of recent findings relating to a range of health issues including HIV and AIDS. Whilst the concept has a resonance for gay men and lesbians, and is widely used in `lesbian and gay-affirmative' interventions, the paper demonstrates that research findings have been equivocal and the term is often used without full consideration of its sociopolitical consequences. The paper concludes that the concept does have a valuable role to play in health promotion work with lesbians and gay men but invites further discussion and examination of the construct.
This paper aims to present both an overview and critical evaluation of the usefulness of the concept of internalized homophobia1 in explaining health difficulties affecting lesbians and gay men. It has been argued by a variety of lesbian and gay social scientists that internalized homophobia has a central role as a predisposing and perpetuating factor in various aspects of ill-health, and may affect both the progression of illness and health-related decision-making processes with significant effect on the prevention of illnesses such as HIV infection. However, a number of theorists have argued that internalized homophobia is both frequently used uncritically with regard to its conceptualization and operationalization, and without due concern for its sociopolitical consequences (i.e. to repathologize the `sick' lesbian or gay individual and focus attention away from the more salient issues of cultural and institutionalized heterosexism). My aim is to provide a synthesis which examines research suggesting an important relationship between health and internalized homophobia whilst deconstructing the concept and offering a discussion of the potential effects on gay and lesbian communities in contemporary British society.
Defining anti-gay and lesbian prejudice and its internalization
There has been considerable discussion within lesbian and gay academic circles about how best to conceptualize the nature of anti-gay and lesbian prejudice. Whilst the term `homophobia' is most widely used within British society, there appears to be a consensus amongst queer3 academics that the term is in many ways unhelpful and inaccurate for a variety of reasons. These include the emphasis on the affective (fear) component of prejudice at the expense of anti-gay and lesbian cognitions, and the contextualization of prejudice within the individual rather than in society and its structures.