A recent study conducted by researchers from Cornell University and the University of Toronto has shed light on the impact of concealing sexual identity on healthcare seeking behaviors among sexual minority men during the global outbreak of mpox. The study revealed that openly gay, bisexual, and other sexual minority men were more likely to seek care for mpox compared to those who conceal their sexual orientation. However, the reason behind the disparity was not necessarily the fear of being outed, but rather the knowledge gap and reduced community connection caused by identity concealment.
The study, titled “Identity Concealment May Discourage Health-Seeking Behaviors: Evidence from Sexual Minority Men During the 2022 Global Mpox Outbreak,” was published in Psychological Science. Joel Le Forestier, a postdoctoral researcher in the Department of Communication in the College of Agriculture and Life Sciences at Cornell, served as the first author of the study. The co-authors of the study were professors Elizabeth Page-Gould and Alison Chasteen, who were Le Forestier’s doctoral advisers at the University of Toronto.
To conduct the study, the researchers recruited hundreds of sexual minority men from Australia, Canada, the U.K., and the U.S. at two different points during the mpox outbreak: its peak in August 2022 (864 participants) and approximately two months later as the outbreak waned (685 participants). The participants completed an online questionnaire designed to test the researchers’ hypothesis that sexual orientation concealment would be associated with reduced mpox-related health behavior. The questionnaire included statements such as altering appearance, mannerisms, or activities to “pass” as straight and intending to receive a vaccine for monkeypox.
The findings of the study mostly confirmed the researchers’ expectations. Participants who concealed their sexual orientation expressed concerns about seeking mpox resources that could potentially out them. However, contrary to the researchers’ predictions, these concerns did not necessarily lead to a lower likelihood of accessing those resources. Some participants indicated that the importance of addressing mpox outweighed their fears of identity revelation.
The research was sparked by Le Forestier’s friend’s observation of a long line of sexual minority men waiting at a vaccination clinic during the mpox outbreak. Initially, Le Forestier believed that the fear of being outed prevented these men from seeking mpox vaccinations. However, after discussing the issue with his friend, he realized that the lack of awareness might be the primary factor preventing individuals from accessing healthcare resources. The friend pointed out that the only places where he saw advertisements for mpox vaccine clinics were in gay bars and the local gay village community center, suggesting that individuals who were not actively involved in the community might not be aware of available resources.
The study’s findings raise important questions about how public health departments can effectively disseminate health-related information to marginalized groups. Le Forestier highlighted the challenge of efficiently messaging to ensure that key populations receive the necessary information. While there is ongoing research in this field, the study suggests that there is still work to be done in effectively reaching marginalized communities.
Le Forestier emphasized the importance of community engagement for sexual minority individuals. Affiliating with and becoming a part of the community can provide significant benefits, including access to public health resources. While knowledge of public health resources is not the sole solution, it plays a crucial role in improving healthcare seeking behaviors among sexual minority men.
The study serves as a reminder that bridging the information gap and fostering community connections are vital for ensuring that all individuals, especially those from marginalized groups, have access to the healthcare resources they need.
