3. cbrc.net/investigaytors

6. Under the Lens
The Investigaytors Journey
Who did Sex Now?
Gender (non) conformity
Generational Differences
Relationships
Body Image
Drugs and Sex
Social support
cbrc.net

7. Our Journey Into Qualitative Research

8. Focus Group

9. Photovoice: Being a young gay guy in Vancouver

10. On-Going training
Theoretical Approaches:
Social Determinants of Health
Intersectionality
Minority Stress
Life Course

11. Research Methodologies
Photovoice
Observation
Interview
Focus group
Art-based

22. Research
Gender and
sexual identities
Structural
issues
Gay Spaces
Coming out
Diverse
experiences
relationships

23. Community programs

25. priorities
Build
Coalitions
and
Solidarity
Engage
Activism
Promote
Diversity
by
Addressing
Stigma
Build
Support for
Healthy
Relationships
Bridge the
Knowledge
Gap

28. comments
“
Great discussion, appreciated and
valued the diversity of experiences and
perspectives among the participants.
”

29. comments
“
More decolonization, accessibility,
discussion of racism in gay men's
community and body image hype and
masculinity as ideal
”

30. comments
“ ”

31. comments
“
”
We need to keep doing this.

33. Body mapping
photovoice
Qualitative Research
interviews
Focus groups

34. Photovoice

35. The method
1. A question
2. A photo
3. An answer

36. What did you do for Pride?
What are this Pride's messages?
What is it like to be part of the festivities?
What does Pride mean to you?
How does this Pride compare to your first?
What does Pride avoid or ignore?

39. technology and social
media have been more
and more present
during pride festivities
seeing the look of
wonder on this
young man’s face at
what was occurring
around him
it was such a foreign, yet
exciting concept for me
While I see it as a time
to celebrate diversity, I
see that it's become too
polished and corporate.
a metaphor for most
queer people’s struggle
to find acceptance
within the community
having pride in each
other and celebrating
our friendships

40. Theme: Pride as political

41. “I was too busy caught up in the politics
of Pride; shaking hands, sending e-mails,
and posing for photos...”

42. “At it’s core, I believe
Pride still functions as an
outlet for the LGBTQ
community to come
together and take a
political stance against
prejudice and
discrimination while
promoting equal rights.”

43. “Pride isn't a parade for me really, not at its core
anyway. The parade is only an homage to marches
and protests. For me pride is an act of subversion, or
at least it ought to be.”

44. Theme: Pride as personal

45. “Like many gay men, I have personally
dealt with these feelings of shame
regarding my sexual orientation, so to
have this experience of celebration
was very positive.”

46. “We first met 13 years ago in a grade 8
wrestling match and the adventures and
friendship that we’ve shared over that time
are what I think my pride is all about. It’s
about a very personal narrative. It’s about
life. It’s about people.”

47. “This last picture represents what pride means to me the most:
spending time with people you love. This is an image of me and my
best friend who over the years was unable to spend pride with me
due to him working. This was our first pride together and because
he was able to celebrate with me I would dare to say he made my
pride experience the best yet.”

48. What did we learn?
It’s complex
It’s reflective
It’s unique

49. Body Mapping
by Joshun Dulai

50. Outline
An Introduction to Body Mapping
Why We Chose To Do It
The Process
What Shapes Our Lives
The Investigaytor Experience
Conclusion

51. Introduction
What is a Body Map?
- A life size a visual and artistic representation of
one’s physical body and it’s relation to his or her life
and it is used as a way of storytelling one’s personal
experiences
What are it’s origins?
- Originally used as a therapeutic technique for HIV+
women and women living with AIDS to share their
personal stories of being positive and living with
AIDS
How we’ve adapted it for the Investigaytor program
- Typically done alone in the presence of a researcher
but we decided to create our maps in front of one
another in the same room at the same time

52. Why We Chose To Do It
1. An alternative qualitative research
method
2. A lesson in reflexivity
3. Understanding intersectionality
–
Intersectionality considers the simultaneous
interactions between social differences and identity
as well as the different forms of systemic oppression
that reflects relationships of power.
Intersectionality, with its attention to the
multifactorial causes, has been demonstrated to
advance health and social issues and to propose
radically different solutions for advancing health
equity. Its potential for advancing gay men’s health
is also increasingly recognized.

53. The Process:
Body Position

54. The Process:
Making Your Map

55. The Process:
The Personal Slogan

56. What Shapes Our Lives: Our Identities

57. What Shapes Our Lives:
Relationships

58. What Shapes Our Lives:
Sex and Men

59. What Shapes Our Lives:
Our Bodies

60. What Shapes Our Lives:
Moods and Emotions

61. What Shapes Our Lives:
Our View of the World and Its View of Us

62. What Shapes Our Lives:
Our Interests

63. What Shapes Our Lives:
Difficult Experiences

64. The Investigaytor Experience
The artistic process
Process versus presentation
Self-censorship

65. Conclusion

66. interviews
at would you tell them? What do you think y
? Who participated in your study? What wo
What would you talk about? What would y
m? What do you think you'll find? Who part
our study? What would you say? What wou
about? What would you tell them? What do
k you'll find? Who participated in your stud
at would you say? What would you talk abo
at do you think you'll find? Who participate

67. Outline
Interview
•
•
•
Methods
Questions
Analysis
Research Priorities
•
•
•
Biomedical vs. Social
Holistic Approaches
Understudied Populations

68. Outline
Metholodogy
•
Who is studied?
Recruitment
Life-course
Theoretical Lens
• Syndemics
• Social Determinants of Health
• Intersectionality

69. methods
We wanted to gain expertise in qualitative interviews
in preparation for Sex Now 2014 from research
leaders to see what priorities are identified
Participants chosen for their involvement with the
gay/queer community in BC
14 individuals in total were interviewed
Approximately 1 hour in length interviews
Participants engagement with the queer community
were varied  community organizations, public
health care providers, researchers, communityleaders

70. Questions
Set list of questions for each interviewee
“
You've just received an enormous award for
your work in gay men's health and it allows
you to research any topic in gay men's health
with unlimited funding and without any
limitations. What would you study or what
study would you commission?
“
”
You have won an international award for your
project, the Nobel Prize of gay men's health!
”

71. Analysis
• Listening and transcribing portions of
every interview
• Created emerging and priori codes based
on research questions
• Coded our data and we identified
patterns and themes within our data
• Working as a group to review data over
several meetings
• The experience was fun, interesting and
enlightening!

72. Theme:
Research
Priorities

73. Biomedical versus social
Narrow focus doesn't strengthen health in other areas,
treats symptoms instead of promoting health
Moving out of behavioral-based perceptions of health,
and looking at syndemic, co-factors, and intersectionality
Biomedical isn't the only solution
• Bringing in community to help with knowledge
translation increases effectiveness and uptake of
interventions
• Creates a sense of ownership over health
Currently focus too much on biomedical over short term

74. Biomedical versus social
“
If we’re not looking through a community lens,
we’re actually, ah, then giving over the cultural
components of illness and health over to a
biomedical model, which takes it out of the
hands of the community and puts it into
scientists’ hands who don’t necessarily have
the comprehension of what it means to be
certainly not a trans person, for instance, or even
a gay man’s
”

75. Holistic approaches
HIV is still an important area for
research in gay men’s health
Many areas in HIV could use more
research and knowledge such as
research into innovative interventions
“
And we need to be looking at a much
more holistic concept of what Queer
and trans health can be

76. Holistic approaches
Beyond Illness and Toward Health
Ways to improve the overall health and well-being
of gay men
Resilience, social support, and community
More research on the health care system and health
communication
Beyond Disease
More attention needed to the causes of the disease
– Structural Issues
– Discrimination

77. Understudied populations
“
“
“
Invisible and marginalized populations:
indigenous, transgender, and senior
populations
Being indigenous I find that is not really
represented in the research
”
Queer transmen experience a lot of invisibility
and are under-represented in research
”
The population is aging and gay people are a
part of that population

78. Understudied populations
Structural barriers:
People with disabilities, people who are deaf,
indigenous people
“
Impacts of colonization in residential
schools—our elders feel that homosexuality
and the Queer community is a sin ... imposed
belief upon our communities
”
Experiences of audism amongst the deaf queer
Community in Vancouver
Stereotypes and stigma around disability

79. Theme: methodology

80. methodology
While the majority of gay men’s health
research in BC relies on cross-sectional
surveys, informants suggested an array of
other research methodologies including:
• Interviews/Focus groups/Discussions
• Evaluations
• Ethnography
• Art-Based Methodologies
• Longitudinal cohorts
• Mixed-methods

81. methodology
• The majority of informants mentioned that
Community-Based Research is the best
practice for researching the health and lives
of gay men.
• More so, some informants argued for research
that is driven by social justice, such as social
change and transformative research.
• Informants highlighted the importance of
considering potential ethics issues specific to
the study of gay men (i.e. inclusion of
participants, results that are stigmatizing,
etc.)

82. Who is being studied?
Some informants highlighted some of the
issues inherent with categories such as
“gay” and “MSM”. Specifically,
informants were concerned that by using
either categories it would exclude some
sexual minority men.
“
“
… Nobody self-identifies as an MSM so
how is that applicable?
”
Huge population of MSM that don’t
identify as gay, how do we reconcile that?

83. Who is being studied?
Some informants recognized the large
diversity of experiences within our
community – some highlighted that
some experiences are less likely to be
represented in research.
“
The term gay men, or gay men’s
health, or MSM implies there is a
singleness, rather than a constellation
of ways of living and being a guy

84. Theme: recruitment

85. recruitment
There were some concerns from some participants that not all gay
men are being captured by the current research initiatives - most
research focus on white, cisgender, Vancouver residents and able
body men.
“
It would be great to have studies that aren't all white
”
Participants suggested the following strategies for recruitment:
• Champions and people with social ties
• Offering Honorariums
• Recruitment at large event, such Pride
• Recruit beyond sexualized environment (i.e. Community
groups)
• Online Marketing (i.e. Social networking sites like facebook,
gay blogs)
• Snow-ball sampling
• Make it fun!

86. Theme: Life-course

87. Life-Course
Approach that looks at long-term effects
on health from biological, behavioural,
social, and psychological events during
different life stages, and how these effects
may operate independently, cumulatively,
and interactively (Kwon & Borrell)

88. Life-Course
“
“
“
People who are affected most in adolescent and
early life, we are not catching them in retroactive
studies because they may have left the gay
community or worst, died
”
Because we are looking at the fundamentals about
how men learn, think, and process, setting up that
foundation in the early part of their life greatly
affects them at different stages in their life
”
Look at generational processes, such as when
someone comes out, and when and where
they enter the healthcare model

89. Cohorts
“
“
“
Great divide generationally
between gay men
”
Older gay men have experienced very different
health phenomena from younger gay men
”
Older men felt isolated and needed physical
spaces to feel comfortable, younger gay men
want to be part of heterogeneous spaces,
older gay men want to be part of
homogeneous spaces

90. Intergenerational
“
“
interested in the historical changes that
brought gay men together under
mechanisms of oppression and disease
”
”
intergenerational community development
intergenerational effects of residential
schools and colonization, including alcohol
and substance use, at the intersections of
Queerness and indigeniety

91. Theme: Theoretical lens

92. Syndemics
“
concentration and deleterious interaction
between two or more diseases or other health
conditions in a population
“
”
- Singer
We’re constantly looking back at the HIV
epidemic, everything tied to gay men’s health
research is tied to HIV
“
”
It’s oversimplified to look at one health outcome,
HIV, and decide if that makes someone healthier

93. Syndemics
“
Gay men have unique needs: e.g. they are at
higher risk of suicide, depression, substance
abuse, homeless and feeling alienated
“
“
I really believe we should focus
‘as well as,’ not instead of
”
”
A lot of the root causes of the HIV
epidemic are actually the causes of
some of the other major health problems
”

94. Social Conditions
“
interaction of diseases or other healthrelated problems commonly occurs
because of adverse social conditions
- Singer
”
social, economic, physical, or
environmental factors, or determinants,
that influence our health

95. Social Determinants
“
“
“
Barriers to Healthcare
Impact of knowledge on people’s behaviour and health
promotion and how people understand this knowledge
So, the effectiveness and efficiency of knowledge
transmission methods.
”
”
”
Would like to know how immigrants with EAL understand
health information not available in their primary language
This refers to culturally appropriate health case services.
Believes that the gay men’s community is siloed off from the
mental health community and that more bridges need to be built
This speaks to syndemics, but also to structural
issues of our health care model.

96. Social Determinants
Lack of Social Support
Social isolation is a problem in the community.
“
Gay men seek spaces and community to validate
ourselves, now we are doing this online
”
This quote highlights the increasing role of of
technology, and that we should take it into serious
consideration.
“
Research has not been specific of the
levels of sexual and intimacy-based
engagements that gay men experience
or in many cases don’t experience

97. Social Determinants
Stigmatization and Discrimination
“
Younger gay men have experienced health
phenomena such as homophobia and
heterosexism and this impacts their health
Trans issues under-prioritized in Queer
communities
”
Inclusion and accessibility (deaf, mobility, foodrelated concerns)

98. Social Determinants
Stigmatization and Discrimination
“
Why are there barriers for people who use
wheelchairs?
”
Stereotypes and stigma around disability
Shame has a negative impact on all aspects of
yourhealth (physical, social, mental, sexual) by
leading to poor decision making because it
affects the way you think about yourself and
other things

99. Intersectionality
syndemics occur “especially as a consequence of
social inequity and the unjust exercise of power”
(Singer)
“health inequities are never the result of singular,
distinct explanatory factors, but the outcome of
intersections of different social locations, power
relations, and experiences” (Hankivsky)
o the intersections between race and ethnicity,
gender, class, sexuality, ability …
o racism, sexism, transphobia, homophobia,
ableism …

100. Intersectionality
“
Being Indigenous, I find that I’m not really
represented in [gay] research. And then, viceversa, in Indigenous research, I don’t see a lot of
gay men represented
”
Public health services are not accessible or are very
limited for Queer-Indigenous people at public
health facilities aimed at serving Indigenous
communities

101. Intersectionality
“
Why is there a need for a gay Sikh man to
surround himself with other gay Sikh men?
Because when we go to mainstream [gay]
groups, we feel alienated
“
”
The Queer community it's becoming more
and more accessible … [but] there’s no
funding for ASL interpreters to talk
about HIV workshops
”

102. summary
“
The term gay men, or gay men’s health,
or MSM implies there is a singleness,
rather than a constellation of ways
of living and being a guy
“
”
No one category of social identity is
necessarily more important than any other
”
- Hankivsky

103. •
Interviews:
Summary
we’re continuing to work through the
interviews
•
so little that we know on gay men’s
health
•
•
so many unexplored research areas
•
research the many underrepresented
and understudied populations within
the gay and Queer community
•
knowledge on how to attend to highpriority issues
•
translate this research into practice
for future studies, particularly in our
upcoming Sex Now Survey
overwhelming interest to research the
social conditions of health and illness

104. Focus groups

105. Main Research Questions
How do young gay men
see themselves?
What challenges or resiliencies
do they have?
What are their favourite parts of the
gay and/or queer communities?

106. Participants
• We conducted 4 focus group with 22
participants
• 19 Caucasian, 2 Asian and 1 South
Asian
• Age 18 to 29 (mean 24)
• 11 students, 14 work full time
• 19 Vancouver; 3 suburbs
• 12 came out before the age of 18

107. Questionnaire
• Intersectional approach
• Emphasis on self-reflection
• Topics
– Aliens
– Personal experiences and identities
– Relationship to gay and/or queer
community
– Contrasting experience of straight peers
– Geographical emphasis

108. How do young
gay men see
themselves?

109. How do young gay men see themselves?
“
“
I have sex with men
”
I don’t think it should be
about anything else than
who you’re attracted to
“
”
I didn’t want being gay to be my ‘thing’
Being gay isn’t the most important
thing about them
”

110. How do young gay men see themselves?
May not just be a about who they’re
attracted to
Informs their relationships, culture,
and behaviour
Acknowledge that if they were
straight, they’d be different

111. How do young gay men see themselves?
Self-Aware
Altruistic
Empathetic
Ambitious
- Vulnerable
Label adverse
Grateful

112. Favourite
things about
being gay

113. Favourite Things About Being Gay
What did we ask them?
The freedom and opportunity to do things your own
way
“
There’s this fairytale worldview about how your life
should be, but as with any person who doesn’t
conform to the norm, you question all the givens in life
and that opens up your mind a lot. The world is a
bigger place in our heads because we don’t subscribe
to these social norms. We get to pave our own way
and make our own decisions. That’s my favourite part.

114. Favourite Things About Being Gay
The rallying point on those aspects of
similarity and our shared experiences
“
I like that even though we all haven’t
gone through the same experiences, we
all have that one thing in common
and as you meet someone, you can
empathize with them...I like that we’re all
connected in that way and that we’ve
created a community around that

115. Favourite Things About Being Gay
The opportunity to be ambassadors and
role models
“
“
I feel like I have opened minds more so
than I have closed them, and that’s a
great thing about being gay.
”
You can be an ambassador to more than
just the gay community. Because you go
through these unique experiences, you
are more compassionate, not just
towards the gay community.

116. Favourite Things About Being Gay
Inclusiveness and acceptance within our
community
“
If there are policies you could say the gay
community adopts, they are the ones that
are the most encompassing as possible
and I think that acknowledges there is
so much diversity in being a gay man,
and yet it’s still inclusive.
”

117. Favourite Things About Being Gay
The opportunity to challenge sex and gender “roles
and norms”
“
I can act as feminine or masculine as I want
and no one will judge me. I can essentially
do or say whatever I want and not have
to feel like anyone’s looking at me in a
negative way and that’s kind of awesome.
”
Our support of one another and our resourcefulness
“
Our resourcefulness, that ‘Gay Mafia’ we talked
about. We support each other and we have those
resources available to us.

118. Favourite Things About Being Gay
The celebratory nature of our community
“
Pride, it’s our own special holiday.
There are record numbers of people
every year who show up to support us.
It’s very empowering.
”

119. Favourite Things About Being Gay
Positivity within our community
“
”
The sex.

120. Challenges and Resilience

121. Challenges and Resilience
What did we ask them?
Some participants suggest life’s challenges are
not unique to young gay men
“
It’s as challenging to be a gay person
as it is to be a straight person...we
just have different challenges.
“
”
There are also things straight
people can’t have that we have.

122. Challenges and Resilience
Challenges were viewed as being context
dependent
“
The advantages and disadvantages
outweigh each other in a geographically
dependent way. It really depends
on where your communities are.
”

123. Challenges and Resilience
For some participants, the challenges they faced
came more easily to mind
“
Keeping up appearances and staying that
ambassador is a lot of work.
“
“
”
”
My Dad told me...being in the
workplace will be harder.
It feels like you’re being told, sorry
the culture is full right now. We’re
not accepting anybody else.

124. Challenges and Resilience
For some participants, the challenges they faced
came more easily to mind
“
What I find with Vancouver, one of the
things I really, really lack and struggle
with not having is that sense of guidance
and community from my elders.
“
”
”
There is the risk of being gay bashed.

125. Challenges and Resilience
Some suggested our challenges are our friends
and families challenges
“
“
”
It’s an emotional burden on my family.
It doesn’t matter if you come home with a
boy, a girl, a dog, a duck, a skateboard, or a
broom. Do what you love and makes you
happy, we well always love you.
”

126. Challenges and Resilience
How young gay men view different challenges
we face regarding living within a
heteronormative society
“
Dating and in any interaction, I feel like I
can’t just go up to a guy in a coffee shop
and ask for a phone number.
”

127. Challenges and Resilience
How participants described learning to deal with
challenges
“
“
“
I think the hardest part was coming out to
myself...it’s an internalized shame. I learnt to
deal with that internalized shame and question
why I have that internalized shame.
”
”
”
It’s about finding strength from within.
By getting involved with gay men’s
health and the gay community.
I wrote poems and shit.

128. Challenges and Resilience
In acknowledging some of our unique challenges,
participants often used ‘but’ statements
“
Some of the challenges are good things. There’s
stigma, but there’s also open mindedness.
“
I think that it’s a disadvantage that we
have to use apps and technology in
order to communicate and get a hold
of the community, that’s us just
being resourceful again.
”

129. Challenges and Resilience
Resilience was a key component of many
discussions regarding challenges
“
It has allowed me to see things in a
more creative light and I think that...
it’s given me an opportunity to be
a more active participant in my
life, in being my own advocate.
”

130. Slogans For Vancouver’s
Gay Community!

131. Slogans For Vancouver’s Gay
Community!
What did we ask them?
Difficult for participants to include the many different facets of
Vancouver’s gay community
“
It’s hard because there are a lot of elements that you’ve got to
include and then there’s things that you should highlight.
”
Overall, the participants felt a need for the slogans to be as inclusive
as possible
“
I think that here the majority of things that happen around the gay
community include allies, and that would be something that I
would highlight. That it’s an allies place too.

132. Slogans For Vancouver’s Gay
Community!
Slogan’s reflected mixed emotions, both positive and negative
“
“
“
“
DON’T COME HERE!
”
”
”
Come here for the mountains, not for the boys.
IT’S RAINING MEN!
Vancouver gays, from the place that brought you Yoga pants.
Participants had a wonderful sense of humour
”

133. Preliminary Conclusions and
Future Objectives
• Preliminary data suggests there is no one archetype in
which to describe a young gay man
• Participants came from all walks of life and had
wonderful stories to share
• Participant feedback highlighted how positive the
research experience was
• Likewise for the investigators, we felt humbled and
honoured to be present
• Future objectives include an in depth data analysis
and the possibility of conducting further sessions

134. acknowledgements
Shooting Stars Foundation
Public Health Agency of Canada
BC Gaming
The Investigaytors
Mentors
Participants

135. Questions?