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UBC Theses and Dissertations

An exploration of middle-aged and older gay men's health and illness practices Handlovsky, Ingrid Emilia


Background: Despite a wealth of knowledge that demonstrates middle-aged and older gay men experience substantial health inequities when compared to heterosexual men, little information is available pertaining to the health and illness practices of gay men. Methods: This dissertation includes three qualitative manuscripts with the overarching aim of exploring middle-aged and older gay men’s health and illness practices. Data were collected via conversational interviews with 25 men who self-identified as gay. The first qualitative descriptive manuscript examined how middle-aged and older gay men developed resilience over time to promote health and wellness. Next, a grounded theory was conducted to describe the processes by which middle-aged and older gay men managed their health. The third manuscript involved a qualitative description of how men experienced their mental health and the strategies they used to mitigate the deleterious effects of mental health challenges. Results: The findings from the first manuscript demonstrated that resilience was developed over time by: (1) building and sustaining networks, (2) addressing mental health, and (3) advocating for self. The grounded theory indicated that the core process of health management is overcoming adversity, which is achieved by three overarching and interrelated processes: (1) advocating for health needs, (2) knowing about health issues and treatments, and 3) engaging in health promoting practices. The third manuscript findings yielded three categories as to how mental health was experienced, and how the deleterious effects of mental health challenges were mitigated: (1) gaining new perspectives of mental health over time, (2) reaching out to formal health services for support with mental health challenges, and (3) engaging in practices to maintain and improve psychological well-being. Conclusion: These findings highlight the influence of age and experience, historical and ongoing discrimination, as well as capacity, to middle-aged and older gay men’s health and illness practices. Consequently, meaningful and effective health services must be developed with recognition of men’s strengths and capacities amidst discrimination. Potential approaches to health service development and delivery to improve health outcomes include equity-oriented primary health care, trauma-informed care, social public health approaches and peer-based services and resources.

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