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There are gay people out where I live but they don't want to be found…for example, when you get on dating apps you'll see them kind of around you within like 15 or mile radius, but they won't have face pictures, won't have text in their profiles…they don't want any type of relationship, they just want sex. Acknowledgment The research results discussed in this publication were made possible, in total or part, by funding through an award Project no.

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Religion, politics, and support for same-sex marriage in the United States, — Soc Sci Res. Region, social identities, and disclosure practices as predictors of heterosexist discrimination against sexual minorities in the United States. Sociol Inq. Rural location and exposure to minority stress among sexual minorities in the United States.

Psychol Sex. The continuum of HIV care in rural communities in the United States and Canada: what is known and future research directions. Introduction to the special issue on structural stigma and health.

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Soc Sci Med. Perceptions of HIV—positive men who have sex with men. Hatzenbuehler ML. A psychological mediation framework. Psychol Bull. Stigma, concealment and symptoms of depression as explanations for sexually transmitted infections among gay men. J Health Psychol. Structural stigma and all-cause mortality in sexual minority populations. Prospective associations between HIV-related stigma, transmission risk behaviors, and adverse mental health outcomes in men who have sex with men.

Ann Behav Med. The influence of structural stigma and rejection sensitivity on young sexual minority men's daily tobacco and alcohol use. Understanding concealable stigmatized identities: the role of identity in psychological, physical, and behavioral outcomes. Soc Issues Policy Rev.

Confronting discrimination: overcoming HIV-related stigma and discrimination in health-care settings and beyond. Google Scholar United States Department of Agriculture. Oklahoma-rural definitions: state-level maps. Experiences of HIV-positive gay, bisexual and other men who have sex with men residing in relatively rural areas.

Cult Health Sex. Social milieu and mediators of loneliness among gay and bisexual men in rural Indiana. J Gay Lesbian Ment Health. Barriers to access and adoption of pre-exposure prophylaxis for the prevention of hiv among men who have sex with men MSM in a relatively rural state. Corbin J , Strauss A.

Warbelow S , Diaz B. Boso LA. Urban bias, rural sexual minorities, and the courts. Barth J , Parry J. Polit Policy. Changing public opinion on same-sex marriage: the case of California. Does policy adoption change opinions on minority rights? The effects of legalizing same-sex marriage. Polit Res Quart.

Rural perspectives on same-sex marriage. J Gay Lesbian Soc Serv. Public roles of US physicians: community participation, political involvement, and collective advocacy. Sexual and gender minority health: what we know and what needs to be done.

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Am J Public Health. Physician-citizens—public roles and professional obligations. Outness, stigma, and primary health care utilization among rural LGBT populations. PLoS One. The effect of psychosocial syndemic production on 4-year HIV incidence and risk behavior in a large cohort of sexually active men who have sex with men. J Acquir Immune Defic Syndr. Promoting the sexual health of MSM in the context of comorbid mental health problems. AIDS Behav. The relationship of stigma to the sexual risk behavior of rural men who have sex with men.

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Kwon P. Resilience in lesbian, gay, and bisexual individuals. Personal Soc Psychol Rev. J Prim Prev. Gates GJ. Geography of the LGBT population. In: International Handbook on the Demography of Sexuality.


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Edited by A. Dordrecht, The Netherlands: Springer, , pp. Sexual behaviors, sexual health practices, and community engagement among gay and bisexually identified men living in rural areas of the United States. Indeed, such interventions are ethically suspect because they can be harmful to the psychological well-being of those who attempt them; clinical observations and self-reports indicate that many individuals who unsuccessfully attempt to change their sexual orientation experience considerable psychological distress.

For these reasons, no major mental health professional organization has sanctioned efforts to change sexual orientation and virtually all of them have adopted policy statements cautioning the profession and the public about treatments that purport to change sexual orientation.

SOCE have been controversial due to tensions between the values held by some right-wing faith-based organizations, on the one hand, and those held by LGBT rights organizations, human rights and civil rights organizations, and other faith-based organizations, as well as professional and scientific organizations, on the other. Some individuals and groups have, contrary to global scientific research and consensus, promoted the idea of homosexuality as symptomatic of developmental defects or spiritual and moral failings and have argued that SOCE, including psychotherapy and religious efforts, could alter homosexual feelings and behaviors.

Medical attempts to change homosexuality included surgical treatments such as hysterectomy , [11] ovariectomy , [12] clitoridectomy , [11] castration , [13] [14] vasectomy , [15] pudic nerve surgery, [16] and lobotomy. Richard von Krafft-Ebing was a German-Austrian psychiatrist and one of the founders of scientific sexology. His first systematic work on sexual pathology was published in in a German psychiatric journal.

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His influential work, Psychopathia Sexualis was published in Numerous expanded German editions followed, and it was widely translated. Krafft-Ebing became a proponent of the sickness model of homosexuality. Krafft-Ebing believed that hypnosis was therefore the "only means of salvation" [37] in most cases. He stated that he knew of only a single case in which self-hypnosis had proven successful, and that hypnotic suggestion by another person was usually necessary to change homosexuality. Krafft-Ebing wrote about this method that " He rejected castration as a cure for homosexuality, and the internment of gay people in asylums, except in cases involving sex crimes.

Krafft-Ebing cautioned that the success or failure of treatments for homosexuality proved nothing about its causes. He defended the right of patients to receive such treatment. Krafft-Ebing criticised several objections to medical treatment of homosexuality, including the charges that it was ineffective and that it gave an opportunity "to tainted individuals to propagate their perversions".

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In the last two decades of the 19th century, a different view began to predominate in medical and psychiatric circles, judging such behavior as indicative of a type of person with a defined and relatively stable sexual orientation. In the late 19th and 20th centuries, pathological models of homosexuality were standard. In , the World Health Organization replaced its categorization of homosexuality as a mental illness with the diagnosis of ego-dystonic homosexuality.

At that time APA stressed that removing homosexuality from the list of psychiatric disorders does not mean it is "normal" or as valuable as heterosexuality. They also stated that modern methods of treatment allow interested homosexuals to change their sexual orientation with a significant degree of success. No major mental health professional organization has sanctioned efforts to change sexual orientation and virtually all of them have adopted policy statements cautioning the profession and the public about treatments that purport to change sexual orientation.

Christian right political groups have marketed sexual orientation change directly to consumers. A majority of people who attempt to change their sexual orientation come from conservative religious backgrounds. Many people may seek to change their sexual orientation as a way to avoid behaviors which they perceive as being associated with homosexuality, [46] such as non-monogamy. An article in the American Medical Association 's Journal of Ethics argues that clinicians who care for adolescents face a "common challenge" of parents seeking interventions to change the sexual orientation of their teenage children.

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The article states that adolescents are increasingly comfortable in revealing their same-sex attraction to their parents because of the "generational shift in views of sexual orientation" due in part to increasing acceptance of LGBT rights and same-sex marriage. An APA task force found that people often sought out SOCE due to a a lack of other sources of social support; b a desire for active coping and c access to methods of sexual orientation identity exploration and reconstruction.


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These pressures may lead people to feel forced into attempting to change their sexual orientation. Types of behavior therapy used to change sexual orientation include aversion therapy , covert sensitization and systematic desensitization. A series of experiments appeared promising, and the practice became popular, but when reports were shown to be flawed, it fell out of favour. Bioenergetics is a therapeutic technique developed by Alexander Lowen and John Pierrakos , who were students of Wilhelm Reich.