Suicidality and internalised homophobia from the perspectives of gay, bisexual, queer and questioning (GBQ+) men: A narrative study.

Abstract

Sexual minority individuals often face physical and mental health challenges, including higher suicide rates compared to heterosexuals. Research indicates that prejudice, discrimination, and rejection related to sexual orientation are internalised over time, resulting in negative self-attitudes and poorer mental health; a process known as internalised homophobia (IH). This research investigates the psychoanalytic concept of IH and whether it can be meaningfully identified in the stories of suicidality of gay, bisexual, queer and questioning (GBQ+) men. I approached the investigation by interviewing patients at out-patient community mental health services at a National Health Service (NHS) institution in a rural county that have experienced suicidality. Researcher reflexivity is used and where appropriate the results are discussed from a psychoanalytic perspective. Six key narratives are identified. The first four narratives are about the environmental challenges or failures the men told such as in school, home, interpersonal relationships and wider society. The fifth key narrative is about the impact those external challenges had on the internal world of the men and the suicidal state of mind. The final key narrative is about navigating the challenges of suicidality and living as a GBQ+ man in the UK today. The men develop their own coherent theories about their experiences, outlining a conceptual framework that links sexuality, negative encounters, suicidal tendencies, and the formation of a detrimental feedback loop. I understood this as driven by IH, where some participants showed a more explicit and severe form than others. Suicide motivators are summarised as; (1) an identification with the aggressor where the individual harbours an intense dislike for themselves (and their sexuality); (2) desire to escape from the desolate and intersecting experience of external isolation and internal loneliness; and (3) desire to escape from mental anguish, distress and shame. Implications for clinical practice in NHS settings are discussed. The conclusions from the research make a contribution to the psychoanalytic theory of IH and suicide motivations for GBQ+ men.