Femmephobia Is a Uniquely Powerful Predictor of Anti-Gay Behavior.

The current study explored a form of femmephobia (specifically, negative attitudes toward femininity in men) as a predictor of anti-gay behaviors among a sample of heterosexual men (N = 417). Additional predictor variables included hierarchical worldviews (i.e., social dominance orientation, right-wing authoritarianism, narcissism) and prejudicial attitudes (i.e., old-fashioned and modern homonegativity). Femmephobia emerged as a robust predictor, accounting for 23% of the variance in anti-gay behavior, surpassing the explanatory power (15%) of all other considered variables combined. Moreover, social dominance only predicted anti-gay behavior when femmephobia levels were high. Future research on discrimination and violence related to sexual identity and gender expression should incorporate femmephobia as a key predictive factor.

A Pilot Study of Metacognitive Training in U.S. Republican Leaners: Reducing Polarization Toward LGBTIQ+ Persons.

Negative attitudes and stigmatization toward sexual minorities is a cause of minority stress of non-heterosexual persons on an individual level and has a negative impact on democratic coexistence in postmodern, plural society on a societal level. Derived from clinical research, we developed a short metacognitive training (MCT) intended to induce doubt toward inaccurate beliefs about LGBTIQ+ persons. We expected this MCT to reduce homonegativity, threat perceptions of LGBTIQ+ persons, and to foster extended outgroup tolerance compared to an education and a no-treatment control condition. We tested this hypothesis in U.S. Republican leaners who represent a social group that is likely to hold homonegative attitudes. We randomly assigned 490 U.S. Republican leaners to an MCT condition comprising 16 questions and respective answers (n = 166) vs. an education control condition (n = 164) vs. a no-treatment control condition (n = 160). We found that Republican leaners after receiving MCT (1) had a significant reduction of homonegativity (ds ≥ 0.28), (2) significantly perceived LGBTIQ+ persons as less threatening (ds ≥ 0.30), and (3) were significantly more tolerant of various outgroups such as LGBTIQ+ persons, feminists, liberals, and climate activists (ds ≥ 0.23) relative to both control conditions. The small effects of this short intervention and the possibility of systematically applying MCT in social discourse to reduce homonegativity with its potential significance for LGBTIQ+ individuals' mental health are discussed. Furthermore, we highlight this pilot study's significance toward intervention possibilities regarding political division and polarization in postmodern, democratic societies.

Heterosexual, Lesbian, and Gay Adults' Reactions to Same-Gender versus Other-Gender Flirtation: Findings from a German Study.

Using a vignette methodology, this study examined reactions to same-gender versus other-gender flirtation in a sample of 445 German young adults: 320 participants with a heterosexual orientation and 125 participants with a lesbian or gay (LG) orientation. Even in LG-friendly societies as Germany, receiving advances from someone of the same gender might still evoke heterosexuals' homonegativity. Another factor that might influence heterosexuals' reactions to same-gender flirtation is the fear of being misidentified as LG (social contagion concerns). Contrary to hypothesis, results provided little evidence to classify heterosexual participants' reactions to same-gender flirters as homonegative. Firstly, heterosexual participants showed the same degree of negative affect and avoidance behavior in the same-gender flirtation condition as LG participants did in the other-gender flirtation condition. Only positive affect scores were somewhat lower for heterosexual participants in the same-gender flirtation condition compared to LG participants in the other-gender flirtation condition. Secondly, when anti-LG attitudes and social contagion concerns were considered together, only social contagion concerns contributed to explaining variance in heterosexual participants' response to same-gender flirters. Specifically, the impact of social contagion concerns on heterosexual participants' avoidance of same-gender flirters was mediated by (lacking) positive affect, but not negative affect.

Factors associated with intention of HIV testing among Asian American men: a path analysis.

Research has pointed to myriad cultural and socio-psychological factors associated with HIV testing, such as acculturation, social norms about HIV testing, masculinity, homonegativity, and constructs from the Theory of Planned Behavior. However, the interrelationships of these factors on the intentions of HIV testing among the population of Asian American men remains unknown. A dataset of 425 Asian American men in the U.S., collected online with convenience sampling method during 2020-2021, was analyzed to test a conceptual framework that aimed to fill this gap. Results from a path model with two endogenous variables (homonegativity and HIV testing intention) indicated that perceived social norms about HIV testing, attitude about HIV testing, and perceived HIV risk had directandindirect relationships with the intentions of HIV testing in the study population. However, social norms about HIV testing and perceived HIV risk showed stronger direct effects (standardized estimates = 0.37 and 0.34, respectively, p-value < 0.001). Additionally, we found that the relationships of these factors with HIV testing intention were also mediated by homonegativity. Findings from this study advance our understanding of pathways of associations between a host of cultural and socio-psychological factors with HIV testing intention among an understudied population - Asian American men. Our results will help inform the development of future intervention programs to increase HIV testing in this population.

Homonegativity, binegativity, and transnegativity among substance use treatment practitioners in the United States.

Lesbian, gay, bisexual, and transgender (LGBT) people have an elevated risk for substance use disorder relative to heterosexual and cisgender people. Scholars have predominantly explained this disparity as resulting from LGBT people's chronic exposure to interpersonal and structural stigma and discrimination. Despite their front-line role in serving LGBT people with substance use disorder, investigations of homonegativity, binegativity, and transnegativity among substance use treatment practitioners have been limited. An online survey of 225 practitioners examined levels of homonegativity, binegativity, and transnegativity and their demographic and socio-political correlates. Levels of homonegativity were lower than those of binegativity and transnegativity. Educational attainment, connectedness to LGBT people, and having a liberal political identity were associated with lower homonegativity, binegativity and transnegativity, while religiosity was associated with higher scores in all categories. Addressing substance use treatment practitioners' stigma toward LGBT people, particularly bisexual and transgender people, should be prioritized. Substance use treatment organizations are recommended to examine how their policies and practices may perpetuate structural stigma toward LGBT people.

On the Link Between Reciprocal/Authoritarian Filial Piety and Internalized Homonegativity: Perceived Pressure to Get Married in a Heterosexual Marriage as a Mediator.

Previous research has revealed that filial piety belief plays a critical role in self-acceptance of sexual orientation, but studies have rarely examined whether and how reciprocal (i.e., providing care and support based on affective bonding) and authoritarian (i.e., showing unconditional obedience to parents because of parental authority) filial piety contribute to internalized homonegativity. A total of 477 Chinese lesbian, gay, bisexual, questioning/queer, or other non-heterosexual (LGBQ +) adults participated in this study. These participants completed a battery of measures for reciprocal and authoritarian filial piety, perceived internalized, social, and parental pressure to get married in a heterosexual marriage, internalized heteronormativity, socially oriented identity (i.e., negative beliefs about how others in society would negatively treat them because of their sexual orientation), and family-oriented identity (e.g., guilt related to filial piety and worries about present and future life). The results indicated that higher reciprocal filial piety was directly associated with higher internalized heteronormativity. Higher authoritarian filial piety had a direct link with higher family-oriented identity. In addition, authoritarian filial piety was positively associated with internalized heteronormativity through internalized pressure to get married; authoritarian filial piety had a positive link with socially oriented identity through perceived social pressure to get married; authoritarian filial piety was positively related to family-oriented identity through perceived parental pressure to get married. Conclusions: Authoritarian filial piety is a risk factor for internalized homonegativity, and perceived pressure to get married in a heterosexual marriage might be the underlying mechanism for the relationship between authoritarian filial piety and internalized homonegativity.

Homopositivity Across Europe: Predictors, Pathways, and Moderators.

Although homopositivity, the attitudinal acceptance of homosexuality, has generally increased across Western societies, there remains considerable homonegativity across certain regions of the world as well as certain demographic and socioeconomic groups. Although previous cross-national research has successfully identified the key factors affecting homopositive attitudes, the literature neglects both potentially key mediation pathways and moderating interactions between those factors that may unlock more nuanced understanding of these variations in homopositive attitudes across individuals and places. In response, the present study innovatively applied a multivariate structural equation modelling approach to the latest Wave 9 (2018 data) of the large-scale cross-national European Social Survey data in order to shed new light on these currently neglected predictors, pathways, and moderating influences on homopositive attitudes. It used a three-item latent variable to measure the homopositive attitudes outcomes construct. Its explanatory variables were focused across three key sets of factors identified in theoretical and empirical literature (socioeconomics, religiosity, and values) alongside various wider controls. Our analyses made several innovative methodological and empirical contributions to existing debate. Key innovative findings include the original identification of important indirect effects of religious beliefs on homopositive attitudes via religious practices, important indirect effects of education on homopositive attitudes via household income, and the role of national welfare regimes to homopositive attitudes (and with its effects interestingly not moderated by household income).

Unpacking the Internalized Homonegativity-Health Relationship: How the Measurement of Internalized Homonegativity and Health Matter and the Contribution of Religiousness.

Internalized homonegativity (IH) is widely recognized to negatively influence the health of lesbian, gay, bisexual, and queer/questioning (LGBQ +) individuals. It is not clear, however, the role that religiousness may play in the relationship between IH and health or how differing conceptualizations of IH or health may influence this relationship. We conducted a multi-level meta-analysis of 151 effect sizes from 68 studies to examine the relationship between IH and health as well as what may moderate this relationship. Results suggested that IH was consistently and negatively related to health (r = - .28). Analyses suggest that IH was most strongly related to mental health and well-being, evidencing a relatively weaker (though still negative) relationship with physical or sexual health. Analyses of different ways to measure IH suggest that scales that conceptualize IH to include distress (e.g., the Internalized Homonegativity Inventory) report stronger relationships with health than scales that conceptualize IH orthogonally from distress (e.g., the Internalized Homonegativity scale of the Lesbian, Gay, Bisexual Identity Salience Scale [LGBIS]). We failed to find significant moderation effects for religiousness, though it was hard to evaluate this relationship due to the poor quality of most measures of religiousness. We encourage researchers to use measures of IH that conceptualize IH orthogonally from distress (e.g., the LGBIS) and to use more nuanced measures of religiousness (e.g., religious belief, religious activity). We also encourage researchers to focus on how IH impacts less-often studied measures of health (e.g., physical health, suicidality).

Impact of Migration and Acculturation on Turkish Men Who Have Sex with Men in Germany: Results from the 2010 European MSM Internet Survey.

To examine the impact of migration and acculturation of Turkish men who have sex with men (MSM) to Germany, using data from the European MSM Internet Survey (EMIS-2010), on measures of acculturation including circumcision status, internalized homonegativity (IH), HIV/STI knowledge, sexual orientation, outness, HIV-testing, and sexual behaviors. We compared four groups of MSM: MSM born and residing in Germany who had completed the questionnaire in German (n = 38,915), MSM born and residing in Germany, with a father or mother born in Turkey (n = 97), MSM residing in Germany who were born in Turkey or whose parents were born in Turkey (n = 262), and MSM who were born and residing in Turkey and who completed the questionnaire in Turkish (n = 1,717). Data showed that there were significant dose-response curves between level of migration and several outcome variables. As exposure to Germany increased, MSM had lower IH, higher HIV/STI knowledge, increased outness, and were less likely to be circumcised. There were similar significant findings with regard to sexual HIV risk behavior (condomless anal intercourse with partners of unknown (or sero-discordant) HIV status). Data were consistent with acculturation over generations in immigrant groups in MSM migrating from Turkey to Germany. Integration includes both cultural aspects (circumcision) and integration into a more homopositive gay environment (IH, outness, increased HIV/STI knowledge), and sexual HIV risk behavior. Migration and associated acculturation may constitute a risk change for HIV/STI and mental health issues associated with IH and outness.

Association of internalised homonegativity with partner notification after diagnosis of syphilis or gonorrhoea among men having sex with men in 49 countries across four continents.

BACKGROUND: Partner notification (PN) after a sexually transmitted infection (STI) diagnosis is being promoted as a means to interrupt transmission chains. We investigated whether Internalised Homonegativity (IH) is associated with PN among men having sex with men (MSM). METHODS: PN, defined as notifying at least one partner after diagnosis of syphilis and gonorrhoea, was queried in two internet-based self-completion surveys conducted between Oct 2017 and May 2018 in 68 countries in Europe, Latin America, Canada, and the Philippines. IH is defined by a man's level of agreement or disagreement with negative social beliefs about male homosexuality. Covariates included in a multivariate regression model with a random intercept at country level were age, HIV diagnosis, partnership status, sexual self-efficacy, HIV serostatus communication during last sex with a non-steady partner, place where this partner was met, and PN-related socio-historical background of the country of residence. We grouped countries in three areas: North- and Central-Western European countries plus Canada, former socialist countries, and Latin-American/Mediterranean countries plus the Philippines. In each of the three areas individuals were assigned to 4 subgroups based on IH quartiles and PN rates were determined for each subgroup. RESULTS: PN rates were calculated for 49 countries (excluding countries with less than 10 diagnoses). Mean proportions of MSM notifying their partners were 68.1% and 72.9% after syphilis and gonorrhoea diagnoses, respectively. PN rates were lower in Latin American countries and the Philippines compared to European countries. Within Europe, a North-South divide with lower PN rates in Mediterranean countries was observed. In each of the three regions we mostly observed a stepwise increase of PN rates with decreasing IH. Regression analysis showed lower IH scores associated with higher PN rates. Higher perceived self-efficacy, living in a partnership, and HIV status communication were positively associated with PN. Men who had met their last partner in a gay social venue were more likely to have notified their partners of a syphilis diagnosis compared to men who had met this partner online. Men with diagnosed HIV were less likely to report PN. CONCLUSIONS: We could demonstrate that IH was associated with PN among MSM across all countries included in our analysis. Reducing cultural homophobia and ensuring inclusive policies may contribute to STI prevention and control.

Contextual Influence of School-Level Gender Role Attitudes and Sexual Prejudice on Allyship, Bullying, and Internalized Homonegativity.

Previous studies have primarily used an individual differences approach to identify dispositional factors associated with bullying behavior, which often neglect the broader school context in which bullying occurs. The present study used a multilevel research design to examine the contextual influence of school normative climate on allyship, bullying, and internalized homonegativity. The study included 3020 students (M = 15.83 years, SD = 1.50) from ten secondary schools in China. The results showed that school-level gender role attitudes were positively associated with bullying perpetration among heterosexual students as well as bullying victimization and internalized homonegativity among LGBQA+ students. In addition, there was a negative association between school-level sexual prejudice and allyship among heterosexual students. The findings demonstrate the contextual influence of school normative climate and highlight the need for regular school climate assessments, so that appropriate instructions, policies, and practices can be implemented to address gender biases and homophobia and the resulting bullying behavior.

Black sexual minority women's Internalized stigma and coping motivated alcohol use: the role of emotional suppression.

Black sexual minority women have an increased risk for excessive alcohol use, which has been attributed to their use of alcohol to cope with oppression. Internalized stigma is suggested to be one of the most insidious byproducts of systemic oppression whereby people internalize ideologies of self-hatred. Still, research has yet to examine the association between internalized stigma and alcohol use among sexual minorities of color. This survey-based study investigated the associations between internalized homonegativity and internalized racism with coping motivated alcohol use among 330 Black sexual minority women. Additionally, we explored the role of emotional suppression within these associations. Internalized homonegativity was significantly positively associated with coping motivated alcohol use. The significant positive association between internalized racism and coping motivated alcohol use was strongest at higher levels of emotional suppression. Given the majority of our sample identified as having a masculine gender expression, we recommend research exploring whether the identity-based experiences of masculine Black sexual minority women impact their substance use behaviors. Implications for culturally sensitive and emotion-centered practice with Black sexual minority women are discussed.

The negative effects of internalized homonegativity on sexual satisfaction: dyadic effects and gender-based differences in Chile.

Heterosexism is not only expressed through sexual prejudice as an external stressor, but also as an internalized rejection toward one's own (and others') sexually diverse identity. That is, lesbian women and gay men themselves internalize negative societal attitudes toward their sexual orientation and identity-a phenomenon called internalized homonegativity. A wealth of research shows that internalized homonegativity negatively affects the health and social adjustment of gay and lesbian people. However, the literature has documented this trend from an individual (over a dyadic) perspective, and largely among gay (over lesbian) samples. To address this oversight, we analyzed data from 210 gay and lesbian couples in Chile to examine both actor and partner effects of internalized homonegativity on their sexual satisfaction. Results from moderation analyses from an actor-partner interdependence model (APIM) approach show that partners' internalized homonegativity negatively affects actor sexual satisfaction, a pattern significantly moderated by gender; that is, only observed among lesbian couples. Our results further demonstrated that these effects hold above and beyond the actor and partner effects of age and relationship satisfaction, as well as relationship length. These results are consistent with the broader literature, which discusses the specific features of internalized homonegativity in lesbian women, characterized-among other aspects-by restrictive social demands over their sexuality. Accordingly, our findings highlight the deleterious relational consequences of internalized homonegativity and offer a relevant empirical contribution to the understanding of specific minority stress dynamics among lesbian women.

An Analogue Study Investigating Differential Parenting of Gender Conforming and Nonconforming Boys.

Gender nonconforming children are at heightened risk for negative parenting interactions. This study investigated possible explanations for differences in parenting behaviors with gender conforming and nonconforming boys. A sample of 201 adults (43% women/57% men; 81% White, 10% Black/African American, 6% Multiracial, 3% Asian, and 1% American Indian or Alaska Native; and 7% Hispanic/Latinx) ranging in age from 20 to 74 years (M = 35.44, SD = 9.76) were presented two vignettes describing a gender conforming and nonconforming boy. Following each vignette, participants provided endorsements of parenting behaviors and reported their concern for that child's future. In addition, participants completed measures assessing their attitudes toward homosexuality and need for closure. Contrary to expectations, there were no significant differences in endorsements of physical discipline or positive parenting for the two boys. Participants did, however, report higher concern for the gender nonconforming boy's future. Individual differences in homonegativity were associated with greater endorsements of physical discipline toward the gender nonconforming boy, after accounting for endorsements of physical discipline toward the gender conforming boy. Further, higher concern for the gender nonconforming boy's future was associated with greater endorsements of physical discipline and lower endorsements of positive parenting, after accounting for endorsements of each behavior for the gender conforming boy as well as concern for their future. Intervention efforts to support the parent-child relationship for gender nonconforming boys may benefit from identifying and responding to both negative attitudes toward homosexuality and addressing motivations to change behavior resulting from concern for their child's future.

Internalized Homonegativity and Mental Health Among Chinese Gay and Bisexual Cisgender Men: Exploring the Moderating Influences of Psychosocial and Sexual Identity Factors.

Much research on Chinese gay and bisexual men has focused on sexual health and, in particular, HIV-related issues. However, relatively little research has considered psychosocial aspects of being a gay or bisexual man in China. The present study was designed to address this gap by examining psychosocial predictors of mental health from a minority stress perspective. Results from an online survey of 1,786 Chinese gay and bisexual cisgender men revealed that higher levels of internalized homonegativity predicted greater psychological distress and a lower sense of positive well-being. Higher self-esteem, social support, and resilience were strong predictors of lower psychological distress and higher well-being, but these psychosocial factors mostly did not moderate associations between internalized homonegativity and mental health. A stronger sense of sexual identity superiority weakened the associations between internalized homonegativity and both mental health measures, but sexual identity centrality only moderated the association between internalized homonegativity and positive well-being. This study is among the first to examine minority stressors and psychosocial factors, distinct from the HIV-focussed literature, in a Chinese context. These findings may inform interventions targeting increased self-esteem, social support, and resilience, which could be beneficial for the mental health of Chinese gay and bisexual cisgender men.

Relationships of familial sexual stigma and family support with internalized homonegativity among lesbian, gay and bisexual individuals: The mediating effect of self-identity disturbance and moderating effect of gender.

BACKGROUND: The mediators of the association between familial attitudes toward sexual orientation and internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals have not been well examined. METHODS: A cross-sectional survey study was carried out to examine the (i) associations of familial sexual stigma and family support with internalized homonegativity among young adult LGB individuals in Taiwan, and (ii) mediating effect of self-identity disturbance and the moderating effect of gender. Self-identified LGB individuals (N = 1000; 50% males and 50% females; mean age = 24.6 years) participated in the study. Familial sexual stigma, family support, self-identity disturbance, and internalized homonegativity were assessed. Structural equation modeling was used to examine relationships between the variables. RESULTS: The results indicated that familial sexual stigma was directly associated with increased internalized homonegativity, and indirectly associated with increased internalized homonegativity via the mediation of self-identity disturbance among LGB individuals. Family support was indirectly associated with decreased internalized homonegativity via the mediation of low self-identity disturbance. The direct association between family support and internalized homonegativity was only found among lesbian and bisexual women but not among gay and bisexual men. CONCLUSIONS: Program interventions for familial sexual stigma, family support, and self-identity disturbance are warranted to help reduce internalized homonegativity among LGB individuals.

Chemsex users in Czechia: EMIS survey.

OBJECTIVES: Chemsex is a phenomenon highly relevant to public health concerns. Our primary aim is to describe the Czech chemsex scene regarding substances used, sexual behaviour, mental health, sexual life satisfaction, internalization of homonegative attitudes, and prevalent chemsex patterns. METHODS: The data from the European Men Who Have Sex With Men Internet Survey (EMIS) 2017 were used. The mental health of chemsex users was assessed by the Patient Health Questionnaire 4 (PHQ4), internalized homonegativity was measured using the Short Internalized Homonegativity Scale. A sample of 87 men who have sex with men (MSM) chemsex users and a comparison group of 261 MSM were selected from the total sample of 1,688 respondents. Mann-Whitney and χ2 tests were used to compare groups. RESULTS: Active chemsex users made up 5% of the sample (87 of 1,688), with an average age of 37 years. Chemsex users were more likely to engage in condomless sex with non-steady partners (χ2 = 46.8, p < 0.001), and had dramatically more STIs, such as HIV (χ2 = 52.9, p < 0.001), HCV (χ2 = 25.9, p < 0.001), and syphilis (χ2 = 41.5, p < 0.001). Chemsex users frequently injected drugs (n = 19, 20%). More than half (n = 48; 55%) of chemsex users had sober sex in the last 4 weeks. Chemsex culture was associated with riskier substance use, both in terms of mode and frequency. The mental health of chemsex users in our sample did not differ significantly from the comparison group (χ2 = 0.2, p < 0.7). Chemsex users did not conceal their sexual identity more often than the comparison group, on the contrary, 69% (n = 59) of them were out to most significant others, compared to 53% (n = 134) in the comparison group (χ2 = 8.8, p < 0.05). In addition, we did not find differences in the degree of internalized homonegativity (χ2 = 0.9, p < 0.4). Chemsex users were clearly and significantly more satisfied with their sex life than the comparison group (Mann-Whitney U test, p < 0.001). CONCLUSIONS: In our sample, chemsex use was not associated with a negative impact on health or wellbeing. Our results suggest that chemsex is not a homogeneous phenomenon. Many different patterns and subcultures exist, some of them are riskier, some safer than others.

Is Conservative Religiousness Inherently Associated with Poorer Health for Sexual Minorities?

Results of path analysis involving sexual minority participants (N = 1317) from diverse sociopolitical contexts revealed health outcomes to be associated with internalized homonegativity and the resolution of conflict between religious and sexual minority identities. Contrary to expectations, several markers of religiousness were not directly associated with either improved or worsened health outcomes for depression or anxiety. However, religious activity moderated the influence of internalized homonegativity (IH) on depression such that IH was less strongly related to depression among individuals who frequently attended religious services than among individuals who infrequently attended religious services. These findings have special salience for advancing a more accurate understanding of conservatively religious sexual minorities and directing culturally sensitive research, clinical services, and public policy.

Experiences of gestational surrogacy for gay men in Canada.

This paper reports on findings from a qualitative study that examined how Canada's socio-political context influenced gestational surrogacy for same-sex male couples. Semi-structured interviews were conducted with gay fathers and gestational surrogates to investigate supports and barriers of pursuing surrogacy. Questions explored publicly available information, policies and practices of fertility clinics and hospitals, post-birth resources and cultural attitudes regarding same-sex parenthood. Findings suggest that in Canada, a global leader in LGBT rights and inclusive same-sex parenting legislation, participants encountered inadequate same-sex inclusive resources and insufficient provider competencies. The aim of this study was to inform individual and institutional recommendations to counteract biases in fertility care and post-birth services. Following interview analysis, five key strategies were identified: (1) more accessible information on paths to same-sex parenthood; (2) more inclusive fertility clinic and hospital practices; (3) recognition of same-sex fatherhood in formal documentation; (4) post-birth resources such as formula feeding, play groups and first aid courses intended for same-sex parent families; and (5) shifts in cultural attitudes of same-sex parenthood and, specifically, gay fatherhood. Approaches that subvert heteronormative discourses embedded in fertility and reproduction are required to legitimise and support same-sex parent families.

Translation and validation in Brazilian Portuguese of the reactions to homosexuality scale.

Internalized homonegativity results from the acceptance of negative attitudes about one's same-sex orientation, which has negative consequences for the health of gay, bisexual and other men who have sex with men (GBM). We translated the 7-item Reactions to Homosexuality Scale (RHS) to Brazilian Portuguese and assessed its factor structure, validity and reliability. The first step included the translation, back-translation, evaluation, peer review, and pre-testing of the scale. Then, we piloted the scale in two convenience samples of adult Brazilians recruited online during October 2019 and February to March 2020 through advertisements on Grindr and Hornet, respectively. The largest sample was randomly split into two groups for exploratory factor analysis (EFA) then confirmatory factor analysis (CFA). Criterion and construct validity were assessed via correlations between scale scores and study variables. A total of 5573 GBM (sample 1: 218; sample 2: 5355) completed the RHS. EFA (N = 2652) yielded two eigenvalues greater than one (Factor 1: 3.5 and Factor 2: 1.1). A one-factor solution provided the most interpretable model based on examination of scree plot and item factor loadings (χ2(14) = 1373.1, p < 0.001; CFI = 0.89; TLI = 0.84; RMSEA = 0.19; SRMS = 0.09). Though one-factor CFA showed moderate fit, freeing errors terms to covary, based on item content and interpretation, significantly improved model fit (χ2(12) = 309.1, p < .001; CFI = 0.97; TLI = 0.96; RMSEA = 0.09; SRMR = 0.02). As hypothesized, men who did not self-identify as gay (mean score 17.9 compared to those self-identifying as gay: 11.8) and men who reported no sex with men in the past 6 months (mean score 12.6 compared to those who reported sex with men: 10.6) scored higher reflecting higher internalized homonegativity. The RHS was effectively translated and validated in Brazilian Portuguese and can be used to evaluate the role of internalized homonegativity on GBM's health, as well as its impact on the uptake of HIV prevention technologies.