Since the onset of HIV/AIDS, medical and behavioral researchers have focused their energy on the physical, psychological, social, and socioeconomic ramifications of HIV/AIDS. However, with respect to HIV+ gay men, spirituality as a coping style has been neglected. Why?
By Anthony Oltean MSW LCSW CADC* [Essay #2]
Read Essay #1
Multiple factors may account for this neglect in research. Both social science researchers and therapeutic clinicians tend to be less religious than the general population. Religion seems to be taboo in research and health care settings.
One possible explanation for its avoidance can be that some clinicians fear imposing a system of beliefs or values onto their patients. The construct of spirituality is often considered vague, difficult to operationalize and therefore difficult to build empirical support for specific measures. And lastly, researchers may not want to be associated with the less empirical or “softer” science.
All and all, there remains considerable debate regarding the definitions of religion and spirituality. Given the abstract nature of these concepts, they are often criticized as overlapping and non-mutually exclusive. Characteristics inherent to religion may also be found in spirituality, and vice versa.
For example, both spirituality and religion may involve a sense of personal transformation, an encounter with transcendence, or a search for ultimate truth or an ultimate reality that is sacred to the individual. However, the research literature tends to regard religion as the institutional and doctrinal expression of faith. In contrast, spirituality has been observed leaning predominately toward beliefs, activities, and experiences referring to the personal connection to sacred beliefs.
Documentation of the gay community’s exploration toward several spiritual and religious avenues (such as Dignity for Catholics) practices or new spiritualities altogether (such as shamanism, and earth-spirit faiths, etc) are emerging in the social science literature. However, the positive relationship of spirituality and religion to mental health is less clear for gay individuals when compared to the literature describing their heterosexual counterparts.
As indicated in the limited literature on this topic, the integration of a sexual identity with a traditional religious faith is typically portrayed as a struggle. Gay men are typically left abandoning or being abandoned by their faith in the process of developing and securing an openly gay identity. These individual’s struggles often overlap those of the organized religions themselves, particularly over the ordination of openly gay and lesbian clergy and support for same-sex marriages.
Difficulties from integrating concepts of spirituality and sexual orientation don’t only play out externally and/or socially. Many gay individuals do report internal conflict between their religious faith and sexual orientation. Further, these conflicts are associated with increased shame, depression, suicidal ideation, and difficulty accepting a positive gay identity.
Gay individuals who are members of faith communities that frame homosexuality in a negative light face significant distress when attempting to reconcile the two identities, often furthering a sense of learned shame, hopelessness, and damnation. Given the fact that the majority of mainline Protestant, Catholic, Islamic, and Judaic traditions strictly prohibit any desires or behaviors of homosexuality. When homosexuality is not outwardly condemned in traditional religious activities, it is rarely embraced as a viable sexual orientation. Gay parishioners and their relationships typically remain unacknowledged and invisible.
In additional, some religious messages perpetuate that mythos that the HIV/AIDS crisis was caused by God’s divine retribution for homosexuality. Because gay men and intravenous drug users were the first populations to enter societal awareness as AIDS sufferers, this disease has never fully escaped the moral judgments and scrutiny. Lack of immediate response to current minorities (non-gay men) impacted by HIV/AIDS has exemplified an ever-present sense of degradation to this disease by the U.S. government. Researchers have reported that many patients encounter stigmatizing experiences among religious congregations because of such attitudes.
In response to heterosexist, hetero-normative, and/or unwelcoming religious institutions, HIV+ gay men, and lesbian, gay, bisexual and transgendered (LGBT) affirming faith communities have evolved. Either by altering traditional denomination’s doctrine to be inclusive (e.g., Dignity for LGBT Catholics) or creating entirely new denominations (from traditional religious ones) specifically serving the LGBT community (e.g., Rev. Troy Perry and the Metropolitan Community Church MCC), these communities are present in most major cities in America.
As a result of these and other movements toward greater inclusiveness, LGBT individuals are experiencing increased opportunities (perhaps unlike any other point in history) for integrating their sexual orientation with their religious or spiritual beliefs. Although research and anecdotal literature have explored the conflict between sexual and religious/spiritual identity, minimal empirical research has investigated the role of affirming faith group experiences on the spiritual and mental health of gay men.
As discussed briefly above, the literature indicates that many LGBT individuals, including HIV+ gay men, have reported negative experiences with their faith groups. These experiences have lead to an elimination of formal religion (such as church/temple attendance) from their lives. Unfortunately, spirituality as a coping style is also eliminated.
However, many who leave their traditional faith find spiritual growth by redefining their spiritual and/or religious beliefs and practices. From this, LGBT and HIV+ gay men are provided with a sense of spiritual awakening. Likewise, LGBT and HIV+ gay men who are lucky enough to find affirmation in their formal/traditional faith groups might feel that affirmation enhances both their spirituality and their psychological health (particularly when combating negative feedback and/or homophobia from the larger society).
Given the developing distinction between organized religion and spirituality, it is necessary to consider them separate constructs as they relate to psychological health. Because spirituality can be seen as distinct from religion, developing a sense of spirituality separate from more formalized experiences with their faith groups may mediate the effect of negative religious experiences on the psychological health of these individuals. This can prove particularly useful and advantages for individuals living with HIV/AIDS that have felt that a relationship with a God or higher power was no longer an option for them, and not able to benefit from spiritual coping mechanisms.
In the next essay installment, the science behind how spirituality can benefit HIV + gay men will be discussed. Stay tuned.
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* After a hiatus from all religion, coming out, building myself into a proud man (all of which were challenging chapters), I have only recently begun to reconcile my feelings about a higher power and their place in my life. I know that many young LGBTQ people have had experienced similar, and often much worse, messages from religious figures in their lives. Many have turned away from religion and/or any spirituality because of these experiences. This is a great injustice. Spirituality, at a minimum, is an important coping skill for millions of people around the world. Many of those people are LGBTQ’s. However, researchers in the behavioral sciences have only begun to explore its utility for LGBTQ’s with regards to self-esteem, coping with chronic illness such as HIV/AIDS, and coping with an oppressive society. The following essays are part of my dissertation. They will discuss spirituality as a coping style, how it works, the academic dilemmas in examining these topics, and will hopefully spark more interest from researchers, and those of us still in hiatus from spirituality.
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