恐同對待對同性戀和雙性戀男性之精神健康影響

Effects of Homophobic Maltreatment on Mental Health in Gay and Bisexual Men

王建權(Chien-Chuan Wang)

指導教授 ： 顏正芳

高雄醫學大學/醫學院/醫學研究所博士班/博士(2019年)

摘要

對同性戀和雙性戀族群而言，霸凌和騷擾受害是重大且常見的負向經驗之一。本研究目的有二：(一) 檢驗在兒童青少年時期經歷過基於性別角色不一致和性傾向的恐同傳統和網路霸凌之同性戀和雙性戀男性，在成人初期的憂鬱、焦慮、身體疼痛的關聯，以及家庭和同儕支持對於此關聯性的調節效果；(二) 同性戀和雙性戀男性在成人初期經歷傳統和網路騷擾與自我認同混亂之間的關聯性。
本研究包括兩部分。第一部分是在2015年8月至2017年7月期間招募500名年齡為20至25歲的同性戀和雙性戀男性參與研究，依據兒童青少年時期經歷過的傳統和網路恐同霸凌，區分為兩種恐同霸凌經驗皆有組(n = 109)、僅經歷過傳統或網路恐同霸凌其中一種組(n = 173)、未經歷過傳統或網路恐同霸凌組(n = 218)，比較三組憂鬱、焦慮以及身體疼痛嚴重程度的差異，同時檢驗家庭和同儕支持對恐同霸凌受害和憂鬱、焦慮、身體疼痛的關聯性之調節效果。第二部分是在2016年7月至2017年5月期間招募305名年齡為20至25歲的同性戀和雙性戀男性參與研究，調查受試者的自我認同混亂、與過去一年遭受傳統和網路恐同騷擾間的關聯性，並檢驗恐同騷擾受害經驗的種類、傳統恐同騷擾發生地點，與自我認同混亂的關聯性。
第一部分研究發現：相較於非受害者，在兒童青少年時期經歷過任何型式之恐同霸凌的受害者，在成人初期有較嚴重的憂鬱、焦慮、身體疼痛。傳統和網路兩種型態恐同霸凌的受害者，比只經歷過傳統或網路恐同霸凌其中之一的受害者，在成人期有較嚴重的焦慮。同性戀和雙性戀男性所感受在兒童青少年時期的家庭支持程度，調節了恐同霸凌受害與成人初期焦慮和身體疼痛程度的關聯性，但同儕支持並無此調節效果。第二部分研究發現：相較於非受害者，過去一年遭受言語嘲笑和關係排斥、和遭受肢體暴力和財物遭掠奪的受害者，都有較高度的自我認同不安和缺乏認同。在多處地點經歷過傳統騷擾的受害者，相較於在單一地點經歷過騷擾的受害者，有較高度的自我認同未鞏固和缺乏認同。經歷過多種型式騷擾的受害者，相較於經歷過單一型式騷擾的受害者，有較高度的自我認同未鞏固。
本研究的結果顯示：(一)兒童青少年時期遭遇恐同霸凌，與同性戀和雙性戀男性在成人初期精神健康問題有顯著關聯，而家庭支持具有調節效果；(二)同性戀和雙性戀男性在成年初期遭受恐同騷擾，與目前自我認同混亂有顯著的相關。

關鍵字

同性戀 ； 雙性戀 ； 恐同霸凌 ； 性別角色不一致 ； 性傾向 ； 騷擾 ； 自我認同

並列摘要

Being the victims of homophobic bullying and harassment is one of the most miserable experiences that gays and bisexual individuals can have. The aims of the present study examined: (1) the differences in the current levels of depression, anxiety, and physical pain among gay and bisexual men in emerging adulthood with various experiences of traditional and cyber homophobic bullying victimization based on gender role nonconformity and sexual orientation in childhood and adolescence, as well as the moderating effects of family and peer support, and (2) the relationships between traditional and cyber harassment in the past one year and current self-identity confusion among Taiwanese gay and bisexual men in emerging adulthood.
The present study contained two parts. In the part one of the study, a total of 500 gay or bisexual men (age, 20–25 years) in Taiwan were recruited since August 2015 to July 2017. The levels of depression, anxiety, and physical pain among gay or bisexual men who have experienced both traditional and cyber homophobic bullying (n = 109), only traditional or cyber bullying (n = 173), and neither traditional nor cyber bullying during childhood and adolescence (n = 218) were compared. The moderating effects of family and peer support on the relationships of homophobic bullying victimization with depression, anxiety, and physical pain were also examined. In the part two of the study, a total of 305 gay or bisexual men (age, 20–25 years) in Taiwan were recruited from July 2016 to May 2017. Participants’ current self-identity confusion and the experiences of traditional and cyber harassment in the past one year were assessed. The relationships of harassment victimization, number of places at which traditional harassment occurred, and type of harassment victimization with self-identity confusion were examined.
In the part one of the study, victims of any type of homophobic bullying in childhood and adolescence had more severe depression, anxiety, and physical pain in emerging adulthood than nonvictims. Victims of both traditional and cyber homophobic bullying had more severe anxiety in adulthood than victims of only traditional or cyber homophobic bullying. Family but not peer support in childhood and adolescence moderated the relationships of homophobic bullying victimization with current levels of anxiety and physical pain in emerging adulthood. In the part two of the study, both victims of verbal ridicule and relational exclusion and victims of physical aggression and theft of belongings had higher levels of disturbed identity and lack of identity than did nonvictims. Those who experienced traditional harassment at multiple places had higher levels of unconsolidated identity and lack of identity than did those who experienced traditional harassment at only one place. Those who experienced multiple types of harassment had higher levels of unconsolidated identity than those who experienced only one type of harassment.
The results of the present study support that: (1) homophobic bullying victimization in childhood and adolescence was significantly associated with depression, anxiety and physical pain in emergent adults among gay and bisexual men; family support had the moderating effect. (2) traditional harassment victimization and multisite and multitype harassments were significantly related to self-identity confusion in gay and bisexual men.

並列關鍵字

gay ； bisexuality ； homophobia ； homophobic bullying ； gender role nonconformity ； sexual orientation ； harassment ； self-identity

參考文獻

性別平等教育法(民 93年6月23日)。

台灣版世界衛生組織生活品質問卷發展小組(2001)。台灣版世界衛生組織生活品質問卷之發展及使用手冊（第一版修訂版），台北，台灣版世界衛生組織生活品質問卷發展小組。

姚開屏(2002)。台灣版世界衛生組織生活品質問卷之發展與應用。台灣醫學，6(3)，193-200。

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition. Washington: American Psychiatric Association.

American Psychological Association. (2008). Answers to your questions:For a better understanding of sexual orientation and homosexuality. Washington, DC. Available at http://www.apa.org/topics/lgbt/orientation.pdf.