Presenter(s):

Alex Siu Wing Chan; Elsie Yan; Florence Kwai Ching Wong; Anelise Gregis Estivalet, Hong Kong Baptist University, Hong Kong

Abstract

Background: Older men who have sex with men (MSM) frequently experience discrimination and marginalization due to intersecting forms of ageism and homophobia, which significantly undermine their psychological well-being. While previous research has examined the challenges faced by older MSM in Western contexts, fewer studies have explored these dynamics in East Asian societies, where cultural norms and social policies regarding aging and sexual orientation differ considerably.

Aim and objectives: This study investigates the influence of social factors—including stigma, social acceptance, and policy environments on the psychological well-being of older MSM, with a comparative analysis across China, Hong Kong, and Taiwan. These regions share cultural roots but differ in their legal and social treatment of LGBTQ+ individuals, providing a unique opportunity to assess how varying sociopolitical contexts shape mental health outcomes.

Methods: A comparative approach was employed, collecting survey data from a total of 453 older MSM (aged 50+) across mainland China, Hong Kong, and Taiwan. Standardized measures were used to assess perceived stigma, social acceptance, psychological well-being, and the impact of local social policies. Control variables such as age, education level, and income were included to account for potential confounding influences. Data analysis involved descriptive statistics, ANOVA for regional comparisons, and regression modeling to evaluate the relationships between stigma, social support, and psychological well-being.

REsults: The findings reveal that stigmatization exerts a significant negative effect on psychological well-being across all three regions. Regression analyses confirmed the overall significance of the models, with F-statistics indicating strong predictive power: China (F = 69.583, p< 0.001), Hong Kong (F = 51.971, p< 0.001), and Taiwan (F = 57.725, p < 0.001). Adjusted R-squared values further demonstrated that the models explained a substantial proportion of variance in psychological well-being: China (Adj R² = 0.632), Hong Kong (Adj R² = 0.514), and Taiwan (Adj R² = 0.565). Notably, while stigma was a consistent predictor of poorer mental health, the strength of this relationship varied slightly by region, with mainland China exhibiting the highest explanatory power, possibly due to its more restrictive social climate.

Conclusion: Additionally, social acceptance and inclusive policies were found to mitigate some of the adverse effects of stigma, particularly in Taiwan, where LGBTQ+ rights are more advanced. These findings underscore the importance of addressing structural discrimination while fostering supportive environments for older MSM. The study contributes to the broader literature on aging and sexual minority health by highlighting the role of sociopolitical contexts in shaping mental health disparities. Practical implications include the need for targeted anti-stigma interventions, community support programs, and policy reforms to enhance the well-being of older MSM in East Asia.

Bio(s):

Prof. Alex Chan is an Assistant Professor (tenure track) in the Department of Social Work at Hong Kong Baptist University, a Chartered Psychologist (BPS), and a Registered Social Worker in Hong Kong. His research focuses on promoting physical and mental health within the LGBTQ community, covering topics such as culture and homosexuality, psychological well-being, aging, HIV/AIDS, and stigma related to men who have sex with men. During the COVID-19 pandemic, his research on the impact of COVID-19 on chronic diseases was included in the WHO COVID-19 database. Additionally, Prof. Chan is a Fellow of the Royal Society for Public Health (U.K.), and the Royal Society of medicine (U.K.). He serves on the editorial boards of several journals, including the Journal of Medicine, Surgery, and Public Health, PLOS One, and BMC Public Health, while also acting as an Associate Editor for Frontiers in Public Health.