Professional Help-Seeking in Men Experiencing Sexual Problems The Role of Sexual Identity and Minority Stress

Background: Only a minority of men experiencing sexual problems will seek professional help and the proportion of gay or bisexual men can be even lower. Aim: To investigate if sexual identity and minority stress are related to professional help-seeking in Polish gay and bisexual men. Methods: Sexual identity was measured with the standard question: " Do you consider yourself to be heterosexual, gay, or bisexual?" Men who provided a complete set of answers to the study tools and replied "yes" to the question: "Have you ever had a problem with sexual functioning that lasted at least several months?" were included (N-total =644, N-straight = 203, N-gay = 324, N-bi = 117). A simple question on help-seeking was: "Did you seek professional assistance then?" Other data were gathered with the use of a self-constructed questionnaire. Minority stress processes, that is, internalized homophobia, expectations of rejection, and identity concealment, were measured with the subscales of the Sexual Minority Stress Scale. Bivariate analyses and multivariate logistic regressions were performed to test the statistical significance of sexual identity and minority stress processes as predictors of professional help-seeking. Outcomes: Contacting a specialist when experiencing a sexual problem. Results: A total of 84.5% of all men did not seek professional help. Gay identity (OR = 0.58, P =.045), as opposed to bisexual identity, was significantly related to reduced odds of consulting a specialist. Age (OR = 1.03, P =.005), number of doctor's visits per year (OR = 1.51, P <.001), and a psychiatric diagnosis (OR = 1.65, P =.043) were positively related to help-seeking behaviors. Identity concealment significantly decreased the likelihood of consulting a specialist (OR = 0.94, P =.017). Clinical Translation: Specialists need to be aware that gay identity and identity concealment may prevent a proportion of men from seeking their help and thus should be publicly explicit about their inclusive and nonpathologizing approach to sexual diversity. Strengths and Limitations: The major strengths of the study include the use of a relatively large sample size and data from the little recognized Polish context characterized by a predominantly hostile anti-LGBT social climate, and exploration of a neglected topic of substantial significance at the public and individual levels. The major limitations are the use of nonprobability sampling, cross-sectional self-report design, and a single question to capture the presence of sexual problems with no measurement of associated distress. Conclusion: Gay men are at risk of avoiding help-seeking when experiencing sexual problems because of identity concealment.