Still, We Thrive: Understanding How Gay, Bisexual, Transgender, and Other Men Who Have Sex with Men (GBTMSM) Experience Structural Barriers & Facilitators to Wellness
Bibliographic record
Abstract
Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, little is known about the relevance of 2SLGBTQIA+ affirming systems and policies for the wellbeing of GBTMSM. As such, this study seeks to expand on the scarce qualitative literature exploring how systems and policies may act as structural barriers and facilitators to wellness for GBTMSM. 30 GBTMSM with diverse ethnoracial identities, gender identities, HIV statuses and ages from across Southwestern Ontario (five per region) were purposively sampled through local AIDS service organizations (ASOs), other agencies and services who serve GBTMSM, and through social media platforms, including Instagram and Facebook. Semi-structured/narrative blended interviews were implemented to characterize how systems and policies serve as barriers and facilitators to wellness. Particular questions tended to favour a structural-level analysis, asking participants to reflect on their experiences with heteronormativity and/or cisnormativity, racism, healthcare access, sexual health education, and community cohesion. An inductive latent thematic approach following Braun & Clark’s Six Phases was employed to develop a coding grid, where a final set of themes were identified. Knowledge produced through this project will be used to identify tangible points for systems change, where greater 2LGBTQ+ affirming policies and services can be introduced.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.011 | 0.018 |
| Scholarly communication | 0.008 | 0.009 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".