Dana Rosenfeld

Identity work among lesbian and gay elderly

Abstract Both traditional and interactionist sociologies ignore the intersection of history, generations and life-course on the one hand and the local production of identity on the other. To document the local enactment and contestation of historically specific discourses that implicate and shape identity, I analyze the identity work of thirty-seven gay men and lesbians over the age of 65. I focus on the invocation and elaboration of competing discourses of homosexuality by subjects who identified as homosexual during different stages of life and different historical eras, and suggest that these “identity cohorts” are unique, unconsidered groups whose experience can shed light on the interplay between identity, generations, and social change.

Heteronormativity and Homonormativity as Practical and Moral Resources: The Case of Lesbian and Gay Elders

Studies of heteronormativity have emphasized its normative content and repressive functions, but few have considered the strategic use of heteronormative and homonormative precepts to shape sexual selves, public identities, and social relations. Adopting an interactionist approach, this article analyzes interviews with homosexual elders to uncover their use of heteronormative premises (specifically, the presumption of heterosexuality, and the gender binary) to pass as heterosexual. Informants also used homonormative precepts, grounded in a postwar, pre-gay liberation assimilationist homosexual politics they adopted in their early years and maintained in later life, to justify passing and to frame their understanding and evaluation of past and present homosexual practices. Viewed through a homonormative lens, heteronormativity provided the tools for personal survival in a hostile society and for the collective production of a respectable homosexual culture. Informants’ strategic use of heteronormativity can help explain heteronormativity’s survival despite the incoherence and fragility of its content.

The cross-culturing work of gay and lesbian elderly

Abstract Homosexuals wend their way through a hostile culture in which an understanding of the attitudes and actions of the dominant heterosexual culture is necessary for practical, emotional, and even physical survival. By virtue of their life-long experiences in such a culture, gay and lesbian elderly provide a perspicuous opportunity to examine practices through which people define and engage other cultural groups—practices we call “cross-culturing”. Our analysis of in-depth interviews with a sample of gay men and lesbians over the age of 65 showed that, for them, cross-culturing is complicated by divisions within the homosexual community regarding the appropriate response to the “heterosexual other”. We examine how our subjects use their relation to both heterosexual culture and to the alternative paradigms within the homosexual community to define and evaluate the self over the life course. We conclude the paper by suggesting the possibilities and concerns for exploring the response to cultural diversity among future cohorts of elderly, homosexual or otherwise.

Vital scientific puzzle or lived uncertainty?: Professional and lived approaches to the uncertainties of ageing with HIV

Abstract The ageing of the HIV population is unfolding within the context of a politicised history of medical care, medical breakthroughs changing HIV from a fatal to a chronic illness, and a long-standing treatment partnership between medical professionals and HIV patients. This article draws on in-depth interviews with those living with HIV in later life (aged 50 and over), as well as those working with them, to uncover how these various actors understand the nature and consequences of this new phenomenon, and whether their understandings and approaches vary according to the individual’s connection to it. All informants described the interaction between ageing and HIV as complex and incompletely understood, and accounted for their own uncertainties about this interplay as due to a global knowledge gap produced by the novelty of ageing with HIV. In these data, working in the area of, or being personally affected by, ageing with HIV emerged as ‘experiments in living, ’ with those variously involved in the phenomenon forced to take tentative, exploratory steps while navigating ‘uncharted territory.’ Yet, the poorly-understood nature of the ageing/HIV interplay was framed differently, with clinicians and scientists constructing it as a temporary gap in technical knowledge (a scientific puzzle), and non-medical stakeholders and older people living with HIV describing it as an anxiety-provoking source of chronic uncertainty permeating daily life. These differences and similarities can help us to reformulate what medical sociology has often constructed as a static ‘gulf’ between the clinical and the lifeworlds as, instead, gravitational pulls towards clinical and experiential dimensions of chronic illness as it unfolds in later life.

Midwifery as established sect: an expanded application of the church–sect continuum

Based on church–sect theory, this paper asserts that midwifery is much like an established sect in relation to its church equivalent: Western medicine. We find that midwifery can endure in this form – as both protest movement and established institution – because of its ability to maintain its central oppositional values while being accepted as a legitimate, if marginalized, profession. Using interview data from 25 Florida midwives, we draw an analogy between the liminal status of midwifery and three of the most important characteristics of the established sect: limited institutionalization, acceptance and opposition, and a unique value set. This comparison sheds light on both church–sect theory and midwifery, which also leads us to suggest that similar analogies be used for analysis across other sub-fields in sociology.

Strategies for improving mental health and wellbeing used by older people living with HIV: a qualitative investigation

ABSTRACT Recent research into “successful ageing” and “resilience” in the context of ageing with HIV highlights older people living with HIV’s (OPLWH) adaptations and coping strategies hitherto neglected by early research’s emphasis on difficulties and challenges. Yet “resilience” and “successful ageing” are limited by their inconsistent definition, conflation of personal traits and coping strategies, normative dimension, and inattention to cultural variation and the distinctive nature of older age. This article thus adopts an interpretivist approach to how OPLWH manage the challenges to their mental health and wellbeing of ageing with HIV. Drawing on interviews with 76 OPLWH (aged 50+) living in the United Kingdom, we document both the strategies these participants use (for example, “accentuating the positive” and accessing external support) and the challenges to these strategies’ success posed by the need to manage their HIV’s social and clinical dimensions and prevent their HIV from dominating their lives. This points to (a) the complex overlaps between challenges to and strategies for improving or maintaining mental health and wellbeing in the context of ageing with HIV, and (b) the limitations of the “resilience” and “successful ageing” approaches to ageing with HIV.

What influences quality of life in older people living with HIV

BackgroundPeople with HIV with access to treatment are growing older and living healthier lives than in the past, and while health improvements and increased survival rates are welcome, the psychological and social consequences and quality of life of ageing are complex for this group. Understanding how ageing, HIV and quality of life intersect is key to developing effective interventions to improve QoL.MethodsOne hundred people with HIV over the age of 50 (range 50–87, mean 58), were recruited through HIV community organizations, and clinics, and included men who have sex with men (MSM), and Black African and White heterosexual men and women. The WHOQOL-HIV BREF was used, as well as the Every Day Memory Questionnaire, and additional questions on anxiety and depression to supplement the WHOQOL.ResultsWhile most rated their quality of life (QoL) positively, bivariate analysis showed that better QoL (total score and most domains) was strongly associated with being a man; in a relationship; in paid employment; having higher level of income; not on benefits, and to a lesser degree with being MSM, having higher level of education, and diagnosed after the age of 40. Multivariate analysis showed that not being on benefits was the variable most consistently associated with better quality of life, as was being partnered. Concerns about everyday memory difficulties, and anxiety and depression scores were strong predictors of poorer quality of life.ConclusionWhile the cross-sectional nature of the investigation could not establish that the associations were causal, the findings indicate that concerns about memory difficulties, anxiety and depression, as well as gender, ethnicity, financial factors, and relationship status, are important contributors to QoL in this group. These findings point towards the need for further research to clarify the mechanisms through which the factors identified here affect QoL, and to identify possible interventions to improve the QoL of older people living with HIV.

Peacocks, Chameleons, Centaurs: Gay Suburbia and the Grammar of Social Identity:

This book offers a refreshingly new look at identity, its configuration, enactment, display, and contentious relation to other configurations and displays. Brekhus argues that the traditional focus on minority ghettos (symbolically “marked” or socially highlighted spaces that encourage the open display of marked social categories) has produced a skewed understanding of identity management, while suburbs (unmarked, generic spaces that do not encourage this display) provide an ideal opportunity to examine identity changes across social space. It is the very ordinariness of suburbia that Brekhus’ subjects (28 gay male residents of a Northeastern suburb) use to negotiate sexual identity. Space, its marked or unmarked nature and its use as a resource for constructing identity, figures largely here: The author seeks to advance the traditional assumption that social identity shapes the meaning of space, rather than the other way around. In contrast to work that posits identity as a static aspect of individuals, Brekhus is interested in capturing “identity variability across time and space,” which he terms the “micro-ecology of identity” (p. 17). Identity, Brekhus writes, has three components: “duration” (the length of time a particular attribute is presented), the “intensity” with which actors present this attribute, and identity “dominance” (the extent to which an attribute “occupies one’s whole self” [p. 28] and thus a combination of duration and intensity). Brekhus constructs ideal types based on distinct configurations of these components to uncover how identity is differentially deployed across contexts. The “peacock,” or “lifestyler,” has a high-density, long-duration gay identity, enacting a strong version all the time. The “centaur,” or “commuter,” has a low-duration, high-density gay identity, enacting a strong version only in marked gay spaces (i.e., Manhattan gay bars) for short periods of time, then returning to the suburbs where he declines to enact it. Finally, the “chameleon,” or “integrator,” has a low-density, high-duration gay identity, living openly as gay on his own turf, but treating his homosexuality not as a master status but as one of a number of equally important attributes. The author suggests that identity be seen as a grammar: Gay identity is treated as a noun by lifestylers, a verb by commuters, and an adjective by integrators. Not surprisingly, this is a contested grammar within the gay community, as it is among other groups (i.e., religious, subcultural, class, occupational, and hobbyist: Consider the cultist versus the holiday Christian). Both ascribed and achieved identities are thus the product of complex work that takes space, time, and intensity into account as idealized standards and practical circumstances to which identity work must adjust, a finding that furthers our understanding of identity construction and deployment in important ways. Unfortunately, these insights are insufficient to sustain an entire monograph. The book is almost overwhelmingly repetitive, within paragraphs and across chapters and footnotes. Chapter 5 repeats the findings of Chapters 2–4; later chapters, based on secondary sources and seeking to demonstrate the applicability of the author’s theoretical framework to other groups, offer little, if anything, new; Chapters 8–10, examining how subjects’ views on the appropriate duration, density, and dominance of identity differ, repeat previous findings or convey subtleties that the reader could have uncovered herself. A light reading might suggest that these later chapters chart new territory, but this is only because the author, in distractingly Goffmanian style, repeats old findings using a slew of metaphors: identity is variously monogamous/polygamous, spicy/bland food, strong/watered down liquor, single/multi-course meals, univerous/omnivorous, quiet/noisy, and singular/plural. Other