Sex, gender and sexuality

ARCSHS is the major player in framing the agenda and delivering the evidence to understand sex and sexuality in contemporary Australia. Through national surveys of the general population, the Centre helps track patterns and practices across the life course and across time. Over the next three years, ARCSHS will seek to maintain, profile, and draw upon these major research activities to influence policy and practice.

ARCSHS will also define and build on areas of expertise in specific aspects of health and wellbeing with diverse sexuality and gender minorities, including same-sex-attracted and gender-questioning young people. The Centre also has a focus on the intersection of sexuality with ageing, disability, and mental health.

ARCSHS has a focus on gender and its intersection with sexuality and health. This involves research into the conditions that normalise violence and abuse, and the ways that these cultures can be changed to promote respect and non-violence. ARCSHS research provides evidence upon which to base policy development and culture change programs in settings in a wide range of community, sport, workplace, and education settings.

The Second Australian Study of Health and Relationships

Anthony Smith, Juliet Richters (University of New South Wales), Chris Rissel (University of Sydney), Richard de Visser (University of Sussex, UK), Judy Simpson (University of Sydney), Andrew Grulich (Kirby Institute) and Paul Badcock

The Australian Study of Health and Relationships (ASHR) is our most important study of sexual and reproductive health. Conducted once a decade, it provides a snapshot of the sexual health and well-being of the Australian population and provides information essential for the development of policy and the delivery of sexual and reproductive health programs across Australia.

The survey is anonymous and people aged 16-69 from randomly selected households are personally invited to take part. The survey is designed to accurately reflect the experiences of all Australians regardless of their relationship status or whether they are sexually active. In order to achieve this, the interview is specifically tailored to the history the participant reports and does not ask questions that, given the history of the participant, are not relevant.

The types of questions that might be asked include a sexual history, partnership status, health status, recent sexual activity, sexual difficulties, reproductive history, sexual coercion and intimate partner violence, information about sexually transmitted infections along with knowledge and attitudes related to sexuality and sexual health. Interviews average less than 20 minutes.

Australian Longitudinal Study of Health and Relationships

Anthony Smith, Marian Pitts, Julia Shelley, Juliet Richters (University of New South Wales), Judy Simpson (The University of Sydney), Wendy Heywood and Kent Patrick

This NHMRC-funded study was established in 2003 to document the natural history of sexual and reproductive health in the Australian population. Evidence provided from this study will allow for more effective sexual health interventions and will enable researchers to understand the links between ‘risk events’ and health outcomes. In 2005, the first wave of data was collected and the fifth and final wave of data collection was completed in 2010. The results of this ground-breaking study will not only provide the foundations for future research but will be used to inform government policies, health professionals, and the Australian public as a whole. More than 25 articles from the study have been published in international journals.

Sexual Well-being and Ageing: A Study of Older Australian Women

Marian Pitts, Victor Minichiello (University of New England) and Gail Hawkes (University of New England)

This study of the sexuality of older women is the first to examine a significant cohort of women now entering old age: the women who demanded freedom of sexual expression in the swinging sixties. They present a unique historic opportunity to explore the subjective world of the first generation of post sexual liberation women growing old sexually. This project will undertake a qualitative analysis of the sexual subjectivities, health and wellbeing of women born between 1930 and 1950 to identify and challenge the complex relationships between ageism, sexism and sexual subjectivity, and develop a conceptual framework that advances our understanding of sex and sexuality in older women.

Work, Love and Play: Understanding Resilience in Same-Sex Parent Families

Amaryll Perlesz (Bouverie Centre), Andrew Bickerdike (Relationships Australia), Jen Power (Bouverie Centre), Marian Pitts and Margot Schofield (School of Public Health, La Trobe University)

Same-sex attracted parents and their children can experience discrimination within health, welfare, education and legal systems. This national and international longitudinal study, the largest ever conducted with same-sex parented families, aims to examine family patterns and relationships, and factors supporting resilience in same-sex attracted parents and their children. The study explores ways that health and community service providers can enhance the health and wellbeing of same-sex parented families. A major outcome of the study will be the development of Good Practice Guidelines for working with same-sex parented families that will inform policy and practice in a range of sectors, including health, counselling, education and courts.

Well Proud Women

Catherine Barrett and Anne Mitchell

The Well Proud Women project was funded by the Australian Lesbian Medical Association and involved working with Breast Screen Victoria (BSV) to increase their capacity to provide services that are inclusive of lesbian, bisexual and transgender women. The project involved working with BSV to develop a survey to understand the knowledge and screening practices of LBT women. A breast cancer forum was also facilitated and BSV has developed a tool to audit their services and will establish a working party to support change in response to the audit.

Exploring the Relationship Between Hazardous Drinking, Depression and Anxiety in Lesbian, Bisexual and Same-sex Attracted Women: Culture, Motivation and Behaviour

Ruth McNair (University of Melbourne), Dan Lubman (Turning Point Alcohol and Drug Centre), Tonda Hughes (University of Illinois), Kelsey Hegarty (University of Melbourne), William Leonard, Rhonda Brown (Deakin University), Amy Pennay (Turning Point Alcohol and Drug Centre)

The study will look at the reciprocal influence of hazardous alcohol use and depression and/or anxiety amongst women of minority sexual orientations. The study will explore the cultural significance of alcohol use among lesbian, bisexual and same-sex attracted women, and the relationships between their experiences of discrimination, stress and abuse and hazardous drinking and mental health problems. The study will also look at the barriers these women face in accessing mental health services and in particular a perception that mental health care professionals lack cultural awareness of and sensitivity to their issues. The project is funded for two years (2012-2013) by beyondblue as part of its Victorian Centre of Excellence in Depression, Anxiety and Related Disorder grants round.

Contemporary Issues in Sex and Sexuality: An Online, Cross-Faculty Elective for First Year Undergraduates at La Trobe University

Gary Dowsett, Gillian Fletcher, Dion Kagan, Lilian Austin and Joni Meenagh

Semester 2, 2012 saw ARCSHS deliver its path-breaking, online, undergraduate, elective Unit called Contemporary Issues in Sexuality Studies for the second time. The Unit is notable for its subject matter, its mode of teaching—which includes the use of both synchronous and asynchronous sessions designed specifically to promote active learning—its cross-Faculty and cross-campus availability, and its status as Faculty of Health Sciences ‘Signature Unit’. Contemporary Issues in Sex and Sexuality (unit code HLT1CSS) cuts across disciplinary boundaries to offer a valuable and interesting learning experience for students from all backgrounds. The Unit is offered entirely online, using advanced web teaching and learning technologies. It draws on a wide range of sources including media, web-based material and theory from the social sciences to help students examine and re-assess the range of meanings, values, assumptions and expectations embedded in social understandings of sex and sexuality. This second offering of the Unit was completed by a total of 65 students from the Melbourne and Bendigo campuses. Contemporary Issues in Sex and Sexuality has now been identified as a La Trobe University ‘Exemplar of Flexible and Online Learning’, and the unit is featured in a special issue of Journal of University Teaching and Learning Practice, published in 2012 and available at http://ro.uow.edu.au/jutlp/vol9/iss3/5.

Sexual Health and Ageing – Preventing the Sexual Assault of Older Women

Catherine Barrett, Jean Tinney (National Ageing Research Institute), Rosemary Mann (The McCaughey Centre) and Philomena Horsley (Centre for Women’s Health, Gender and Society)

The project was funded by the Department of Families, Housing, Community Services and Indigenous Affairs. It involves collaboration with the National Ageing Research Institute; the McCaughey Centre and the Centre for Women’s Health, Gender and Society at the University of Melbourne; Alzheimer’s Australia and the Council on the Ageing, Victoria. The project aims to strengthen the community’s ability to prevent the sexual assault of older women in aged care services and the broader community. The first stage of the project involves interviews and a survey to gather evidence from older women, their families, service providers and the broader community on the context of sexual assault. This stage of the project will be completed in 2013 and will form the basis of a national strategy for the primary prevention of the sexual assault of older women. To accompany the strategy, resources and an education program will be developed. As the first project to document an evidence base and strategy for the primary prevention of the sexual assault of older women, the project has generated significant community interest. A project support network has been established to engage stakeholders, who are considered pivotal to the development and successful implementation of the strategy.

Sexual Health and Ageing – Sexuality after Stroke

Catherine Barrett, Marian Pitts and Carolyn Whyte

This research and interdisciplinary practice change project is a collaboration with the Victorian Stroke Clinical Network. The project aim is to build the confidence and capacity of stroke clinicians to provide stroke survivors and their partners with information on sexuality after stroke. Nineteen clinicians from eight stroke services around Victoria are participating in the project as co researchers and change agents. The clinicians are being supported to conduct a needs analysis in their service including: surveying the knowledge and beliefs of staff, interviewing patients and auditing work structures and practices. In the 12 months following the needs analysis the clinicians are supported to change practice, evaluate outcomes, write a report on their processes and outcomes and present their project at a statewide seminar. The project is expected to result in improved patient care in the participating services, as well the development of a body of knowledge about ‘what it takes’ to implement that National Stroke Foundation’s guideline on providing patients and their partners with information on sexuality after stroke.

Sexual Health and Ageing – GLBTI-inclusive Home and Community Care Services

Catherine Barrett and Carolyn Whyte

This project is a partnership with the Municipal Association of Victoria and received funding from the Department of Health, Victoria. The project aim is to assist Home and Community Care (HACC) services to develop assessment practices that are inclusive of their gay, lesbian, bisexual, transgender and intersex (GLBTI) clients. The project involves developing resources for GLBTI inclusive assessment and providing education to assist in the implementation of the resources.

Sexual Health and Ageing – Discrimination, Depression, Anxiety and Older GLBTI People

Catherine Barrett, Carolyn Whyte, Liam Leonard and Jude Comfort (Curtin University)

This project is a collaboration with Curtin University and was funded by beyondblue. The aim of the project is to document older GLBTI people’s experiences of discrimination and the effect on their mental health. The project involves interviews with 10 older GLBTI people in Victoria and Western Australia, the analysis of themes from these interviews and the construction of small case studies to highlight the links between discrimination and mental health.

Sexual Health and Ageing – A Resource Kit targeting Depression and Anxiety among Older Gay, Lesbian, Bisexual, Transgender and Intersex Australians

Briony Dow (National Ageing Research Institute), Jean Tinney (National Ageing Research Institute), Catherine Barrett and Phil Maude (RMIT)

This project was funded by beyondblue and is a collaboration between the National Ageing Research Institute, ARCSHS and RMIT. The project will draw on the experiences of older GLBTI people and the research evidence to develop an education resource. Interviews with older GLBTI people will explore coping strategies, including how family members and health professionals have helped. The education resource will be piloted and evaluated in workshops for service providers, lectures for undergraduate students and a community forum for the GLBTI community.

Creating Healthy Workplaces: Y Respect Gender

Sue Dyson, Gillian Fletcher and Lizzie Smith

This project is part of the VicHealth Creating Healthy Workplaces program, which is building a body of knowledge about how to promote good health and prevent chronic disease in the workplace. It specifically focuses on identifying best practice approaches for addressing stress, gender inequality, alcohol-related harm, race-based discrimination and prolonged sitting at work. The Y Respect Gender project addresses gender inequality, is being conducted by YMCA Victoria and evaluated by ARCSHS. In its first year the evaluation has worked alongside the YMCA to develop a workplace for the project and the evaluation, and collected baseline data. The evaluation is based on a constructivist approach, and is based on a strong partnership between those working on the program and the evaluator with a focus on continuous learning.

Beyond the Glass Box of Silence and Inclusion: Victorian Health Promotion Foundation (VicHealth) Innovations Grant

Gillian Fletcher and Sue Dyson

This two-year project will analyse whether approaches and implementation processes within current safe sports participation and inclusion culture change projects in Victoria enable, or constrain, the participation and inclusion of gay, lesbian, bisexual, transgender and intersex (GLBTI) people in mainstream sporting settings. ‘Beyond the Glass Box of Silence and Inclusion’ will include use of innovative online methods to create discussion communities among GLBTI-identified, and non-GLBTI identified, sports people from across Victoria. It will result in the development of practical, evidence-based, principles for effective promotion of greater inclusion of GLBTI people in sport.

Fair Go! Sport (Phase 2): Evaluation

Gillian Fletcher and Lottie Turner

Early 2012 saw ARCSHS complete its collaborative evaluation of the innovative Fair go, sport! project, implemented by the Victorian Human Rights and Equal Opportunity Commission (VHREOC) and Hockey Victoria (HV); late 2012 brought with it a new contract, for the evaluation of Fair go, sport! Phase 2. The initial project, which began in September 2010, sought to increase awareness of sexual and gender diversity in hockey, promote safe and inclusive environments in sport, and develop a flexible model of engagement that could be adapted for other sporting codes and their governing bodies. The evaluation acknowledged project successes and identified five key components of these successes: use of an asset-based, action learning methodology; the attention paid to the complex, emotional aspects of the project; branding and visibility; commitment, expertise and representation; and use of networks to ‘spread the word’. In Phase 2, Hockey Victoria is deepening its work while Fair go, sport! is also being extended to another sporting code and to a schools setting.

Evaluation of AFL Victoria’s Fair Game Respect Matters Project

Sue Dyson and Jo Grzelinska

This five year evaluation (2008 – 2014) has worked alongside a project that focuses on shifting attitudes and behaviours that support violence against women in community sporting clubs. This includes sexism and group disrespect (rude and aggressive behaviour, and the marginalisation and denigration of women and girls). The ongoing evaluation works closely with AFL Victoria as the program is implemented with a view to providing feedback to enable continuous improvement. As the project enters its final year the focus is on sustainability into the future.

Taking a Stand: a Case Study of the Respect and Responsibility Program in the AFL, 2005-2011

Sue Dyson, Julienne Corboz, Moira Carmody (University of Western Sydney) and Michael Flood (University of Wollongong)

This is ARC Linkage project is a partnership between ARCSHS, the AFL and VicHealth. The project aimed to understand how the AFL had implemented the Respect and Responsibility program as a strategy to prevent violence against women, and focused on the AFL as a case study in workplace prevention. During 2011 data were collected and analysed and work is underway to report on the project’s key findings. Reporting and knowledge transfer activities will occur during 2013.

Evaluation of the AFL’s Community Education Program

Sue Dyson and Jo Grzelinska

In 2011 the AFL introduced a community education program to State Leagues and community clubs around Australia. The program provided education on the risks associated with, and the short and long term health effects of using illicit drugs and misuse of alcohol, and on respectful relationships and consent in sexual relationships. The target group for the education program was players in non-elite clubs aged 16 to 25 years; club administrators and volunteers were also welcome to attend. The program was delivered by trained educators in mixed gender pairs: the men were all current or past AFL players (near peers), women were from a range of backgrounds, all brought a range of expertise to the program. In 2012 ARCSHS was engaged to evaluate the program. The evaluation found that while a 90 minute education program cannot solve the problems the community faces in relation to alcohol, illicit drugs and respectful behaviours, the AFL’s community education program is a valuable addition to other forms of health education and social marketing. The approach used for the community education program proved to be an effective model for reaching this group of young men and others in community football clubs. In particular the delivery of the program by a male near peer and female co-facilitator was well received, and the interactive process was appreciated by participants.

Healthy Sporting Environments Evaluation

Sue Dyson collaborating with Russel Hoye, Matthew Nicholson and Emma Sherry (LTU Faculty of Law & Management, Research Centre for Sport and Social Impact)

This project has evaluated the Healthy Sporting Environments Demonstration project in 80 sporting clubs Geelong and south western Victoria. Leisure Networks is the agency implementing the project (2010 – 2012), which addresses alcohol, smoking, SunSmart behaviours and promotes the development of safe, inclusive environments for women, people from diverse communities, and those with a disability in a range of different winter and summer sports over two years. The evaluation has monitored the process and outcomes of the intervention in participating clubs.

Research report: ‘For the Love of the Game’: equal and respectful relationships in country football clubs

Sue Dyson, Jo Grzelinska and Carmel Hobbs

This VicHealth funded research aimed to establish an evidence base for the introduction of a culture change program to introduce equal and respectful relationships in country football/netball clubs. The research made recommendations for the roll-out of the Fair Game Respect Matters program in the Ballarat Football/Netball League in 2012. These included capacity building for effective change leadership, using a systems approach, creating a learning community and encouraging skills development.

The Tensions for Parents, Educators and Children in building a Sustainable Culture of Ethical and Respectful Relationships early in Life

Sue Dyson, Moira Carmody (University of Western Sydney) and Kerry Robinson (University of Western Sydney)

This ARC Discovery project (2011 – 2014) is a partnership between the University of Western Sydney and ARCSHS. It is located at UWS, and data collection is underway in New South Wales and Victoria. The project is investigating how parents, educators and children aged between 5 and 11 years develop the knowledge and skills necessary to build respectful relationships and ethical sexuality in their lives. A survey was conducted for parents, and interviews and focus groups were conducted with parents and children during 2011/12. In 2013 the focus will turn to collecting data from educators of children in the target age group.

Writing Themselves In 3: The Third National Study on the Sexual Health and Wellbeing of Same Sex Attracted and Gender Questioning Young People

Lynne Hillier, Tiffany Jones, Marisa Monagle, Naomi Overton, Luke Gahan and Anne Mitchell

This study, part of a VicHealth Public Health Fellowship, is the third national study on the sexual health and wellbeing of same-sex attracted and gender-questioning young people. The first was in 1998 and the second was in 2004. In this 2010 study, 3134 young people aged 14-21 took part in an online qualitative and quantitative survey about their sexual attractions, identity and behaviours, experiences of homophobic abuse, experiences of disclosure and support and their experiences of school. The data showed that homophobic abuse continued to rise and that 80% of those abused were abused at school. Significant links between abuse, self-harm, suicide attempts, drug use and feeling unsafe were identified. Despite this, young people felt better about their sexuality than in 1998 and 2004 and were more likely to disclose and receive support. Sexuality education in most cases failed to be inclusive with most young people finding it useless to them. It may not be surprising, therefore, that these young people had higher rates of pregnancy and sexually transmitted infections. There was evidence that support can be a buffer against the negative impacts of homophobia with young people who received support being less likely to self-harm or attempt suicide. Moreover, schools with protective policies against homophobic abuse and those which young people deemed supportive rather than homophobic had lower rates of self-harm and suicide and young people who attended them felt safer. This research will be used to inform policy in education and other government sectors. The report was launched on November 19th 2010 and since then the results of the survey have been widely disseminated at international and national conferences and at forums of key stakeholders. The data has also been used as the basis for resource development such as the training package developed by Gay and Lesbian Health Victoria for Headspace – this package is currently being rolled out nationally. These data were particularly showcased at the National Safe Schools Symposium run by the Foundation for Young Australians in October 2012.

Exposing Men’s Bodies: Young Men, Health and Body Image in Contemporary Australia

Duane Duncan

This project was funded by a La Trobe University, Faculty of Health Sciences Faculty Research Grant for Early Career Researchers, and began in early 2011. Recent research has indicated that body image is a significant concern for young Australian men with increasing evidence of engagement in unhealthy body image practices. This project seeks to contextualise these issues in relation to the wider emphasis placed on men’s bodies and individual identity in ‘late’ modernity. A series of in-depth interviews have been completed with young men aged 18-28 in Melbourne. Key emergent themes include an emphasis on athletic fitness as a measure of health and a focus on appearing sexually attractive, offset with the notion of not appearing to care ‘too much’. A Discovery Early Career Research Award application that develops and expands this pilot project will be submitted to the ARC in early 2013.

The Healthy Equal Youth Project (The HEY Project) - A Victorian same-sex attracted and sex and gender diverse (SSASGD) youth suicide prevention initiative

William Leonard

The HEY Project is an initiative funded by the Department of Health Victoria (DH) aimed at reducing self-harm and suicide among SSASGD youth and improving their mental health. The project is funded for four years (2011-2014) at a total cost of $4 million. The project involves funding of seven separate agencies and programs with proven expertise and success in working with, and on behalf of, SSASGD young Victorians. The project aims to increase the capacity of each of these organisations to address a particular area of need among SSASGD youth. It also aims to encourage these agencies to work in partnership with each other, and with mainstream youth and youth mental health services, to build an SSASGD youth platform within the mainstream youth sector. Gay and Lesbian Health Victoria in partnership with the Youth Affairs Council of Victoria is responsile for project management and coordination.

Men, Sexuality and Health Research Projects

ARCSHS now undertakes a number of collaborative research projects focused on men, sexuality and health, with a new focus on sexuality, resilience and recovery after men’s experience of prostate cancer.

Prostate Cancer Survivors’ Sexual Health and Well-being: A Pilot Study of Quality of Sexual Life and Health Services

Gary Dowsett, Duane Duncan, Murray Drummond (Flinders University), Shaun Filiault (Flinders University) and Annette Street (La Trobe University)

This pilot study, funded by a La Trobe University Faculty Research grant, is a collaboration between Gary Dowsett and Duane Duncan at ARCSHS, Associate Professor Murray Drummond and Dr Shaun Filiault at Flinders University in Adelaide, and Professor Annette Street, Associate Dean, Research, Faculty of Health Sciences at La Trobe University. The sexual function implications of prostate cancer (PCa) treatment are well documented in the scientific and medical literatures. This pilot study, situated in the fields of Sociology and Health and Illness, sought to explore men’s experience of treatment effects and sexual recovery following a diagnosis of PCa, and the health service support they have accessed to assist them. Participants were men diagnosed with PCa and who have undergone either radical prostatectomy or radiation therapy in the treatment of their cancer at least 12 months prior to recruitment. Seven men in all were interviewed in Melbourne and Adelaide. To optimise the diversity of the sample, for the purposes of testing the research interview schedule, five heterosexual and two gay men, were recruited with a mixture of single and partnered men. In all, this pilot study successfully tested an interview schedule and generated preliminary findings on men’s experiences of post-treatment recovery of sexual life following radical prostatectomy or radiation therapy for prostate cancer (PCa), which are currently being written up. Analysis of these data continues in relation to further findings from related projects listed below.

The FLEX Study: An Online Survey of Sexual Activity before and after Prostate Cancer

Gary Dowsett, Richard Wassersug (Dalhousie University and University of British Columbia), Anthony Lyons, Duane Duncan and Marian Pitts

This study was developed by ARCSHS Visiting Fellow, Professor Richard Wassersug. Professor Wassersug is from the Department of Anatomy and Neurobiology, Dalhousie University, Halifax, Nova Scotia, and the University of British Columbia, Vancouver, British Columbia, Canada. FLEX aimed to discover how men adjust their sexual practices when they are affected by prostate cancer treatments. The survey instrument was developed and data collection began in late 2010 and was completed in 2011. In all, 558 men from 25 countries completed the survey, the vast majority coming from the US, Australia, the UK and Canada. Analysis of the data has continued throughout 2011 and papers were presented at the Canadian Association of Psychosocial Oncology (CAPO) 2012 Conference. One paper from the project in currently under review and others are planned. Further analysis will take part in 2013. The findings of the survey should benefit all men who are overcoming the challenges of prostate cancer treatments. It will also help to guide the development of new ways for men to maintain sexual activity when affected by prostate cancer.

Prostate Cancer and Health Promotion for Gay/Bisexual Men

Gary Dowsett, Anne Mitchell and David O’Keeffe

ARCSHS was commissioned by the Prostate cancer Foundation of Australia in 2010–2011 to undertake an audit of health information resources targeted at, and available to, gay and other homosexually active men. Following from that audit, ARCSHS was commissioned in 2012 to undertake a small qualitative research project in Sydney and Melbourne assessing the needs of gay/bisexual men in terms of prostate health information and resources to inform the Foundation’s development of new resources. The project occurred in the third quarter of 2012 and a report, ‘They just assume Everyone’s Straight’: A Technical Report on Prostate Cancer and Health Promotion for Gay And Bisexual Men, was delivered to the Foundation in October 2012.

Other Activities and Future Projects

Under the leadership of Gary Dowsett, ARCSHS continues to be a partner in the Prostate Cancer Foundation of Australia’s National Initiative on Gay and Bisexual Men. Building on this work, November 2012 saw Gary Dowsett, Garrett Prestage and Duane Duncan awarded a major grant in the beyond blue National Priority Driven Research Program – Men’s Stream, on ‘Mental Health, Resilience and Sexual Recovery among Gay Men with Prostate Cancer’. Also, Gary Dowsett is an Associate Investigator on a Prostate Cancer Foundation of Australia Movember New Concept Research Grant funded in late 2012 on ‘Sexual Well-being and Quality of Life after Prostate Cancer for Gay and Bisexual Men and their Partners’, led by Professor Jane Ussher, University of Western Sydney, with other national and international investigators.