Culture and Sexuality: Familismo and Mental Health Stigma

Yeshiva University Wurzweiler School of Social Work alumni and adjunct professor Carlos E. Gerena, PhD, LMSW, published an article, “Navigating Culture and Sexuality: What Social Workers Need to Know,” in the Journal of Ethnic & Cultural Diversity in Social Work.

Gerena notes that familismo, a central theme in the Latino community, and its impact on mental health, specialically in gay men, has not been studied, meaning that culturally senstive interventions are lacking. Stigma around mental health in this community also means that mental health needs go unaddressed. In this article, Gerena highlights the current gaps in research and offers implications for future research to help devise culturally appropriate interventions for this population.

Gerena notes that familismo is a cultural concept that places importance on the family—cohesion, support, and loyalty. It places the family before the individual and puts an emphasis on honoring the family. Familismo is often influenced by machismo, which celebrates hypermasculinity and eschews any feminine traits in men. In machismo culture, homosexuality is viewed as taboo.

For Latino gay men, the concept of familismo often means that they are viewed as challenging their traditional roles in the family. Homosexuality, then, would be viewed as a shame or dishonor on the family. Gerena cites a 2017 study about how gay men would hide their sexuality from their families, suggesting that familismo has an impact on the coming out process. In the study, 70 percent of the men involved felt that being gay hurts their families, while 64 percent said they hid their sexuality in order to be accepted.

Gerena notes that, compared to other cultures, Latino’s underutilize mental health services. Seeking mental health treatment is stigmatized and due to cultural influences, Latinos are more likely to seek help from informal or religious services. For Latino men operating under the cultural ideals of familismo and machismo, seeking mental health treatment is difficult. They are less-likely to see treatment than African-, Asian-, and European-Americans.

Gerena notes that Latino gay men experience higher rates of phyciatric disorders, and when paired with familismo, mental health issues were exacerbated. In order to see any improvement in attitudes toward mental health treatment for Latinos as a whole, and for gay men specifically, social workers and counselors will need to have a cultural understanding of familismo.

Gerena underscores the need for more scholarly research in this area. There have been some studies on familismo and how it impacts the mental health of Latino gay men, but proper interventions are still lacking. And that lack of research limits social workers’ knowledge and skills when working with Latino gay men. More information around this topic would help navigate sessions with affected individuals.

Culturally appropriate interventions will be key to reaching Latino gay men, and social workers must be willing to adjust their practices. Getting these men to use mental health services and keeping them in treatment long enough to address their psychological needs may not be an easy task, but will be necessary to improve the mental health outlook for this population. Gerena suggests that social workers can help by actively seeking ways to help Latino gay men build resource networks, learn self-care, and implement goals and objectives. Social workers should also run a review of treatment plans at regular intervals to find evidence of progression in their clients, or to identify potential barriers.

What are some specific ways that social workers can help right now? Gerena suggests that acknowledging cultural norms and how they influences the coming out process for Latino gay men is an important first step. Since cultural norms can dictate how family members react to an individual coming out, social workers can explore the relationship between Latino gay men and their families to determine if the family is a supportive network.

Acceptance will be a community effort. Social workers can help families bridge the gap to better navigate between accepting their homosexual family memeber and meeting the traditional norms dictated by familismo. This can be done by social workers encouraging families to have honest conversations about a family member’s sexuality during a safe and open session, if the family is supportive and open to the honest discussion.

The full article can be found here, but note that an account is required to view the entire piece.

Gerena is a mental health therapist whose research interests include issues within the gay Latino community, health disparities among gay men of color, and clinical social work. Genera is an adjunct professor at Yeshiva University, teaching courses on cultural diversity and human behavior and social environment. He earned his MSW from Fordham University with a specialization in childhood and adolescent trauma. He earned his PhD in Social Work from the Wurzweiler School of Social Work. His doctoral dissertation was entitled, “Conflict between Culture and Sexuality: A Qualitative Study of the Coming Out Experience of Latino Gay Men.”

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