Social Science & Medicine 272 (2021) 113735

Contents lists available at ScienceDirect

Social Science & Medicine

journal homepage: http://www.elsevier.com/locate/socscimed

Minority stress, psychosocial health, and survival among gay and bisexual
men before, during, and after incarceration
Tyler D. Harvey *, Danya E. Keene, John E. Pachankis
Social and Behavioral Sciences Department, Yale School of Public Health, 60 College St, New Haven, CT, USA

A R T I C L E I N F O A B S T R A C T

Keywords: Gay and bisexual men (GBM) are incarcerated at nearly twice the rate as the general United States male pop­
Incarceration ulation. Minority stress, namely the unique social stressors related to anti-GBM stigma and discrimination, is
Gay and bisexual men central to GBM’s experiences in ways that might put them at risk of incarceration and psychosocial risks during
Sexual identity
and after incarceration. In this qualitative study, we examined how GBM navigate minority stress and how this
Minority stress
Identity management
navigation influences their psychosocial health before, during, and after incarceration. We conducted semi-
Psychosocial health structured, in-depth interviews with 20 formerly incarcerated GBM in New York City, diverse in terms of race
and time since last release. Our findings document the many ways in which GBM manage their identities in the
context of minority stress and how such management exposes them to, or helps them avoid, minority stress and
associated psychosocial health risks surrounding their incarcerations. Here, we report dominant themes before,
during, and after incarceration for GBM, including minority stress: 1) as catalyzing incarceration-related expe­
riences, 2) as motiving identity management techniques to survive the hegemonic masculinity and normative
anti-GBM stigma of incarceration, and 3) as a determinant to reentry support and sexual expression after
incarceration. These findings suggest potential changes to public health policy and practice to better serve the
needs of currently and formerly incarcerated GBM and to prevent such incarceration in the first place.

1. Background
The United States (US) incarcerates more people per capita than any
other country in the world (Wagner and Sawyer, 2018). Compared to the
general US population, gay and bisexual men (GBM) and other men who
have sex with men (MSM), including those who may not identify as a
sexual minority but engage in sexual activity with members of the same
sex, are disproportionately more likely to be incarcerated at some point
during their lives (Meyer et al., 2017). According to the National Inmate
Survey (2011–2012), 6.2% and 9.3% of men in jails and prisons,
respectively, are sexual minorities (Meyer et al., 2017), despite this
group making up only 2.2% of the general US male population (Ward
et al., 2014). Further, sexual minority men of color are particularly
impacted by incarceration; 27% of incarcerated GBM men are Black, and
near one in two Black MSM report an incarceration history (Meyer et al.,
2017; Schneider et al., 2017).
Incarceration has numerous health effects, including possibly
increasing risk for communicable diseases, chronic health conditions,
substance use, and mental health disorders (Wildeman and Wang,
2017). The little evidence that exists regarding the distinct effects of
incarceration on the health of GBM suggests that criminal legal
involvement among GBM and other MSM is associated with increased
substance use, elevated HIV risk behaviors, and high rates of sexually
transmitted infections (STIs) both during and after incarceration (Har­
awa et al., 2018; Khan et al., 2011; Lim et al., 2011; Schneider et al.,
2017). This limited evidence therefore suggests that incarceration might
further exacerbate the psychosocial health risks that GBM in the general
population disproportionately experience.
Despite the known sexual orientation disparities in incarceration and
its public health impact, little research exists on understanding the
unique stressors that place GBM at risk for incarceration and how
incarceration, in turn, may distinctively impact GBM. To address this
gap, we conducted semi-structured interviews with 20 formerly incar­
cerated GBM in New York City to better understand their minority stress
experiences prior to, during, and after incarceration. The analysis pre­
sented here examines how minority stress may lead to disproportionate
risk of incarceration among GBM and how GBM navigate their sexual
identity in light of the normative minority stress of the carceral setting

* Corresponding author.
E-mail address: tyler.harvey@yale.edu (T.D. Harvey).

https://doi.org/10.1016/j.socscimed.2021.113735
Received in revised form 8 December 2020; Accepted 27 January 2021
Available online 30 January 2021
0277-9536/© 2021 Elsevier Ltd. All rights reserved.
T.D. Harvey et al.
and community reentry.
2. GBM’s minority stress in the context of incarceration
Evidence suggests that unique forms of structural, interpersonal, and
individual stigma compromise the psychosocial health of GBM (Meyer,
2003). Particularly, the minority stress model outlines the excess stress
that GBM men experience because of their sexual identity across struc­
tural (e.g., anti-GBM laws and policies; Hatzenbuehler, 2016), inter­
personal (e.g., victimization and discrimination; Mays and Cochran,
2001), and individual (e.g., identity concealment; Pachankis et al.,
2020) levels (Meyer, 2003). As reviewed below, research suggests that
minority stress might also operate across these levels in carceral contexts
to explain GBM’s disproportionate risk of adverse outcomes in these
settings.
As evidence of structural minority stress, US correctional facilities
have administrative rules barring consensual sex among those incar­
cerated, and breaking such rules can result in removal of certain privi­
leges (Borchert, 2016). A non-representative sample of 1118 currently
incarcerated lesbian, gay, bisexual, and transgender (LGBT) individuals
in the US found that two-thirds of incarcerated LGBT individuals have
been placed in solitary confinement for consensual sex (Lydon et al.,
2015). Further, GBM are 1.8 times as likely to experience solitary
segregation compared to heterosexual men (Meyer et al., 2017). Evi­
dence has also established that GBM experience harsher sentencing,
which could expose this population to higher and longer levels of
distress compared to the general incarcerated population (Meyer et al.,
2017). GBM inside prisons and jails also have limited access to appro­
priate sexual health services pertinent to their needs. Very few U.S.
detention facilities have condom distribution programs, and to date,
pre-exposure prophylaxis (PrEP) is largely unavailable for those who
wish to continue its usage or who are interested in initiating it while
incarcerated (Brinkley-Rubinstein et al., 2018; McCuller and Harawa,
2014).
These documented structural realities may contribute to interper­
sonal forms of minority stress for incarcerated GBM. LGBT incarcerated
individuals are six times as likely to be sexually assaulted compared to
heterosexual/cisgender prisoners (Lydon et al., 2015). Other forms of
violence include verbal harassment, with 83% of LGBT incarcerated
individuals reporting harassment by fellow incarcerated individuals and
70% stating that have been harassed by correctional staff (Lydon et al.,
2015). GBM are also 18.5 times more likely to report being assaulted by
another individual while incarcerated compared to heterosexual men
(Meyer et al., 2017). Violence exposure is associated with numerous
psychosocial health problems, including depressive symptoms and sui­
cide attempts, for GBM in the general population (Miltz et al., 2019;
Mustanski et al., 2014). Indeed, GBM are 2.5 times as likely as hetero­
sexual men to report poor mental health while incarcerated (Meyer
et al., 2017).
3. Sexual identity management to navigate minority stress
At the individual level, one way in which minority stress and stigma
gets under the skin to compromise GBM’s psychosocial health is through
continual demands to manage one’s identity to avoid structural and
interpersonal manifestations of minority stress (Pachankis, 2007).
Identity management theory suggests that GBM must continually decide
if, when, and how to reveal their sexual identity and emphasizes the role
of contextual factors in dictating how sexual minorities make decisions
to reveal or disclose their identities (Cain, 1991; Chrobot-Mason and
Button, 1999; Clair et al., 2005). Studies document that sexual minor­
ities are keenly aware of the costs and benefits surrounding disclosure of
their stigmatized sexual identity depending on the particular contexts
that they inhabit (Griffin, 1991; Oakleaf, 2013; Woods and Harbeck,
1992). Research also shows that individuals with a concealable stig­
matized identity decide whether or not to disclose their identities upon
2
Social Science & Medicine 272 (2021) 113735
weighing the anticipated pros and cons of doing so (Chaudoir and
Fisher, 2010). However, identity management theory has not been
applied to GBM in carceral settings, despite the prominent features of
such settings that make disclosure of sexual minority identities within
them a particularly salient decision with potentially important impli­
cations for psychosocial health and perhaps survival.
The prison environment is a hypermasculine space in which hege­
monic masculinity is emphasized and perpetuated (Hensley et al., 2003;
Michalski, 2017). The construct of hegemonic masculinity provides a
useful framework for understanding how GBM navigate minority stress
while incarcerated for several reasons: 1) masculinity is contextualized
in specific scenarios (e.g., prisons or jails) in which “maleness” takes
unique forms, 2) it allows for framing social hierarchy within “domi­
nant” (i.e., heterosexual) and “subordinate” (i.e., sexual minority) cat­
egories based on the performance of local sexual and gender norms, and
3) it understands men’s identities in terms of their actions, thoughts, and
relative power (Donaldson, 1993). The minority stress experiences of
incarcerated GBM may widely vary depending on the ways in which
they choose and are allowed to manage their sexual identity against the
standards of hegemonic masculinity in carceral systems. Given the rigid,
hypermasculine notions of sexuality and gender expression within
prisons and jails, GBM may experience psychosocial health risks as a
function of how they manage minority stress while incarcerated. For
example, those who decide to publicly disclose and embrace their
identity may be at increased risk of experiencing interpersonal forms of
minority stress, including violence, given the prominent masculine
standards within carceral institutions; whereas those who conceal might
forfeit certain identity-based resources.
A recent qualitative study among 14 currently and formerly incar­
cerated GBM in Australia provides insight into the identity management
strategies employed by GBM within heteronormative prison structures
(Yap et al., 2019). Specifically, this study found that currently and
formerly incarcerated GBM managed their sexual identity in four ways
within the context of their incarcerations: 1) coming out (of the closet),
2) being forced out, 3) going back in, and 4) staying out. Some also
employed strategic outness, a disclosure technique that involved
revealing their identity after carefully assessing the social dynamics,
costs, and benefits within their specific settings (Yap et al., 2019). Other
qualitative work supports the fact that strategic outness might provide
certain advantages for incarcerated GBM. For example, in-depth in­
terviews in a separate sample of 14 heterosexual men revealed that GBM
may gain power within correctional facilities by taking on more femi­
nine gender roles, such as growing their hair and changing their voices
to be higher pitched (Hefner, 2017). To use the language of a related
theory, GBM’s decision-making about disclosure in carceral settings
responds to the “moral economy” (Hansen et al., 2014; Thompson,
1971) of social value and survival in those settings, which research
suggests is heavily driven by the micropolitics of gender and its enact­
ment. Given the hegemonic masculine structure of incarceration, the
everyday interactions of those incarcerated may place more social value
on traditional masculine norms than in contexts outside of incarceration.
Therefore, GBM may be in a unique position to enact identity strategies
that align with, go against, or exist outside the moral economy of the
carceral setting by managing their identities in ways that mitigate mi­
nority stress and promote survival. In this way, a moral economy
framework highlights the high stakes of successful identity management
imposed by carceral settings for GBM.
4. The current study
While emerging research sheds light into the structural and inter­
personal minority stress experiences of formerly and currently incar­
cerated GBM, less is known about how minority stress plays out for GBM
at the individual level and whether identity management may be one
such manifestation with consequences for psychosocial health. Given
the importance of both minority stress and identity management to the
T.D. Harvey et al.
overall psychosocial health of GBM (Pachankis et al., 2020), identity
management strategies likely impact GBM’s psychosocial health at all
stages of incarceration. Indeed, while previous research in the general
population of GBM suggests that disclosure is typically associated with
psychosocial health benefits (Pachankis et al., 2020), the opposite might
be true for incarcerated GBM ,or–under particular circumstances within
the carceral moral economy–might potentiate risk for incarceration.
Applying theories of minority stress, identity management, hege­
monic masculinity, and moral economy to GBM’s incarceration experi­
ences, we seek to examine how formerly incarcerated GBM experienced
minority stress and managed their sexual identity prior to, during, and
following incarceration and the psychosocial health consequences of
these experiences. The results of this study can highlight unique mi­
nority stress pathways to incarceration for GBM as well as the impact of
minority stress and identity management on GBM’s psychosocial health
during incarceration and upon community reentry.
5. Method
5.1. Study design and setting
We conducted semi-structured interviews with GBM residing in New
York City (NYC). We employed an abductive approach in which we
utilized established theoretical frameworks (i.e., minority stress, iden­
tity management, hegemonic masculinity, and moral economy) along­
side inductive analysis to understand how GBM navigated minority
stress in relation to their incarcerations (Timmermans and Tavory,
2012). Given the limited knowledge surrounding this topic, we asked
open-ended questions while following up on any unanticipated themes
that emerged. This study took place in NYC, with a jail population of 166
persons per 100,000 and prison population of 374 persons per 100,000
for the general population aged 15–64 years old (Vera Institute of Jus­
tice, 2020).
5.2. Recruitment
We recruited potential participants through local community orga­
nizations and online venues between January and March 2020. Flyers
were displayed at organizations across NYC, including LGBT community
centers, social services organizations, and criminal legal-focused pro­
grams. We also used Facebook and Grindr to virtually recruit partici­
pants through targeted advertising. Lastly, we advertised on Reddit and
Craigslist in order to connect with this hard-to-reach population.
5.3. Participants
Eligible participants were over the age of 18; self-identified as a
cisgender gay or bisexual male; had been incarcerated in a U.S. adult jail
or prison for longer than 30 days at any point during their lives; and had
been last released from jail or prison more than 90 days prior to
completing the study eligibility screener. We utilized purposive sam­
pling to ensure diversity in term of race and time since last release. Given
the over-representation of incarcerated Black Americans (The
Sentencing Project, 2018), we aimed to recruit a sample in which at least
50% of participants were Black. To account for diverse community
reentry experiences following release from incarceration, we aimed to
have near-equal representation from those recently released (in the last
3 years) and those who had been released more distantly (more than 3
years ago). Table 1 provides additional demographic information on this
sample.
5.4. Procedures
Participants provided written informed consent prior to completing
the interview focused on GBM’s experiences with the criminal legal
system, experiences of minority stress and stigma before, during, and
3
Social Science & Medicine 272 (2021) 113735
Table 1
Demographic characteristics of participants (N = 20).
Characteristic n (%)
Age, years (mean + SD) 40.2 ± 12.4
Sexual Identity
Gay 15 (75.0)
Bisexual 5 (25.0)
Race
Black 16 (80.0)
White 3 (15.0)
Two or more races 1 (5.0)
Ethnicity
Non-Hispanic/Latino 17 (85.0)
Hispanic/Latino 3 (15.0)
Last Release from Jail/Prison
Less than 1 year 5 (25.0)
1 year or greater and less than 3 years 4 (20.0)
3 years or greater and less than 5 years 3 (15.0)
5 years or greater 8 (40.0)
after incarceration, psychosocial health surrounding their in­
carcerations, and community reentry following incarceration. The first
author conducted all interviews, which lasted approximately 60–90
min, were audio-recorded, and were transcribed verbatim. Participants
received $50 in cash following the interview. The Human Subjects
Committee of [blinded for review] approved all study procedures.
5.5. Data analysis
The first author and a research assistant with experience in qualita­
tive methodology utilized an iterative process to analyze the data with
an abductive approach. We developed an initial codebook through an
open-coding process that followed each major domain of the interview
guide (e.g., minority stress and stigma experiences before, during, and
after incarceration; psychosocial health surrounding incarceration; and
community reentry following incarceration) using a small set of tran­
scripts. We then applied the initial codebook to an additional set of
transcripts, after which we met to discuss any inconsistencies and
needed modifications. We revised the codebook, applied it to another set
of transcripts, and met to discuss needed updates. We completed this
process three times before developing a final codebook. After finalizing
the codebook, we independently coded all 20 transcripts and resolved
coding disagreements through discussion. We used Dedoose software for
transcript coding. In presenting our results, we use pseudonyms and
adjust minor details to protect participants’ confidentiality.
6. Results
Below, we summarize the ways in which minority stress influenced
participants’ experiences surrounding incarceration and psychosocial
health. We organize the results in terms of the role of minority stress in
participants’ psychosocial health before, during, and after incarceration.
Participants discussed how, prior to incarceration, experiences of mi­
nority stress placed them at risk of incarceration. Participants also
described experiencing a moral economy of hypermasculinity and
heightened minority stress during incarceration. In this context, they
discussed utilizing both sexual identity disclosure and concealment to
gain power; to build sexual, romantic, and nonromantic relationships;
and quite simply, to survive. Following release, participants spoke of
minority stress as a determinant of whether and how they accessed
reentry support and their post-incarceration experiences of their
sexuality.
6.1. Prior to incarceration: minority stress as a route to incarceration
6.1.1. Sexual identity as source of minority stress
Participants consistently reported experiencing identity-related
T.D. Harvey et al.
minority stress and stigma prior to incarceration. When asked “How was
coming to terms with your sexual identity?”, Eduard (29, gay, Black,
Latino) responded, “Traumatic […] When it comes to mental health and
I think being gay, it’s like there’s so many layers of shame and pain that,
at least for me, I didn’t even know I was going through, or that I was
experiencing. So, I sought to relieve that pain and that shame by just
engaging in sexual activity and doing drugs.” Many participants further
highlighted how the strategies they adopted to disclose or conceal their
sexual identity prior to incarceration were influenced and complicated
by their racial and ethnic communities. Rashan (35, gay, Black) noted,
“In other groups, I see it’s [openness about sexual identity] a lot more
acceptable […] I think as a young Black boy, me, my cousins, people I go
to school [with], you’re always told by your dad or stepdad, ‘Oh, if I ever
found out you’re gay, I’m going to beat your ass. I’m going to kill you.’”
Dominic stated, “Well, again I’m Hispanic Latino, Puerto Rican. At the
time, the stigma was really really bad in the Latino community, being
Catholic and so forth and so on. So, I steered away from telling people
that I thought might react in a very negative way” (54, gay, Black,
Latino).
6.1.2. Minority stress as catalyst of incarceration-related experiences
Many participants framed minority stress as leading to circumstances
that facilitated their incarcerations. Specifically, participants reported
that they were placed in situations that led to incarceration given the: 1)
negative reactions they received from their social networks when
disclosing their sexual identity, or 2) internal stress of constantly con­
cealing their identity in a stigmatized environment. Leo (28, gay, Black,
Latino) described how family rejection precipitated his incarceration,
explaining, “I got kicked out when I was 19 or 20. One of my sisters
accidently outed me to my mom, and my mom literally picked me up
from work with a bag of my stuff […] She said, ‘We’re going to the
store.’ She pulled up to the bus station, gave me a ticket to New York
City and said, ‘See you.’ Yeah. When I first came to New York, I came
from [hometown], I was homeless. I got in some trouble in between
hopping trains, stealing stuff from stores, and just getting caught up in
fast, easy money and sex work.”
Other participants who had not revealed their sexual identity to their
close networks described how concealment-related minority stress put
them at risk of incarceration. In talking about his sexual identity, Eli
noted “I just was screwing up. The drugs and alcohol played a huge part.
Not knowing who I was played a part because I would just mask
everything with the drugs and the alcohol. And there was always that
constant, ‘What’s wrong with me?’ That was, I pretty much kept that
[sexual identity] hidden … I’ve never, and in jail, I wouldn’t let anybody
know how I was, really. And so, I think that’s some of the reason why I
tried to get [into] drugs so much, I suppressed everything” (39, bisexual,
White). Eli further describes how all his experiences leading to incar­
ceration involved substances—whether it was getting arrested for
possession of different illicit substances or violent encounters with
others while intoxicated.
With both situations—scenarios in which sexual identity was dis­
closed (actively or passively) and scenarios in which it was con­
cealed—participants described how managing their identity within the
context of minority stress predisposed them to incarceration-related
experiences.
6.2. During incarceration: managing the interpersonal and structural
minority stress of the carceral environment
6.2.1. Concealment as a protective interpersonal strategy
Many participants concealed their sexual identities while incarcer­
ated to avoid potential violence from others and protect their psycho­
social health. In particular, some participants recognized the politics of
gender within their carceral settings and reported that expressing
femininity could put them at risk for violence. Isaiah (58, bisexual,
Black) explained, “I wasn’t really openly gay in jail. I kept it in the closet,
4
Social Science & Medicine 272 (2021) 113735
you know what I’m saying? I didn’t because I was scared of the violence,
man. A lot of violence was directed to gay people.” Duante (31, gay,
Black) described how his masculine physical features added a layer of
protection, but that he nonetheless decided to conceal his sexual identity
given the hypermasculine norms of the system, “I was basically out, an
out gay man [outside of jail]. I wasn’t out when I was incarcerated.
Mainly, safety reasons. Not that I was afraid physically, but just
maneuvering through a system that I’d never been through, it was best
that they not know I was gay, considering how they treated the more
feminine.” Participants also reported monitoring their physical and
verbal actions in numerous ways to conceal their sexual identity. In
many cases, this concealment strategy involved participants adjusting
their mannerisms to appear less feminine, which added stress to their
lives. Eduard (29, gay, Black, Latino) noted, “While I was there [in
prison], I was under a lot of tension because I felt like I had to monitor
myself more in how I spoke and how I acted, how I behaved. I couldn’t
really be free to be myself as much as I wanted. So, I think having that
constant threat is … It must create some sort of negative impact on your
health. Yeah. I cried a lot at first, when I was there.”
6.2.2. Strategic outness for local interpersonal power
Another group of participants reported disclosing their sexual iden­
tity within the context of incarceration, with emphasis placed on stra­
tegic outness as a protective strategy that advantageously harnessed
their sexuality and, in many cases, femininity within their hypermas­
culine settings. Many participants gained agency through this disclosure
that allowed them to facilitate sexual and romantic relationships with
heterosexual men. Through these relationships, participants felt they
acquired a sense of protection, local power in dictating what happen to
them, and material gains in addition to mitigating perceived psychoso­
cial health risks associated with their sexual identity. Terrence (56, gay,
Black) stated, “Particularly in state facilities, sexual orientation, for me,
was a commodity. So, there were all these 2500 guys in there, and
maybe 6 to 10 out gay men. So, it’s like, ‘If I can be really, really nice to
them, then maybe they’ll provide some sexual gratification to me.’
There was a whole life of almost reverse exploitation. You are nice to me,
so maybe I will put you on my list … You go to your Eastbay catalog, get
me some sheets and get me some sneakers.” Terrence further described
one relationship he developed while incarcerated with, “There was a guy
who, I was very clear that I wasn’t attracted to him, but I was also very
clear that I could kind of get what I needed from him by doing some
stuff.” In Terrence’s case, his relationships with heterosexual men
allowed for gaining access to sexual pleasure but also material gains,
despite not always being romantically or physically attracted to these
men. Malik (33, gay, Black) noted that his relationships with hetero­
sexual men provided him protection in exchange for sexual acts and
exposed him to a new notion of his sexual identity in regard to his gender
expression. “It [being incarcerated] was scary at first, but probably
within my second day, I realized that I was like a jewel […] When you’re
young and you’re good looking and you’re openly gay and you’re
incarcerated, it’s almost like you’re protected in a way. And this is not
really discussed, I don’t think much in the free world. But when you’re a
young gay guy and you’re bottom, you’re treated like a queen. And it’s
interesting because I never really identified myself as being someone
who wanted to cross dress or be transgender, but it was while I was
incarcerated that I started having ideas of myself being a woman.
Because when you’re an openly gay person in jail or prison, they treat
you as a woman. And so, it’s like you’re put on this pedestal, if you will.”
6.2.3. Cost of disclosure: sexual, physical, and verbal violence
Nevertheless, the social and material gains that some participants
received from relationships with heterosexual men did not negate the
harms that often came from other heterosexual men when disclosing
their sexual identity. Many participants reported violence directed to­
ward them when they were open with their sexual identity while
incarcerated. Leo described one experience of interpersonal violence,
T.D. Harvey et al.
“That [victimization experience] was when I was waiting to go into
court. It was this guy. I was sleeping and I woke up and he was standing
above me. Then he spit on me and I was just [not] having it […] He was
standing above me, he said, “Fucking faggot,” and he spit on me. So, I got
up and punched him in the face” (28, gay, Black, Latino). Terrence
stated, “There was a situation in [urban jail] where I was being sexually
harassed by an individual for several weeks, and it escalated, and he and
three other guys attempted to rape me in the staircase. I was able to find
my way out, and I ran up the stairs toward my housing unit. As I ran
toward the door, the female housing unit officer closed and locked the
door. She did not open it, they caught up with me and I got jumped” (56,
gay, Black). A few participants also described situations in which their
own misunderstanding of others’ sexual interests placed them in violent
predicaments. Rashan explained, “Actually, that was a guy who was like
a porter on my unit and he kept looking at me. So, one day he kept
looking at me and I made a pass at him. So, he blows up and he’s going to
beat my ass and all that. So, that’s where the fight [happened] … Come
to find out after that the reason why he was looking at me, he was trying
to steal my shoes” (35, gay, Black).
6.3. Structural minority stress and the carceral environment
Participants reported aspects of correctional living that further
contributed to the minority stress they were experiencing, particularly
around the design of the facilities they were housed in and treatment at
the hands of correctional staff. In most cases, these situations placed
participants in stressful scenarios in which they actively took measures
to avoid having their sexual identity disclosed. For example, several
participants expressed concerns with showering in group settings. Leo
explained “I didn’t want to shower. I was so paranoid. I was stressed out.
I was always looking over my back, I’d come out [of my cell] maybe
once, get some food. I didn’t shower at all. I was not to use the showers
just because of the vibes I was getting” (28, gay, Black, Latino). Rashan
(35, gay, Black) feared that open showers would out him because of his
potential sexual attraction to other men showering; ultimately, to avoid
such situation, he committed a violent offense to be transferred to a
maximum security jail with individual showers. He described the situ­
ation with:
“I didn’t like the medium security jail because the medium security
jail is a full open shower. So, I actually went to my counselor and
said, ‘Get me out of here or I’m going to commit a violent offense’ to
get me out of here. And I actually did. But, that is actually how I
ended up in maximum security because I didn’t like the close quar­
ters of that … I couldn’t be in that type of environment where every
guy, you got to think any guy that you could possibly think that’s
walking down the street hot, good looking guy, is in that shower […]
You got to think, if I’m sitting there and the guy next to me and I’m
getting an erection because I’m looking at his ass […] I didn’t like
that fact, that position it put me in. You know what I’m saying?
Because it was just natural for me that I was going to get aroused, it
wasn’t going to stop. Maximum security … it’s individual showers.
You get less showers. You only get to shower every other day, but it’s
one at a time.”
Participants also reported visitation time as creating fear of being
outed to others, particularly when other LGBT friends and romantic
partners came to visit. Specifically, some worried that their feminine-
presenting LGBT visitors would out them and expose them to violence.
As a result, participants actively navigated visitation time by altering
interactions with LGBT visitors to, as Maurice (44, gay, Black) stated,
“portray a sense of masculinity that would equate to that of the straight
guys.” Maurice goes on to describe the first visit from his partner with: “I
kind of gave him a little dap, which is like two fist bumps and held
conversation that was a lot less romantic than it would’ve been if it had
been at home. And the idea of being identified as gay in that moment
5
Social Science & Medicine 272 (2021) 113735
makes your palms sweat. Makes you fear what would happen when you
finish up this visit and have to go back to your cell. Who’s going to tell
them what they saw you doing type of thing. That’s a scary feeling.
Especially because my partner at the time, he’s been called twink. He’s a
flamboyant guy and always dressed really colorful and really happy go
lucky type person.”
Finally, many participants described situations in which correctional
staff policed their identities and upheld hypermasculine standards of the
carceral environment. Specifically, when staff stripped participants’
agency surrounding their identity in front of others, participants felt a
lack of control and anticipated conflict. Terrence (56, gay, Black) noted,
“The processing piece really, really was shaming for me as a Black gay
man. I remember, you come upstate, they make you get naked, you have
to open your mouth, you have to bend over, pull your butt. I remember
an officer getting in front of me, and the officer behind me said, ‘Spread
your butt cheeks.’ The officer in front of me says, ‘Open your mouth.’
And the officer behind me says, ‘Well goddamn, I can see the sunshine.’
And they all had a big laugh. This is all happening while all these other
folks are being searched, and they are referring to me as Sunshine, and
Cupcake. But now I have become this focal point, because now there is a
gay guy on the draft. Here comes the gay dude coming in. So, there’s
that. There was a lot of anxiety around it, a lot of anger at the officers.
But yeah, mostly anxiety.”
6.4. Following incarceration: minority stress as a determinant of
community reentry experiences
6.4.1. Sexual identity disclosure shaping reentry
Following release, participants noted the ways minority stress
continued to influence their access to services and support systems.
Participants who had experienced social rejection, particularly by family
members, prior to being incarcerated noted that this lack of support
made the reentry process more difficult. For example, Duante (31, gay,
Black) explained, “If I was heterosexual, I wouldn’t have been kicked out
[of my mother’s house]. I would’ve had more family support. I would’ve
had an actual base when I got out [of jail]. I could’ve gone home, living
with my mother, and she would’ve taken care of me until I got on my
feet.”
On the other hand, several participants reported that disclosing their
identity allowed them to build relationships with LGBT-specific orga­
nizations and supportive social connections that were key to their
community reentry. Leo detailed, “My [LGBT-identifying] friend had
brought me to an LGBT shelter when I got out, because I needed stable
housing, because I was [on] probation so I needed to be somewhere
where they could find me. So, they immediately housed me which was
really cool … That place really helped with therapy. I was having to talk
to a therapist for a while. The housing part, getting that together,
making sure I went to my drug programs, stuff like that. I really lucked
out” (28, gay, Black, Latino).
6.4.2. Managing another minority identity
Participants reported challenges related to navigating the stigma­
tized label that comes from having an incarceration history alongside
their sexual identity following release. Many participants believed that
their incarceration history particularly shaped their social and romantic
relationships within the LGBT community and reported experiences of
rejection from the LGBT community based on their perceived dimin­
ished social status due to incarceration. Maurice (44, gay, Black)
described how his new incarceration label influenced both his romantic
relationship as well as his social circle. He explained, “Our relationship
[boyfriend and participant’s relationship] quickly kind of unraveled
afterwards, though. The whole foundation of what we had was kind of
stripped away once I had that title on me. That criminal or person that’s
gone to jail … within a month we were already broken up, mainly
because he didn’t want to be seen with me now. Things had changed.
That ended up being the same for, not just him, but for friends as well.
T.D. Harvey et al.
All of my gay friends kind of just left me hanging with the idea, ‘Oh, he’s
been incarcerated. He’s not one of us now. He’s another type.’" Peter
(61, bisexual, White) echoed similar intragroup rejection but further
emphasized the perception of incarceration as a threat to the gay com­
munity’s respectability, stating “A lot of it is people are afraid to be near
me once they find out about the incarcerations. They think that I will
bring some sort of shame on the gay community, saying you violated the
rules. You were in prison.”
6.4.3. Sexual expression after incarceration
Participants reported how incarceration impacted their sexual
expression following release. Duante (31, gay, Black) who attempted to
conceal his sexual identity and not act upon sexual desires while
incarcerated spoke of his greater sexual engagement following release,
stating, “I’ll say I was reckless as fuck. I’ll be honest with you because I
was incarcerated, and I didn’t have sex … I think the first night I got out,
I definitely had unprotected sex with … I don’t want to say two of my
boyfriends … guys who were my boyfriends. The same 12 hours. And
then, I went to [a large city], and I was pretty reckless there. I definitely
think [that] had to do with incarceration.”
Conversely, Terrence (56, gay, Black) stated how his sexual experi­
ences became more cautious post-incarceration with him avoiding
certain sexual situations given his sexual harassment and almost rape
while incarcerated. He stated, “Even now, if I’m dating somebody and
they seem a little aggressive sexually, it makes me nervous. I’m very
aware of that. I don’t like aggressive sex, because I was almost raped …
Rape is something that I knew anecdotally but being in the criminal
justice system put me very, very close to it. And so, it’s something that I
have a heightened awareness about. I drink now, but I am very clear, I
don’t have sex when I’m drinking, because I always want to be in control
of my faculties so that I don’t get taken advantage of, so that I don’t get
exploited, or manipulated, or whatever.”
7. Discussion
In this study, 20 formerly incarcerated GBM described how minority
stress influenced their psychosocial health before, during, and after
incarceration. Consistent with the minority stress model, men in this
study were allowed to, and, in some situations, forced to make decisions
that were determined by the social context in which they existed,
including negative family environments, hypermasculine carceral set­
tings, and highly stigmatized social situations. Participants also
described how hegemonic masculinity characterized the carceral
context against which their GBM identity could be strategically, and
necessarily carefully, managed to derive value and safety within its
moral economy. Overall, participants noted the ways in which minority
stress and associated identity management techniques can potentiate
incarceration and thereafter influence one’s psychosocial health and
safety during incarceration and after release.
Prior to incarceration, participants described how minority stress
surrounding their sexual identity sometimes catalyzed the conditions
leading to their incarceration. Notably, for GBM whose identity was
disclosed, by choice or by being outed, family rejection precipitated
engagement with criminalized activities (i.e. sex work, homelessness,
substance use). On the other hand, for participants who had not dis­
closed their sexual identity, internalized homophobia, anticipated
rejection, and the stress of concealment facilitated psychosocial health
risks, such as substance use, that led to incarceration. The minority stress
model posits that concealment (and disclosure), internalized homo­
phobia, and expected rejection related to one’s sexual identity influence
psychosocial health. Coping behaviors like substance use served as
mechanisms through which participants mitigated minority stress and,
for some, these behaviors played a role in leading to their incarcerations.
Our findings also demonstrate how minority stress influenced iden­
tity management techniques employed to survive incarceration. Identity
management theory suggests that individuals with a concealable stigma
6
Social Science & Medicine 272 (2021) 113735
must continuously weigh the risks and benefits of disclosing a sexual
identity (Cain, 1991; Clair et al., 2005; Meyer, 2003; Oakleaf, 2013).
Our findings indicate how concealment and disclosure, in particular,
operated as key minority stressors for for incarcerated GBM. Specif­
ically, participants managed their identities within the moral economy
of hypermasculinity and gender structures surrounding them. For some
participants, this meant recognizing social value placed on hyper­
masculinity and heterosexuality and going to great length to ensure their
sexual identity was kept in the closet. For others, it meant harnessing
their sexual identity and, in some cases, femininity in ways that provided
heterosexual males with interactions they were being deprived
from—mainly sexual—and in return acquiring local power and protec­
tion over their identity disclosure, including material gains and, in some
cases, sexual pleasure. This phenomenon has been described in earlier
work as “protective pairing” in which dominant men protect
weaker-status men while in prison in exchange for sex; this has been
classified as a form of prison rape (Sabo et al., 2001). As similarly
documented elsewhere, participants in this study actively managed their
identities in the context of these relationships to survive within a hy­
permasculine setting in which they otherwise feared the consequences
of their weaker-status identity (Trammell, 2011). Many participants
reported experiencing victimization based on identity disclosure; how­
ever, for those entering relationships with heterosexual males, they did
so as a preventive technique to avoid violence and by actively har­
nessing their sexuality and femininity. Further, participants expressed
agency and choice when selecting these relationships, often enacting
strategic outness. However, this choice still occurred in a context of
homophobia, hypermasculinity, and the moral economy created by both
gender and sexual identity hierarchies, all of which added to the mi­
nority stress experienced by participants. These men often chose the
lesser of two perceived evils to survive in their carceral settings. For
them, minority stress demanded identity management techniques while
incarcerated that were exacerbated by serious risks (i.e., sexual
violence) and concomitant benefits (i.e., protective relationships with
heterosexual men). The carceral context and its minority stressors
required them to carefully recognize the social value placed on mascu­
linity and heterosexuality within the given setting and manage their
sexual identities and expression of both masculinity and femininity
accordingly.
Finally, following release from jail or prison, participants reported
rejection from within the LGBT community because of their incarcera­
tion history, further restricting their already constrained social networks
based on their sexual identity and creating another type of minority
stress, this time directed to an incarceration history. Overall, findings
highlight evidence of the pathway from incarceration to post-
incarceration being exacerbated by sexual minority stress and rejec­
tion rooted in stigma toward GBM with a criminal record. For many
participants, a lack of family support compounded by the lack of support
from within the sexual minority community given their incarceration
history left them without the necessary supports for healthy reentry.
Many spoke of financial hardships, housing instability, relapse of drug
addiction, and the trauma of incarceration that could have benefitted
from social support. Consistently, social support has been documented
as an necessary protective factor following release from correctional
settings, and lack of reentry support for males has been documented as
being associated with increased drug use, increased psychological stress,
and poor mental health (Pettus-Davis et al., 2018; Visher and Travis,
2011; Wallace et al., 2016). Social support may be particularly needed
for GBM, as research has documented societal integration as a key driver
of suicidality among sexual minorities (Bränström et al., 2020). Further,
upon release from incarceration, GBM face another largely concealable
identity (i.e., criminal record status) in which they must balance the
risks of disclosing, such as loss of LGBT relationships, against any po­
tential benefits, such as not having to hide this part of their lived
experience (Pachankis et al., 2018). For these reasons, the reentry pro­
cess might be particularly stressful for GBM.
T.D. Harvey et al.
While this study provides valuable insights into how minority stress
shapes experiences with incarceration and associated psychosocial
health risks for GBM, it has several limitations. While we purposively
constructed our sample to reflect racial disparities in incarceration and
variation in time since last release, some experiences of formerly
incarcerated GBM were not captured in this data. For instance, the racial
composition of our sample did not allow us to compare incarceration
and minority stress experiences across races, a particularly important
future goal given the health-depleting role of structural racism and
perhaps its intersections with sexual minority stress. Further, experi­
ences may vary considerably based on the length, type, and location of
incarceration, which warrants future examinations of how these factors
influence incarcerated GBM’s experiences of minority stress. Finally,
this study required individuals to recall details from their pasts, poten­
tially introducing recall bias. To mitigate this limitation, we searched for
concrete and specific examples related to participants’ experiences.
Regardless of such limitations, these findings provide important insight
into the experiences of this population and can inform policy and
practice.
7.1. Policy and practice implications
Our findings have several implications for policy and practice to
improve the experiences of GBM before, during, and after incarceration.
First, findings suggest that minority stress can place GBM at greater risk
of incarceration. Thus, efforts to reduce structural, interpersonal, and
individual forms of stigma surrounding sexual minorities could perhaps
protect GBM from minority stress experiences that may lead to incar­
ceration (Cook et al., 2014).
Second, our findings show that, while incarcerated, GBM may
experience unique manifestations of minority stress in correctional fa­
cilities. Current correctional policies on showering and public group
visitations strip agency from GBM. Increased privacy in daily life within
facilities could reduce the minority stress of navigating those spaces,
allow GBM more control in managing their identity, and prevent placing
GBM in social environments where they may be at high risk for being
outed or assaulted because of their sexual identity. Correctional staff are
key actors in how GBM experience correctional living. From verbal
harassment to publicly outing GBM, staff homophobia can shape GBM’s
daily psychosocial health. Sensitivity trainings among correctional staff
could thus be particularly beneficial for this population. Interventions
aimed at improving healthcare providers’ knowledge of the unique
needs of transgender individuals within correctional settings have been
shown to be efficacious (Jaffer et al., 2016; White Hughto et al., 2017),
suggesting that similar interventions across all correctional staff that
encompass the full range of LGBT experiences possess promise for
improving the wellbeing of incarcerated GBM.
Finally, release from correctional facilities may be particularly
difficult for GBM. The services that currently help recently released in­
dividuals from incarceration with employment, housing, access to
healthcare, and education opportunities are likely unequipped to
address the unique stressors of GBM (Center for American Progress &
Movement Advancement Project, 2016). Reentry programs that are
LGBT-inclusive and recognize the unique stressors facing formerly
incarcerated GBM are warranted.
8. Conclusion
In conclusion, our findings highlight how GBM navigate minority
stress prior to, during, and following incarceration and the unique
psychosocial health risks that they are exposed to as a result. This study
details the ways in which minority stress can catalyze GBM’s risk of
incarceration, how minority stress demands identity management stra­
tegies within the carceral system for GBM, and the minority stress
challenges upon formerly incarcerated GBM’s community reentry.
Findings suggest needed interventions including combatting minority
7
Social Science & Medicine 272 (2021) 113735
stress to protect GBM from situations predisposing them to incarcera­
tion, ensuring that GBM maintain agency over their identity while
incarcerated by adjusting policies and practices of correctional facilities
that specifically impact GBM, requiring sensitivity training for correc­
tional staff, and guaranteeing that GBM have adequate support
following release through LGBT-inclusive reentry programs.
CRediT statement
Tyler D. Harvey: Conceptualization, Methodology, Formal analysis,
Writing- Original Draft, Funding acquisition. Danya E. Keene: Meth­
odology, Formal analysis, Writing- Review & Editing. John E.
Pachankis: Conceptualization, Formal analysis, Writing- Review &
Editing, Supervision, Funding acquisition.
Author note
The authors have no conflict of interest to disclose.
Acknowledgments
We would like to thank the Fund for Gay and Lesbian Studies
(FLAGS) at Yale University for funding this project. We also thank Skyler
Jackson and Kobe Pereira for their contributions to this work. Finally,
we thank all the participants in this study for sharing their experiences
with us.
References
Borchert, J.W., 2016. Controlling consensual sex among prisoners. Law Soc. Inq. 41 (3),
595–615. https://doi.org/10.1111/lsi.12221.
Bränström, R., van der Star, A., Pachankis, J.E., 2020. Untethered lives: barriers to
societal integration as predictors of the sexual orientation disparity in suicidality.
Soc. Psychiatr. Psychiatr. Epidemiol. 55 (1), 89–99. https://doi.org/10.1007/
s00127-019-01742-6.
Brinkley-Rubinstein, L., Dauria, E., Tolou-Shams, M., Christopoulos, K., Chan, P.A.,
Beckwith, C.G., Parker, S., Meyer, J., 2018. The path to implementation of HIV pre-
exposure prophylaxis for people involved in criminal justice systems. Curr. HIV AIDS
Rep. 15 (2), 93–95. https://doi.org/10.1007/s11904-018-0389-9.
Cain, R., 1991. Stigma management and gay identity development. Soc. Work 36 (1),
67–73. https://doi.org/10.1093/sw/36.1.67.
Center for American Progress & Movement Advancement Project, 2016. Unjust: How the
Broken Criminal Justice System Fails LGBT People.
Chaudoir, S.R., Fisher, J.D., 2010. The disclosure processes model: understanding
disclosure decision making and postdisclosure outcomes among people living with a
concealable stigmatized identity. Psychol. Bull. 136 (2), 236–256. https://doi.org/
10.1037/a0018193.
Chrobot-Mason, D., Button, S.B., 1999. Sexual identity management strategies: an
exploration of antecedents and consequences. Acad. Manag. Proc. 1999 (1), H1–H6.
https://doi.org/10.5465/apbpp.1999.27607877.
Clair, J.A., Beatty, J.E., Maclean, T.L., 2005. Out of sight but not out of mind: managing
invisible social identities in the workplace. Acad. Manag. Rev. 30 (1), 78–95.
https://doi.org/10.2307/20159096.
Cook, J.E., Purdie-Vaughns, V., Meyer, I.H., Busch, J.T.A., 2014. Intervening within and
across levels: a multilevel approach to stigma and public health. Soc. Sci. Med. 103,
101–109. https://doi.org/10.1016/j.socscimed.2013.09.023.
Donaldson, M., 1993. What is hegemonic masculinity? Theor. Soc. 22 (5), 643–657.
https://doi.org/10.1007/BF00993540.
Griffin, P., 1991. Identity management strategies among lesbian and gay educators. Int.
J. Qual. Stud. Educ. 4 (3), 189–202. https://doi.org/10.1080/0951839910040301.
Hansen, H., Bourgois, P., Drucker, E., 2014. Pathologizing poverty: new forms of
diagnosis, disability, and structural stigma under welfare reform. Soc. Sci. Med. 103,
76–83. https://doi.org/10.1016/j.socscimed.2013.06.033.
Harawa, N.T., Brewer, R., Buckman, V., Ramani, S., Khanna, A., Fujimoto, K.,
Schneider, J.A., 2018. HIV, sexually transmitted infection, and substance use
continuum of care interventions among criminal justice–involved Black men who
have sex with men: a systematic review. Am. J. Publ. Health 108 (Suppl. 4), e1–e9.
https://doi.org/10.2105/AJPH.2018.304698.
Hatzenbuehler, M.L., 2016. Structural stigma: Research evidence and implications for
psychological science. Am. Psychol. 71 (8), 742–751. https://doi.org/10.1037/
amp0000068.
Hefner, M.K., 2017. Queering Prison Masculinity: Exploring the Organization of Gender
and Sexuality within Men’s Prison. Men and Masculinities. https://doi.org/10.1177/
1097184X17695037.
Hensley, C., Wright, J., Tewksbury, R., Castle, T., 2003. The evolving nature of prison
argot and sexual hierarchies. Prison J. 83 (3), 289–300. https://doi.org/10.1177/
0032885503256330.
T.D. Harvey et al.
Jaffer, M., Ayad, J., Tungol, J.G., MacDonald, R., Dickey, N., Venters, H., 2016.
Improving transgender healthcare in the New York City correctional system. LGBT
Health 3 (2), 116–121. https://doi.org/10.1089/lgbt.2015.0050.
Khan, M.R., Epperson, M.W., Mateu-Gelabert, P., Bolyard, M., Sandoval, M., Friedman, S.
R., 2011. Incarceration, sex with an STI- or HIV-infected partner, and infection with
an STI or HIV in Bushwick, Brooklyn, NY: a social network perspective. Am. J. Publ.
Health 101 (6), 1110–1117. https://doi.org/10.2105/AJPH.2009.184721.
Lim, J.R., Sullivan, P.S., Salazar, L., Spaulding, A.C., DiNenno, E.A., 2011. History of
arrest and associated factors among men who have sex with men. J. Urban Health 88
(4), 677–689. https://doi.org/10.1007/s11524-011-9566-5.
Lydon, J., Carrington, K., Low, H., Miller, R., Yazdy, M., 2015. Coming Out of Concrete
Closets: A Report on Black and Pink’s National Lgbtq Prisoner Survey. https://www.
issuelab.org/resource/coming-out-of-concrete-closets-a-report-on-black-and-pin
k-s-national-lgbtq-prisoner-survey.html.
Mays, V.M., Cochran, S.D., 2001. Mental health correlates of perceived discrimination
among lesbian, gay, and bisexual adults in the United States. Am. J. Public Health 91
(11), 1869–1876. https://doi.org/10.2105/ajph.91.11.1869.
McCuller, W.J., Harawa, N.T., 2014. A condom distribution program in the Los Angeles
men’s central jail: sheriff deputies’ attitudes and opinions. J. Correct. Health Care:
The Official Journal of the National Commission on Correctional Health Care 20 (3),
195–202. https://doi.org/10.1177/1078345814530870.
Meyer, I.H., 2003. Prejudice, social stress, and mental health in lesbian, gay, and bisexual
populations: conceptual issues and research evidence. Psychol. Bull. 129 (5),
674–697. https://doi.org/10.1037/0033-2909.129.5.674.
Meyer, I.H., Flores, A.R., Stemple, L., Romero, A.P., Wilson, B.D.M., Herman, J.L., 2017.
Incarceration rates and traits of sexual minorities in the United States: National
inmate survey, 2011-2012. Am. J. Publ. Health 107 (2), 267–273. https://doi.org/
10.2105/AJPH.2016.303576.
Michalski, J.H., 2017. Status hierarchies and hegemonic masculinity: a general theory of
prison violence. Br. J. Criminol. 57 (1), 40–60. https://doi.org/10.1093/bjc/azv098.
Miltz, A.R., Lampe, F.C., Bacchus, L.J., McCormack, S., Dunn, D., White, E., Rodger, A.,
Phillips, A.N., Sherr, L., Clarke, A., McOwan, A., Sullivan, A., Gafos, M., 2019.
Intimate partner violence, depression, and sexual behaviour among gay, bisexual
and other men who have sex with men in the PROUD trial. BMC Publ. Health 19.
https://doi.org/10.1186/s12889-019-6757-6.
Mustanski, B., Andrews, R., Herrick, A., Stall, R., Schnarrs, P.W., 2014. A syndemic of
psychosocial health disparities and associations with risk for attempting suicide
among young sexual minority men. Am. J. Publ. Health 104 (2), 287–294. https://
doi.org/10.2105/AJPH.2013.301744.
Oakleaf, L., 2013. “Having to think about it all the time”: factors affecting the identity
management strategies of residential summer camp staff who self-identify as lesbian,
gay, bisexual or transgender. Leisure/Loisir 37 (3), 251–266. https://doi.org/
10.1080/14927713.2013.856100.
Pachankis, J.E., 2007. The psychological implications of concealing a stigma: A
cognitive-affective-behavioral model. Psychol. Bull. 133 (2), 328–345. https://doi.
org/10.1037/0033-2909.133.2.328.
Pachankis, J.E., Mahon, C.P., Jackson, S.D., Fetzner, B.K., Bränström, R., 2020. Sexual
orientation concealment and mental health: A conceptual and meta-analytic review.
Psychol Bull 146 (10), 831–871. https://doi.org/10.1037/bul0000271. PubMed
PMID: 32700941. Epub 2020/07/24.
Social Science & Medicine 272 (2021) 113735
Pachankis, J.E., Hatzenbuehler, M.L., Wang, K., Burton, C.L., Crawford, F.W., Phelan, J.
C., Link, B.G., 2018. The burden of stigma on health and wellbeing: a taxonomy of
concealment, course, disruptiveness, aesthetics, origin, and peril across 93 stigmas.
Pers. Soc. Psychol. Bull. 44 (4), 451–474. https://doi.org/10.1177/
0146167217741313.
Pettus-Davis, C., Veeh, C.A., Davis, M., Tripodi, S., 2018. Gender differences in
experiences of social support among men and women releasing from prison. J. Soc.
Pers. Relat. 35 (9), 1161–1182. https://doi.org/10.1177/0265407517705492.
Sabo, D.F., Kupers, T.A., London, W.J., 2001. Prison Masculinities. Temple University
Press.
Schneider, J., Lancki, N., Schumm, P., 2017. At the intersection of criminal justice
involvement and sexual orientation: dynamic networks and health among a
population-based sample of young Black men who have sex with men. Soc. Network.
51, 73–87. https://doi.org/10.1016/j.socnet.2017.04.001.
The Sentencing Project, 2018. Report to the United Nations on Racial Disparities in the
U.S. Criminal Justice System. https://www.sentencingproject.org/publications/un-
report-on-racial-disparities/.
Thompson, E.P., 1971. The moral economy of the English crowd in the eighteenth
century. Past Present 50, 76–136.
Timmermans, S., Tavory, I., 2012. Theory construction in qualitative research: from
grounded theory to abductive analysis. Socio. Theor. 30 (3), 167–186. https://doi.
org/10.1177/0735275112457914.
Trammell, R., 2011. Symbolic violence and prison wives: gender roles and protective
pairing in men’s prisons. Prison J. 91 (3), 305–324. https://doi.org/10.1177/
0032885511409891.
Vera Institute of Justice, 2020. New York City, NY—Incarceration Trends—Vera Institute
of Justice. http://trends.vera.org/rates/new-york-city-ny?incarcerationData=all.
Visher, C.A., Travis, J., 2011. Life on the outside: returning home after incarceration.
Prison J. 91 (3), 102S–119S. https://doi.org/10.1177/0032885511415228.
Wagner, P., Sawyer, W., 2018. States of Incarceration: The Global Context 2018. Prison
Policy Initiative. https://www.prisonpolicy.org/global/2018.html.
Wallace, D., Fahmy, C., Cotton, L., Jimmons, C., McKay, R., Stoffer, S., Syed, S., 2016.
Examining the role of familial support during prison and after release on post-
incarceration mental health. Int. J. Offender Ther. Comp. Criminol. 60 (1), 3–20.
https://doi.org/10.1177/0306624X14548023.
Ward, B.W., Dahlhamer, J.M., Galinsky, A.M., Joestl, S.S., 2014. Sexual orientation and
health among U.S. Adults. National health interview survey 77, 12.
White Hughto, J.M., Clark, K.A., Altice, F.L., Reisner, S.L., Kershaw, T.S., Pachankis, J.E.,
2017. Improving correctional healthcare providers’ ability to care for transgender
patients: development and evaluation of a theory-driven cultural and clinical
competence intervention. Soc. Sci. Med. 195, 159–169. https://doi.org/10.1016/j.
socscimed.2017.10.004.
Wildeman, C., Wang, E.A., 2017. Mass incarceration, public health, and widening
inequality in the USA. Lancet (London, England) 389, 1464–1474. https://doi.org/
10.1016/S0140-6736(17)30259-3.
Woods, S.E., Harbeck, K.M., 1992. Living in two worlds. J. Homosex. 22 (3–4), 141–166.
https://doi.org/10.1300/J082v22n03_06.
Yap, L., Simpson, P., Richters, J., Donovan, B., Grant, L., Butler, T., 2019. Disclosing
sexuality: gay and bisexual men’s experiences of coming out, forced out, going back
in and staying out of the “closet” in prison. Cult. Health Sex. 1–13. https://doi.org/
10.1080/13691058.2019.1668963.