Sexuality Across Cultures 1 Sexual Orientation Across Culture and Time

Although “gay rights” may be considered a contemporary issue in modern global society, history is replete with accounts of same-sex attraction and sexual behavior across a multitude of Western and non-Western cultures. The present chapter reviews the status of sexual orientation across cultures. We pay particular attention to how varying degrees of belief and public discourse about gender work in concert to shape the experiences of sexual minorities. We review this from two perspectives: (1) the ways in which sexual minorities are perceived and treated by heterosexuals and the broader culture, and (2) the influence that cultural context and gender expectations have upon the cognitions, behaviors, and social experiences of sexual minorities. Finally, we devote considerable discussion to the most recent advances in behavioral research examining the social, cognitive, and ecological impact of perceptions of sexual orientation. Specifically, we review the literature on the consensus and accuracy of judgments of sexual orientation from minimal cues (e.g., facial appearance, vocal cues, nonverbal behavior), how this occurs in the minds of perceivers, and the consequences that the capacity to perceive sexual orientation holds for both perceivers (heterosexual and not) and targets. Importantly, we situate this within the context of culture, attending to how both intra-cultural and inter-cultural factors influence the conception, perception, and treatment of sexual minorities across and within nationally-defined cultural groups. Sexuality Across Cultures 3 Sexual Orientation Across Culture and Time Sexual orientation has received increased public attention in the past few decades across the globe (Herek, 2000a; 2000b). Political campaigns in the United States have recently begun paying special attention to issues such as gay marriage (Adam, 2003) and military policy (Policy Concerning Homosexuality in the Armed Forces, 1993). In other geographic regions, political and religious intolerance of sexual minorities has resulted in the discussion of laws intended to limit the individual freedoms of non-heterosexuals (Herek, 2009); a prominent recent example being the institutional blindness of Russian authorities to anti-gay violence (Human Rights Watch, 2014). While some societies have implemented policies that punish homosexuality by imprisonment and death (Hood, 2002), other countries have expanded their definition of gender to be more inclusive (Newsnext Bangladesh, 2013). Although the international dialogue about issues regarding sexual orientation has gained momentum only in recent years, history is replete with examples of same-sex romantic attraction and sexual behavior across a number of cultural groups (Blackwood, 2000; Gay, 1986; Herdt, 1981; Scanlon, 2005; Sweet, 1996). The goal of the current review is to demonstrate a small fraction of the enormous variability and change in the dialogue, perceptions, experiences, and attitudes towards gender identities and sexual orientations that have occurred across cultures over time. In doing so, we begin with a discussion of the variability of sexual orientation across cultures. We then discuss how the historical and current cultural contexts shape attitudes towards sexual minorities, affecting their everyday experiences. We conclude by summarizing the behavioral and cognitive research relevant to the perception of sexual orientation and the effects that these perceptions have on the lives of sexual minorities. Culture, History, and Sexual Orientation Sexuality Across Cultures 4 Ethnographies of different social and cultural groups consistently suggest that heterosexuality is not the only form of sexual behavior and multiple reports suggest that sexual orientation goes beyond what people find attractive (Blackwood, 2000). There are notable works describing aspects of sexual orientation that are more closely related to cultural practices, traditions, and institutions than to sexual relationships alone. For example, researchers have documented same-sex sexual experiences among intimate friendships between younger and older girls in Lesotho, a South African culture (Gay, 1986). In the context of these mummy-baby relationships, older girls serve as mentors for younger girls and sexual relations in the context of these mentorship relations are not uncommon. Furthermore, the intimate friendship continues as the former baby becomes a mummy and starts to mentor other girls about sex, relationships, and other aspects of traditions, even if she is married to a man. These relationships are generally accepted within the community—they reflect tradition and are far removed from contemporary Western conceptions of sexuality. Perhaps a more popular example of this type of mentorship bond comes from Classical Greece where older men trained younger boys and had sexual relations with them (Bertosa, 2009, Percy, 1996). In these relations, a younger man was a passive sexual partner until the age of 20, thereafter starting to train younger boys in a similar manner and assuming a more active and dominant sexual role. Homosexuality was institutionalized in ancient Greece, but only as a part of homosocial life, meaning that men tended to form close bonds of homosexual character with each other (e.g., nude athletics; Scanlon, 2005). Although men were expected to have a wife and children, leading some to suggest that a non-heterosexual orientation was unacceptable in ancient Greece, an examination of cultural practices seems to suggest that male same-sex relations were considered natural (Hoffman, 1980). Specifically, Hoffman suggested that the Sexuality Across Cultures 5 pressure placed on men due to family bonds, the unavailability sexual relations with women outside of the household, the absence of a term for same-sex relations, and hypersexualization within Greek myths, made homoerotism acceptable. It is important to note, however, that the expression of sexuality within ancient Greek culture went beyond a mere mentorship role, becoming a product of spirituality, religion, and belief (see Pflugfelder, 1999, for a similar account in Japan). Indeed, some cultures attach a special meaning to sexuality through religion and associated beliefs. In Papua New Guinea, for example, genital fluids have special cultural meaning: although male semen is considered to be the sacred and pure epitome of masculinity, female fluids are seen as poisonous, especially to men (Herdt, 1981). Thus, cross-sex interaction may be limited to occasional sexual intercourse for the purposes of procreation at an appropriate age. Importantly, the male fluid is considered to be a limited resource that needs to be attained by boys in order to become men. Thus, young boys orally stimulate the genitals of grown men to acquire the valuable fluid through ingestion. Although this practice would be considered homoerotic in the West, it is an institutionalized ritual for the members of the tribe: when boys grow up and become men, they perpetuate the tradition by passing their own fluid to the next generation. As exemplified in the cases of ancient Greece and the importance of masculinity in Papua New Guinea, the interaction between gender and sexual behavior not only precipitates the social, political, and religious structures of a society, but also works to shape the concept of sexuality as a whole. Male-female relations and beliefs about human masculinity and femininity form the expression of sexuality and the manifestation of variability in sexual orientation in cultural and religious traditions. Sexuality Across Cultures 6 Following this broad conception of sexual orientation, cross-cultural writing identifies sexual identities that go beyond the categorical sexual distinctions that are popular in the Western world. The Native American berdaches (Callender et al., 1983) and the South Asian hijras (Nanda, 1990), for instance, represent alternatives to present-day Western typologies. Numerous accounts describe berdaches as people within Native American societies who transcend their biological sex to assume the identity of the opposite gender (Callender et al., 1983). Although there is a great amount of variability between different Native American societies’ conceptions of this identity, berdaches are frequently mentioned as a part of the social and religious structure. From a sociocultural standpoint, the berdache identity could be associated with transsexualism, as these people dress in the clothing traditionally associated with, and perform duties prescribed to, the opposite sex. Although some berdaches engage in samesex intercourse, others enjoy intimate interactions with the opposite sex as well. The berdache identity, both social and sexual, seems to transcend the dichotomous view of gender and is considered intersectional. This in-between identity is associated with religious practices, as their apparent transcendence of sex is believed to correspond to a transcendence of spirit. Thus, becoming a berdache is often not considered to be an individual’s choice, but a spiritual calling. Similarly, South Asian hijras represent a non-traditional gender role that is atypical for the Western world’s conception of identity. Hijras are fundamentally associated with religious beliefs and intersectionality of the sexes (Nanda, 1990). Although they are often similar to berdaches in their manner of opposite-sex dress, the religious emphasis of hijras is much greater. Whereas berdaches may perform spiritual rituals on occasion, the very core of hijra-hood is religious practice and some male hijras even sacrifice their genitalia in exchange for the ability to bless and curse. Many anthropologists consider hijras to be a third-sex—a gender identity that Sexuality Across Cultures 7 surpasses traditional dichotomous definitions of biological sex (Agrawal, 1997). Although some hijras indeed engage in same-sex sexual behaviors, others are asexual, and some are married heterosexual men who did not go through a ritual of emasculation (Hossain, 2012). Thus, there is much variation in the sexual orientation of these people, whereas the role itself seems to be scaffolded on traditional definitions of gender and heterosexuality. Within each of these cultures, it seems that diverse sexual orientation was initially accepted. With the spread of the Western civilization’s beliefs and practices, however, these nontraditional orientations and gender identities became the target of discrimination. The numbers of berdaches, for example, has decreased since the introduction of Western European ideas (Callender et al., 1983) and Native Americans feel reluctant to speak of berdaches to Western heterosexual anthropologists (Williams, 1993). This narrowing of sexual experience was partly influenced by the polarity of Western ideas about what is right and wrong in the world. Because of this new influx of Western influence, it is difficult to draw conclusions about the status and perceptions of these groups by their native societies, particularly as Western authors have conducted most of this research. Given that both groups have been associated with spirituality, however, it appears that hijras and berdaches may be well respected within their host cultures (Callender et al., 1983; Nanda, 1990). In a different part of the world, the African diaspora transported to South America during the colonial slave trade was initially accepting of different sexual identities. Non-heterosexuals transcended dichotomy and were considered to be connected with the spirits. This changed following the Catholic Inquisition widespread across the European-populated regions of South America (Sweet, 1996). The non-heterosexual Black African practice did not fit mainstream Catholic morality and, thus, was a target for elimination. Later, in the West, nontraditional Sexuality Across Cultures 8 gender and sexual identities were viewed as a disease that necessitated a cure (Adams & Sturgis, 1977; Bayer, 1987)—still a persistent belief among many individuals living in Western cultures (APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation, 2009). Although ideas about sexuality seem to change rapidly (Andersen & Fetner, 2008; Herek, 2000a), they continue to influence the shaping of gender and sexual orientation between and within cultures. We readily recognize that we cannot provide an exhaustive account of every instance of non-heterosexual orientation in the human experience—the examination of the spectrum would be a scholarly book on its own. However, this brief discussion of sexual orientations in non-Western societies suggests that across time, space, and culture, contemporary society is influenced by Western ideas that shape the attitudes about sexual and gender expressions—attitudes that remain in the minds of people today. Attitudes Beginning with Darwin’s (1859; 1871) writings on natural and sexual selection, scholars have stressed the idea of polarity between men and women; some considering any other forms of biological and psychological sexual distinction sinful and anomalous (Herdt, 1994). The basic male-female dichotomy is predominant in conscious thought about sex and, consequently, variability in sexual experience has become defined in categorical terms (Ding & Rule, 2012). Indeed, the anthropological literature briefly reviewed above suggests that sexual orientation often becomes synonymous with gender in contemporary society (Herek, 2000a). Even as sexual variability has recently begun to surface as a topic of great public visibility, the attitudes and perceptions of sexual minorities are still influenced by cultural conceptions of sex and gender (Herek, 2000a). Despite the great degree of diversity in sexual experience, much of the sexual orientation research has focused on same-sex attraction in the context of gender polarity rather Sexuality Across Cultures 9 than the full spectrum of experiences (Johnson, 2007). Thus, research on sexual orientation has provided invaluable insights as to how culture shapes attitudes and perceptions of sexual orientation. The word homophobia, for example, was coined by Weinberg (1972), a psychologist trained in psychoanalysis. The term arose from mental health professionals who, around the same time, petitioned that homosexuality be removed from the Diagnostic Statistical Manual of Mental Disorders (DSM; Bayer, 1987). The term homophobia holds a connotation of mental disorder. However, it has multiple lexical interpretations: the fear of man, the fear of sameness, and the fear of homosexuality, among others. However, because of colloquial popularity, widespread use in the media, and appropriation of the term by different gay-rights activist groups, the term most commonly refers to the fear of homosexuality. Importantly, the word homophobia suggests that it is indeed a phobia, or fear, and is therefore an abnormality. Close examination of this concept reveals that homophobia has little to do with the emotion of fear, however—an indicator of anxiety (Herek, 2000b). In fact, scholars examining the emotions attached to homosexuality have found disgust and anger to be most associated with same-sex sexuality (Bernat, Calhoun, Adams, & Zeichner, 2001; Herek, 1994; Van de Ven, Bornholt, & Bailey, 1996). These findings are consistent with those from social psychology, which suggest that minority group members tend to be viewed with disgust by majority group members (Mackie, Devos, & Smith, 2000). In turn, this leads to the general understanding that, like other minority groups, sexual identities do not fit the dominant and normative way of thinking (i.e., heterosexuality). Very few today would deny that homophobia refers to prejudicial attitudes towards sexual minorities. Indeed, because it has little to do with fear, the term was Sexuality Across Cultures 10 revised to represent general negative attitudes towards sexual minority groups—sexual prejudice (Herek, 2000a). Sexual Prejudice and Some Correlates Sexual prejudice has been studied extensively in the U.S. (Herek, 2000a; 2000b) but also crosses national boundaries (e.g., Gelbal & Duyan, 2006; Kite & Whitley, 1996; Lingiardi, Falanga, & D’Augelli, 2005; Williams, 1993), suggesting several broad trends. First, men tend to hold more negative sexual attitudes than do women (Kite & Whitley, 1996). Herek (2000b), furthermore, found that men were more negative towards gays than lesbians. These findings demonstrate a curious cognitive effect: when men were presented with the Attitudes Towards Gay men scale prior to the analogous Attitudes Towards Lesbians scale, scores on the latter became more negative; an effect not observed when the order was reversed. This suggests that men’s negative attitudes towards gay men can transfer into negative attitudes toward other sexual minority groups (i.e., lesbians). Yet it is unclear why straight men have more negative attitudes towards gay men. Because beliefs about sexual orientation and gender tend to be interconnected in contemporary society, hypermasculine men (those who endorse traditional gender roles and sexist attitudes) tend to perceive sexual minorities more negatively then men who are not hypermasculine (Barron, Struckman-Johnson, Quevillon, & Banka, 2008). In an Italian study, men in the military were much more negative towards sexual minorities than were heterosexual male university students (Lingiardi, Falanga, & D’Augelli, 2005). Other studies have even reported that when men’s masculinity was threatened by priming them with derogatory words referring to gay men (e.g., fag), they demonstrated stronger negative attitudes towards gay men compared to male participants who were primed with less offensive gay-related words (e.g., gay; Sexuality Across Cultures 11 Carnaghi, Maass, & Fasoli, 2011; Falomir-Pichastos & Mugny, 2009). Similarly, a cross-cultural comparison of three nations varying in their general levels of societal homophobia (Australia, Finland, and Sweden) found that cultures less accepting of male homosexuality may associate being gay with lower levels of masculinity (Ross, 1983). These findings suggest that gender identity is important to men and, thus, thoughts about the self may be implicitly associated with conceptions of sexual orientation. Much of the scholarly work examining masculinity and reactions to sexual minorities seems to conclude that men have negative attitudes towards non-heterosexual individuals (Herek, 2000b). Psychological research reinforces this by demonstrating that core concepts of male heterosexuality seem to be violated in the context of same-sex relationships and intimate interactions (Herek, 2004). Specifically, because men typically penetrate women in heterosexual intercourse, the penetration of men in gay relationships violates normative expectations (Carballo-Diéguez et al., 2004). Thus, in some cultures, a man who is penetrated is considered to be feminine or gay whereas the penetrator does not carry a social stigma and may be considered effectively heterosexual (Carballo-Diéguez et al., 2004; Lancaster, 1988). This specific framing of same-sex behavior is present across multiple contemporary cultures (e.g., Latin America, Middle East), as well as across time (i.e., the Catholic Inquisition in South America; Sweet, 1996). Additionally, because homosexuality is often associated with cross-dressing and transvestism, gay men are often conceived as feminine, even when there may be little evidence for this. In one of the earlier studies examining perceptions of sexual orientation, researchers asked participants to list the ideas that they had about gay and heterosexual men and women (Kite & Deaux, 1987). After examining the participants’ responses, the authors found a great Sexuality Across Cultures 12 degree of similarity between the traits that were ascribed to gay men and those ascribed to heterosexual women. Similarly, lesbian women were thought to possess qualities similar to heterosexual men. Lay opinions therefore stereotype gay men and lesbian women as possessing the traits and qualities of the opposite sex. However, there may be a dissociation between groups’ and individuals’ actual levels of masculinity or femininity and how they are perceived or believed to behave. In other words, although there may be few differences between heterosexuals and non-heterosexuals of the same sex, perceivers may view or imagine them through a lens of “gender inversion” (e.g., Kite & Deaux, 1987). Simply examining the association between gender and sexual orientation does not fully explain sexual prejudice, however. Researchers across the world have identified several other factors that are associated with negative attitudes towards sexual minorities (Barron et al., 2008; Baunach, 2012; Gelbal & Duyan, 2006; Lingardi et al., 2005; McCann, 2011; Rosik, Griffith, & Cruz, 2007). Political conservatives tend to have more negative attitudes towards sexual minorities, possibly due to greater endorsement of traditional gender roles and support for the exclusivity of marriage to heterosexual couples (Baunach, 2012; McCann, 2011). Similarly, people who score lower on personality measures of openness to experience also tend to view sexual minorities more negatively (Barron et al., 2008). Often, religious beliefs affect perceptions of sexual minorities (Gelbal & Duyan, 2006). For example, Muslims endorsing traditional gender roles tend also to report greater levels of antigay prejudice (Siraj, 2009). The violation of sociallyand politically-accepted gender roles within society often translates to negative attitudes towards sexual minorities (e.g., Taylor, 1983). As gender roles constitute one of the core concepts of contemporary cultures, it may be unsurprising that people Sexuality Across Cultures 13 perceive an absence of conformity to these gender roles as evidence of homosexuality (Ulrichs, 1994), which is subsequently evaluated as something negative. Perceptions of Sexual Orientation Although sexual orientation is considered perceptually ambiguous (i.e., has few visible markers differentiating the groups; Rule, Ambady, Adams, & Macrae, 2007), research in Western cultures has demonstrated that sexual orientation, like other distinctions (e.g., sex, skin color, age, political orientation), can be perceived with accuracy that exceeds chance guessing. Ambady, Hallahan, and Conner (1999) demonstrated that sexual orientations could be perceived from brief videos of gay and straight North Americans speaking about work-life balance. They found that people accurately estimated sexual orientation from videos of targets as short as one second and that perceivers’ accuracy remained significantly greater than chance even when the participants viewed only still frames from the videos. Furthermore, judgments of grayscale photographs of faces can provide sufficient information to accurately judge sexual orientation (Rule et al., 2007) and additional testing showed that even individual facial features (e.g., eyes) provide enough information to judge sexual orientation accurately across a multitude of Western nations (Rule, Ambady, Adams, & Macrae, 2008; Tskhay, Feriozzo, & Rule, 2013; Valentova, Kleisner, Havlíček, & Neustupa, 2014). Initial studies found that North American undergraduates needed as little as 40 milliseconds to view a face in order to accurately judge the target’s sexual orientation (Rule et al., 2009a). Moreover, this accuracy did not significantly improve when participants were given more viewing time (Rule & Ambady, 2008). When instructed to think carefully about their judgments, however, participants were significantly less accurate than when basing their assessment on first impressions (Rule et al., 2009a). These studies suggest that others’ sexual Sexuality Across Cultures 14 orientations may be evaluated unconsciously. Supporting this view, one series of studies found that American perceivers were not able to estimate their accuracy in judging sexual orientation (Rule et al., 2008). This absence of awareness supports the non-conscious nature of the judgments. In an even stronger test, researchers asked American university students to decide whether strings of letters presented on a computer screen were words or non-words (Meyer & Schvaneveldt, 1971). One-quarter of the strings presented were words relating to stereotypes about heterosexual men (e.g., truck), another quarter were words relating to stereotypes about gay men (e.g., rainbow), and the remaining half were letter scrambles (Rule et al., 2009b). Before each string, the participants saw a photo of either a gay or straight face appear for 100 milliseconds. Thus, if perception of sexual orientation is automatic, gay and straight faces should facilitate processing of gay and straight concepts, respectively. Indeed, the participants reacted faster to gayand straight-related words following the presentation of gay and straight faces. The perceptions of the faces therefore triggered thoughts about the targets’ sexual orientations (Collins & Loftus, 1975), leading to faster processing of related words. To examine the consequences of automatically processing sexual orientation, Rule et al. (2007) capitalized on the phenomenon of the ingroup memory advantage wherein people remember members of their ingroup better than members of the outgroup (Meissner & Brigham, 2001). This is believed to occur because perceivers allocate more attention to ingroup members than outgroup members (Rodin, 1987). Consistently, Rule et al. found that straight male students remembered straight faces better than gay faces, whereas gay participants remembered gay and straight faces equally well; thus, attending to both groups. Importantly, these data show not only that sexual orientation is processed automatically, but also that the initial categorization of sexual orientation can affect attention and memory, Sexuality Across Cultures 15 Following the cross-culturally prevalent inversion hypothesis whereby gays and lesbians are thought to be men and women trapped in the opposite-sex bodies (Kite & Deaux, 1987), studies have examined how targets’ masculinity affects perceptions of their sexual orientation. Research examining participants’ judgments of sound recordings, photographs, and brief videos have not only replicated the previous effects of accuracy in judging sexual orientation, but have also demonstrated that perceptions of gender typicality may mediate this accuracy (e.g., Rieger et al., 2010). In these studies, gay men were perceived as more feminine and lesbian women as more masculine than heterosexual men and women, respectively. Indeed, individuals who walked in a sex-atypical manner were more likely to be judged homosexual, which they largely were (Johnson, Gill, Reichman, & Tassinary, 2007). Gender typicality in children even predicts adult sexual orientation (Rieger, Linsenmeier, Gygax, & Bailey, 2008). Additionally, studies have examined the perception of masculinity and sex atypicality from faces, again finding that gender atypicality tends to be an accurate predictor of who is gay and lesbian both in North America and the Czech Republic (Freeman, Johnson, Ambady, & Rule, 2010; Valentova & Havlíček, 2013). Comparing the two cultures, Valentova, Rieger, Havlíček, Linsenmeier, and Bailey (2011) observed that sexual orientation can be accurately extracted from facial cues. Although Valentova et al. found that people were better at making these perceptions from the faces of targets from their own culture, Rule, Ishii, Ambady, Rosen and Hallett (2011) did not find such differences in a comparison of targets and perceivers from the U.S., Spain, and Japan. Rather, judgments of sexual orientation from men’s faces from all three cultures did not differ in accuracy regardless of the culture of the person making the judgment. Instead, they did find a significant tendency whereby perceivers were more likely to categorize targets as gay as a function of the extent to which homosexuality was accepted by their culture (see Rule, 2011, for Sexuality Across Cultures 16 similar results for different racial groups within North America). Related to this, another study found that Italians who reported greater familiarity with sexual minorities tended to be more accurate at perceiving sexual orientation (Brambilla, Riva, & Rule, 2013). In addition to the research in psychology on perceptions of sexual orientation, work in linguistics has examined perceptions of sexual orientation from speech cues. In one early study conducted in the U.S., Linville (1998) presented participants with 5 straight and 5 gay voices and found that sexual orientation was perceived more accurately than chance guessing. Further examination showed that gay and straight men differed in their pronunciation of the sound associated with the letter s. Other research has documented that pitch variability may cue sexual orientation (Gaudio, 1994). In Canada, Rendall et al. (2008) found that gay men spoke more like straight women and that lesbians spoke more like straight men. Similarly, one non-English study showed that raters were able to accurately perceive sexual orientation from Czech speakers, lending cross-linguistic support to these effects (Valentova & Havlíček, 2013). Congregating across modalities of perception and expression, there seems to be a strong case for the validity of gender inversion in predicting the accurate judgment of sexual orientation, at least in North America and Eastern Europe. However, it should not be assumed that gender inversion is the only mechanism responsible for accurate judgments of sexual orientation (Freeman et al., 2010; Tskhay & Rule, 2013a; Zimman, 2010). Sexuality in Daily Life Whereas many cultures show evidence of being generally more accepting of sexual minorities in the past, sexual minorities generally tend to experience a greater degree of sexual prejudice in the present day (Herek, 2000a; 2000b). Sexual minorities and people perceived to be non-heterosexual have historically experienced harassment and violence across different contexts Sexuality Across Cultures 17 (Berrill, 1990) and nations (Sexual Health and Rights Project, 2007). A recent meta-analysis surveying 500,000 participants estimated that a large proportion of sexual minorities have experienced verbal harassment (55%) or discrimination (41%) at some point in their lives (KatzWise & Hyde, 2012). The meta-analytic effects were consistent and strong, suggesting that sexual minorities’ lives tend to be profoundly affected by sexual prejudice. These discrimination and stigmatization experiences can lead to a number of negative outcomes, such as mental and physical health issues (Lick, Durso, & Johnson, 2013). Indeed, sexual minorities tend to experience more mental, physical, and social problems than their heterosexual counterparts. The concept of minority stress is at the core of the experiences that sexual minorities face in their lives (Meyer, 2003). In this framework, the consistent experience of discrimination and stigmatization from society can lead to negative attitudes and views of the self. As in Allport’s (1954) early theoretical work The Nature of Prejudice, a minority person consistently receives messages about being abnormal, which leads to negative attitudes about the self and negative life outcomes. The idea of stress itself rests in the incongruence of identity with social standards, expectations, and environment (Meyer, 2003; Selye, 1982). Indeed, a mismatch between an individual’s gender role or sexual identity and the society’s expectations about behavior and sexual orientation could result in such distress. Indeed, non-heterosexuals tend suffer higher rates of depression, and sexual orientationrelated stress and stigmatization account for a large part of this (Lewis, Derlega, Griffin, & Krowinski, 2003). Furthermore, American men who reported having male partners displayed a greater lifetime prevalence of suicidal ideation and suicide attempt (Cochran & Mays, 2000; see also Mereish, O’Cleirigh, & Bradford, 2014). This relationship is expected, given that even the Sexuality Across Cultures 18 mere perception of being the target of discrimination is correlated with negative health behaviors (Pascoe & Richman, 2009). Similar effects emerge in other cultures. For example, a large proportion of gay and bisexual individuals in Mexico City have experienced physical violence, largely because of the mismatch between their gender identity and cultural expectations (Ortiz-Hernández & GrandosCosme, 2006). Moreover, sexual minorities in Mexico tend to engage in more risky health behaviors (e.g., smoking; Ortiz-Hernández, Gómez Tello, & Valdés, 2009). Similar effects are found in China. Sexually-stigmatized individuals are more likely to engage in sexual behaviors with a high risk for HIV infection (Nielands, Steward, & Choi, 2008). Importantly, cultural factors play a key role: concerns about family acceptance and the ability to maintain interpersonal relationships after coming out as non-heterosexual contribute strongly to the increased anxiety and felt discrimination among sexual minorities in China (Liu & Choi, 2006). Indeed, interpersonal interactions with family members may be strained by one’s sexual orientation (Herek & Capitano, 1996). Greater levels of family rejection tend to be associated with greater levels of depression, substance abuse, unprotected sex, and suicide attempts in North American samples (Ryan et al., 2009, 2010). Frost and Meyer (2012) found that sexual minorities’ psychological well-being depended on the extent to which they felt connected with others. Interactions with other members of the sexual minority community may therefore have positive effects on personal well-being. However, many sexual minorities feel isolated, which is related to suicide attempts and substance abuse (Grossman & Kerner, 1998). Relatedly, North American studies of close relationships have identified important unique aspects of gay and lesbian relationships (Klinkenberg & Rose, 1994). For example, Nardi and Sherrod (1994) found that gay men were more likely to have sex with their friends. Unlike Sexuality Across Cultures 19 heterosexuals, sexual minorities report greater awareness of the social barriers that obstruct their pursuit of intimacy, which may influence aspects of relationship formation among sexual minority group members (Frost, 2011). Nevertheless, heterosexual and same-sex couples tend to show similar amounts of relationship quality and satisfaction (Duffy & Rusbult, 1986). Within romantic relationships, there are several important factors among sexual minorities that could have an effect on relationship quality but are rare among heterosexual couples. For example, one North American study found that same-sex partners in monogamous relationships experienced greater levels of relationship satisfaction and lower levels of tension than partners in non-monogamous relationships (Kurdek & Schmitt, 1986). Furthermore, female same-sex couples tend to stay in relationships longer than male same-sex couples, on average (Kurdek, 1989). Internalized homophobia also shapes the relationships of sexual minorities (Herek, 2000b). Sexual orientation-related negative attitudes towards the self predicted lower relationship satisfaction levels among gay men partly because men who experienced a greater degree of internalized homophobia were more depressed, which strained their relationships (Frost & Meyer, 2009). Perceptions of masculinity and femininity could play a role in the formation of sexual, dating, and longer-term relationships between partners. It is generally accepted that, at least in the context of same-sex male relationships, compatibility in sexual roles is important to relationship satisfaction (Kippax & Smith, 2001; Tskhay & Rule 2013b; Tskhay, Re, & Rule, 2014). This is evident within both Western and non-Western cultures and could be exaggerated as a function of the normative perceptions of sexes within a society. Even same-sex relationships, which can mirror traditional heterosexual roles, may reinforce the sex and gender hierarchies specified by a society (Carballo-Diéguez et al., 2004). Furthermore, one study Sexuality Across Cultures 20 demonstrated that men who were born in Asia were more likely to occupy receptive roles in same-sex male sexual intercourse in the U.S., reinforcing the race and sexual orientation stereotypes common within Western culture (Wei & Raymond, 2011). Specifically, Asian men were expected to be receptive in sexual intercourse, because they were stereotyped as feminine and submissive (Han, 2008). Within the East Asian Chinese community, however, researchers found that gendered personality traits dictated sexual roles: more masculine men preferred to penetrate their partners and less masculine men preferred to be penetrated (Zheng, Hart, & Zheng, 2012). Thus, these findings demonstrate that social expectations, attitudes, and beliefs about gender roles within a culture could have important and, at times, detrimental effects on relationships. Conclusions In the current chapter, we aimed to demonstrate (1) the incredible diversity of, and change in, the conception of sexual orientation across different cultures and time; (2) how sexual orientation is perceived in contemporary society; and (3) what effects sexual orientation has on life outcomes for sexual minorities. In doing so, we focused on different manifestations of minority sexual behavior across different cultures (Blackwood, 2000; Sweet, 1996; Williams, 1993), which generally cast the concept of gender as primarily related to peoples’ beliefs about sexuality. Indeed, prior to the emergence of the Western social system, non-heterosexual relationships and sexuality were accepted within specific roles and contexts in some cultures. Furthermore, the overall perception of sexuality was often based on concepts relating to the duality of sexes such that sexuality was intrinsically, and often spiritually, intertwined with gender. The spread of Western European cultural ideals through colonialism, however, seems to Sexuality Across Cultures 21 have led to a suppression of nontraditional gender roles and non-heterosexual behaviors via persecution and prejudice (Williams, 1993). In terms of sexual prejudice (Herek, 2000a), we reviewed how contemporary societies tend to generally condemn sexual relationships between same-sex individuals. Furthermore, individuals with more conservative political beliefs tend to score higher on measures of anti-gay prejudice. Importantly, the emergence of the link between sex, gender, and sexual orientation present in ancient and minority cultures seems also to be relevant within contemporary global society. Specifically, any person whose sexual identity does not fit the traditional dichotomy established within dichotomous views of biological sex has the potential to become a target of prejudice and discrimination. Data show that men are especially negative towards sexual minorities and that more sexist and masculine attitudes in society result in greater overall levels of sexual prejudice, which can affect the lives of sexual minorities both directly and indirectly. This point was largely supported in the examination of beliefs about sexual orientation and the emergence of the “inversion hypothesis” that gay men are women living in male bodies and lesbians are men inhabiting female bodies (Kite & Deaux, 1987). This notion perpetuates basic beliefs about what constitutes the essence of gender and also emerges in the cognitive processes underlying the ways in which individuals are perceived and construed (Rieger et al., 2010). Behavioral researchers have consistently found that sexual orientation can be perceived from thin slices of behavior and other minimal cues with accuracies that readily exceed what would be expected from chance guessing (Tskhay & Rule, 2013a). Variations in individuals’ expressed levels of gender typicality contribute meaningfully to the accurate perceptions that people make (Johnson et al., 2007). People therefore tend to rely on gender cues to inform their judgments of sexual orientation (Freeman et al., 2010). Naturally, this poses a problem: any Sexuality Across Cultures 22 deviation in individuals’ appearance or behavior towards that of the opposite sex could lead to the perception that one is a member of a sexual minority group (Rieger et al., 2010), potentially eliciting subsequent negative personal outcomes regardless of whether that perception is correct (Herek, 2000a). In examining these outcomes, we elaborated on how sexual minorities tend to experience a great degree of victimization, which predicts negative outcomes such as depression, anxiety, and general psychological and physical maladjustment (Lick et al., 2013). Importantly, the nonacceptance of sexual minorities by society could be the primary reason for why sexual minority individuals report higher rates of suicidal ideation and suicide attempts (Cochran & Mays, 2000). Discrimination against sexual minorities has been further related to substance abuse, physical health issues, and social support difficulties (Lick et al., 2013). Indeed, in one study conducted in New York City, a large proportion of the sample of sexual minorities reported feeling socially isolated: that they have a small number of friends and that this social support circle is too small (Grossman & Kerner, 1998). Social connectedness within and beyond the sexual minority community seems to increase psychological well-being, however (Frost & Meyer, 2012). Unfortunately, there is very little research examining friendships among sexual minority individuals, neither within the non-heterosexual community nor outside of it (Klinkenberg & Rose, 1994). Yet, one conclusion does seem consistently well-supported by the literature to date: a greater number of interactions with sexual minorities seems to be related to lower levels of prejudice (Herek & Capitanio, 1996). Perhaps if society becomes more diverse and sexual minorities become more visible, then the societal level of sexual prejudice will decrease. In terms of close relationships, we described how same-sex relationships tend to be similar to heterosexual relationships (Duffy & Rusbult, 1986). However, there are notable Sexuality Across Cultures 23 differences in the way that sexual minorities psychologically and practically approach relationships (Nardi & Sherrod, 1994). Importantly, many same-sex couples have to face a detriment unfamiliar to heterosexuals—internalized homophobia, or negative attitudes about one’s own sexual minority status that have been shown to be toxic to gay relationships (Frost & Meyer, 2009). In general, however, the literature on same-sex relationships is scant and future research should focus on sexual minorities alongside the traditional focus heterosexuals to provide a richer understanding of the general processes involved in interpersonal interactions and relationships. Importantly, the research literature examining sexual minorities is still fairly nascent with many questions presently left unresolved and unknown. Much of the research examining questions related to sexual orientation has been conducted in either the U.S. or Europe and, thus, says very little about other cultures, norms, and individual experiences. Furthermore, most of this research has focused on gay men. Examination of different groups (e.g., lesbians) would naturally challenge the assumption that all non-heterosexual identities are alike, and perhaps will introduce a greater level of diversity to research and practice. Last, and very important, the negative focus of research on sexual minorities itself is problematic—although informative, it perpetuates the idea that being non-heterosexual is detrimental to health and protrends a difficult life of discrimination, stigmatization, and prejudice. In taking this perspective, researchers may overlook the positive experiences that both sexual minorities and heterosexuals have every day, and even some of the potential psychological and cultural benefits contributed by sexual minorities to society more broadly. For example, although it of the research on heterosexual relationships seems concerned with improving relationships and other positive outcomes, most of the literature on same-sex relationships has examined relationship strain, violence, and Sexuality Across Cultures 24 negativity. Perhaps negative attitudes or beliefs about sexual orientation have biased researchers—a serious concern that should be addressed in the future. In sum, we suggest that, although various forms of sexual expression exist in the world and have been met with different levels of acceptance across different places and different times, sexual minority members are generally viewed negatively in contemporary global society. Part of the reason, it seems, is the predominant view that sexual orientation is a function of gender and sex. Thus, any violation of traditional sex norms tends to lead to sexual prejudice, discrimination, and negative life outcomes. Indeed, more research on sexual minorities is needed to gain a better understanding of the group dynamics and prejudiced attitudes in our contemporary gendered global society. Sexuality Across Cultures25 ReferencesAdam, B. D. (2003). The Defense of Marriage Act and American exceptionalism: The" gaymarriage" panic in the United States. Journal of the History of Sexual Orientation, 12,259-276. doi: 10.1353/sex.2003.0074Adams, H. E., & Sturgis, E. T. (1977). 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