Identifying The Views Of Nursing Students On The Topic Of Homosexuality

Abstract

Aim: The aim of this study is to identify the views of nursing students about homosexuality. Methods: This research was planned as a mixed methods study with an in-depth interview and descriptive approach. The study was conducted between 1 April and 15 June 2017 with 32 (16 male, 16 female) nursing department students at the Kafkas University Health Science Faculty in Kars, Turkey. Two main data-collection tools were used in the study: the “Personal Information Form” and the “In-depth Interview Questionnaire”. Data from this study were evaluated using content analysis. Results: 96.8% of the participants said that homosexuality is not a preference, 87.5% said that it was a psychological problem and could not be treated, 93.8% said that it was against the religion of Islam, 50% said that homosexuals should not adopt and 96.6% said that a negative approach should be taken with homosexuals. All of the participants said that homosexual marriages are wrong and that they should not be legalized in our country conclusion: In conclusion, although the participants had negative views of homosexuality, they still concluded that homosexuals should benefit from health services and that nurses should provide them with a full range of health services.

Keywords: Homosexualitynursing studentviews

Introduction

Homosexuality is defined as a situation where an individual has emotional and sexual attraction to the same gender. Male homosexuals are referred to as gay while female homosexuals are referred to as lesbians (LGBT rights are human rights, 2017). Homosexuality was included in a separate category recommended by the American Neurology Association in 1930: Psychopathic personality. In three different classifications made by the American Psychiatric Association from 1935 until the late 1940s, homosexuality was classified as a psychological disorder in DSM-I (Diagnostic and Statistical Manual of Mental Disorders) in 1952 and DSM-II in 1968 (Mert, 2009). However, homosexuality has been accepted as a different sexual orientation and not a disease since 1973 by the American Psychiatric Association (American Psychiatric Association,1980; Stoller et al.,1973), by the World Health Organization since 1993 (WHO, 1993), by the Chinese Psychiatric Association since 2001 (Assessment report, 2002) and by Turkey since 2010 (Tpd And Cetad Press Release: Homosexuality is Not Disease, 2017). Still, in every segment of society, we encounter negative attitudes and judgments associated with various religious beliefs that view homosexuality as a psychiatric disorder, perversion, disease or a degenerate type of behavior (Yıldız, Atamer, & Yavuz, 2003).

Almost all cultures and major religions consider homosexuality an abnormal type of sexual behavior. Throughout human history, many civilizations have been less accepting of homosexual relations and more accepting of heterosexual relations (Uğurlu, 1999). Even though homosexuality is today viewed as an alternative lifestyle (Feng et al., 2012) and there is an increasing positive perception of homosexuality, negative perceptions of homosexuality, such as negative attitudes, heterosexism and homophobia, are quite common (Avery et al., 2007). Homosexual gays and lesbians encounter prejudice everywhere, including home, school and the workplace (Harry, 1989; Remafedi, 1987).

Problem Statement

However, research has found that health professionals have negative attitudes towards homosexuality (Chaimowitz, 1991; Eliason & Randall, 1991; Evans, Bingham, Pratt, & Carne, 1993; Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991). One study found that gays and lesbians are forced to deal with discriminatory health professionals (Dardick & Grady, 1980).

Purpose of the Study

This study aims to identify the views students in the nursing department, who will be future healthcare professionals, hold regarding about homosexuality.

Research Methods

Type of Research

This study was planned as a mixed methods study with an in-depth interview and descriptive approach.

The Location and Time of the Study

The study was conducted between 1 April and 15 June 2017 with with nursing students at the Kafkas University Health Science Faculty in Kars, Turkey.

Population and Sample

The sample of this study consisted of 32 (16 male, 16 female) nursing students. Participants in the in-depth interviews were selected until data saturation was reached according to non-probabilistic sampling. Data saturation was reached when similar patterns were provided by the participants.

Data Collection Tool

Participants were selected randomly from among nursing students. After disclosing the purpose and study method of the research, potential participants were invited to take part in the study as volunteers. Two main data-collection tools were used in the study: the “Personal Information Form” and the “In-depth Interview Questionnaire”. We tested the questions for structure and clarity in a pilot study. No revisions to the questions were indicated. The results of the pilot study are not included in the results of this study.

In-depth interviews were held in the interview room at school so that the students could make their classes on time. Prior to starting the interviews, each student in the sample was informed about the aim of the study. The students were assigned a number instead of names, and all of the interviews were tape recorded and transcribed by researchers. In-depth interviews were lasted an average of 70 minutes.

Procedure

Data were collected by the researchers through face-to-face In-depth interviews method.

Data analysis

Data were analyzed descriptively and quantitatively. Descriptive statistics were presented with frequency and percentages. Quantitative data gathered by tape recordings and transcribed verbatim were analyzed and interpreted to determine themes and to create a conceptual framework (Lacey & Luff, 2009) of Nursing Student Perceptions on Homosexuality. The units of analysis for this study were words or concepts, themes, and numbers of subjects which described the same concept or themes. Transcribed data from the in-depth interviews were grouped by themes and concepts, and then the participants’ statements were coded numerically according to these groups (Bowen, 2006; Thomas, 2017). In addition, direct quotations were used to make the data meaningful and reliable.

Ethical Aspect of the Study

Written approval was obtained from the Provincial Health Directorate. Informed consent was obtained from the women prior to the study. The study was conducted in accordance with the directives of the Helsinki Declaration.

Findings

The study included a total of 32 students, four males and four females randomly selected from the freshman, sophomore, junior and senior classes in the nursing department (16 males and 16 females). The median age of the students was 21.9, 65.6% of their families lived in the provincial capitals, 70% had nuclear families, 40.6% of their mothers were elementary school graduates and 62.5% of their fathers were elementary school graduates, 56.3% had income that was equal to their expenses, 81.3% were covered by social security and all of them held Islamic religious views. Furthermore, 55% of the students said that their knowledge of homosexuals came from the internet, 20% from social media and newspapers, 9.4% from books, and 15.6% because there were homosexual individuals in their social circles.

Views about the definition of homosexuality and whether or not it was a preference

96.8% of participants defined homosexuality as the sexual and emotional union of two people from the same gender and said that homosexuality is not a preference.

“The fact that two people from the same gender have emotional feelings for one another is union. It could be a preference but it is also a necessity. For example, girls who are raped or molested at a young age (especially if a father rapes his daughter) may hate men and be attracted to girls.” (Participant No. 1, Female).

“It is people from the same sex having sexual relations and experiencing a sexual relationship. I do not think it is a preference. When they cannot suppress their feelings, interest in the opposite sex becomes more prominent.” (Participant No. 1M (Male)).

I do not think homosexuality is a preference. It is sexual attraction and love between same sex individuals, feeling something emotional for each other and viewing each other romantically.” (Participant No. 11F).

Views about whether homosexuality is a disease and about its treatment

Of the participants, 87.5% said that homosexuality is a psychological problem. The other participants said that it was an emotional problem and could not be treated.

“In my opinion, it is a psychological disorder. I don’t think treatment will be completely effective even if they are treated.” (Participant No. 16F).

“In my opinion, homosexuality is an emotional problem. However, it is an emotional problem that could turn into a psychological disorder. Those who are homosexual from birth can be treated, but those who become infatuated with it cannot be treated.” (Participant No. 4F).

“Homosexual individuals who cannot be treated do not view themselves as sick because it is the individual’s choice.” (Participant No. 2M).

Views about what Islam teaches on homosexuality

Of the participants, 93.8% said that homosexuality is not compatible with Islam.

“Religion separates men and women. It is not religiously allowed. Homosexuality is unacceptable according to Islam.” (Participant No. 4F).

“It is not religiously acceptable. How can people continue their bloodline if there are homosexual marriages” (Participant No. 1F).

“I listened to a religious program on television. I heard that this type of relationship is a sin and that those who engage in this type of relationship will be punished severely.” (Participant No. 3M).

“When tribes were first established in the Quran, for example the tribes of Lot and Pompei, homosexuality spread, so the people in those tribes were destroyed. Homosexuals were turned into stone as a lesson. Today, there are statues of homosexuals who were turned to stone in Rome. As we know, there is no place for homosexuality in Islam. This is a disaster.” (Participant No. 8M).

Views about homosexual adoptions

All of the participants said that it was not right for homosexuals to marry and that homosexual marriage should not be legalized in Turkey.

“No, they should not marry. When they marry, they will live in the same home. They will go out into the community and this will be seen. Society will be disturbed by this, and it could be a bad example for the community. If this idea gained acceptance, the number of homosexuals could increase. It should not be legalized.” (Participant No. 10 F).

“I don’t think it is right for them to marry, and it should not be legalized because it violates the ethical rules of our society. When it is legalized, there could be an increase in violent incidents. Imagine two bearded men are walking in the park hand in hand. It will have a negative effect on children.” (Participant No. 2M).

“They can marry, but if it is legalized in our country, there could be perversions. The moral fabric of society will be disrupted. There will be an increase in homosexual orientation, homosexuals and homosexual marriage.” (Participant No. 2F).

Views about whether homosexuals have the right to marry and whether homosexual marriage should be legalized in Turkey

Of the participants, 50% said that homosexuals should not adopt, 15.6% said that they they could adopt and 34.4% were undecided.

“They can adopt a child but only after they have reached a certain age and if they want to be part of such a family. In other words, permission must be obtained from the children.” (Participation No. 14M).

“If it is obvious that children have a homosexual orientation, they can adopt them. They should not adopt other normal children.” (Participant No. 16M).

“Even though it may appear that they can adopt children, I don’t think they can. As people, we have physical as well as spiritual needs. Imagine a gay couple adopted a child. When the child is with his peers, and they criticize the child’s family, and the child is ostracized, the child will distance himself from his peers.” (Participant No. 2M).

“I don’t think they can adopt. Think about it. The child will have either two fathers or two mothers and the child will experience role confusion.” (Participant No. 4F).

I think that parents should be from heterosexual families. Homosexuals cannot provide the interest, love, compassion and confidence that heterosexual families give to a child” (Participant No. 4M).

Views about how society should approach homosexuals

96.6% of the participants said that society should take a negative approach to homosexuals. “In my opinion, they should not live comfortably because this will destroy the moral values of society. They will be a bad example for society. The trend towards homosexuality might increase. If we view them positively, their numbers will increase. We must prevent them from increasing.” (Participant No. 12F).

“First of all, if possible, we should provide them with psychological and medical assistance. If they do not accept the offer of assistance, we should ostracize them.” (Participant No. 9M).

“I would be lying if I said I wouldn’t ostracize them. I cannot live in the same environment as them. I don’t know if you call this prejudice, but their lifestyle and the way they dress is different from our lifestyle and the way we dress. We cannot live in the same environment as them” (Participant No1M).

Views about homosexuals taking advantage of health services and how nurses approach homosexuals

All of the participants said that homosexuals should be able to benefit from health services and that nurses should provide homosexuals with all of the necessary health services.

“If we are talking about treatment for normal diseases, of course, health services should be provided. However, if we are talking about sex change operations, in other words about changing something that God gave them, they should not be provided with health services because this is not religiously acceptable.” (Participant No. 8M).

“In my opinion, they should take advantage of health services. However, a single room should be designated for their treatment. There is the chance that they might make sexual advances on other patients. I also think that they could be a bad example for other patients” (Particpant No. 11F).

In my opinion, nurses should provide them with the necessary treatment and care without judging them. Even if nurses disapprove of homosexuals privately, they should provide the necessary care without making this obvious to the homosexual patient” (Participant No. 4M).

Discussion

Although it is not known exactly how sexual orientation develops, it is known that no person makes a conscious choice by deciding of their own free will between sexual orientations. Homosexuality is defined as a person feeling a sexual and emotional attraction to their own gender (Eşcinsellik, 2017). 96.8% of the participants in our study defined homosexuality as the sexual and emotional union of two people from the same gender and said that homosexuality is not a preference. One study found that medical students and interns did not have enough information about homosexuality (Banwari, Mistry, Soni, Parikh, & Gandhi, 2015). It is thought that the reason for these differences might be connected with the fact that students access information about homosexuals from sources such as the internet, books, newspapers and social media.

Although sexual orientation is not currently viewed as a disease, there are people both in society at large and among medical professionals that view homosexuality as a disease (Herek, 2007). In our study, 87.5% of the participants said that homosexuality is a psychological problem. In a study by Kan et al. (2009), they found that more than 25% of medical students thought homosexuality was a psychological disorder that required treatment. Another study found that 46.6% of the participants who stated their views about gays and lesbians said homosexuality was a psychological disorder (Güney, Kargı, & Çorbacı-Oruç, 2004). These studies are similar to our study.

The Global Divide on Homosexuality (2013) report states that the vast majority of people in Muslim countries think homosexuality should be rejected: 97% in Jordan, 95% in Egypt, 94% in Tunisia, 93% in Palestine, 93% in Indonesia, 87% in Pakistan, 86% in Malaysia, 80% in Lebanon and 78% in Turkey. The reason is that Islamic law defines different sexual orientations defined by emotional attachment as crimes and sin because they violate the boundaries set by God. According to the Quran, each human has a single gender. A person must act in accordance with their identity as a man or woman based on their gender (Şahin, 2015). In our study, 93.8% of the participants said that homosexuality is not compatible with Islam. Studies have found that strong religious convictions have a negative effect on attitudes towards homosexuals (Steve & Jerry, 2007; Çabuk, 2010; Campo-Arias, Herazo, & Cogollo, 2010; Bostanci Daştan, 2015). Our study is similar to these studies.

In addition, the view that Islam takes of homosexuality is determined by the verses related to the tribe of Lot, who committed this act. The tribe of Lot was accused of committing this act, which had not been committed by anyone previously. Because homosexuality became generally accepted by society as moral general, the tribe of Lot, was described as a society that transgressed the boundaries (Şahin, 2015). In our study, the 8th male participant mentioned the tribe of Lot and said that homosexuality had absolutely no place in the religion of Islam. We can clearly see the negative effect that religion has on views of homosexuality.

Adoption is defined as a legal relationship between a child whose situation is suitable for being adopted and people/couples whose situation is conducive to adopting (Evlat Edinme, 2017). In our study, 50% of the participants said that homosexuals should not adopt. In a study conducted in Northern Ireland in 2012, 40% of the participants said that homosexuals could adopt children (McAlister, Carr, & Neill, 2014). In addition, male number 16 in our study said “If children with a homosexual orientation are obvious, they can adopt them. They should not adopt other normal children.” which indicates that homosexuals could adopt children with homosexual tendencies. A study conducted by Cambridge University examined 130 adopting families in detail, including homosexual fathers (41 families), lesbian mothers (40 families) and heterosexual parents (49 families) and found no evidence that would support “speculations that the sexual orientation of either male or female children could be affected by homosexual parents” (Golombok et al., 2014). The fact that other studies have reached different conclusions than our study suggests that maybe it is due to the students’ prejudices about homosexuals.

Negative attitudes towards homosexuals are common in several societies (Herek & Glunt, 1993). In our study, 96.6% of the participants said that a negative approach should be taken towards homosexuals. Studies have found that students have negative views of gay men and lesbians (Güney et al., 2004; Steve & Jerry, 2007). The findings of these studies are similar to our study.

Benefiting from health services is a basic human right. All of the participants in our study said that homosexuals should benefit from health services. One study found that medical students have a positive attitude towards homosexuals and that they opposed discrimination in the provision of health care to either heterosexuals or homosexuals (Dunjić-Kostić et al., 2012). The results of these studies are similar to our study. However, male number 8 and female number 11 in our study said that homosexuals should benefit from health services. Yet, if one looks at their statements, we see that they have a negative attitude and prejudice against homosexuals. One study found that medical professionals with a negative attitude towards homosexuals were reticent to help homosexual patients (Yen et al., 2007). A study that Kan et al. (2009) conducted at Hong Kong University found that medical students were significantly more homophobic than students in other departments. A study that Jones, Pynor, Sullivan, & Weerakoon (2002) conducted with graduate students in the health field in Austria found that approximately 30% of the sample felt uncomfortable working with lesbian patients and 27% were uncomfortable working with gay patients. The findings of these studies are similar to statements made by two of the participants in our study.

Conclusion

In conclusion, the views of students in the nursing department about homosexuality, which is one type of sexual orientation, were negative except when it came to receiving health services. Students said that homosexuality is not acceptable in Islam, and that homosexuals should not adopt children and homosexual marriage should not be legalized in Turkey and that it is not right for them to marry. Furthermore, students said that homosexuals should be able to benefit from health services and that nurses should provide them with the full range of all health services. Therefore, courses on types of sexual orientation should be organized for students and they should be given opportunities to meet and speak with individuals with different sexual orientations. This might mitigate some of the negative views and attitudes held by student nurses, who will be the health workers of the future.

Acknowledgments

I would like to thank Sevilay Senol Celik for his support in the analysis of the findings of the study.

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Turk, R. (2019). Identifying The Views Of Nursing Students On The Topic Of Homosexuality. In E. Soriano, C. Sleeter, M. Antonia Casanova, R. M. Zapata, & V. C. Cala (Eds.), The Value of Education and Health for a Global, Transcultural World, vol 60. European Proceedings of Social and Behavioural Sciences (pp. 667-676). Future Academy. https://doi.org/10.15405/epsbs.2019.04.02.83