This article was published on July 23rd, 2020
As a multifaceted intervention for gay, bi, trans, and queer self-identified men, Two Spirit, and non-binary people, OutsideIn, a new campaign from the Health Initiative for Men, addresses those who are less open about their sexual and romantic lives, and their service providers.
Phrases like ‘out and proud’ make it easy for some to believe that coming out is a one-time occurrence that every queer person goes through in order to have a healthy, fulfilling life. Even for those that consider themselves out, it is a process that must be repeated over and over as there always comes a time when we must come out to new people we meet, from co-workers to healthcare providers, or just people we casually meet in public. For many, coming out is not easy, and this complicated issue can lead to health needs that potentially can go unaddressed.
Through OutsideIn, HIM seeks to address the health inequities for members of the queer community who are less out. The aim is to encourage members and to provide resources and services that support mental, sexual, and social well-being. Extensive literature review and community consultation has proven the imbalance in access to services, and these lower rates of accessing HIV prevention tools, lower health literacy, and specific iterations of isolation and stress that are detrimental to overall health.
Queer people that are less out often don’t identify with sexual health interventions aimed at the community, leading sometimes to sexual health misinformation that is shared by word of mouth. By interacting directly to the needs and experiences of less out queer members, while tackling the related stigma, we can encourage less out people to access the health resources they may require.
Why some queer men are reluctant to share their true selves with family, friends, and romantic partners
Of the members of the LGBTQ+ community, bisexual men are the ones that are least represented in the media. While women have been the subject of several shows and literature over the years, it is rare to see the same for men, with a shortage of public role models. Also, queer men are typically viewed as less masculine as heterosexual men and this macho veil has been a sticking point since the beginning of time. A change in gender titles will be pivotal in helping men take off the masculinity mask.
Many men are also afraid to come out to family members as they are concerned about what they may think about their queer lives. This fear factor is one of the prevailing reasons why many men opt to not come out and lead a double life that can cause even more stress and trauma as the years progress. There are also fewer support systems in place for queer men and research has shown that being able to express concerns to those that understand is a huge asset to queer men that are not out. And lastly, men that identify as bisexual may choose to not come out because of how they may be perceived by women that have preconceived notions about bisexuality.

What Is OutsideIn?
OutsideIn is comprised of three main components:
1. Resources aimed at providing support to healthcare providers in adapting practices to be more responsive to the needs of less out members of the queer community and other less out men that have sex with men.
These include two best practices documents that were developed based on multi-level consultation with queer members and healthcare providers, and possess information on specific health inequities experienced by less out members and the steps healthcare providers can take to address these inequities. One is aimed at general and sexual healthcare providers, and the other to mental healthcare providers.
The second discussion-based workshops are meant to help healthcare providers identify assumptions and the ways in which providers can adapt practices to better address the clients’ needs. There have been discussions with two sets of mental healthcare providers, and VCH STOP team. Also included was the presentation conducted at the Summit, and Kiarmin’s webinar through PAN as iterations of the training workshop. For future sessions, there are preliminary discussions underway with Fraser Health Authority to bring in nursing teams, as well as contact with Interior Health.
2. Outness.ca encourages less queer members to access health and community services, and promote the message that being out is complicated, with outness meaning many different things to a lot of different people. Together, these messages allow for less out members of the queer community to access services while also reducing the stigma around these issues. The social marketing campaign involves print collateral, digital content, promotion on sexual networking apps, and earned promotion.
3. The Let’s Talk It Out community workshops are aimed at community members to assist them in reducing and removing the stigma about being out, and also increase compassion towards community members that have complicated relationships with being out.
Who Developed OutsideIn and How?
Developed by the Health Initiative for Men (HIM), OutsideIn is a non-profit organization that aims to improve the health of the queer community in the Lower Mainland and across British Columbia. OutsideIn was developed in consultation with community members, community organizations, and healthcare providers to ensure intervention activities accurately represent the needs and experiences of less out members of the community and are effective in speaking to and addressing those needs.