Chapter 2: Population-specific HIV/AIDS status report: Gay, bisexual, two-spirit and other men who have sex with men - Demographic profile
Chapter 2 – Demographic Profile
This chapter provides an overview of available data on selected demographic characteristics of gay, bisexual, two-spirit and other men who have sex with men (MSM) in Canada. Few studies have examined the demographic characteristics of gay and other MSM outside the context of HIV/AIDS. As a result, comprehensive demographic data are not available.
As discussed in Chapter 1, categorizing gay, two-spirit, bisexual and other MSM into one collective group is problematic, since the only commonality is a descriptor of sexual behaviour. Conflating these identities under the descriptor "gay men" is also inaccurate, since this term has cultural and social meanings with which bisexual, two-spirit and other MSM do not identify. (1)
The majority of data used in this chapter was obtained from a custom data analysis produced by Statistics Canada using information from the 2007 and 2008 cycles of the Canadian Community Health Survey (CCHS). The CCHS is an annual cross-sectional survey, which collects data on health status, health services utilization and factors related to the determinants of health. Responses from males who identified as gay and bisexual in the 2007 and 2008 CCHS were cross-tabulated against a number of demographic and socio-economic variables. The results of this cross-tabulation, which are presented here, are statistically valid; however, they should be interpreted with caution because they represent a small sample of exclusively self-identified gay and bisexual men.
This chapter also makes use of the 2006 Census of Canada, which asked respondents whether they were a member of a same-sex couple. This was the second census to include this question (the first was in 2001). Data on married and common-law same-sex partnerships, derived from the 2011 National Household Survey, are also included in this chapter.
In addition, this chapter includes relevant demographic characteristics from several other surveys of gay and other MSM, including:
- Sex Now, a survey of over 4,000 men in British Columbia in 2002 and 2004 (2)
- The Ontario Men's Survey, a survey of over 5,000 self-identified gay and bisexual men in 13 regions in Ontario in 2002 (3)
- M-Track Phase 1, an enhanced surveillance system for HIV and other STBBIs among gay, bisexual and other MSM conducted through periodic cross-sectional surveys administered at sites across Canada from 2005 to 2007 (4)
Although the findings of these studies do not reflect the total population, they do provide useful demographic information on large subgroups of gay and other MSM.
It is important to note several key differences among the data sources cited in this chapter. Both the Sex Now study and CCHS data analysis included men who self-identified as gay or bisexual. Any man who identified as heterosexual was excluded from both the Sex Now study (6) and the CCHS analysis. In contrast, the Ontario Men's Survey sought out men in places frequented by gay and other MSM (such as gay bars), but also included men who self-identified as heterosexual. (7) In this chapter, therefore, populations are referred to as they are defined in the specific studies or surveys from which the data derive.
There are several important challenges in interpreting the data presented here. First, any research regarding gay and other MSM requires that individuals be willing and able to self-identify as "gay" or "bisexual." Those who are able to do so represent a subset of these populations, not all MSM.
On a related point, the studies presented in this chapter rely on a set of definitions of personal identity and sexual behaviour that may overlap or reach beyond the categories primarily discussed in this report. Some studies include only men who self-identify as gay, homosexual or bisexual, while other studies include all MSM regardless of their personal sexual identities. Some men, for example, may identify as heterosexual, yet have sex with men. In an overview of population estimates of gay and lesbian persons in the United States, Black et al., describe significant variation in responses, depending on whether the question asked related to sexual behaviour or the respondent's sexual identity as gay or lesbian. Across all samples examined, respondents were significantly more likely to report same-sex sexual behaviour than to self-identify as gay or bisexual. (5)
Furthermore, the concepts of sexual identity prevalent in mainstream Canada may not be shared by non-Western cultures. (6) Accordingly, some ethnocultural minority men from non-Western cultural backgrounds who have sex with men may not identify with the terms "gay" or "bisexual."
The stigma and discrimination experienced by this population may be another factor impeding some individuals from self-identifying as gay or reporting same-sex sexual behaviour. These factors are discussed in greater depth as determinants of health in Chapter 4.
A clear understanding of the impact of HIV/AIDS among gay, bisexual, two-spirit and other MSM in Canada is hindered by the lack of a reliable estimate of the size of this population. There is no nationally representative survey data on the number of gay, bisexual, two-spirit or other MSM in Canada. Therefore, the total number of gay, bisexual, two-spirit and other MSM is unknown.
A custom cross-tabulation of 2007 and 2008 CCHS data estimated that there are over 190,000 self-identified gay and bisexual males in Canada, which represents about 1% of the total male population. (7) However, surveys in different locations and contexts have produced varying estimates of the gay, lesbian and bisexual population, which suggests that this estimate may reflect underreporting.
A review of 46 international studies that estimated the size of the gay, lesbian and bisexual population suggests a median proportion of 5%, ranging from a high of 37% to a low of 0.2% of the population. (8) A 1998 stratified random sample of 750 males in Calgary aged 18 to 27 found that 15.3% of the men "reported being homosexual to some degree" on the basis of three (often overlapping) measures: voluntary, same-gender sexual contact from age 12 to 27 (reported by 14.0%); overlapping homosexual (reported by 5.9%) and/or bisexual (reported by 6.1%) self-identification (total of 11.1%); and exclusive (reported by 4.3%) and non-exclusive (reported by 4.9%) same-gender sexual relationships in the past six months (total of 9.2%). (9) Another study, the BC Adolescent Health Survey (a periodic survey of youth in British Columbia high schools), has consistently found that about 2% of male youth identify as gay or bisexual. (10)
Data derived from the CCHS 2007-2008 suggest that, like the Canadian population as a whole, the majority of self-identified gay and bisexual men reside in Quebec, Ontario and British Columbia (Figure 1).
Figure 1: Province of residence of adult males who self-identified as gay or bisexual, Canada, 2007-2008
|Province of residence of respondent – Groupeda||Proportion of total Gay and Bisexual Males by Province.||Proportion of total Males by Province (2007)Footnote 4|
|Total||100% (194,470)||100% (16,332,277)|
|Eastern Provinces (Newfoundland and Labrador, Prince Edward Island, Nova Scotia and New Brunswick)a||b||6.98% (1,141,207)|
|Prairie Provinces (Manitoba, Saskatchewan and Alberta)a||13.9%||17.4% (2,847,550)|
|British Columbia||14.3%||13.3% (2,172,191)|
|TerritoriesFootnote 5||c||0.3% (53,467)|
Source: CCHS 2007-08 
aCategories rolled up in order to give more reliable data
bSuppressed to meet the confidentiality requirements of the Statistics Act
cToo unreliable to be published
This supports a common assumption that self-identified/out gay and bisexual men are more likely to live in (or self-identify in) the three most populous provinces with the biggest cities. Many of the major research studies on self-identified gay men and other MSM are primarily based in Toronto, Montréal and Vancouver, (2;3;11) as a result of the large population of "out" gay and bisexual men.
Data derived from the CCHS 2007-2008 suggest that gay and bisexual men are evenly distributed among all adult age groups (Figure 2). (7)
This finding is consistent with the socio-demographic profile of participants in Phase 1 of M-Track and that of participants in other studies focused on gay men and other MSM in Canada. (2;12) The majority of M-Track respondents were between the ages of 30 and 49 (54%), with fewer between the ages of 15 and 29 (26%) or over the age of 50 (20%). The mean and median age of all M-Track participants was 39. (13) This is similar to the median age of all Canadian males in 2006 (38.6 years). (14)
Figure 2: Age range of men who self-identified as gay or bisexual, Canada, 2007-2008
|Age Groups||Gay & Bisexual Men|
|18 to 24||15.4%|
|25 to 31||16.2%|
|32 to 38||15.2%E|
|39 to 45||22.0%|
|46 to 52||17.0%|
|53 and over||14.0%|
Source: CCHS 2007-2008 
EUse with caution
The majority of gay, bisexual and other MSM surveyed in a variety of Canadian studies self-identify as White. (2;3;13;15)
CCHS 2007-2008 found that gay and bisexual men were more likely to be Canadian born (82.4%) when compared to total males (75.0%) and more likely to identify as White (86.6%) compared to total males (77.8%). Similarly, the majority of M-Track respondents most strongly identified as North American (72.4%). (13) This finding may indicate a reporting bias, such that white men may be more likely to self-identify as gay or bisexual than men from other ethnocultural groups. This will be further discussed in Chapter 4.
Due to small numbers, CCHS 2007-2008 did not produce reliable data on the ethnic characteristics of non-White gay and bisexual men, with the exception of 4.2% having self-identified as Aboriginal. (7) According to M-Track, 2.8% of participants most strongly identified as Aboriginal and 6% of the sample reported some Aboriginal ancestry. In Winnipeg, nearly half of M-Track participants most strongly identified as Aboriginal (49.4%). Other more commonly reported ethnicities among M-Track participants included: East and Southeast Asian (4.2%), Southern European (3.4%), Latin American (3.4%), British Isles (3.3%) and African/Caribbean (2.6%), with some variation across sentinel sites. (13)
The Sex Now (2006) study found the following ethnocultural composition in a sample of 2,197 gay men in Vancouver: less than 1% of the sample identified as African, Caribbean, Middle Eastern, Pacific Islander, or South Asian; 2.4% identified as Aboriginal; 3.6% identified as Latino/Hispanic; 9.5% identified as Asian; and 73.8% identified as Caucasian (7.0% identified as "other"). (2)
The Ontario Men's Survey (2004), which included MSM from across Ontario, included 83.9% White and 16.1% non-White men. In the Toronto sub-sample, 75.6% identified as White and 24.4% identified as non-White. (12)
This larger proportion of ethnocultural minorities represented among men who identify as gay or bisexual in Vancouver (2) and Toronto (12) is broadly consistent with the difference in total population demographics between Canada as a whole (16.2% visible minorities), and Vancouver (24.8% visible minorities) and Toronto (46.9% visible minorities). (16) These factors will be discussed in greater depth in Chapter 4.
Educational levels for the overall male population in Canada are generally high (Table 3, right column). Data from the 2006 Census indicate that 44.8% of males from 25 to 64 years of age had completed a college or university degree. (17)
According to CCHS 2007 – 2008 data, self-identified gay and bisexual men tend to have higher levels of education than self-identified heterosexual men (Figure 3). (7) The difference between the reported educational levels of self-identified gay/bisexual men and heterosexual men is statistically significant, although the disparity is not large.
Likewise, cross-sectional studies of gay and other MSM in Canada have also found that gay men tend to have higher levels of education relative to all Canadian males between the ages of 25 and 64. (2;3;18) In addition, approximately 60% of the M-Track sample had completed a minimum of a college or university degree. (13)
It is important to note that these data reflect responses by self-identified gay and bisexual men, and as such the findings may not be reflective of all members of these populations.
Figure 3: Adult Male Self-reported Education Level, Canada, 2007 – 2008
|Education level||Gay & Bisexual Males||Total Males|
|Graduated from High School||95.9%||90.5%|
|Diploma / Certificate – College / CEGEP||27.9%||25.0%|
|University Degree or Certificate Above Bachelor's Level||14.4%||11.5%|
Source: CCHS 2007 – 2008 
Regarding income, CCHS 2007-2008 data showed that the income of self-identified gay and bisexual men was similar to that of self-identified heterosexual males. Of those who responded to the question, 22.1% of gay and bisexual men reported earning less than $20,000 per year, compared to 20.8% of total males. Similarly, 36.6% of gay and bisexual men reported earning less than $40,000, compared to 33.2% of total males. Of those gay and bisexual men who reported earning $40,000 or more (Figure 4), the largest proportion within that income bracket (27.2%) earned between $60,000 and $80,000 annually, while 14.2% earned $100,000 or more each year. (7)
Similarly, about one third of M-Track participants reported an annual personal income of $50,000 or more, with 20% earning more than $60,000 annually. However, over 10% of men reported an annual personal income of $10,000 or less or reported no income. (13) Generally, M-Track respondents' personal income increased with age and level of education. (13)
Figure 4: Income Range Among Gay, Bisexual and Total Males Earning $40,000 or More Per Year, Canada, 2007-2008
|Income||Gay & Bisexual Males||Total Males|
|$40,000 to less than $50,000||22.2%||23.8%|
|$50,000 to less than $60,000||22.8%||19.3%|
|$60,000 to less than $80,000||27.2%||27.2%|
|$80,000 to less than $100,000||13.5%E||12.2%|
|$100,000 or more||14.2%E||17.5%|
EUse with Caution
The 2011 Census counted 64,575 self-identified same-sex (male or female) couple families, (both married and common-law) an increase of 42.4% from 2006. Of these, 21,015 were same-sex married couples, representing approximately 0.33% of all married couples – nearly triple the number of same-sex marriages counted in 2006. The Census counted 43,560 same-sex common-law couples, representing approximately 2.78% of all common-law couples. (23) Male same-sex couples accounted for 54.5% of all same-sex couples.
The tremendous increase in the number of same-sex marriages between 2006 and 2011 is unsurprising, given that this was the first full five-year period in which same-sex marriage was legal in Canada, following its legalization across Canada in 2005. While 16.5% of same-sex couples were married in 2006, this share nearly doubled to 32.5% in 2011.
While the distribution of same-sex couples by province and territory was similar to that of opposite-sex couples, same-sex couples were more likely to live in the largest census metropolitan areas. In 2011, 45.6% (a decrease from 50% in 2006) of all same-sex couples lived in Toronto, Montréal, and Vancouver, compared to 33.4% of opposite-sex couples.
Same-sex partners were relatively young, with 25.3% aged 15 to 34 compared to 17.5% of persons in opposite-sex relationships, and only 6.2% aged 65 and over, compared to 17.8% of persons in opposite-sex relationships.
Figure 5: Proportion of Men in Same-sex Relationships, Canada, Provinces and Territories, 2011 Counts
|Province||Number of Male Same-sex Spouses||Proportion|
|Newfoundland and Labrador||465||0.66%|
|Prince Edward Island||175||0.25%|
Source: . Data for Canada, Quebec, Ontario, Manitoba, Saskatchewan, Alberta and British Columbia excludes census data for one or more incompletely enumerated Indian reserves or Indian settlements.
a = Data quality index showing a global non response rate higher than or equal to 5% but lower than 10%
b = Data quality index showing a global non response rate higher than or equal to 5% but lower than 10%.
c = Data quality index showing a global non response rate higher than or equal to 10% but lower than 25%.
In 2011, approximately 3.4% of men in same-sex unions had children living with them, a rate five times less than that of female same-sex couples (16.5%). (23)
An analysis of the 2003 and 2005 CCHSFootnote 6 data found that men who identify as gay or bisexual reported the same level of general health as heterosexuals, but reported more chronic conditions (Figure 6). (22) It should be noted that gay and bisexual men in this sample were older than the heterosexual sample, and therefore, the extent to which age plays a role in these differences in self-reported health status is not clear.
Figure 6: Indicators of Physical Health in Men Who Self-identified as Gay, Bisexual or Heterosexual, Canada, 2008
|Self-perceived General Health||Men|
|Excellent or very good||65.4||57.1||36.9|
|Fair or poor||8.5||12.0a||7.7|
|Three or more||11.5a||11.3||9.0|
|Disability Day in Past Two Weeks (Physical)||17.9a||11.7||13.6|
a = Significantly different from estimate for heterosexual population of same gender (p < 0.05)
The same study indicated that “homosexuals and bisexuals are more likely than heterosexuals to find life stressful.” Men who identify as gay reported the same level of self-perceived mental health as heterosexuals, but reported more mood and anxiety disorders and more often took mental “disability days” (Figure 7). More of the men who identified as bisexual considered themselves in “fair or poor” mental health compared to gay and heterosexual men. In terms of mental health indicators, bisexual men were more similar to gay men in reporting more mood and anxiety disorders and mental “disability days” in the past two weeks than to heterosexuals. (22) These issues will be discussed in greater depth in Chapter 4.
Figure 7: Indicators of mental health in men who self-identified as gay, bisexual or heterosexual, Canada, 2008
|Self-perceived Mental Health||Men|
|Excellent or very good||73.8||66.7a||75.4|
|Fair or poor||5.7||9.4a,b||4.3|
|Type of Disorder|
|Disability Day in Past Two Weeks (Mental)||3.0a,b||5.5a,b||1.2|
aSignificantly different from estimate for heterosexual population of same gender (p < 0.05)
bUse with caution (Coefficient of variation 16.6% to 33.3%)
Both gay and bisexual men reported having more unmet health needs in the past 12 months than heterosexual men. However, men who identify as gay and bisexual were more likely than heterosexual men to use a wide variety of healthcare providers both traditional and alternative (Figure 8). (22) The study examined whether gay and bisexual men consulted health practitioners as a result of a higher prevalence of health conditions, and found that when controlling for health conditions, gay and bisexual men were still more likely to consult a wide variety of healthcare professionals than heterosexual men. (22)
Figure 8: Use of Healthcare Providers Among Men Who Self-identified as Gay, Bisexual or Heterosexual, Canada, 2003 – 2005
|Consultation in Past 12 Months||Men|
|Family doctor or general practitioner||74.8a||72.1||69.2|
|Social worker or counsellor||6.8a,b||9.3a,b||3.5|
|Alternative care provider||20.3a||13.4b||11.0|
|No regular doctor||22.2||26.2||21.9|
|Unmet health care need in past 12 months||14.2a||17.8a||10.9|
aSignificantly different from estimate for heterosexual population of same gender (p < 0.05)
bUse with caution. (Coefficient of variation 16.6% to 33.3%)
Note: Missing values are excluded.
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