Factors Associated with Moral Disapproval of Same-Sex Sexual Behavior in Denmark: Baseline Findings from the Project SEXUS Cohort Study.

Homophobia is considered a central driver of minority stress, mental health problems and suicidality among non-heterosexual people. We used baseline questionnaire data from 31,808 participants aged 15-89 years in the nationally representative Danish cohort study Project SEXUS to identify factors associated with moral disapproval of same-sex sexual behavior, an assumed proxy for homophobia. Respondents who answered that they did "not at all" or only "to a low extent" find same-sex sexual activity morally acceptable were operationally defined as expressing moral disapproval of same-sex sexual behavior, whereas respondents who considered same-sex sexual activity morally acceptable "to a high extent" or "to a very high extent" were considered not to hold such moral reservations. Demographically weighted prevalence estimates of sociodemographic, health-related, sexual, moral, and religious characteristics among individuals with and without moral reservations concerning same-sex sexual behavior were calculated and compared in polytomous logistic regression analyses. Overall, 21.7% (women: 14.4%; men: 29.2%) expressed moral disapproval of same-sex sexual behavior. Upon adjustment for potential confounding variables, such moral reservations were significantly positively associated with late sexual debut, low lifetime number of sex partners, lacking sex education in school, missing communication with parents about sex and, among men, a poor or non-existent sex life within the last year. Individuals expressing moral disapproval of same-sex sexual behavior also expressed significantly more restrictive moral attitudes toward other sexual matters. Religiousness was strongly positively associated with moral reservations concerning same-sex sexual behavior, most notably among followers of Islam, Jehovah's Witnesses, Danish Inner Mission, or a composite category of minor Christian denominations. In conclusion, even in a sexually liberal country such as Denmark, which decriminalized homosexuality in 1933 and legalized registered same-sex partnerships in 1989, moral disapproval of same-sex sexual behavior remains widespread. To reduce the negative mental health ramifications of homophobia and ensure the health and rights of all citizens, school-based sex education should stimulate social inclusion and destigmatization of sexual minorities, and religious communities should be encouraged to counter homophobia within and outside their circles.