LGBTQ communication is not my primary research interest. But I find the overlap in theoretical constructions and research methods between the study of LGBTQ communication and the study of minority health (which is my research interest.)

My interests in LGBTQ communication in China and co-culture theory started during a conversation with a doctoral student at Alabama many years ago. We talked about the fact that unlike in the US, the Chinese society is generally more “resistant” toward the LGBTQ communities and some even think being gay is a mental illness. [See our prior study about it]As a result, we studied the coming-out stories of gay men in China. We found the co-culture theory developed by Dr. Mark Orbe was perfect for such a study as the theory describes how marginalized group members (what he calls “co-culture group”) communicate with dominant group members.

We examined Chinese gay men’s coming-out experiences through a narrative analysis of 60 self-reported stories online. It finds that Chinese gay men’s decision to come out, their communication orientations, and the outcomes of their coming out are influenced by traditional Chinese cultural values such as family, marriage, and duty. Assertive assimilation, assertive accommodation, and nonassertive accommodation are the most used communication orientations. The study adds to co-cultural theory by demonstrating that types of social relationships affect the communication orientations adopted, at least in the context of China.

Bie, B., & Tang, L. (2016). Chinese gay men’s coming out narratives: Connecting social relationship to co-cultural theory. Journal of International and Intercultural Communication, 9(4), 351-367. doi: 10.1080/17513057.2016.1142602 [Full article]

Answering the calls of Anderson and Bresnahan (2013) and Weiss, Ramakrishna, and Somma (2006) to explore the gender and cultural dimensions of illness-specific stigma, we examined how popular magazines targeting women and men in the US portrayed mental illness between 2009 and 2013 through a theory-driven content analysis.

The magazines we examined include:

Women’s magazines: Vogue, Cosmopolitan, Marie Claire, Shape, Self.

Men’s magazines: GQ, Esquire, Details, Men’s Health, Men’s Fitness

We found that women’s magazines tend to present a more positive coverage of mental illnesses by citing patients, adopting human interest discourse, and using challenge cues such as hope than men’s magazines. 

• In terms of major topics covered, both women’s and men’s magazines paid most attention to depression, stress, and anxiety,
• Both men’s and women’s magazines were more likely attribute mental health issues to individual causes rather than social causes.
• Women’s magazines are more likely to give a human face to mental illnesses than men’s magazines.
• Women’s magazines are more hopeful than men’s magazines in coving mental illness, even though both project a lack of optimism, social inclusion and fight.

Yang, Y., Tang, L., & Bie, B. (2017). Portrayals of mental illnesses in women’s and men’s magazines in the United States. Journalism and Mass Communication Quarterly,94(3), 793-811. doi: 10.1177/1077699016644559 [Full article]

Another research interests I shared with some of my doctoral students (former and current) was mental illness stigma. Mental illness is a serious health risk around the world, especially among young people. At the same time, mental illnesses are often highly stigmatized. In several studies, we examined the discourse around mental illness through interviews as well as analysis of media contents.

My first study on mental illness stigma explores the cultured understanding of mental health and mental illnesses among members of Generation Y in China. We conducted interviews with college students in China to collect stories about people with mental illness. A narrative analysis of more than 100 stories identified five narratives featuring the tragic genius, the psychotic criminal, the fragile victim, the antisocial recluse, and the homosexual. These narratives are gendered, in that women are the primary protagonists in the narrative about the fragile victim, while men are featured prominently in the narratives about the tragic genius, the psychotic criminal, and the antisocial recluse. Our study demonstrates that these narratives are based on, and will further reinforce, highly cultural-specific stereotypes and biases about mental illnesses in China.

Tang, L., & Bie, B. (2016). Narratives about mental illnesses in China: The voices of Generation Y. Health Communication, 31(2), 171-181. doi:10.1080/10410236.2014.940673 [Full article]

The physician-patient relationship in China is highly strained. According to the latest survey conducted by the Chinese Medical Doctor Association (CMDA, 2015), 60% of medical personnel had suffered verbal abuse, and 13% had suffered physical violence in 2014. Initially, mainstream news media often blamed physicians for being irresponsible, immoral, or simply incompetent. Lately, the tide has been reversed and patients were often portrayed as being too demanding, too greedy, and too unreasonable. China’s medical schools start to teach courses in physician-patient communication based on western textbooks and theories. However, attributing the problematic physician-patient relationship to individual stakeholders’ competence or morality does not address the root of physician-patient conflicts in China: the rise of health consumerism and the change in the culture of health.

In this study, we examined the professional identities of physicians and their perceptions of the physician-patient against the backdrop of the rise of health consumerism in China. We conducted in-depth interviews with physicians in China during the course of two years to create a new theoretical perspective for the study of physician-patient communication in China. We argued that because of the marketization of healthcare in China in the last two decades, the traditional bureaucratic relationship between physicians and patients based on implicit trust was gradually replaced by an arm’s length relationship characterized by self-interest, opportunism, and mistrust. This is the cause of many communication problems and conflicts between physician and patients in China.

Tang, L., & Guan, M. (2018). Rise of health consumerism in China and its effects on physician’s professional identity and physician-patient relationship. Health Communication, 33(5), 636-642. doi: 10.1080/10410236.2017.1290015. [Read full text here]