{'fraction_non_alphanumeric': 0.03378787878787879, 'fraction_numerical': 0.014848484848484849, 'mean_word_length': 5.325347388596071, 'pattern_counts': {'":': 0, '<': 8, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 1, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Determining the Homophobia Level of Individuals in Different Countries: A Case Study of Community in Turkey, Nigeria, Pakistan, India, Bangladesh and Nepal

Objective: To determine the homophobia level of ındividuals in different countries. 
Material and methods: A descriptive cross-sectional study among 518 individuals of ages 18 years and above living in Turkey (Agri), Nigeria (Ibadan), Pakistan (Charsadda), India (Punjab), Bangladesh (Chittagong) and Nepal (Kathmandu). Using google form they completed a demographic characteristics form and Hudson and Ricketts Homophobia Scale 
Results: The homophobia scale total score mean was 92.97 ± 27.47. The total score means the homophobia scale was statistically significantly higher among Nigeria nationality, religious belief Christian, male, health personnel and those who do not have a homosexual acquaintance (p <0.05). A statistically significant relationship was also found between homophobia scale total score mean and age (p <0.05). 
Conclusion: Nationality, religion, gender, occupation, age and whether or not one has homosexual acquaintances are key demographic correlates of homophobia level. However, the study recommends that further investigation should be conducted with a larger group for a proper inference of causation to be drawn.  
 


Introduction
The social life in the society we live is such that imposed heterosexuality on individuals by gender policies. Individuals with different sexual orientations are not only ignored but also exposed to oppression and violence [1,2]. Today, it is known that many lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals are subjected to human rights violations and are forced to live in a discriminatory and exclusionary society with social sanctions and social control mechanisms. Sexual orientation refers to the gender to which an individual is attracted [3,4].
Individuals who are attracted to their own gender are homosexual, individuals who are attracted to both genders are bisexual, individuals who feel themselves belonging to the opposite sex are transsexual, and individuals who have congenital reproductive organs and glands of both sexes are called intersex people [3,4]. LGBTI individuals are tolerated in some societies; however, in most communities, they are still regarded as having low dignity, deviant, and sick [2]. Homosexuality is illegal in many countries, which impose penalties such as imprisonment, forced labor, and even the death penalty [5]. Defining them as abnormal, sick, and sinful, condemning them, and exposing them to human rights violations, homophobia, marginalization, violence, and social exclusion are just a few of the problems LGBTI individuals experience [1,2]. Especially homophobic attitudes, stigmatization, discrimination, and social exclusion cause LGBTI individuals to hide their sexual orientation, which is an important part of their identity and personality. This situation prevents LGBTI individuals not only from being accepted by society as they are but also from accepting themselves as they are. As such, LGBTI individuals struggle with low self-esteem and a lack of self-confidence, as a result of which they experience psychological problems such as stress, depression, anxiety, substance use, and suicidal ideation more than heterosexuals [1,2,5,6]. Therefore, to create social unity, societies must strive to bring an end to homophobic bullying. However, the lack of knowledge and sensitivity of those who provide health and education services affects LGBTI individuals negatively. For this reason, it is very important to understand and know the health problems and needs of LGBTI individuals. As a matter of fact, it was stated in a report by the European Union Parliament that sexuality education should include the fight against all forms of violence against LGBTI individuals. This is because creating a welcoming and safe environment for LGBTI individuals is essential for the well-being and health of societies [3,7]. The study focused mainly on determining the homophobia level of individuals in different countries. Specifically, the study; 1) described the respondents demographic characteristics, 2) determined the respondents homophobia levels, 3) compared the respondents demographic characteristics and homophobia levels, 4) determined whether there is a relationship between the respondents homophobia levels and age.

Material and methods
The study employed the cross-sectional design. The study was carried out in the following countries: Turkey (Agri), Nigeria (Ibadan), Pakistan (Charsadda), India (Punjab), Bangladesh (Chittagong), and Nepal (Kathmandu).
The Population of the Study; The population comprises all individuals aged 18 and above living in Turkey (Agri), Nigeria (Ibadan), Pakistan (Charsadda), India (Punjab), Bangladesh (Chittagong), and Nepal (Kathmandu). The sample size comprises five hundred and eighteen (n=518) individuals from the above-mentioned countries.
Data Collection Tools; The researchers explained the purpose of the research to the respondents and obtained verbal consent from them. An online Google Form developed by the researchers was then administered to those who agreed to participate in the research. The survey consists of two forms: 1. Demographic Characteristics Form; It consists of questions regarding the demographic characteristics of the respondents (nationality, religion, gender, etc.) 2. Hudson and Ricketts Homophobia Scale; The scale was developed by Hudson and Ricketts (1980) to determine attitudes towards homosexual individuals [8]. In Turkey, bearded origin of the small number of bilingual and Sakall and U urlu (2001) scale was used by the Turkish version validity and reliability study conducted [9]. The original scale consists of 25 items. However, in the present study, the item, "walking comfortably in parts of the city where homosexuals are present" was removed since the countries where the respondents live do not have many such places. As a result, the scale consisted of 24 6-point Likert type items (I never agree: 1 point; Quite disagree: 2 points; Slightly Disagree: 3 points; Slightly Agree: 4 points; Strongly Agree: 5 points Strongly Agree: 6 points). The 5th, 6th, 8th, 10th, 11th, 13th, 17th, 18th, 23rd, and 24th items were reversely scored. Higher scores indicate higher levels of homophobia. The scale is considered reliable since the Cronbach Alpha coefficients calculated for the original scale and determined in the validity and reliability study of Sakall and U urlu (2001) were 0.90 and 0.94, respectively (2001) [8,9].
In our study, the Cronbach Alpha coefficient was found to be 0.93. Ethical Approval; The study was approved by the Agri Ibrahim Cecen University Scientific Research Ethics Committee (Date 08.09.2020 and number 123). The study was conducted in accordance with the ethical standards established in the Declaration of Helsinki.

Statistical analysis
The data analysis was done using the Statistical Package for the Social Sciences (SPSS-22) statistical software. Descriptive statistics such as frequency, percentage, mean, and standard deviation were used to analyze the data. The Kolmogorov Smirnov test was used to test the distribution normality. The Mann-Whitney U test was used for binary groups, and the Kruskal-Wallis test was used for multiple comparisons. The Spearman correlation test was used to determine the linear relationship between variables and the severity of the relationship. Statistical significance was set at p<0.05.

Results
As can be inferred from Table 1  Also, a statistically significant correlation was found between the total mean score from the scale and age (p<0.05) ( Table  3).

Discussion
Although homosexuality has encountered different attitudes and approaches in different cultures over the years, the general attitude and approach towards homosexuality are still negative [10]. Even in places where social judgments, including those about sexuality, are formed in the light of correct information, societal attitudes change very slowly and difficultly. Moreover, negative attitudes and judgments are likely to be reinforced by false information [11]. This study aims to determine homophobia levels of individuals from different countries and evaluate the demographic correlates of the homophobia levels. In our study, the total mean scores from the Hudson and Ricketts Homophobia Scale were found to be significantly higher among Nigerian nationals and followers of Christianity (p<0.05). Likewise, the study of Sekoni linked religion (Christianity) to a higher homophobia level among Nigerians [12] and other studies that examined the role of religion [13][14][15] in relation to homophobia. The religious unity, the cultural context, the unbearable stigma as well as the legal punishment attached to the practice of homosexuality are possible explanations for higher homophobia levels observed among Nigerians. Nigeria and many other African countries encourage heterosexuality. Hence, other types of sexual orientation are generally perceived as a deviation from the cultural and social norms of Africa, resulting in the scarcity of publication on homosexuality [16,17]. The findings of Valentine & McDonald (2004) also indicated higher homophobia levels among Christians. The researchers noted in their work that the hatred against homosexuality can be a result of strong religious beliefs that condemn homosexuality [18]. In Nigeria, homosexual activity is illegal; in fact, across the twelve northern states (predominantly Muslims) that adopted Sharia law, the punishment is death by stoning [19]. In other southern states where the secular criminal law is adopted, the maximum punishment for homosexual activity is 14 years' imprisonment [20]. Mapayi et al. (2016) concluded that while the Nigerian society s awareness of homosexuality has been increasing in recent years, the societal attitude towards it is still largely unfavorable, noting that it is a reflection of the social norms and the law that promotes stigma and violence towards homosexual individuals [21].
In our study, the total mean scores from the Hudson and Ricketts Homophobia Scale were found to be significantly higher among men (p<0.05). In fact, higher homophobia levels among men were an expected finding when the relevant literature was examined. It is known that men are more effective than women at the point of adopting gender roles, and men feel more pressure to act in conformity with these roles [22]. It was concluded in a study that men exhibit a more active role in adopting and protecting traditional beliefs, and these traditional beliefs and roles push men to take a more negative attitude towards homosexuality [23]. In the studies of both Brien and Feng et al. (2012), it was observed that male participants were more homophobic than female participants [24,25].
According to our research findings, homophobia total mean scores were significantly higher among unemployed respondents (p<0.05). This situation is thought to be related to the income level. In a study, it was found that individuals of lower socioeconomic status were more homophobic [26]. Likewise in the USA, it was reported that gay men mostly come from families with middle and highincome levels [27].
In our study, the mean scores from the scale were found to be significantly lower among those who were acquainted with homosexual individuals (p<0.05). In his social relationship hypothesis, Allport et al. (1954) stated that if members of different groups communicate with and get to know each other, they can see the similarities, and thus, it becomes possible to reduce the prejudices and conflicts between groups. In line with this hypothesis, researchers stated that people with negative attitudes and prejudices towards homosexuals can reduce their own prejudices if they communicate with them [28]. This is also noted in studies conducted abroad [29,30]. In line with these findings, people who are acquainted and have social contact with homosexuals have lower homophobia levels. Therefore, we can say that moving away from cultural stereotypes and having social contact and making friends with homosexual individuals are effective in lower homophobia levels.
Strengths and Limitations of this Study: The fact that this study is aimed at determining the level of homophobia of individuals from different regions and with different religious beliefs makes the study valuable. The fact that this study was conducted in only one province of each country is the limitation of the study.

Conclusion
Nationality, religion, gender, occupation, age, and whether or not one has a homosexual acquaintance are key demographic correlates of homophobia levels. With this study, the attitude of different regions and religions towards homophobia was determined. This study has not been conducted before, the attitude of individuals in different regions regarding homophobia has been determined and it is thought that it will shed light on future studies. However, the study recommends that further investigation should be conducted with a larger group for causal inference to be drawn.