Community-Engaged Research to Identify House Parent Perspectives on Support and Risk within the House and Ball Scene

Abstract

This paper describes a community-engaged study with the Los Angeles House and Ball scene, in which the perspectives of the leaders of these communities are captured to better understand how the House and Ball communities may protect and/or increase its members’ risks for HIV infection. Data were collected through in-depth interviews with House parents (N=26). This study identified key features of both support (e.g., family and support; acceptance; validation and recognition) and risk (e.g., members’ struggle to maintain status in the Ballroom scene; sex work; substance use; danger of becoming too involved in the Ball community; perception and stigma of Ballroom scene within the larger gay community) within these communities. Findings are discussed in relation to framing how to leverage the supportive aspects of the House and Ball communities to design relevant HIV prevention interventions.

INTRODUCTION

Community-engaged research can provide researchers a unique opportunity to work more closely with their population of interest and therefore, the opportunity to obtain a more “emic” or insider perspective. Community-engaged research is a framework or approach for conducting research, not a methodology in and of itself. It is characterized by the principles that guide the research and the relationships between the communities and academic researchers. Community-engaged research requires partnership development, cooperation and negotiation, and commitment to addressing local health issues. The opportunity for community members and researchers to learn from each other to work towards a common goal can make interventions more relevant and meaningful for the target population and more effective for interventionists and other researchers. Community-engaged research in the area of HIV-prevention intervention development has led to the a number of population-specific prevention interventions (Baptiste et al., 2005; Jenkins, 2007; Kraft, Beeker, Stokes, & Peterson, 2000).

Research has shown that African American young men who have sex with men (AAYMSM) are at high risk for contracting HIV and other sexually transmitted infections (Hart & Peterson, 2004; Millett, Peterson, Wolitski, & Stall, 2006). Nearly two-thirds (63%) of all YMSM aged 13–24 years with HIV infection in 2008 were AAYMSM (Centers for Disease Control and Prevention, 2009). Specific to Los Angeles County, Africans Americans represent 9.4% of the county, but 20% of AIDS cases (Los Angeles County Department of Health Services, 2009) Further, AAYMSM in Los Angeles have much higher HIV prevalence (26%) than White YMSM (7%), and have 4.4 times higher odds of HIV infection compared to White YMSM (Bingham, 2005; Bingham et al., 2003). It is therefore important to gain a rich and meaningful understanding of the different communities in which AAYMSM live and interact to provide researchers and service providers the opportunity to better understand the social and cultural structures that may serve as risk or protective factors for HIV-risk behaviors. This level of understanding is crucial to the development of culturally and developmentally appropriate HIV-prevention interventions.

Minority Stress and Social Support

AAYMSM occupy a unique position in the larger society; they are often stigmatized within the larger African American (Lewis, 2003) and gay communities (Loiacano, 1993) and face racism and homophobia in the general society (Bontempo & D’Augelli, 2002; Huebner, Rebchook, & Kegeles, 2004; Sellers, Caldwell, Schmeelk-Cone, & Zimmerman, 2003). While the effects of coping with these challenges are not well understood, a theoretical framework to explain the relationship between stigma, prejudice, discrimination and negative health outcomes, including involvement in HIV risk-related behaviors is the theory of minority stress (Meyer, 1995, 2003). Minority Stress Theory suggests that socially marginalized groups, such as the African American community and the gay community, experience mental and physical health problems resulting from negative social environments created by stigma, prejudice, and discrimination (Gee, 2002; Meyer, 2003; Williams, Neighbors, & Jackson, 2008)

Social support may serve as an effective coping mechanism against life stress. Few researchers have explored the stress-buffering and positive effects of social support among African Americans, and those studies report inconsistent or contradicting and complex findings (Dressler, 1985; DuBois, Felner, Brand, Adan, & Evans, 1992; McCreary, Slavin, & Berry, 1996; H. W. Neighbors & Lumpkin, 1990). Researchers have found that friend and family support can serve as a stress-buffer (Dressler, 1985; McCreary, et al., 1996), whereas other researchers have found no stress-buffering effects (Fischer & Shaw, 1999; Zimmerman, Ramirez-Valles, Zapert, & Maton, 2000). Interestingly, African Americans have been shown to seek out informal (e.g. friends, family) support for advice or help to reduce negative consequences of stress (H.W. Neighbors & Jackson, 1984). Moreover, an ethnographic study on African American MSM (AAMSM) in New York City reveals that AAMSM developed alternative familial networks as an alternative to their biological family (Hawkswood, 1996).

This seeking of support from informal networks is not unique for AAYMSM. Research among other youth who feel marginalized from more mainstream society indicates that these youth may form or join a subculture to provide them support and identity (Wilkins, 2008). Subcultures such as punks, Goths, “gamers” and “ravers” offer a place and community that is welcoming of youth of various ethnic and cultural backgrounds seeking others with similar interests and beliefs, and who, for a variety of reasons, may not fit into mainstream American culture. These subcultures can provide a sense of support and solidarity for its members.

Introduction to the House and Ball Communities

The House and Ball community is one such subculture. The roots of the House and Ball communities originate in Harlem in the 1920s. Annual Harlem Balls of the 1920s involved working-class, mostly African American men under the age of 30 performing in elaborate and ostentatious female attire as a popular form of entertainment (Chauncey, 1994). In addition to offering entertainment for spectators at these annual Balls, young men dressed in women’s attire, or “in drag”, to compete in costume competitions for cash prizes. Although Balls originated as a safe space for “female impersonators” to compete amongst one another in New York, this phenomenon has become more inclusive of AAYMSM of different sexual and gender identities. House and Ball communities are currently present in cities such as Los Angeles, Oakland, Atlanta, Chicago, Philadelphia, Baltimore, and Washington, DC (Arnold & Bailey, 2009).

As a result of a 1990 documentary of the New York House and Ball scene, “Paris is Burning,” (Livingston, 1990) the House and Ball scene gained some notoriety as a subculture for transgender and men who have sex with men of color. The limited research with these communities suggests that HIV is a major public health concern. From 1998 to 2000, research on an outbreak of tuberculosis among House members in Baltimore, Maryland and the New York City area found that 16 of the 26 (62%) House and Ball participants were living with HIV (Sterling, Stanley, & Thompson, 2000). This study highlights the importance of HIV research within these communities as well as the closely connected nature of its members, which has epidemiologic implications for the spread and transmission of disease. In a more recent study (N=504) on the New York City House and Ball scene, (Murrill et al., 2008) found a seroprevalence rate of 20%, with 73% of those testing positive for HIV unaware of their HIV status.

Little research exists on the House and Ball scene and the role it plays with respect to social support. One qualitative study (Arnold & Bailey, 2009) describes the House and Ball communities in the San Francisco and Detroit areas as communities that are accepting of AAYMSM, as well as African Americans of other gender and sexual identities. Houses are identified as having a sense of family, friendship, and support. Sanchez, Finlayson, Murrill, Guilin and Dean (2009) also suggest that support is an integral component of the House and Ball communities that assuages the negative effects of stigma and life stress on risk-taking behaviors.

In this paper, we describe a community-engaged research project with the Los Angeles House and Ball scene, in which the perspectives of the leaders of these communities are captured to better understand how these communities may protect and/or increase its members’ risks for HIV infection. Data from this study will be used to inform the development of an intervention that is designed for and by the target population.

METHODS

This study utilized a number of different methods including; participant observations at Balls, meetings and other events; and semi-structured, qualitative interviews with House leaders. All methods were presented to the local House leaders in order to ensure that the methods were not intrusive to the community’s activities and that the methods were appropriate for the target population.

The methods and research activities were reviewed and approved by the Institutional Review Board at Children’s Hospital Los Angeles. Prior to being enrolled in the study, all interview respondents completed an informed consent.

Ethnographic Study Design, Sampling, and Measures

Participant observations were completed under the direction of the ethnographer, in teams of 2-4 research staff. Between June 2008 and December 2009, participant observations were conducted for a total of 135 hours at 37 events. Research staff attended all scheduled Ball events as well as monthly Alliance meetings (held with the Los Angeles House parents and leaders). Observation notes were taken and stored on an observation form which was developed to capture observations related to: the setting, number and types of participants, behavior related to social and sexual networks (e.g., interactions between members, Houses present, arguments/fights), familism within and between Houses (e.g., relationships between leaders and “kids”), substance use, House standards and rules (e.g., differences in behavior and conduct between Houses) and presence and attitudes towards HIV prevention (e.g., emcee messages, information disseminated). These observations provided an opportunity to observe the different events and conduct informal interviews with participants including House parents and members. Staff members were encouraged to interact with participants and ask questions to clarify activities or to help identify members of the community.

Between July 2008 and December 2009, 26 respondents were identified and recruited to participate in semi-structured qualitative interviews. Through our community engagement activities and participant observations, we identified and approached each of the local leaders to participate in this portion of the data collection; all leaders who we approached agreed to participate in the study. Follow-up phone calls and emails were made to confirm interview dates and times; at that time, three House leaders did not return our messages. Participants included at least one parent or leader from each of the fifteen Los Angeles Houses. The interview discussion guide was designed to gather in-depth information on the structural, social, and cultural characteristics of the Houses; challenges members experience in the House and Ball scene; perceived benefits of participation; House rules, activities, and communication; relationships within and outside the House; values, norms, and expectations related to HIV/STI risk behaviors; and receptiveness to interventions. Each interview lasted 1.5 to 2.5 hours and was digitally recorded, professionally transcribed and checked for accuracy. All interviews were conducted in the P3 project offices or at a convenient location (e.g., coffee house). Respondents were provided a $45 incentive for completing the interview.

Analysis

The qualitative analysis for this manuscript utilized a “constant comparative” approach, an aspect of grounded theory that entails the simultaneous process of data collection, analysis and description.(Glaser, 1992; Glaser & Strauss, 1967). In this process, data are analyzed for patterns and themes to discover the categories that are most salient, as well as any theoretical implications that may emerge. As the data are collected, they are immediately analyzed for patterns and themes, with the primary objective of discovering theory implicit in the data. Interview transcripts and observation notes/field notes were included in the analysis. Atlas.ti was used for coding and analysis of relationships between and within text segments.

Interview transcripts and observation notes were imported into a single Atlas.ti database for analysis. Members of the research team reviewed an initial sample of interviews and field notes to identify key themes, which formed the basis of the project codebook. Codes focusing on a range of topics were identified and defined, based on the key constructs included in the discussion guide and observation form. The codebook was modified as needed, and once finalized, three members of the research team were responsible for coding the interviews. Inter-coder reliability was assessed through double coding a sample of approximately 15% of the interviews. Differences in coding were discussed and resolved by the team. The open coding process included refining codes based on the data.

Codes related to leader expectations, challenges and risks experienced in the House and Ball scene, benefits to participation, and experiences with discrimination were included in the current analysis. This process led to the structure of the present study which: 1) describes the Los Angeles House and Ball communities based on participant observations at local events; 2) describes the perceived benefits and sources of sources of participating in the House and Ball community; and 3) the perceived risks that members experience from participating in the community. Throughout the paper, pseudonyms in the form of spices (e.g. Fennel, Wasabi) are used in lieu of House names to maintain confidentiality and protect respondents’ identities.

RESULTS

Houses and Balls

Data gathered from participant observations has provided a general description of the Los Angeles House and Ball communities. In general, we found that the House and Ball communities work in tandem to develop and support a community involving primarily African American and Latino individuals of diverse sexual and gender identities ranging from gay men to transgender women. Balls and Houses function as different entities, yet are dependent of each other in order for each community to sustain. Houses are different groups of individuals that compete against each other during Balls—underground events that reward individuals who win competitions focused around dance, athletics, and gender expression. It is important to note the gender and sexual fluidity of many of the House members and Ball participants. Observations consistently noted that it is not uncommon young men to wear women’s attire and refer to each other with female pronouns while taking on stereotypically masculine gender roles during their normal, everyday lives. This is an integral aspect of the Ball scene given the few safe spaces AAYMSM and transgender youth typically are able to access.

Although Balls have occurred in other parts of the United States since the 1920s, it was not until 1998 that the first Ball occurred in Los Angeles. House parents related that the history of the local Ball scene, revealing that the first House, originally named the Hoopla Divas, was created in 1996. From 1999 to the present, the Los Angeles Balls flourished, and during the study’s data collection period, the number of Houses fluctuated between twelve and fifteen active Houses competing in the Ball scene.

Most competitors of Balls are affiliated with a House, a group of young people who prepare to compete at Balls against other Houses. Houses are typically led by a House mother and/or father, and may have more than one mother and/or father in a single House—depending on House structure. Observations indicate that the number of members in Los Angeles Houses ranges from five to thirty-five.

House structures vary and may include other roles besides father and mother, such as prince/princess, godfather/godmother, emperor/empress, and ambassador. The roles and responsibilities of a House parent vary from House to House but typically involve: recruiting new members; maintaining the direction and status of the House; organizing Ball events and House meetings; grooming members for specific categories; acting as mentors for Ballroom success; and liaising with out of state chapters of the House.

Los Angeles Balls are typically organized and sponsored by a single House in a range of different venues such as bars, warehouses, and community spaces. During the study period, we found that, Balls typically start at 2:00 am and can end as late as 8:00 AM, and are held once or twice per month during the “Ball season” (usually between the months of May and November). Balls are highlighted by competitions, which combine athletics, dance, and gender performance, where participants compete for cash prizes in front of a panel of judges comprised of House leaders.

Balls are characterized by categories that focus on different aspects of a competitor’s skills, endurance, athleticism, knowledge, confidence, and creativity. Observations and category lists prepared for each Ball indicate standards for each major category. For example, Fashion and Runway categories (e.g., Best Dressed, Labels, Foot & Eye) test a competitor’s knowledge in current fashions and trends, as well as their ability to confidently walk down a runway in front of a panel and a room full of spectators. Realness categories (e.g., Thug Realness, Executive, Femme Queen, Schoolboy) focus on a person’s ability to pass as a heterosexual person (for MSM or gay men—also called butch queens) or a biological woman (for transgender women or femme queens) through appearance, demeanor, and attitude. Performance and Vogue categories test dance and athletic skills as participants battle each other on the runway by incorporating dance moves such as vogueing, pirouettes, flips, and the shablam, a move that requires a person to slam her or his body on the floor followed by an immediate lift off the ground. Face categories require competitors to have a well-groomed face to personify youth and beauty. Features such as clear skin, bone structure, trimmed hair, and straight, white teeth are lauded. Body and Sex Siren competitors are judged on their bodies, and competitors usually wear little clothing to emphasize muscular structure. Lastly, the Virgin category provides an opportunity for novice competitors who have not walked before to make themselves known in the Ball community.

Study Sample

The age of the House parents interviewed ranged from 22 to 42, with a mean age of 31. The majority are African American or Black (90%), followed by Latino (10%). Sixty-four percent were male and 36% are transgender (male to female).

House and Ball Scene as a Supportive Environment

Based on descriptions provided by the House parents, the House and Ball scene serves as a subculture that is able to provide a sanctuary where its members can freely express themselves creatively, artistically and sexually. House parents tended to view the Ball and House communities as a “safe haven” for its members. Parents often described instances of rejection from family or friends that their members experienced and felt that the House and Ball scene offered an attractive alternative to a “society who doesn’t know how to deal with you or doesn’t know how you feel”. The Mother of Fennel described this safe haven as essentially being able to create “our very own family”:

Some of us come from backgrounds where we were abused or kicked out or not really appreciated or supported by our own family because of our journeys whatever they might be. So this was kind of an avenue to create that safe haven and to really be able to say, “I do belong to something. I am wanted.”

House parents frequently described scenarios that they or their members had faced dealing with discrimination based on their gender or sexuality. For those facing such challenges, the House and Ball scene offered an opportunity to be themselves, express their individuality and be creative. For AAMSM, finding a safe place to “support their norms” was particularly challenging, as Father Clove reported :

White gay men have the opportunity to-- economically had the opportunity to create geographies that are based upon their norms…[where] White gay men can shop, gym, bank, party, work all in the community that supports their norms. Black gay men oftentimes still live in the social minefields of the Black community where homophobia is huge.

According to most parents, this support was something that was generally not afforded to them. Instead, parents reported that they and their children were often criticized, harassed, bullied or abused when expressing who they really were. The Father of the House of Cinnamon described his own abusive childhood, which he believed was related to his parents finding out that he was gay. He compared the House and Ball scene to the fantasy world of the X-Men comic books:

For some reason America is not ready for X-Men. Now I use the term X-Men because we are a people who are outcasted because of our sexuality … Sometimes we feel like X-Men and I am Professor X rolling around on my wheelchair and there is this great school for creative kids with a gift of being gay.

For those involved, the House and Ball scene is typically viewed as a type of refuge from the stigma and discrimination that they often face in the outside world. House parents, when describing the benefits of being involved in the House and Ball communities, generally cited: 1) the structure as it provides a sense of family and support; 2) a sense of acceptance; and 3) the validation and recognition that participants receive from others in the community. Though described as separate and unique systems, both the House structure and the Balls themselves were reported to provide these different benefits to members.

House Structure: Family and Support

The basic structure of the House, with a Mother and a Father naturally suggests a sense of family. This sense was referenced by each of the House parents, as they described their role as a Mother or Father. For some, being a parent was what they identified as their primary motivation for remaining in the House and Ball scene. When asked what made her want to remain in the community, one leader from the House of Coriander reported that “the love of my family … or the love of my House keeps me in it … I love them more than I love the Ball. It’s the people, our family.” This sense of love led several to also indicate that being a parent carried with it a certain level of responsibility or as one Mother put it, an “opportunity to contribute”. At times, this opportunity was described as the ability to make a difference in a young person’s life, and in some ways, repaying a debt to their own House Mother. This opportunity was described by the Mother of Wasabi as a sense of gratitude:

I feel like a real mother because it’s like gratitude. ’Oh my God, he had a good night, he won the trophy he wanted … or whatever. We all got together and became a family’, not just for the Ball but to help each other out and that kind of stuff is rewarding.

For many, it was this family structure that was the primary benefit of being a member of a House. The Father of the House of Cinnamon reported that when he first joined a House as an eighteen-year-old, he was immediately attracted to this family structure:

I didn’t quite understand it, but I knew at that point in time that I was engulfed in it. I saw the energy, the passion, the love, the sorrow. My father never told me he loved me. My mom barely was there …so coming into that type of family setting and people told you that ’Hey we care about you, we love you.’ It made me feel like this is for me.

Parents reported that the family structure provided House members support in the form of love, a place to stay when needed, and financial assistance. When necessary, Houses may replace biological families by providing support, guidance and a place to go when feeling alone or on holidays. Father Rosemary described his last Thanksgiving as including both biological family and his House children: “a lot of them [House members] won’t really participate with their family, probably due to rejection and stuff. They prefer to come around the House families and have Thanksgiving and stuff.”

Parents acknowledged that this sense of togetherness was often set aside during the Balls themselves when House members often compete against each other for prizes. However, at the end of the night, parents and “kids” both agree that they are still a family. The Mother of Fennel summarized it as excitement, which she described as:

…getting together, the competition, the enjoyment, getting around friends .. . being able to compete and then after the Ball is over everybody gets together and laughs .. .it kind of looks separate but in actuality it’s like a tight knit family bond.

Several parents reported being a member of different Houses before either founding their current House or rising to the rank of parent in their current House. In spite of this instability in membership, most reported feeling that their House was an integral part of their identity.

I am always going to be a part of the House. When I am seventy years old, I am always going to be a [Star Anise]. It’s not just a House, it’s not just a family. It becomes a lifestyle…it helps me define myself.

In addition to the House structure, several parents also mentioned that there are other informal family structures within the community which they termed as “personal” or “gay families”. Members of a gay family may be from different Houses or may not be members of a House at all. Gay families within this community can be very complex, including mothers, fathers, aunts, uncles and siblings. Informal interviews conducted during observations indicate that these families are an additional source of support and may be more stable because their composition does not depend on competitions. Mother Ginseng explained her personal family as:

I just, it’s just like family that you actually weren’t born into. You actually got to pick who is going to be your family and it just goes from having each other’s back 100% and just knowing that if you are absolutely down and out and you just can’t take it no more…or you need something it will pretty much be done or taken care of.

Acceptance

As previously discussed, House parents reported that many of the members of their Houses experienced discrimination in the form of racism and homophobia throughout their lives. This discrimination may have come from peers, neighbors, strangers, employers, or family members. Parents reported that some House members were forced out of their home when their family discovered their sexuality. For these members, discovering the House and Ball communities was seen as fortuitous as these communities were welcoming of many different types of people, making young gay, bisexual and transgender men and women feel accepted and at home. For some, this was the first community that was truly welcoming of their beliefs, talents, and gender/sexual identities. Becoming a part of this community was described as a “freeing experience”, giving individuals a “sense of belonging” and providing a space to freely express themselves without being stigmatized. The Mother of the House of Cardamom described this as:

It’s like Cheers, it’s like everybody knows your name…it’s just a really, cool outlet where you can be appreciated by people who understand who you are or what it is that you do.

This sense of belonging was the most common reason for people wanting to be a part of the Ball community. The Mother of the House of Saffron, a young transgender woman, related that she left home at eighteen, confused and fearful of the world, searching for some kind of acceptance. Finding the Ballroom scene helped her realize that there are “other people like me that were living this whole other life which to the ’normal world’ was a mystery.” This intrigued her, and she quickly joined a House where she was able to find the support and acceptance she had not found at home.

Some of the older parents, those who had been a part of the original Los Angeles Houses, also spoke about the fact that the Ballroom community recognizes all types of people and has categories for different body types, talents, genders and styles. Some of them spoke about how this was one of the most unique aspects of the community, in that it was constantly evolving, adding new categories to recognize and including different types of people. In this way, the Ballroom scene has the ability to adapt to changes in fashion and participants - making it a more permanent fixture in the underground gay community. The Father of the House of Clove described this aspect as one of the reasons people gravitate to the scene, as someone may finally identify a place where “I can be me. I am in a place where I can fit in because they have different categories that I can fit into and a place that is actually going to award me.”

Validation and Recognition

Similar to finding acceptance, many of the parents spoke about how the House and Ball communities can provide a sense of validation through Ball competitions and individual contributions to the House. This validation and recognition is most prevalent in the status system of the Ball scene, which recognizes those performers who have made a name for themselves in the community. Before the beginning of each Ball, individuals are called out to “walk” the runway during the “Stars, Statements, and Legends”¹. Younger members who have just begun to consistently win and are known in the scene, are deemed “Stars”; those with more experience and have “memorable moments” at major competitions are called “Statements” and only those who have excelled in a particular category and have been involved in the scene for a number of years can be deemed “Legends”. To achieve this status one must not only win, but also gain the respect of others in the community through their leadership and visibility. The Mother of the House of Ginseng, a young man who, at the age of nineteen had already achieved a high status as a “Butch Queen in Drags” explained:

Everybody’s objective is to become legendary and so until you become a legend or a person known in the Ballroom scene and respected, then it kind of makes you want to keep going and push for that status.

Apart from gaining status in the community, some parents felt that individuals’ contributions to the House were also a source of validation and recognition. In these instances, helping to plan a Ball or a group performance category at a Ball was a way to achieve recognition from parents and other leaders. In addition, “turning” a good performance, regardless of whether they won, was also an opportunity to attain validation within the House, as one leader explained: “it’s always nice to hear your dad go, ’Miss Thing you did that … you turned that.’ That always feels good when you have somebody that you look up to giving you validation.”

For some, this validation was something that they had strived to achieve for a number of years in their everyday “real world”. Achieving this in the mainstream culture was not necessarily possible, given the challenges that many experienced in the form of homophobia and discrimination. Father Cinnamon related that he was invited to join a House when he was in high school while working at McDonalds. He felt that joining a House and competing in the Ball scene helped him realize that he could achieve something in life, something his biological family had never provided for him.

Well my story is unlike any others due to the fact my Ballroom scene started before I entered the Ballroom, and what I mean by that in terms of wanting to be accepted in society and looked upon as something greater than myself. So the Ballroom scene was something that was inside of me for a long time, and it developed at an early age…. As it began to develop, I began to like myself, because as a child I really didn’t like myself… I was always told I could not accomplish anything. I was going to be a failure, that I would be gay…as I approached the Ballroom scene, it made me feel like I was important. It gave me some insight to a whole brand new society that I was willing to just jump into.

The sense of recognition and validation was something that was seen as highly valued – primarily because it was something that could not be achieved in the outside world. Similarly, validation achieved through expressing one’s true self - for which many of the communities’ members had been rejected or devalued - was perhaps even more valuable, because the House and Ball scene is the only venue where this recognition could be achieved.

It’s about being accepted in a society in which you can delve in and take it as far as you possibly can…You can express it though your sex. You can express it through the beauty of your face. It is our--it is our awards, our-- it’s like being at Kodak Theater. Being at a Ball for us, is like being-- getting a Grammy that night. So, that’s what it is for us being able to express yourself in a way in which nobody else would see it vastly or remotely acceptable in a society of today.

Challenges Encountered in the House and Ball Scene

While describing the many benefits of the House and Ball communities, parents also acknowledged that the Ball scene can have a number of challenges for AAYMSM and other sexual minority youth. Many of the challenges noted by House parents can increase members’ risk for HIV and other sexually transmitted infections (STI). Interestingly, these challenges were often directly related to some of the supportive aspects the parents also cited, such as the idea of a “safe haven” free from rejection and discrimination, and the creative outlet the Balls provide. In general, the most common negative aspects of the Ballroom scene identified by parents included: 1) members’ struggle to maintain status in the Ballroom scene, which at times led to violence, sex work or drug use; 2) the danger of becoming too involved in the Ball community, inhibiting one’s ability to effectively manage in the real world; and 3) the perception and stigma of the Ballroom scene within the larger gay community.

Maintaining Ballroom Status

As previously discussed, members typically strive to attain a high level of status in the scene, which in turn provides a greater level of recognition. While this level of status was viewed as a positive aspect, the path to achieving and maintaining this status had a number of challenges. Observations documented a number of altercations that occurred at Balls or after Balls that often resulted in members from different Houses engaging in a physical fight that could include weapons such as knives or mace. These fights usually occurred after a perceived unfair judging decision or other issue on the runway. Parents also reported that these fights occurred due to members “disrespecting” others by stating they are “better or that they can accomplish more. It’s like a tug-a-war of respect.” It was often the case that the manner in which these instances of disrespect were handled was to start a fight with the other party - generally as a means to defend one’s status in the scene. The former Mother of Rosehips related how one of her kids handled a situation where he was continually “chopped”² from his category because one judge did not want her son competing against his House member.

And [House Member} went home … put all his knives in his bag and came back to the Ball and he just went- the Ball just went crazy and that was it. It was over because he was tired of them trying him when he knows that he went out and did that. .. it was like earning your respect.

Achieving status in the Ballroom scene can also be extremely expensive as travel and designer clothes or “labels” are often required. As many parents related, Los Angeles will always be considered “late” to the cities on the East Coast - meaning that Los Angeles was late to the scene and will always be catching up to the trends of Houses and performers on the East Coast. Therefore, for a House member to achieve a higher status, he or she should also compete and win on the East Coast. In addition, some categories such as European/American Runway, Foot and Eye, and Labels require walkers to have new and au courant designer clothes and accessories.

Parents reported that being able to afford travel and clothing was extremely difficult for most members. Therefore, illegal and often risky activities are to obtain the necessary items. For example, parents reported that it was not unusual for kids to make Ball-related purchases through credit card fraud. Perhaps most relevant when considering HIV prevention, is the practice of turning to sex work or “escorting” for money to pay for travel and clothes. Parents agreed that escorting was a major problem in the Ball scene and had increased in recent years, attributing this increase mostly to the ease of soliciting sex online. In the past, escorting was thought to be limited to transgenders or “femme queens” as they needed money to pay for hormones and surgery. Parents reported a recent shift in this behavior as Father Ginseng reported:

It’s been over the last five to ten years that it has just exploded … These guys can make easy money. Most of these guys are pretty young… They-- somebody gives you 50 dollars for this or 100 dollars for that, it’s easy. It’s- five or ten clients within a day and you make a lot of money but at what price or at what cost?

Most parents acknowledged that members of their House were involved in escorting. Some parents said that they have spoken with their kids about it, warning them of the dangers. However, parents also reported that they could not necessarily change their behavior, they could only let their kids know they would help them if they needed it.

Parents also felt that some of the pressures within the Ballroom scene contributed to substance use. For example, Balls typically start between 2:00 and 3:00 AM and can last until 8:00 or 9:00 in the morning. Some parents felt that needing enough energy to compete encouraged members to take different stimulants or club drugs, such as cocaine and ecstasy. Others reported that use of these substances was particularly common among those individuals who walk in some of the performance categories, as the drugs can numb the pain from performing “shablams” or other moves. Father Rosemary explained that these substances may also lessen the anxiety performers might have about hurting themselves: “Well they got to do a lot of extra performance stuff when they think they are going to go out and break their neck.”

Most of the parents had very strong opinions about drug use within the scene, with several of the original Los Angeles House members relating how drug use had torn apart one of the original Houses and created a huge riff in the community. The Mother of the House of Chile, who was a member of one of the original Los Angeles Houses, reported that her memories of that time keep her from using those drugs:

Like I said, dealing with it in the past and watching the Cumin House makes me harder on it [I: So, that really did tear up the Cumin House?] Oh, yes. These people were-- they were exceptional and it’s like a lot of people just deteriorated, like some of the best or the most gorgeous Face kids, all that. When you look now, you are only seeing remainders of them.

These parents voiced concern about the current amount of drug use in the scene and felt that it was a growing problem; several also they feared the increase in escorting was related to the increase in drug use also:

I think that we are going to see--I think in five years we are going to see the effects of escorting… higher drug use because people have to get high to deal with what they are doing or to stomach what they have done. So, I think the drug epidemic is definitely going to go up .. .it’s cancerous. It’s going to deteriorate a little bit more.

The “Normal” and “Fantasy” Worlds

Several parents believed that one of the allures of the Ball scene was the “unreal” or “fantasy” nature of the community. Like some other subcultures, the Ballroom community allows its members to create an “alter ego” complete with a House name and persona. However, parents like the Mother of Saffron explained that an individual in the Ballroom scene must be able to differentiate between their two realities: I still do live in this world which is very hateful towards people like myself, and I have to know how to differentiate between reality and fantasy. People don’t live in the Ballroom scene, they get caught up in it, into the hype. This “unreal” world serves as an escape for many who enter the scene. While this was considered a benefit of the scene, as it does offer a sense of belonging and acceptance, it could also lead to a number of risks as the Mother Rosehips warned:

I mean, the Ballroom scene consists of a world, when you go in there you can be all that you want to be, and when you walk outside that door you are back homeless. You are back broke. Your life is the same as it was before you walked inside those doors. It’s just a world of- a world of-- a fairy tale world.

The risks parents associated with the Ball scene were seen as even more problematic for young men who become too involved in the scene and drop out of school or cannot keep a job. About half of the Los Angeles Houses have rules that specifically state that all members must either be in school or have a job. This rule exists for a reason, as many parents felt it keeps their members more grounded in reality. The Mother of the House of Licorice reported that while there is not a strict rule in his House, he stresses the importance of having a real and meaningful life outside the Ballroom:

A lot of people sometimes get caught up in the fantasy and forget that there are other things besides the Ball scene. That’s why I try to remember to keep the kids in school or work. You got to do something outside of the Ball scene because most will sit and wait for the next Ball … and not try to do anything else with their life. Then when it comes, they would be like, ’I don’t have any money. ’

Several parents also linked this issue of being too wrapped up in the scene to escorting, believing that those involved may be doing so because they did not graduate from school and/or cannot find a job. They worried about what would happen to those members as they got older, and escorting is no longer a viable option “The problem is escorting is a youthful event. The older you get, the less work. So the thing is, what happens when you are no longer escorting … All that time is gone, you don’t have a skill”.

Outsider Perspective of the House and Ball Scene

While members of the House and Ball communities are continually striving to achieve status within the scene, some parents did acknowledge that this status was worth very little outside the scene. In general, parents and others feel that individuals outside the Ballroom community view the scene and those in it as “messy”, meaning gossipy, unmanageable and/or prone to start a fight. Several mentioned that even within the larger gay community, Ballroom kids are stigmatized for their membership and seen as “just a bunch of [gays] showing off, it’s just for vanity and there’s nothing else behind it”. Some reported that they do not talk about the scene with outsiders, particularly romantic interests, and “hide my trophies” when people come to their homes. The Father of the House of Chile reported that his biological mother did not want him to be involved in the Ball scene because “she thought I was going to change and start doing the strange drugs … neglecting bills, school”.

Father Clove, who had previously worked in an HIV prevention organization, felt that these stereotypes had bigger implications, believing that service organizations had historically stayed away because of negative perceptions associated with the Ballroom scene. “The House and Ball community is a community of people who [are] riff raff, in their minds. Who engage in malfeasant behaviors, all they [do] is craft or booze or steal.” This perception was confirmed through observations of House and Alliance meetings where members commented on the lack of consistent service providers’ presence in the community over the last several years.

DISCUSSION

The data presented in this study provide a description of the House and Ball communities and how the structure and activities within this subculture offers both support and risk to its members. Parent descriptions indicate that the ability to be oneself was freeing and gave respondents a sense of respite from the outside world. These data indicate that members of the House and Ball communities are, like members of other subcultures (Wilkins, 2008), savvy cultural actors who use the cultural resources available to them in creative and interesting ways to make their lives more tolerable or exciting. Like other subcultures, the House and Ball scene provides a safe and supportive environment for those who may not feel that they fit in with the larger society. However, the very factors that make the House and Ball communities an appealing environment for its members may also present a number of risks for those who become enmeshed in its surroundings.

The House and Ball communities provide a sense of support for AAYMSM and other sexual minorities, primarily through the House structure which provides members with a sense of family. African Americans have been shown to seek out informal support (e.g. friends, family) for advice or help to reduce negative consequences of stress (H.W. Neighbors & Jackson, 1984). Similarly, there is a long tradition of ethnographic research that documents the “fictive kin” networks among African Americans as a means to extend one’s social network, which can serve as additional social and economic resources to manage societal challenges including poverty, discrimination, and rejection (Anderson, 1978; Liebow, 1977; Stark, 1974). Similar alternative family structures or fictive kin networks have been identified also among other sexual minority groups in general (Muraco, 2006; Nardi, 1999) and AAMSM specifically. This support can be crucial to the health and well-being of AAYMSM who have experienced rejection or discrimination from their family, peers, the larger African American community, and society in general. This rejection and discrimination can in turn contribute to the negative health outcomes of discrimination and homophobia including psychological distress, substance use and high-risk sex use (Rosser, Bockting, Ross, Miner, & Coleman, 2008; Wong, Weiss, Ayala, & Kipke, 2010).

Related to the support AAYMSM typically receive from their House family, members of the House and Ball scene also gain recognition and validation through their performance and achievement in walking the many different categories at Balls. Parents expressed that what was most important about this validation and recognition was that members are able to gain this simply through expressing themselves, something that may have been repressed or seen as taboo in the world outside the Ballroom. Finding a space that embraces and celebrates the uniqueness of its members was seen as invaluable to House parents. Similar findings have been noted with other YMSM populations, noting the lack of “safe spaces” for YMSM and the need for more spaces where young men can be themselves, grow as individuals, and feel accepted in their community (Easton et al., 2007). However, as observed at a number of events, this need to gain or retain status within the community was often related to physical altercations with others; ultimately contributing to the negative perception of the Ballroom scene to those outside the community.

Parents also mentioned that obtaining validation and recognition in the Ball scene can make it difficult to succeed in larger society. Parents described members who are admired and celebrated during a Ball, but still have to walk outside and deal with the reality of the outside world – a world that may have a very negative perception of the Ballroom scene. As parents described, discovering that this acceptance and recognition is only valid within a community that is not respected in the larger world, may lead members to become too involved in the Ballroom scene. Ultimately, parents felt that this blurring of realities between the “fairy tale” of the Ballroom and mainstream society may contribute to members being unable to find work or remain in school, or become involved in escorting.

Finally, the results from this analysis indicate that parents feel that in order to obtain and maintain status in the Ball community, there is a great deal of pressure for members to ”get their tens”³ and successfully compete at Balls. To do this, participants may engage in illegal or risky activities to travel to out-of-town Balls and/or purchase designer clothes for their chosen category. Sex work, or escorting, was identified as a particular problem within the Ballroom community, with parents estimating that up to 70% of Ballroom “kids” are involved in escorting. Several attributed this increase in escorting to the ease of the Internet, stating that members no longer have to look for “tricks” on the street. Rather, they can post a profile online, allowing for greater concealment of the sex exchange, and also making this activity appear to be less unseemly, a phenomenon described by others (Lee-Gonyea, Castle, & Gonyea, 2009). Condom use is typically lower among sex workers, and sex work can increase one’s risk for exposure to violence and substance use (Rekart, 2005). Research among MSM sex workers indicates similar findings, particularly among MSM of color (Boles & Ellifson, 1994; Hwahng & Nuttbrock, 2007).

There are several limitations to this study. The analyses rely on the perceptions of parents and leaders in the House and Ball community in one city. This analysis does not include the members’ perceptions of the communities; future analyses should investigate whether members’ perceptions are comparable to the House parents. These analyses are based on perceptions from one Ballroom community and may not be generalizable to communities in other cities; other cities’ Ballroom communities include larger proportions of Latino and Latina members and future studies may want o investigate potential cultural or ethnic differences in these cities. For HIV prevention efforts, future studies should include comparisons to other cities to identify other mechanisms of support or risk within the scene. However, in spite of these limitations, we feel the data presented here are important and provide ideas for providers on leveraging the support systems available in the House and Ball scene so they can develop and/or advocate for new programs designed for House and Ballroom communities. Little is known about these communities, and this study provides an important foundation for understanding the social and structural characteristics of a Ballroom community, a community whose members have previously been identified as being at-risk for HIV infection (Murrill, et al., 2008; Sterling, et al., 2000).

The findings presented here have a number of implications for practice. Families are often mentioned as integral to HIV prevention efforts (Garofalo, Mustanski, & Donenberg, 2008). This study builds on what others have learned about the family structure of both sexual minorities and African Americans, in that families are not limited to biological members and can encompass a range of individuals. Service providers and interventionists should ensure that, when working with AAYMSM, the term family is broadly defined, and clients should be made to feel comfortable in including a House parent or “personal/gay family” member in HIV prevention work. This follows on the recommendations of the National Institute of Mental Health which created guidelines for measuring and defining the family (Pequegnat et al., 2001). Non-biological family members can be powerful sources of support and should be considered when developing HIV prevention programs.

House leaders unanimously identified sex work as one of the most pressing problems in their community. The ease of soliciting sex on the Internet has reportedly made this practice common for members of all genders and sexual orientations in the House and Ball scene. Providers working with these communities should be aware that this is becoming an increasingly common problem and should consider incorporating harm reduction programs into their service array. For example, education and prevention programs can provide those who are involved in sex work with information that may reduce HIV-risk behaviors. Empowerment programs can help to increase the self-esteem and mental health of those involved in sex exchange to increase their ability to advocate for their own safety and sexual health (Rekart, 2005).

Finally, the House and Ball scene offers many healthful aspects that can be leveraged as part of an intervention effort. In particular, the scene offers a unique, supportive environment for its members to freely express themselves. Prevention programs designed for this community should consider building on these strengths. For example, programs can train current leaders in HIV prevention so that information is disseminated through the House networks. The creative side of the House and Ball scene can also be used in prevention work. Designing programs that encourage performance and other activities may be more appealing for this target population, while also recognizing that it is possible to maintain creative expression outside the Ball scene. Additionally, the practice may provide opportunities for members to express larger social issues (e.g. discrimination) and identify new solutions for managing these experiences. This practice has been used by other social justice activists to overcome oppression (Boal, 1979). Finally, it is important for programs to emphasize the importance of maintaining a life outside the Ballroom scene. This can be accomplished through referrals or engaging guest speakers to provide outside perspectives on how to attain recognition and validation through other outlets.

Using a community-engaged approach to accomplish this work was integral to the success of the project. Our relationships with the House leaders granted us access to formal and informal events within the communities, providing a more inside perspective of the communities. For others wanting to work with the House and Ball scene, it is important to include the leaders of the communities in the planning and implementation of the project. Giving the leaders a voice in developing projects will likely result in programs that are better grounded in the community’s needs and are well received within the community.