The Mental Health Issues Gay Men Deal With

Published on: 16 Jun 2016
gay man smartphone rally

The mental health issues gay men are more likely to deal with go beyond discrimination and stigma. To fully understand how their sexual orientation impacts their mental health, we need to examine existential crises, family problems, stereotypes, the effects of the LGBT community and much more. All of these issues make gay men more likely to develop a mental illness or die by suicide.

Keep reading if you are interested in supporting gay men by helping them improve their mental health and spread awareness about the challenges they face. If you are a gay man, this article might be an opportunity to better understand your issues and consider a path to treating them.

Internalized Homophobia

When gay men spend years exposed to homophobic rhetoric, stereotypes and myths, there are a portion of them who internalize this negativity and — consciously or subconsciously — believe it is true. This is called internalized homophobia.

A summary of this study by UC Davis illustrates how gay men process internalized homophobia. Gay male participants rated how much they agreed with the following statements on a scale of “disagree strongly” to “agree strongly:”

  1. I have tried to stop being attracted to men in general.
  2. If someone offered me the chance to be completely heterosexual, I would accept the chance.
  3. I wish I was not gay.
  4. I feel being gay is a personal shortcoming for me.
  5. I would like to receive professional help to change my sexual orientation from gay to straight.
  6. I have tried to become more sexually attracted to women.
  7. I often feel it is best to avoid personal or social involvement with other men.
  8. I feel alienated from myself because of being gay.
  9. I wish I could develop more erotic feelings about women.

The average score for participants was closer to “agree strongly” for most of the statements. This result points to other mental health issues this article will cover.

Internalized homophobia exacerbates general stress and stress during the coming out process, according to a study from the Department of Counseling and Mental Health Professions at Hofstra University. It is also a predictor of whether gay men will come out to friends, colleagues and extended family.

Body Image and Femininity Issues: “No Fats, No Fems”

If you browse popular gay male dating/hookup sites such as Grindr, you will find many profiles with the statement, “No Fats, No Fems.” It’s a shorthand way of saying, “I don’t want to date or have sex with men who are not muscular and masculine.” It points to larger issues in the gay male community: unreasonable body image expectations and overvaluing stereotypically heterosexual qualities such as being masculine.

Because of this body image issue, homosexuality increases the risk of developing an eating disorder. For gay men, peer pressure and body dissatisfaction are among the top factors that contribute to this increased risk.

The pressure for gay men to be masculine can cause them to have difficulty being emotional and affectionate, according to a study published in the U.S. Library of Medicine. The masculine ideals and rejection of femininity also exacerbate the aforementioned body image issues.

Some gay men find the pressure to be fit and devaluing of femininity frustrating because it contradicts the openness, equality and acceptance the LGBT community should provide.

“Value is placed on being straight and acting straight as opposed to being effeminate,” said Raymond, a gay member of the Talkspace community. “It’s contradictory and traitorous that the gay male community, which is itself a historically marginalized community, enforces such stigmas against effeminacy against its own members.”

Conflicting Pressures to Be Masculine or Feminine

Imagine the pressure and stress heterosexual men feel from society and their peers expecting them to be masculine and devoid of effeminate qualities or mannerisms. Now multiply that pressure several times. Then imagine simultaneously feeling pressure to do the opposite.

This is what gay men experience. They are often caught between these forces:

  1. Natural desires or tendencies to exhibit qualities and mannerisms people believe are feminine, pursue stereotypically female careers, etc.
  2. Other gay men pressuring them to display stereotypically masculine qualities
  3. Other gay men pressuring them to display effeminate qualities, sometimes in an effort to counter the aforementioned force
  4. Family members pressuring them to be masculine
  5. The media perpetuating effeminate gay stereotypes
  6. Certain gay outlets presenting masculinity as ideal for gay men

Overworking to Prove Themselves to Heterosexuals and the World

On average gay men are more successful and have higher income than heterosexuals, according to a study by Prudential Financial. This is great news for the LGBT community, but one of the reasons for this success is troubling.

Many gay men perceive their sexuality as a deficiency, so they overcompensate for it by attempting to be perfect or high-achieving in other aspects of life.

“It is a feeling that we as gay men have to overperform, outdo and live up to a higher expectation to prove our worth as gay people to the straight world around us,” said therapist John Sovec, who works with gay male clients.

Coming Out for the First Time (And the Other Times)

Gay youth and men endure a version of the five stages of grief before they come out, according to Wesley C. Davidson, the author of “When Your Child Is Gay: What You Need to Know.” This is because they perceive being gay as the loss of a normal life as a heterosexual. Here is a summary of that process:

  1. Denial: denying they are gay
  2. Anger: being angry about being gay, treating it like an unfortunate event that is irritating
  3. Bargaining: thinking maybe there is a way to convince themselves they are not gay, put off the coming out process, try to pass as straight, etc.
  4. Depression: becoming sad when thinking about the upcoming challenges of being gay and the loss of an easier life as a straight person, the possibility of people rejecting them or discriminating, etc.
  5. Acceptance: accepting they are gay (some people do not reach this stage)

The response gay men receive upon coming out for the first time out is a major predictor of mental health issues they will deal with in the future. Rejection of their sexuality usually increases the risk of depression and anxiety. The issue resurfaces when gay men come out subsequent times as they grow older and meet new people.

Social Isolation and Anxiety

Many gay men isolate themselves or suffer from social anxiety because they fear the possibility of others judging, bullying or rejecting them. Given the history of discriminating against gays, it sometimes seems easier and safer to limit interactions with people.

For some gay men — especially in metropolitan areas — there is pressure to compete with other gay men for dates. This can be overwhelming and tedious to the point where some become anxious and exclude themselves from that social scene, according to Talkspace LGBT therapist Jor-El Caraballo.


man with marriage sign

When politicians and religious figures around the world propose or defend legislation that limits rights for gay people, it reinforces the belief many gay men hold: they are not equal to heterosexuals. This discrimination exacerbates the mental health issues in this article.

The Anxiety of Terror Attacks, Shootings and Hate Crimes Targeted at Gays

Imagine the anxiety of knowing there are people in the world who want to harm or kill you because of your sexual orientation. It’s horrifying.

Orlando rally Minneapolis
a rally in Minneapolis held in the wake of the Orlando shooting

Attacks on LGBT people threaten the feeling of safety the LGBT community often provides them. The Orlando Shooting was the deadliest incident in history. It is also only one of many attacks on the gay community. Even people who are not directly connected to these incidents worry about being the next victim.

Bullying from Peers and Family Members

The bullying gay males experience while they are young adults can be traumatic and impact them for the rest of their lives. It shapes negative beliefs they can develop, leading to mental illness or lower quality of life.

Talkspace therapist Kendra Simpson worked with a gay male client whose brothers and stepfather bullied him during childhood because he wasn’t “tough enough” or interested in sports. He didn’t fit the male gender role they wanted him to participate in.

“He felt ganged up on and this led to some deep feelings of insecurity as an adult,” Simpson said. “He’s also become a people pleaser and caregiver to the point where he always puts others before himself.”

Her client’s attitude has led to depression and anxiety. It also caused him to attract people who take advantage of him.

Then there is bullying at school, an issue that often causes the social anxiety gay men struggle with. This kind of bullying is usually more vicious.

In a popular blog that features stories from the LGBT community, one gay man said one of his classmates spit on him and called him a faggot. The bullying escalated until he dropped out of school.

Davidson’s son had a similar experience: He cut many classes and refused to join the LGBT alliance because he thought it would attract more attention from bullies.

The bullying can also be a form of shaming effeminate qualities in men.

“Often people would tease me about being gay because of the way I sounded, talked or acted,” said Tyrone, another gay Talkspace community member.

Their Families Don’t Understand or Accept Them

In the worst cases, gay men deal with family members who disown, abuse, neglect or criticize them because of their sexuality. Then there are family members who respond neutrally when a gay male family member comes out but don’t provide emotional support or understanding.

Talkspace therapist Shannon McFarlin sees a client whose family frames his painful breakup as nothing more than a roommate moving out.

“His parents are ashamed and secretive, hoping [the issue of his sexuality] will go away if they don’t talk about it,” McFarlin said.

This lack of acceptance reinforces the self-loathing her client is feeling.

There is Less Expectation for Gay Men to Raise a Family and Structure Their Lives as Heterosexuals Do

gay family question mark

There is a clear standard for how society expects heterosexuals to structure their lives:

  1. Build a career
  2. Get married
  3. Have kids
  4. Retire
  5. Your spouse, kids and grandkids can take care of you

It isn’t fair to expect anyone to follow this path, but there is at least comfort in being able to cling to it. For gay men there is not much agreement on a standard path or set of milestones.

“I could have a similar scenario if that’s what I wanted, but the expectation for what I should do with my life isn’t there,” said Anthony, another gay community member we spoke to. “It feels a bit like trying to squeeze into something that doesn’t quite fit and the question about what would fit is wide open.”

Anthony said this issue has caused him anxiety. He wishes he knew more about what his future would look like.

Dating Difficulties, the Club Scene and the Risk of Dangerous Drugs

Having trouble building meaningful relationships, going to clubs and using harmful drugs may sound like separate issues, but for gay men they tend to be related.

cocaine dollar bill lines

“There is a lot of superficiality in the mainstream gay community that can hinder gay men from creating long-lasting, meaningful relationships,” said therapist Kristen Martinez, who specializes in working with LGBT clients in Seattle. “On a related note, still the most popular or common places for gay men to meet is at a bar, club or a dating/hookup app.”

These environments increase the risk of using and becoming addicted to alcohol and more dangerous drugs, including MDMA, cocaine and meth. Sometimes the drugs are a method of lowering inhibitions to feel more comfortable having sex that can lead to other issues.

Sexual Health Anxiety and HIV

Because of the stigma and possibility of contracting HIV, many gay men develop sexual health anxiety: worrying about contracting a sexually transmitted infection to the point where the worry itself becomes a problem. Some of them excessively test for HIV, read too much material about it or can’t stop obsessing over possible symptoms, according to therapist Perpetua Neo, who has worked with gay male clients.

“One [client] told me, ‘It’s like a pregnancy test for me. I know I will test negative. But I still cannot stop testing,’” Neo said.

How People In and Outside the LGBT Community Can Support Gay Men’s Mental Health

Talk with Them About Their Sexuality More Than Once

Friends and family members of gay men often treat the coming out conversation as something to be checked off a list rather than a continuous discussion.

“I often hear from my clients that parents or family members who they’ve come out to never bring up their sexuality again,” Caraballo said.

Regularly showing interest can be helpful and gradually negate the awkwardness that might arise when a gay man’s sexuality comes up in conversation. You want your gay male friends or family members to know you care about them enough to discuss the important issues in their life without limits.

Provide Unconditional Love

If you treat a gay male friend or family member differently after he comes out, his sexuality becomes a condition for your love. To prevent this from happening, show you love him the same way you did before he came out. Provide the unconditional love he needs.

Become Educated and Spread Awareness About the Issues

By reading and sharing articles like this, you can learn about the issues gay men deal with, spread the word and gather more support. This will offer more people in and outside the LGBT community a chance to understand these issues.

Support Organizations and Centers that Help Gay Men Improve Their Mental Health

Here are some organizations you can support, donate to or spread the word about to support gay men dealing with mental health issues:

You can also support a local LGBT center by finding it using CenterLink.

Recommend They See a Therapist

If you are worried about the mental health of a gay male friend, colleague or family member, you can recommend he see a therapist. Use this article so you can make the recommendation without hurting his feelings or damaging your relationship with him.

What Gay Men Can Do to Improve Their Mental Health

If you are a gay man who is dealing with any of the mental health issues in this article (or maybe one we missed), know it is OK to seek help from friends, family members and mental health professionals. You can also find solace in discussing art that features gay issues, according to Caraballo.

Online LGBTQ therapy from a therapist who specializes in LGBTQ issues can make a huge difference in your life. You can also find local organizations (or a campus LGBT center or counselor if you are in school) that will support you and offer a safe, stigma-free environment.

You deserve to feel proud and live a happy, healthy life. Being gay shouldn’t stand in the way of that.

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Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

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