It can be challenging to find information about gay men's mental health, and HIM wants to change that. The following articles are based on a recent academic review of relevant mental health resources and literature
Anxiety is a regularly occurring emotional state distinguished by anticipation of future danger, that anticipation resulting in muscle tension, devoting time and energy to prepare for the danger, cautious behaviour, and/or avoidant behavior (American Psychological Association, 2013). When the level and the duration of anxiety are in proportion to the anticipated danger, the anxiety can be seen as an emotion that helps assure personal survival. However, when the level of anxiety is too high or low, and when the duration is too long or short for what is reasonable for the circumstances, then the anxiety can have a debilitating effect on one’s health and well-being. Anxiety disorders are forms of mental illness that share out-of-proportion anxiety as a symptom. Anxiety disorders among gay men, bi men, and MSM are associated with the following negative outcomes:
Out of 222,548 surveyed across Canada in 2007-2012, anxiety disorders were reported by:
Regardless of sexual orientation, anxiety is shaped by genetic factors, recent and/or anticipated demands and pressures, anticipated near future demands and pressures, and behavioural and other adaptations in response to those demands and pressures (Wiedermann, 2015).
Causes or risk factors of Social Anxiety Disorder (i.e., intense fear and avoidance of social situations that involved the possibility of being evaluated by others) include the following for gay men:
Causes or risk factors of General Anxiety Disorder among gay men (i.e., persistent and excessive anxiety and worry about performance at work, school, and other domains in life that the individual finds difficult to control) include recently “coming out” (Pachankis et al., 2015).
Bolton, S-L, & Sareen, J. (2011). Sexual orientation and its relation to mental disorders and suicide. Canadian Journal of Psychiatry, 56(1), 35-43.
Burns, MN, Kamen, C, Lehman, KA, & Beach, SRH. (2012). Attributions for discriminatory events and satisfaction with social support in gay men. Archives of Sexual Behavior, 41(3), 659-671. doi:10.1007/s10508-011-9822-5
Feinstein BA, Goldfried MR, & Davila J. (2012). The relationship between experiences of discrimination and mental health among lesbians and gay men: an examination of internalized homonegativity and rejection sensitivity as potential mechanisms. Journal of Consulting and Clinical Psychology, 80(5), 917-927. doi:10.1037/a0029425
Golub SA, Thompson LI, & Kowalczyk WJ. (2016). Affective differences in Iowa Gambling Task performance associated with sexual risk taking and substance use among HIV-positive and HIV-negative men who have sex with men. Journal of Clinical and Experimental Neuropsychology, 38(2), 141-157. doi:10.1080/13803395.2015.1085495
Hatzenbuehler ML, Keyes KM, & Hasin DS. (2009). State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations. American Journal of Public Health, 99(12), 2275–2281.
HealthLinkBC. (2016). http://www.healthlinkbc.ca/healthtopics/content.asp?hwid=anxty#hw257239
National Institute of Mental Health. (2016). Anxiety Disorders. http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
Pachankis, JE, Cochran, SD, & Mays, VM. (2015). The mental health of sexual minority adults in and out of the closet: a population-based study. Journal of Consulting and Clinical Psychology, 83(5), 890-901. doi:10.1037/ccp0000047
Wiedemann, K. (2015). Anxiety and Anxiety Disorders. In International Encyclopedia of the Social & Behavioral Sciences (Second Edition), 804-810. Amsterdam: Elsevier. doi:10.1016/B978-0-08-097086-8.27006-2
Different anxiety disorders have different appearances, such as:
Physiological symptoms of anxiety disorder can include:
If you suspect or know you have an anxiety disorder, or if you aren’t entirely sure whether your experience of anxiety is in healthy proportion, then see your doctor. Treatment possibilities depending on the specific diagnosis include psychotherapy and medication.
Things that you can do on your own to participate in treating your anxiety disorder include acknowledging and understanding what has contributed to your anxiety; applying stress-management techniques; taking the time to be mentally, socially, and physically engaged; and limiting the amount of physical stress you bring to your body (e.g., get enough sleep, eat healthy) (HealthLinkBC, 2016).
Depression is a mental illness. Not to be confused with sadness or grieving, depression can seriously affect your ability to function and can bring about conditions that seem distinct from the mind such as aches, pains, cramps, and upset stomach (American Psychiatric Association, 2013). In depression a person shows less positive affect (i.e., emotions such as alertness, joy, energy, and enthusiasm) and more negative affect (i.e., emotions such as fear, sadness, and serenity) (Eldahan et al., 2016). Depression is distinguished by these characteristics being sustained possibly longer than two weeks, recurring, and intense in how they feel and their impact on one’s health and well-being.
Based on British Columbia data from 2007-2008, prevalence of depression among men was 15.2 % in Vancouver, 14.5 % in the North Shore, and 11.6 % in Richmond (PHSA, 2010). For the same time period, prevalence of depression and/or anxiety among all men province-wide was 15.6 %.
Research suggests that gay and bi men are 1.5 times more likely to experience depression than straight men (King et al., 2008).
Regardless of sexual orientation, depression can be caused by genetic factors, brain chemistry, substance use, medicine use, stress, behaviours, or loss of someone important in one’s life. However, other factors unique to the lives of gay men, bi men, and MSM further increase their risk of depression.
Externalized causes of depression include sexuality-related marginalization (maltreatment) by individuals and society. The greater the number of instances of such marginalization in gay and bi men’s lives (i.e., including but not limited to verbal harassment, physical violence, forced sex, and work discrimination), the more likely those gay and bi men will experience depression (Lewis et al., 2003). Out of 1,805 gay and bi men in British Columbia surveyed during 2011 (Community-Based Research Centre, 2011), depression was experienced by:
Further marginalization and added risk of depression for gay men can be caused by additional forms of stigma that focus on additional aspects of identity above and beyond sexuality, including stigma around gay men’s race, body type, performance of masculinity, cis- or trans-gender identity, HIV status, age, relationship status, employment status, and income.
Internalized causes of depression for gay men include, but are not limited to:
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Blashill AJ and Vander Wal JS. (Spring 2010). Gender role conflict as a mediator between social sensitivity and depression in a sample of gay men. International Journal of Men’s Health, 9(1), 26-39.
Burns MN, Kamen C, Lehman KA, & Beach SRH. (2012). Attributions for discriminatory events and satisfaction with social support in gay men. Archives of Sexual Behavior, 41(3), 659-671. doi:10.1007/s10508-011-9822-5
Bybee JA, Sullivan EL, Zielonka E, & Moes E. (2009). Are gay men in worse mental health than heterosexual men? The role of age, shame and guilt, and coming-out. Journal of Adult Development, 16(3), 144-154. doi:10.1007/s10804-009-9059-x
Community Based Research Centre. (2011). Sex Now survey / Sondage Sexe au présent. Vancouver, BC: Community Based Research Centre.
Eldahan AI, Pachankis JE, Rendina HJ, Ventuneac A, Grov C, & Parsons JT. (2016). Daily minority stress and affect among gay and bisexual men: a 30-day diary study. Journal of Affective Disorders, 190, 828-835. doi:10.1016/j.jad.2015.10.066
Feinstein BA, Goldfried MR, & Davila J. (2012). The relationship between experiences of discrimination and mental health among lesbians and gay men: an examination of internalized homonegativity and rejection sensitivity as potential mechanisms. Journal of Consulting and Clinical Psychology, 80(5), 917-927. doi:10.1037/a0029425
Frost D & Meyer I. (2009). Internalized homophobia and relationship quality among lesbians, gay men, and bisexuals. Journal of Counseling Psychology, 56, 97–109.
Galante J, Galante I, Bekkers MJ, & Gallacher J. (2014). Effect of kindness-based meditation on health and well-being: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 82(6), 1101-1114. doi:10.1037/a0037249
Jennings LK & Tan PP. (2014). Self-compassion and life satisfaction in gay men. Psychological Reports, 115(3), 888-895. doi:10.2466/21.07.PR0.115c33z3
King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, & Nazareth I. (2008). A systematic review of mental disorder, suicide, and deliberate self-harm in lesbian, gay and bisexual people. BMC Psychiatry, 8:70, 1-17. doi:10.1186/1471-244x-8-70
Lewis RJ, Derlega VJ, Griffin JL, & Krowinski AC. (2003). Stressors for gay men and lesbians: Life stress, gay-related stress, stigma consciousness, and depressive symptoms. Journal of Social and Clinical Psychology, 22(6), 716–729.
Provincial Health Services Authority. (2010). Summary Report on Health for British Columbia from Regional, Longitudinal and Gender Perspectives. Vancouver, BC: PHSA.
Rye BJ & Meaney GJ. ( 2010 ). Measuring homonegativity: a psychometric analysis. Canadian Journal of Behavioral Science, 3, 158-167.
The following, especially when often and/or to a high degree, are signs that you may be experiencing depression (Beck et al., 1996):
If you suspect or know you are experiencing depression, see your doctor to talk about it. Your doctor will conduct examinations and ask questions to determine the causes of the depression, help you in those areas he is best suited, and connect you with other health specialists if needed. Depending on causes of the depression, possible treatments include cognitive behavioural therapy (i.e., therapy to help you change any behaviours that triggered your depression) and prescription of anti-depressants.
Research suggests that self-compassion helps individuals overcome depression (Galante et al., 2014). Since internalized homophobia and sexual stigma drive depression, then finding ways to increase self-compassion could be a helpful and positive coping strategy (Jennings et al., 2014).
Since sexuality-based and other marginalization promote depression among gay men, then please consider providing emotional and other support to your peers to help bolster their resilience and understanding that they are not alone. Queer allies as well are encouraged to provide emotional and other support, including promotion and provision of safe spaces, and confirmation through words and actions that marginalization of others will not be tolerated.
First Nations and Aboriginal cultures see overall health as holistic health (FNHA, 2012). “To live in wellness means striving to be in balance, within self (body, mind, spirit and emotion), with others (family & community), with the Spirit World, and with the land (nature). If there is an imbalance in any of these areas, there is stress on our overall system. In time this stress causes illness and it can be physical illness, mental/emotional illness (such as depression), or spiritual illness” (MW & SU Tripartite Strategy Council, 2012). Various forms of stress play a role in bringing about depression, anxiety disorders, Post-Traumatic Stress Disorder, and other mental health conditions that in various ways are debilitating toward one’s mental wellness and overall wellness.
First Nations and Aboriginal people, 5.4 % of the population of BC (Statistics Canada, 2011), are subject to distinct sources of stress consequent of their past and present interactions with dominant non-indigenous cultures. Past sources of stress for First Nations and Aboriginal people in BC include:
Present sources of stress for First Nations and Aboriginal people in BC include experiences of anti-indigenous prejudice, discrimination, and racism.
Sexual minorities within First Nations and Aboriginal cultures include not only men who self-identify as gay and bi, but also as “Two-Spirit”: a term used since the 1990s by First Nations and Aboriginal people to name a minority gender identity long-established within First Nations and Aboriginal cultures, having affinities to, and differences from, non-indigenous sexual minority identities (Deschamps, 1998). The term indicates “a Native person who feels their body simultaneously manifests both a masculine and a feminine spirit, or a different balance of masculine and feminine characteristics than usually seen in masculine men and feminine women” (O’Brien-Teengs & Monette, 2015).
First Nations and Aboriginal sexual minorities experience additional sources of stress that include sexuality-based prejudice, discrimination, and homonegativity, as well as HIV-related stigma – the latter because of presumed association of sexual minority males and HIV infection. In consultations and interviews with gay and bisexual men in BC conducted by HIM in 2011, Aboriginal men were among many ethnocultural minorities who reported feeling race-based exclusion from predominately Caucasian gay communities (Anderson, 2011).
The unique stress in indigenous lives puts First Nations and Aboriginal men at higher risk of less or lost balance in life, mental wellness that is not at its best. The added sources of stress for sexual minority First Nations and Aboriginal men puts them at even higher risk. That contributes to others’ negative outcomes beyond less mental wellness.
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Broader application of the indigenous holistic health model for supporting the health of First Nations and Aboriginal people in BC has led to decreasing mortality rates due to suicide and decreasing gap between these rates and the rate of other non-indigenous British Columbians (BC PHO, 2009).
If you are a First Nations or Aboriginal gay, bi, or Two-Spirit man experiencing less life balance, then recognize the role that particular mental health conditions play in your effectiveness in restoring balance in your life. For example, with an anxiety disorder you could feel convinced and justified that avoidance of social situations (due to excessive or unwarranted fear) is the right thing to do even though such continued behaviour would interfere with your bringing the social quadrant of your health into balance with the mental, physical, and spiritual. If you know or suspect your life to be out of balance, and that your mental wellness might be casualty of that, then see your doctor about it. Your doctor should be culturally aware and respectful of what it means for you to be a First Nations or Aboriginal gay, bi, or Two-Spirit man.
If you are a gay or bi Caucasian, Asian, or East Indian man (these are being singled out here because they take various turns as being ethnic majorities in Vancouver in general and Vancouver’s gay communities in particular), then please consider always being prepared to objectively assess whether you are in any big or even little way contributing to someone else because of their ethnic minority status feeling in any way unwelcome or uninvited. Also, it doesn’t hurt to sometimes question how you know what you know about other cultures. If everybody at least considered these things now and then, then they would have at least this in common.
Self-esteem is one’s overall judgment of and attitude toward one’s own worth – how one feels about oneself. Having high self-esteem is a universal desire and plays a part in one’s effective functioning in the world (Tesser, 2004).
Although there may be plenty that’s good in our lives, sometimes (or often) there’s the not-so-good that comes from prejudice, discrimination, and stigma regarding our sexual identities. Those sources of marginalization affect how good we feel about ourselves. Research identifies various factors promoting gay men’s high or low self-esteem, and the negative health consequences of low self-esteem:
Typically, both young gay and young straight men experience increasing self-esteem during the transition from teen to young adult, although young gay men often have a lower level of self-esteem as their starting point compared to young straight men (Jenkins & Vazsonyi, 2013).
Gay men who see themselves as out, proud, but also openly angry at society over heterosexuals’ oppression of gays tend to have lower self-esteem than peers not as angry over the same issues, possibly due to particular hurtful episodes of sexuality-related discrimination, betrayal, social rebuff, and ostracism (Bybee et al., 2009).
Mentally exploring and developing an understanding of one’s gay identity is associated with greater positive feelings (affirmation) about one’s gay identity, increased self-esteem and satisfaction in life, decreased symptoms of depression and anxiety, and greater sense of belonging to one’s social group – overall better psychological and social well-being (Ghavami et al., 2011).
Among gay and bi HIV-positive men, tendencies towards disclosure of their HIV status to their casual sex partners increased with self-esteem, although high or low self-esteem made no difference with respect to their condom use during anal receptive or anal insertive sex (Moskowitz & Seal, 2011).
In general, low self-esteem isn’t good for one’s mental, physical, social, and sexual health.
High self-esteem is usually, but not always, good for one’s mental, physical, social, and sexual health. But why not always? Because there needs to be a realistic and/or positive basis for high self-esteem:
Unreasonably inflated self-esteem puts you in the awkward position of having to live up to inflated expectations that others may then place on you.
Some attach their self-esteem to behaviours that are not always in one’s best health interests such as displaying aggression, reckless attitude toward alcohol and party drug use (Dubois, 2003), and muscle-enhancing steroid use (Duncan, 2010).
Meanwhile, research suggests that straight men’s sexual prejudice and other negative attitudes toward gay men serves a defensive function for those straight men against perceived threats to their self-esteem from the perspective of social norms around masculinity (Falomir-Pichastor & Mugny, 2009). That’s a case of some straight men’s high self-esteem being bad for gay men’s mental, physical, social, and sexual health.
When self-esteem is high yet uninflated and reflects a reasonable assessment of oneself, it provides motivation to continue with behaviours and attitudes that have contributed to one’s feeling good about oneself, as well as promotes effective coping and resilience against stress (Mann et al., 2004).
Bybee JA, Sullivan EL, Zielonka E, & Moes E. (2009). Are gay men in worse mental health than heterosexual men? The role of age, shame and guilt, and coming-out. Journal of Adult Development, 16(3), 144-154. doi:10.1007/s10804-009-9059-x
Dubois DL. (2003). Self-esteem, adolescence. In Gullotta TP & Bloom M (Eds.) and Gullotta TP & Adams G (Section Eds.), Encyclopedia of primary prevention and health promotion (pp. 953-961). New York: Kluwer Academic/Plenum.
Duncan D. (2010). Embodying the gay self: Body image, reflexivity and embodied identity. Health Sociology Review, 19(4), 437–450.
Falomir-Pichastor JM & Mugny G. (2009). “I’m not gay … I’m a real man!”: Heterosexual men’s gender self-esteem and sexual prejudice. Personality and Social Psychology Bulletin, 35(9), 1233-1243. doi:10.1177/0146167209338072
Ghavami N, Fingerhut A, Peplau LA, Grant SK, & Wittig MA. (2011). Testing a model of minority identity achievement, identity affirmation, and psychological well-being among ethnic minority and sexual minority individuals. Cultural Diversity & Ethnic Minority Psychology, 17(1), 79-88. doi:10.1037/a0022532
Jenkins DD & Vazsonyi AT. (2013). Psychosocial adjustment during the transition from adolescence to young adulthood: developmental evidence from sexual minority and heterosexual youth. Journal of Positive Psychology, 8(3), 181-195. doi:10.1080/17439760.2013.777764
Mann M, Hosman CMH, Schaalma HP, & de Vries N. (2004). Self-esteem in a broad-spectrum approach for mental health promotion. Health Education Research, 19, 357-372.
Moskowitz DA & Seal DW. (2011). Self-esteem in HIV-positive and HIV-negative gay and bisexual men: implications for risk-taking behaviors with casual sex partners. AIDS and Behavior, 15(3), 621-625. doi:10.1007/s10461-010-9692-1
Tesser A. (2004). Self-esteem. In Brewer MB & Hewstone M (Eds.), Emotion and motivation (pp. 184-203), Malden, MA: Blackwell Publishing.
Is your self-esteem low, unrealistically high, and/or attached to behaviours that are not in your best health interests? Ask yourself some questions about what makes you feel good about yourself. Don’t be hard on yourself when you ask, and recognize what makes you feel good about yourself isn’t necessarily the same for everybody else. Be objective and analytical when you consider if things attached to your self-esteem have negative consequences or side-effects despite the positive of making you feel good about yourself. Consider as well whether or not you are anxious or depressed. If any of these are concerns for you, consider talking to your doctor about it who can refer to another professional best equipped to help.
Whether or not you know if others are experiencing low self-esteem, please consider being supportive in acknowledging others’ efforts and accomplishments. Constructiveness, kindness, and proper proportion in our appraisals of others helps them judge their worth and serves as counterbalance to anti-gay attitudes and prejudice that try convince us that we aren’t worth much.
Social support is the protective factors that cushion our lives from the physical and psychological consequences of being exposed to stressful situations (Cassel, 1976). Those protective factors include:
Our receiving and perceiving satisfactory social support plays a key role in promoting significant good health outcomes for gay men across the lifecourse:
People belonging to sexual minority groups tend to increase their emotional investment in close friends to compensate for low levels of family support (Baiocco et al. 2012). Friends have great potential in providing a broad range of practical, emotional, informational, and companionship support because we choose them consciously (or not) on the basis of criteria that include their being:
Research suggests that diversity in those friendships is more potent in promoting positive health outcomes for gay men:
Baiocco R, Santamaria F, Lonigro A, Ioverno S, Baumgartner E, & Laghi F. (2014). Beyond similarities: cross-gender and cross-orientation best friendship in a sample of sexual minority and heterosexual young adults. Sex Roles, 70(3-4), 110-121. doi:10.1007/s11199-014-0343-2
Burns MN, Kamen C, Lehman KA, & Beach SRH. (2012). Attributions for discriminatory events and satisfaction with social support in gay men. Archives of Sexual Behavior, 41(3), 659-671. doi:10.1007/s10508-011-9822-5
Cassel J. (1976). The contribution of the social environment to host resistance. American Journal of Epidemiology, 104, 107-123.
de Vries B. (1996). The understanding of friendship: an adult life course perspective. In Margai C & McFadden S (Eds.), Handbook of Emotion, Adult Development, and Aging (pp. 249-268). San Diego, CA: Academic Press.
de Vries B & Megathlin D. (2009). The meaning of friendship for gay men and lesbians in the second half of life. Journal of GLBT Family Studies, 5, 82–98.
Hansen NB, Harrison B, Fambro S, Bodnar S, Heckman TG, & Sikkema KJ. (2013). The structure of coping among older adults living with HIV/AIDS and depressive symptoms. Journal of Health Psychology, 18(2), 198-211. doi:10.1177/1359105312440299
Hatzenbuehler ML, Keyes KM, & Hasin DS. (2009). State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations. American Journal of Public Health, 99(12), 2275–2281.
Lyons A. (2016). Social support and the mental health of older gay men: findings from a national community-based survey. Research on Aging, 38(2), 234–253.
Be mindful of opportunities for providing social support to others – there are even psychological and social benefits for you in extending help, kindness, and support to others. Although friendships are major sources of support for you, keep in mind they are not the only source: there’s also health professionals such as doctors and counsellors, educators, classmates, acquaintances, neighbours, co-workers, gay men’s health organizations such as HIM, and even the beloved family pet. Regarding friendships, they are the equally the product of conscious and/or subconscious choices based on various important friendship criteria, as well as your tapping into or stumbling upon opportunities that bring you into social contact with others. If you feel yourself withdrawing or withdrawn from social interaction, do your best to assess why and consider talking with your doctor if you have any socialization and social support-related concerns.
“Coming out” or “coming out of the closet” is the act of gay men disclosing their own sexual identity to others. It is a milestone in many gay men’s lives because it paves the way for them to realign their relationships and lives more in sync with who they truly are. Coming out can seem daunting because it makes you a possible direct target for anti-gay stigma, discrimination, prejudice, and violence. Coming out nonetheless can be exhilarating because it gives you new possibilities for living more at one with oneself, new opportunities for meeting others with similar interests and experiences, and new opportunities for receiving and providing support relevant to your identity as a gay man. Being out is not a one-time thing but, rather, an ongoing process, constantly navigating when and how to reveal your sexual identity to others (Knoble & Linville, 2012).
Research shows that gay men’s mental health faces different challenges before, during, and after coming out. Gay men typically are at highest risk for experiencing generalized anxiety disorder (i.e., persistent, excessive, and unrealistic worry about everyday things) when they come out and for several years thereafter (Pachankis et al., 2015). When gay men have recently come out, they are especially sensitive to noticing anti-gay discrimination. This compels them to be vigilant watching for and avoiding that discrimination (Pachankis et al., 2008). The stressfulness of this vigilance can promote anxiety. After gay men have been out for several years, their risk for experiencing generalized anxiety disorder drops. This happens after several years of being out because generally that’s how long it can take to fine-tune the integration of sexual identity into overall identity; explore and develop relationship to the gay community; and commit to being a part of the gay community (Solomon et al., 2015).
When to come out depends on beliefs, attitudes, balance of pros and cons, and other factors:
Bogaert AF & Hafer CL. (2009). Predicting the timing of coming out in gay and bisexual men from world beliefs, physical attractiveness, and childhood gender identity/role. Journal of Applied Social Psychology, 39(8), 1991-2019. doi:10.1111/j.1559-1816.2009.00513.x
Breshears D & Beer CL. (2014). A qualitative analysis of adult children’s advice for parents coming out to their children. Professional Psychology: Research and Practice, 45(4), 231–238. doi:10.1037/a0035520
Bybee JA, Sullivan EL, Zielonka E, & Moes E. (2009). Are gay men in worse mental health than heterosexual men? The role of age, shame and guilt, and coming-out. Journal of Adult Development, 16(3), 144-154. doi:10.1007/s10804-009-9059-x
Durso LE & Meyer IH. (2013). Patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbians, gay men, and bisexuals. Sexuality Research and Social Policy, 10(1), 35-42. doi:10.1007/s13178-012-0105-2
Orne J. (2011). ‘You will always have to “out” yourself’: reconsidering coming out through strategic outness. Sexualities, 14(6), 681-703. doi:10.1177/1363460711420462
Pachankis JE, Goldfried MR, & Ramrattan ME. (2008). Extension of the rejection sensitivity construct to the interpersonal functioning of gay men. Journal of Consulting and Clinical Psychology, 76(2), 306–317. doi:10.1037/0022-006X.76.2.306
Pachankis JE, Cochran SD, & Mays VM. (2015). The mental health of sexual minority adults in and out of the closet: a population-based study. Journal of Consulting and Clinical Psychology, 83(5), 890-901. doi:10.1037/ccp0000047
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Solomon D, McAbee J, Asberg K, & McGee A. (2015). Coming out and the potential for growth in sexual minorities: the role of social reactions and internalized homonegativity. Journal of Homosexuality, 62(11), 1512-1538. doi:10.1080/00918369.2015.1073032
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White D & Stephenson R. (2014). Identity formation, outness, and sexual risk among gay and bisexual men. American Journal of Men’s Health, 8(2), 98-109. doi:10.1177/1557988313489133
Whitehead J, Shaver J, & Stephenson R. (2016). Outness, stigma, and primary health care utilization among rural LGBT populations. PLOS One, 11(1). doi:10.1371/journal.pone.0146139
You come out when it’s right for you. To whom, when, where, how, and why you come out are based in part on how you assess the pros and the cons of coming out. Consider whether you can turn to particular friends to talk things through, or community organizations that provide support for big moments such as this. If you’re already out and know first-hand the good and any bad that comes with it, consider keeping an eye for others for whom it’s now their turn and for whom you can offer any form of support.
The population of planet Earth is roughly 7.4 billion. So many people, but so effortless how we sort them all into groups of us and them. We have a sense of belonging with some, while we feel psychologically distant from others. This sorting of people into groups toward which we have different attitudes is part of how we make sense of ourselves and the world. Sometimes we sort people according to ‘the deep and real’ such as interests, values, beliefs, behaviours, and cultural practices. Other times we sort people according to superficial things such as the skin colour, eye shape, and face shape we use to distinguish race.
We are susceptible to favouritism toward those we group the same as ourselves. Likewise, we are susceptible to feeling self-conscious, cautious, inhibited, alienated, insecure, uncomfortable, threatened by, and even hostile toward those we group as different from ourselves. We have racism when race forms the basis of whether we feel people are same or different from ourselves, and determines that we treat those of different race less favourably and even with hostility. To say we’re susceptible to thinking and behaving in these ways doesn’t mean racism is inevitable. It just means we need to be careful not to slip into that kind of hurtful thinking and behaviour (Clair & Denis, 2015; Pettigrew & Taylor, 2015).
Anti-gay stigma and prejudice put gay men at greater risk than straight men for experiencing mental health problems. That risk is amplified for gay men who experience racism:
The increased risk to gay men’s mental health due to racism plays a part in negative sexual and physical health outcomes of those gay men:
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What to do if you experience racism? You might not always notice it, but you associate yourself with more than one identity group at the same time, including identities of race, sexuality, gender, socioeconomic class, political stripe, nationality, and so on. Your experience of discrimination against any of those identities can dent your self-esteem. Research suggests that when faced with others’ discrimination against one of your identities (say, your race-related identity), you might be able to protect your self-esteem by turning to another of your positively valued identities (say, your sexuality-related identity). This includes not just reminding yourself of other aspects of yourself that you unshakably value, but also considering strategies of resilience against prejudice and discrimination that have proven effective in other arenas of your life. Such strategies include confronting prejudice and discrimination, creating safe spaces, creating support networks, actively cultivating self-acceptance and self-compassion, and accessing spiritual support (Velez et al., 2015; Meyer et at., 2009)
What if you want to avoid or undo racism? Racism is in part born out of discomfort around the unknown such as others’ racial/ethnic cultures. For that reason, friendships offer an antidote. Recent research confirms that friendships can feel equally comfortable within the same and across different races. Friendship across race, because they remove the unknown, can chip away at or avert inter-group racism one pair of friends at a time (Cook et al., 2012).
Suicide is the act of intentionally causing one’s own death. Suicide is not a mental health problem in itself, but can be the outcome of mental health problems such as prolonged depression and anxiety. When a person contemplates, plans, or attempts suicide, often it is in response to an emotional state the person finds painful, unbearable, and endless; obstacles the person feels are overwhelming; or the future the person sees as being relentlessly bleak (DSM-5, 2016). Sometimes gay men can feel overwhelmed by current circumstances and disheartened about their future in response to the anti-gay prejudice, discrimination, stigma, and aggression so prevalent still into the 21st century.
Gay men’s lifetime risk for suicide attempts is roughly 2.5 times greater than that of straight men (King et al., 2008). Out of 8382 Canadian gay and bi men surveyed in 2011:
Gay men most frequently mention sexuality-related problems concerning self-acceptance and acceptance by family and others (Wang et al., 2015), internalized homophobia (McLaren, 2016), and loneliness (Mayock et al., 2009) as their motivations for attempting suicide.
Canadian gay and bi men surveyed in 2011 had roughly 7 times the odds of contemplating and/or planning suicide and 16 times the odds of attempting suicide if their history over the past year has three or more of the following (vs. none of the following): depression, anxiety, frequent smoking, use of one or more party drugs, one or more sexually transmitted infections, and one or more episodes of condomless anal insertive or receptive intercourse with a partner whose HIV status was either unknown or not the same as one’s own (Ferlatte et al., 2015).
As well, Canadian gay or bi men who experienced three or more forms of marginalization in response their sexual orientation (i.e., verbal violence, physical violence, bullying, sexual violence, and work discrimination) had 2 times the rate of contemplating and/or planning suicide compared to those who experienced no forms of such marginalization (roughly 26 % vs. 13 %), and over 4 times the rate of attempted suicide (roughly 4 % vs. 1 %) (Ferlatte et al., 2015).
DSM-5, Major Depressive Disorder: Diagnostic Features, A9.
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McLaren S. (2016). The interrelations between internalized homophobia, depressive symptoms, and suicidal ideation among Australian gay men, lesbians, and bisexual women. Journal of Homosexuality, 63(2), 156-168. doi:10.1080/00918369.2015.1083779
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The following warning signs may be present in adults who have a high possibility for suicide:
Social support perceived as being poor has been repeatedly associated with depression, social anxiety, and suicidality among sexual minority persons (Hatzenbuehler et al., 2009). If you know someone who shows signs on contemplating, planning, or attempting suicide, then please consider the difference that you can make by reaching out and making up for at least a part of the person’s perceived deficit of support from others.