A mental health overview

Gay male mental health, like most of our well being, is under researched, reported, studied and treated. Our general history and culture have not added much in the way of positive acceptance for those who live daily along the spectrum of mental and emotional health concerns.

Neel Burton, MD discussed the long hard road from homosexuality being classified as a mental disorder to something, a bit less. “First published in 1968, DSM-II (the American classification of mental disorders) listed homosexuality as a mental disorder. In this, the DSM followed in a long tradition in medicine and psychiatry, which in the 19th century appropriated homosexuality from the Church and, in an élan of enlightenment, transformed it from sin to mental disorder.”

“In 1973, the American Psychiatric Association (APA) asked all members attending its convention to vote on whether they believed homosexuality to be a mental disorder. 5,854 psychiatrists voted to remove homosexuality from the DSM, and 3,810 to retain it.”

“The APA then compromised, removing homosexuality from the DSM but replacing it, in effect, with “sexual orientation disturbance” for people “in conflict with” their sexual orientation. Not until 1987 did homosexuality completely fall out of the DSM.”

This effectively means that it has only been within the last 30 years that we have been recognized mentally and emotionally healthy as gay males. But, this didn’t easily open the door to treatment for actual mental and emotional health concerns that we may possess, with or without our homosexuality and the subsequent homophobia which naturally follows.

Throughout this piece we seek only to give a brief overview of the types of health concerns most common to gay males and provide a bit of information on each one before you move on to individual pieces about each topic.

Mental and emotional health issues and concerns come packaged in two (2) forms.

  1. Situational: These are stressors that can affect anyone but some individuals or members of particular sub-groups (i.e. gays) are more likely to be affected and become inhibited, experience trauma or uncomfortable when faced with them. This also includes situations that are specifically unique to that group, that others do not face, such as homophobia and/or racism. Situational mental and emotional health concerns should not be over looked as, over time, they can lead to more dangerous forms of mental illness.
  2. Biological: In simple terms, these are traits we are born with. Outside and external triggers may affect us more than others, but either way, the internal coding is hard wired inside of us. Examples would be anxiety and bipolar syndromes.

Note: It is very common for guys to have BOTH, as one may activate or increase the other.

Below are some of the most common forms of situational stressors that can trigger mental and emotional health concerns for gay males. This, of course, is not a complete list, and you may have experienced situations that we have not listed. Throughout the GMJ website we will address these health concerns within the news section under “Mental Health” and/or “Wellness”.

  • Internalized Homophobia
  • Body Image and Femininity Issues
  • Conflicting Pressures to Be Masculine or Feminine
  • Overworking to Prove Themselves to Heterosexuals and the World
  • Coming Out for the First Time (And the Other Times)
  • Social Isolation and Anxiety
  • Discrimination
  • Hate Crimes Targeted at Gays
  • Bullying from Peers and Family Members
  • Families Don’t Understand or Accept You
  • Less Expectation for Gay Men to Raise a Family and Structure Their Lives as Heterosexuals Do
  • Dating Difficulties, the Club Scene and the Risk of Dangerous Drugs
  • Sexual Health Anxiety and HIV

When speaking of biological causes for mental and emotional health issues, this will include genetics but also infections, brain injuries and trauma, as well as substance abuse and toxic chemicals which all can change the brain’s make-up. Mental and emotional health has been considered a luxury for First World Nations and a very modern concern. A few generations ago, people did not publicly seek out therapists and psychiatrist for fear of stigma and shame. It was only when dealing with the most extreme cases, include those who became violent, did many families take action. Far too many guys ended up in mental hospitals that were not equipped to handle the types of illnesses they were facing. We all know the stories about electro shock therapy and isolation chambers.

Luckily, now is not then. At this point in time, in most major cities, it is so common for guys to seek a therapist that New York City has had a shortage for years. Also, to handle the large load of patients, hotlines and websites have been set up to address issues such as suicide, depression and even loneliness.

Because these are more major issues, which require more time to explain and provide answers, biological mental and emotional health concerns will be addressed here, inside of the Library. Below is a list of the major topics we will explore over time. We expect this list to grow and change as more information, specifically related to gay males, becomes available.

Anxiety

Bipolar

Depression

Eating disorders

Obsessive-compulsive disorder

Schizophrenia

One thing we wish to stress is that guys live very normal and healthy lives with all of these illnesses, with managed treatment and therapy as needed. They are able to hold down jobs, go to college and even have long lasting, fulfilled loving relationships. We are not saying that any of this is easy for the individual or his loved ones, but with help and a strong social support network, we can do it!

Finally, there are the dual issues of fear and stigma. It can be very scary to find out, around the age of 18-24 (the common age range for guys to learn they have a mental health issue) that you will not be “normal”, that your brain and emotions don’t seem to work the way that everyone else’s do. Outside of just being gay, now you are another type of different. It can also be very scary to find out that the very cute, handsome and funny guy that you love has an anxiety disorder or something more complex. But, as far as medical advances go, we have come a long way and the treatment options for all of the above are very good.

What we cannot do, as individuals, or a community, is let fear or stigma block access to our personal care or those we care about. Mental health is no laughing matter. It is time that we take it as seriously as we would any physical ailment we, or others, may have. Jokes and smart-ass remarks only add to the stress and pain guys feel everyday and when so many in our community are battling hard against depression and suicidal thoughts, everyone needs as much support as we can give.

Stoping stigma around mental health will go a long way in helping many of our brothers heal. Not everyone is as strong as you, and they don’t have to be. Be a brother, be a friend, be a comfort. But don’t be another one of the issues he has to manage, along with his illness.