Mental Health

The majority of gay, bisexual, and other men who have sex with men (MSM) have and maintain good mental health, even though MSM are at greater risk for mental health problems. Like everyone else, the majority of MSM are highly resilient and able to cope successfully with many negative life stressors, such as those associated with homophobia and discrimination.

Homosexuality is not a mental disorder, but homophobia, stigma, and discrimination have negative effects on the health of MSM, lesbians, and other sexual minorities. The negative effects of social marginalization can be found in adolescent and adult MSM, for example, research has shown that MSM and other members of the LGBT community are at increased risk for a number of mental health problems.^[1] Research also has found that, compared to other men, MSM are at increased risk of:

• Major depression during adolescence and adulthood;
• Bipolar disorder; and
• Generalized anxiety disorder during adolescence and adulthood.

MSM are also at greater risk for other health threats that often occur in conjunction with mental health problems (i.e., co-morbidities). These include greater use of illegal drugs and a greater risk for suicide. For example, MSM are more likely than other men to have attempted suicide and to have successfully completed a suicide attempt. The HIV epidemic also has had a profound impact on the mental health of MSM. The disease affects those men that are living with HIV, loved ones of those living with, or have died from, HIV. ^[2]

Disclosing Sexual Orientation

Keeping one’s sexual orientation hidden from others (being "in the closet") and fear of having one’s sexual orientation disclosed (being “outed”) can add to the stress of being gay or bisexual. In general, research has shown that MSM who disclose their sexual orientation to others have better health outcomes than MSM who do not. However, disclosure in some settings and to individuals who react negatively can add to the stress experienced by MSM, and can lead to more stress, poorer mental health, and discrimination.

Keys to Maintaining Good Mental Health

Having a supportive group of friends and family members is often key to successfully dealing with the stressors of day-to-day life and maintaining good mental health. MSM who are unable to get social support from their friends and families can find it by becoming involved in community, social, athletic, religious, and other groups. Mental health counseling and support groups that are sensitive to the needs of MSM can be especially useful to those who are coming to terms with their sexual orientation or experiencing depression, anxiety, or other mental health problems.

While many gay and bisexual men may not seek care from their mental health provider because of a fear from discrimination or homophobia, it is important to seek help and try to find a provider that you can trust.

1. Cochran, S.D. & Mays, V.M. (2008). Prevalence of primary mental health morbidity and suicide symptoms among gay and bisexual men. In Wolitski, R.J., Stall, R., & Valdiserri, R.O., Unequal opportunity: Health disparities affecting gay and bisexual men in the United States. New York: Oxford University Press.
2. Hayes, R.B., Turner, H., Coates, T.J. (1992). Social support, AIDS-related symptoms, and depresssion among gay men. J Consult Clin Psychol. 60(3): 463-469.