DH Focus: Mental Health of Gay and Bisexual Men

Mental health includes emotional, psychological and social well-being. It affects how people process their thoughts and feelings and how they act. The state of our mental health determines how we handle stress, relate to others, and make choices, so it is very important to give it meaningful attention at every stage of life.

While some may think that it is unusual to address and make distinctions about mental health based upon gender, the reality is that some symptoms and behaviors are more common and specific with males than with females. When it comes to men, especially gay and bisexual men, the subject of mental health is seen as particularly complex because it is influenced by major stigma and outdated values of traditional society. 

In spite of the fact that the majority of men who have sex with men (MSM) show high resilientness and the ability to successfully cope with life stressors, the stigma surrounding men’s mental health is what stops many from seeking help or advice when they are going through stressful times. The stigma can go so deep that it can even prevent a man from recognizing the state he might find himself, to ignore it or rush to quick and temporary solutions. The reasons for having negative prejudgments about mental health are various and they are usually very deep within the core of our “macho” environment, in which mental and emotional struggles of men are interpreted as something private and as a sign of weakness, which is a far more damaging perspective.

According to Mental Health America, one in five men experience mental health problems. When it comes to gay and bisexual men, the most frequent mental health problems are depression, anxiety and bipolar disorder. In fact, depression in gay men is three times higher than the general adult population. Suicides among men in the U.S. have been on the rise since the 2000s. Men in the gay community are at high risk for suicide considering that depression is a known risk factor for suicide.

The most common risk factors for gay men include acceptance of one’s sexual preferences, social isolation, loneliness and alienation from within the gay community, institutional discrimination, and the more general risks like unemployment, military-related traumas, genetic dispositions and different mood disorders. Studies show that substance abuse and substance dependence is also a very important risk factor with gay men. It is crucial to raise awareness that substance abuse is not only about using illegal substances but also that pain meds and alcohol can do harm if used in excessive ways or for purposes other than those for which they are meant to be used. 

Despite high numbers of depression and suicide rates among gay men, when it comes to health, the attention has usually focused on sexual health problems. In fact, gay men’s health was usually defined by sexual practices, while not taking into account the connection of physical and mental health of gay men with social factors, like ethnicity, education, socioeconomic status and many more. Also, gay and bisexual men often experience ongoing homophobia and discrimination with negative effects on their health, which is significantly enhanced if they belong to some other marginalized groups.

Many scientist believe that mental health is conditioned by a group of biological factors, which include the previously mentioned substance abuse, genetics, prenatal damage, infections, exposure to toxins, and brain injuries.  While female menopause is closely related to the end of a menstrual circle, which is one of the reasons why it is maybe easier to identify it or talk about it, it is important to know that men also go through their own menopause and gay men are no exception. The production of testosterone and other hormones decline as men age.

Typically, after age 30, most men experience a gradual decline in testosterone, which is why some develop depression, loss of sex drive, erectile dysfunction, and other physical and emotional symptoms, like mood swings, often anger, aggression and irritability, when they reach their late 40s and 50s. However, the question remains: how many men struggling with mental health challenges undergo a through medical exam to test their hormone levels (blood test),  prior counseling and psychological therapy? Of course, one does not exclude the other, but if we are to recognize the validity of biological factors affecting mental health, among others, shouldn’t it be implied?

Factors which affect mental health are, indeed, many – from the above mentioned biology and genetics, family history and childhood to some crucial social challenges like poverty, discrimination and violence, as they also have an impact on men’s well-being. If one is to dig into men’s mental health statistics, obviously it can paint a gloomy picture, especially considering that many cases go unreported and undiagnosed. But, it is important to know that help and support are available.

It is always good to share, to talk about feelings, but also to stay active as well with daily walks and weekly exercise. Eating well and drinking sensibly can also support good mental health but also keeping in touch with friends and family. If there is a noticeable change in mood, difference in work performance, weight changes, sadness, hopelessness or loss of pleasure with things which were once enjoyed, including physical symptoms, such as headaches and stomach issues – experts say it is time to ask for outside assistance.

That assistance might include psychotherapy, support groups, alternative medicine, medication (strictly prescribed treatments), etc. Making a self-care plan is an excellent way to support your own mental health. It is a unique plan where a person addresses his condition by implementing strategies that promote wellness, but also it may involve addressing recovery, triggers or warning signs. Self-care is an important factor of maintaining your mental health, and a crucial  part of it is resilience which we will address in one of our future articles addressing this subject.  

If you believe you are experiencing problems with your mental health, visit www.mhascreening.org to take a free, quick and confidential mental health screening test, after which you are provided with information, resources and tools to help you understand and improve your mental health. You can also visit LGBTQ+ : Lifeline (suicidepreventionlifeline.org). Whatever you do, please remember that that online screenings are just “a quick snapshot of your mental state’’ and are not a substitute for an actual assessment, the help and support you might be in need of. Given all that we experience on a day-to-day basis, it is important for us all regardless of our age to take this issue seriously and be aware of the warning signs.

Post Submitted by: M. Đaković