quality LGBTQIA Mental Health

Dying for Someone to Talk to

Mature men who question their sexual orientation feel that if they come out as gay, they will sacrifice everything they once valued.

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The majority of gay and bisexual men maintain good mental health.

But compared to other mature men, gay, bisexual, and questioning men are at a higher risk for mental health problems and suicide.

Through the many years I’ve practiced psychiatry and written about it, I’ve heard about the pain many older men in heterosexual marriages experience.

If they come out as gay, they will sacrifice everything.

Deciding to Come Out

Mature men who question their sexual orientation often feel that if they come out as gay, they will sacrifice everything they once valued. They endure a form of preparatory grief when they face a choice between remaining married or coming out as gay.

In considering coming out, these conflicted men magnify the negatives and minimize the positives.

One study found that the age of serious suicide attempts by gay and bisexual men coincided with major coming out milestones.

One group of researchers found that 12% of urban gay and bisexual men have attempted suicide, a rate three times higher than the overall rate for American men. Almost half reported multiple attempts.

Young people have been the focus of most research on suicide, especially with an increased awareness of the impact of bullying. Very little research has explored gay, middle-aged men and suicide.

One common theme underlies almost all successful suicides: a sense of hopelessness.

Coming Out and Suicide

Many people contemplate suicide when they first begin to have serious questions about their sexual orientation. For some, they can think of no other way to resolve the conflict.

Whether you’re young or old, one common theme underlies almost all successful suicides: a sense of hopelessness.

Men who consider coming out, feel they have no one with whom they can speak about it.

Predicament Suicide

A predicament is a situation in which only a bad choice and a worse choice exist.

One psychiatrist has described what he calls predicament suicide, where, in the absence of a diagnosable mental condition, a person faces circumstances from which he or she cannot find an acceptable escape.

A severe financial loss could produce such a predicament. A marriage forced upon someone who resists matrimony provides another example. Considering a decision to come out also often represents such a predicament.

Most mature men who consider coming out, feel they have no one with whom they can speak about it.

For some, this does not represent depression but, perhaps, rational choice.

Factors leading to mental health problems for older gay men

Several things account for the more common mental health issues for older gay men:

  • Homophobia, stigma, and discrimination
  • Social isolation
  • Lack of trust in healthcare providers
  • Lower-income
  • Alcoholism and illegal drug use
  • HIV

Dr. Whitney Carlson, a Seattle based geriatric psychiatrist, said this:

Some individuals decide this is as far as they want the road to take them. Many of them are entirely rational and accurate in their assessment of their situations.

If they are lucky, they will cross paths with someone who can offer hope. For some, this does not represent depression but, perhaps, rational choice.

A consistent correlation exists between race and socioeconomic factors. Those from a racial minority or living in poverty have poorer outcomes and higher risks of successful suicide.

Loneliness comes from trying to be someone you’re not.

Necessary Social Changes

Many of the challenges that lead to gay, bisexual, and questioning men to consider suicide are not immutable. As more and more people have come out in recent years, social attitudes toward homosexuality have changed, albeit with significant backlash.

Since they have been outside the LGBTQ community, older men considering coming out are often less aware of social changes leading to greater acceptance of LGBTQ people.

A 2017 study found that strict , including depression, anxiety, substance abuse, and poor body image.

The three characteristics most closely associated with poor outcomes were self-reliance, power over women, and sexual promiscuity.

Gender militia patrol continuously. These look for boys who transgress the norms for masculinity. They teach boys to be self-reliant and consistently remind them that Boys don’t cry, take it like a man.

Gay boys know the rules of manhood even better than straight boys.

Young boys’ constant self-observance for transgressions of the boy code, creates a sense of shame: I am bad; therefore, I don’t deserve help.

Loneliness comes from trying to be someone you’re not.

One of the essential social changes is to deconstruct the requirement for self-reliance and reconstruct a new sense of masculinity.

Not everyone has to come out all the way, all of the time, and in the same way.

Coming Out in Maturity

The Internet has allowed isolated men, such as those in rural areas or cultures with strong prohibitions against homosexuality, to have anonymous discussions with others of questions concerning sexuality. I frequently hear from these men.

But older men who question their sexuality — frequently in heterosexual marriages — feel that same sense of isolation. I hear from these men all the time.

Coming out is not an event but a process.

Not everyone has to come out all the way, all of the time, and in the same way.

Not everyone has to come out to every person in every circumstance. A supportive group of family and friends is essential. But when families are not accepting, some will need to develop a “family of choice.”

Reaching out to someone can offer hope.

Help is Available

Many older gay, bisexual, and men who have sex with men do not seek care from a mental health provider. They fear discrimination and homophobia.

For those struggling with conflicts about sexual orientation, reaching out to someone can offer hope. Most gay and bisexual men can cope with coming out successfully if they have access to the right resources.

Therapists who are knowledgeable and affirming provide helpful therapeutic experiences. It is essential to keep this as an option and to find a provider that is trustworthy and compatible.

You have a right to interview a prospective therapist about their attitudes and training before committing to therapy.

A good therapist will not impose their values on their clients.

For some, medications may help, mainly if there is significant insomnia or a failure to function in most areas of one’s life.

Counseling from therapists who focus on changing sexual orientation or encourage hiding it is unhelpful and often damaging.

People who seek counseling from religious advisors who considered homosexuality sinful have a higher risk of suicide than those who counsel with affirming religious groups.

“Conversion therapies” do not work and are potentially crippling.

The “It Gets Better” campaign provides an encouraging message of hope for young people faced with conflict about their identity.

But that message of hope, the hope that it gets better, must also be shared with older men who feel a sense of loneliness and despair.

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Written by

Gay father; Psychiatrist; Award-winning author FINALLY OUT. Chapter excerpt here: http://bit.ly/2EyhXTY Top writer on Medium. Not medical advice.

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