NOTE FROM DR. STANGER: I am proud of my young editor, Roger Porter. This article is designed for him & by him. I join him in celebrating Pride Month. And a most hearty kudos for Roger who may be found in the writers room at the NBC TV show Superstore. America Ferrera – you are blessed to have him. –With love, Dr. Louise Stanger

A Shift in Cultural Views

It’s as if it happened over night.

When I was in high school growing up in a one stoplight town in central Texas, there wasn’t a single out gay boy amongst us. There were no t-shirts worn that said EQUALITY in bold rainbow-colored letters. Students had not formed queer alliances that met in the cafeteria on Friday mornings around cold donuts and orange juice to talk about their experiences of being queer.

In the years since I left high school, graduated college in Austin and moved to Los Angeles, the nation has witnessed a shift in their cultural views of gay people. I think a major pivot point came around 2010. News stories of teenage suicide from bullying cropped up in places like Indiana, Texas and New Mexico. Many of them were queer. Ellen Degeneres famously spoke out about this issue being one of grave importance to the American people.

People listened!

Obama Spoke Up for Gay Marriage

I remember vividly when Obama came out in support of gay marriage. I was sitting in my car on my lunch break at work, listening to NPR parked on a rooftop garage in Century City. Obama told Robin Roberts gay and lesbian Americans must be treated “fairly” and “equally,” which sent me into a tizzy of tears that I’ll never forget. He was on our side – the first president to champion our lives.

Since then, marriage became legal, trans representation is on the rise, and despite the cultural shifts that came with the new administration, nobody really cares anymore if you tell someone you’re a homo. Our collective cultural footprint has been cemented.

So, Why Are We Still Hurting Ourselves?

Despite the cultural and political changes that have taken place at lightning speed in our favor, there’s another narrative being told through the lives of many gay men in places all around the world. “Gay men everywhere, at every age, have higher rates of cardiovascular disease, cancer, incontinence, erectile dysfunction, allergies and asthma,” explains Travis Salway, a researcher with the British Columbia Center for Disease Control in Vancouver, Canada. “You name it, we got it.”

In addition to these health issues, LGBT men and women are at increased risk of substance abuse disorders. If you go to just about any party, dance club, rave or bar where gay men gather to socialize, you’ll encounter a litany of drugs and free-flowing alcohol. “Sunday Funday” isn’t just for beer, bros and football – gay men brunch with their friends and consume copious amounts of alcohol throughout the day.

In fact, the National Institute on Drug Abuse found in a 2015 survey that LGBT individuals were twice as likely as heterosexual adults to have used any illicit drug in the past year, nearly a third used marijuana (compared to 12.9 percent for heterosexuals), and 1 in 10 misused prescription pain relievers (4.5 percent for heterosexuals).

The Struggle with Identity

I remember when I was in college, struggling with my sexuality and not yet out of the closet. I thought, “If I just come out, all my problems will be solved.” The closet can be lonely and isolating and beyond its trappings was freedom. Once I was out, I would live the best version of my life. No secrets. No hiding.

And yet, in the years since I proclaimed my independence, the liberating feeling I once felt in my twenties has faded. I admit to struggling with many issues common amongst gay men like loneliness, depression, and substance abuse and alcohol. In recent years, I’ve wondered – if life is so great outside the closet, why am I not happy?

The easy explanation for these issues is the stain of homophobia, cultural indifference, and early childhood emotional trauma. However, these reasons aren’t the only culprits. In fact, Salway, a Canadian researcher, reported that more gay men are dying from suicide than from AIDS, and had been for years, in his native country.

Hyperawareness and Negative Validation

So what explains the tendency toward process disorders, sex, drugs and alcohol, addiction, suicide and other mental health trauma? Alan Downs, a clinical psychologist who wrote The Velvet Rage, explores the psychological terrain of a gay man in the twenty-first century in an attempt to provide an answer.

In his book, Downs culls years of research with gay clients, finding that the tormented young gay man grows up to be hyper aware of himself and his place in the world. Years of overcompensating, attempting to fit in and assimilate to straight culture trains gay men to learn negative ways of seeking out what he terms as ‘authentic validation.’

We begin to think, “If I accumulate this,” or ,“just achieve this status,”… then I’ll find fulfillment.

The Path to Self-Acceptance Is Difficult

It’s true – I remember when I was in school struggling with the SECRET about my sexuality. I thought if I was the best student, made straight A’s and was the class favorite, I’d prove to my parents, friends and community that I was enough. I put on a cloak of perfection so that no one would ever discover my secret. In doing so, I learned to overcompensate to receive the love and approval from my parents that I so desperately wanted.

Then in college all become problematic. I had my first same-sex sexual experience and immediately after felt shame and regret. I rushed back to the dorm, stomach in knots, vomited in the toilet and got in the shower in a futile attempt to wash away the gay. I never spoke to that person again.

It took me several years to summon the courage to even look at a boy in a romantic way after that experience. I started my first gay relationship when I was twenty-four, and we didn’t have sex the first two months we were together. This wasn’t because I didn’t want to, but because I thought if we did I would feel the rush of shame that I did in college and relive that past trauma.

All this compounded by the pressing weight of shame. The shame narrative tells the struggling gay man that he’s not natural, not right in the eyes of a heterosexual society. This narrative plays on loop, driving self-destructive behaviors.

We Can Internalize and Harm Ourselves

I think back on these kinds of experiences that shaped my upbringing and realize it’s no wonder dating and relationships in the gay community is hard. The rise of dating and hookup apps in the digital age brings its own set of challenges. Anonymity on these apps feeds the catty beast, in which gay men may act in racist, bigoted and homophobic ways toward their own kind.

I’ve come to realize, through my own experiences and interactions with gay friends both home and abroad, that these kinds of gay men do so out of their own hatred directed at themselves, and internalized homophobia seeded at an early age. Much the same way I wanted to scrub myself clean of this supposed gay affliction, many gay men put up walls of denial to cope with coming to terms with their identity.

How the Addictions Manifest

Dating and sex in the gay community has also fanned the flames of substance abuse, including “party drugs” such as methamphetamine. The drug is used for its euphoric properties to engage in prolonged sexual experiences, including risky behaviors like unprotected and group sex. It’s highly addictive and these kinds of behaviors are common in urban neighborhoods where gay men live. Though sex is a healthy and an essential part of living, researchers suspect that this kind of behavior facilitated the spread of HIV, according to the Los Angeles LGBT Center.

Although there is not a proven direct link between meth use and HIV, the Los Angeles LGBT Center, a health and resource center for the gay community, reports data collected from their patients that gay men who had used meth within the previous 12 months were five times more likely to test positive for HIV than those who did not use meth. Moreover, meth is so pervasive that 71% of gay and bisexual men who were surveyed said they have been asked to try crystal meth.

And with the ubiquity of social media and smartphones, meth has found a new conduit for distribution. Gay men have been reported using hook-up apps (i.e. Grindr, Scruff, Hornet) to sell and purchase “Tina,” the slang word used for meth. The spread of meth through hook-up apps has seen an increase of users in prominent gay neighborhoods like West Hollywood in Los Angeles and other metropolitan areas around the United States.

As such, meth’s psychological addictive qualities and negative physiological effects on the body (i.e. dry mouth, tooth decay, gum disease) can devastate whole communities like these. The issue reached a boiling point when the mayor of West Hollywood, city manager and three city council members contacted the founder and CEO of hook-up app Grindr about it facilitating the illegal sales of meth and requesting the company look at its policies and procedures, according to an article in WeHoVille in October 2016.

Celebrating Being Gay

If these kinds of issues are built into the gay man’s experience, how do we find a way forward, where happy and healthy gay men live productive lives just like their straight counterparts?

Downs argues that it starts with learning and embracing “authentic validation,” a term he coined to mean that love and belonging comes from within ourselves when we embrace who we are.

Drugs, multiple sexual partners, fabulous houses and cars, extravagant vacations and parties may provide fun and needed distraction, but authenticity is absent from their DNA.

The authentic gay person – much like anyone who was born into a shame-based family – must learn that rejection, disappointment and invalidation are natural parts of the human experience. I remember in my early days of dating, every time I didn’t get a text back or was ignored or blocked on social media from a guy, I turned it on myself and said it was my fault. This confabulation in my head fed my perfectionist beast – the behavior I learned in high school to overcompensate and prove to my family and friends I was good enough for them – opening the door to destructive behaviors like process disorders and depression.

In time, through meditation, counseling, writing in my journal and funneling my angst into fun activities, I began to embrace disappointment, rejection and invalidation in my dating life. When the date went bad, I simply laid it to rest and moved on. I wasn’t to blame. The same goes for relationships with family, friends, careers and all the intricacies of life. This was something I had to learn for myself and practice with each step forward.

Maybe life outside the closet isn’t so bad. In the same manner a person who comes out of recovery must reorient their life toward sobriety and fulfillment beyond drugs and alcohol, gay men are challenged to learn new ways of living. Our past is behind us and the future is bright.

Are You Struggling?

For those struggling with substance abuse, mental health and process disorders, my co-writer, Dr. Louise Stanger, is a highly trained clinician and interventionist who has years of experience working with individuals and their families who deal with these issues. Moreover, she has experience working with folks who grew up wounded in shame-based homes and need the tools and instruction to build a better life.

In addition to great resources like Dr. Stanger, there are wonderful treatment centers in my home town of Los Angeles like La Fuente Treatment Center in Hollywood. La Fuente uniquely tailors its treatment programs to LGBT men and women and their friendly professional staff create a home for our vibrant community. Everyone is welcome at La Fuente.

Additionally, the LGBT Center in Hollywood and West Hollywood provide services (health, social services and housing, culture and education, leadership and advocacy) for more LGBT people than any other organization in the world. Some of their services are free or at reduced cost to help underprivileged men and women in our community.

You Are Never Alone

Because of the cultural advances my community has enjoyed in the last ten years, real help is available to LGBT men and women of all colors and ages, native and foreign. We must bring down our walls, stop the infighting, and embrace our place in the larger American tapestry as essential, vital and a part of history.

This pride month, wave your rainbow flag of truth, march with friends, donate to LGBT causes, and let your light shine. I’ll be joining my brothers and sisters in the West Hollywood Pride Parade, marching with the knowledge that I’m living my authentic life.

By Roger Porter

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