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Gay Men and Trauma: The Big and Little Ts

A man comforts a friend in a group, placing his hand on his shoulder

The mass shooting at Club Q in Colorado Springs last month was a traumatic event that sent shockwaves across the nation and around the world.

The impact especially reverberated throughout the LGBTQ community as the attack, which left five people dead, occurred at a popular gay nightclub that served as a sanctuary for the city’s LGBTQ population.

For many, the tragedy was a painful reminder of the repeated traumas that queer people often endure and carry with them throughout their lives — from being bullied to being rejected to living a life of secrecy.

Though these may not be considered “big traumas” like the Club Q shooting, these “little traumas” can build up and lead to a lifetime of emotional pain and distress.

“Those little Ts or those microtraumas can often be the most insidious because they’re the ones you live with every single day,” said Kyle Bonner, LCSW, LCADC, Diversity Equity Inclusion Coordinator at Penn Medicine Princeton Health.

Bonner says that, while gay women and other LGBTQ people may face similar traumas, the manifestation of those traumas is often different, especially for gay men, compared to other subgroups.

“As with any trauma, it’s the behaviors that follow that are critical. In gay men specifically, sometimes those behaviors can manifest in extremely ineffective ways,” he said.

Research shows that compared to other men, gay and bisexual men have higher chances of major depression, bipolar disorder, and generalized anxiety disorder. Gay men are also at greater risk for substance abuse and suicide.

At Penn Medicine Princeton House Behavioral Health, gay men struggling with trauma and its effects have access to care that is inclusive and accepting of all patients regardless of sexual identity or orientation.

This care includes the Men’s  Program, which serves as a safe, trust-filled environment for men who have experienced traumatic events that are impacting their well-being and overall functioning.

Little Boy with a Secret

“For a lot of gay men, the foundation of trauma begins as a little boy, a little boy with a secret,” Bonner said. “They can’t live as their authentic self and feel they have to hide who they are, or risk being picked on or harassed or worse.”

At the same time, Bonner explained, they see a world around them where their heterosexual peers can be themselves, which can leave them feeling isolated and excluded.

“Heterosexual folks don’t have to be concerned about kissing in the street and being called a derogatory name,” Bonner said.  “For many gay men, it’s messages like that that deplete their self-image, increase social anxiety and keep them from living their full truth. It’s constant retraumautization.”

Moreover, when some of the few places considered safe are bars, clubs and social settings, where alcohol and drugs are readily available, it is no wonder that gay men are at greater risk for substance abuse, Bonner said.

Lived Experience

“I was that little boy with a secret,” Bonner said. “I have my own big and little Ts but helping others has helped me to care for myself in a way.”

Bonner came out to his family in 2011 when New York passed the Marriage Equality Act, which made same-sex marriage legal in New York State. He was a freshman in college then and remembers watching people celebrate and being so happy.

“I said to myself ‘I’m going to tell my parents tonight,’” Bonner recalled. “I come from a very accepting, very loving family so if I was scared to share that news, imagine if your family is not that accepting.

“The support of my family and friends has been so important to my journey,” Bonner said.

But even now, he still occasionally struggles with being his authentic self.

“Public affection is a big one,” Bonner said. “To this day it is something I have to work on with my partner.”

Accessing Therapy

In addition to being at greater risk for a range of mental health complications, gay men also face additional barriers to mental health treatment.

“A lot of times men in general are resistant to treatment,” Bonner said. “For gay men, seeking behavioral health care when you’re wondering if you’ll be treated differently can be especially intimidating.”

Moreover, when you’ve learned to keep your life secret, it can be uncomfortable reaching out and sharing things with others.

Finding a compassionate therapist who doesn’t shy away from conversations about sexual orientation and who understands the trauma gay men experience is important, Bonner said, adding that finding a therapist who self-discloses their sexual orientation can also help remove roadblocks to care.

“We all have an invisible backpack and as we go through life we collect and carry around different rocks,” Bonner said. “If we don’t check in and see what’s back there and empty our backpack every now and then, we’ll fall over.”

All of Penn Medicine’s hospitals, including Princeton Health along with Chester County Hospital, Lancaster General Health, the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center and Pennsylvania Hospital, have been honored by the Human Rights Campaign (HRC) Foundation, the educational arm of the nation’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ+) civil rights organization, for their dedication and commitment to LGBTQ+ inclusion.


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