Are mental and physical health problems really a reaction to bigotry?
Sixteen years ago, at 19, James Brandon drove cross-country from St. Louis to study at the prestigious American Academy of Dramatic Arts in Pasadena. A year earlier, his alcoholic father, whom he had nursed nearly daily, had died of cancer. Handsome, talented and affable, Brandon was determined to achieve his dream of becoming an actor. Then he got caught up in the gay partying scene.
“It was fun at first,” recalls Brandon, who came out when he was 21, “but not fulfilling at all.”
With his new friends, for three years Brandon hit the gay bars and night clubs in L.A. and West Hollywood, partying hard with drugs and alcohol. After one drug-fueled Saturday night at age 24, he drove alone on Pacific Coast Highway in his black Saturn toward Malibu as the sun rose. With only a guardrail between him and the rocky outcroppings of the Pacific Ocean below, he considered what would have been unthinkable when he first arrived in L.A.
“I thought, ‘Nothing is stopping me from driving off the cliff,’?” Brandon recalls. “It was an intense moment. I was confused. I was lost. I was also thinking it would be so poetic: I’d die with the sunrise.”
On the verge of possibly becoming a suicide statistic — one that’s far more common among gay men than straight — Brandon suddenly got a call from a friend on his cellphone, asking if he would go to yoga with her this morning. He turned around, and that day made a decision that changed everything.
The working actor threw himself into yoga’s mental, physical and spiritual disciplines. “I stopped doing all the drugs and found different tools to reach my ecstasy,” Brandon says. “My focus was being on a new spiritual journey.”
Some of his gay male friends followed a more lethal path. One died from a drug overdose. Another passed away under mysterious circumstances, which Brandon suspects were connected to drugs.
Brandon says, “I have friends who say, ‘You’re just lucky. You found a way out.’ But I’m no different than anyone else. I just woke up to the fact that I can make choices, and that I wanted to empower myself. It’s always there within all of us. But we can cover it up with drugs, sex or alcohol.”
Forty-three years after the Stonewall Riots in New York City, gay men still struggle with high rates of drug-, sex-, and alcohol-related problems — a situation that gay leaders are hesitant to discuss openly for fear that anti-gay factions will use these facts to promote the bigoted view that gay men are sick and disturbed.
According to the Centers for Disease Control and Prevention, gay men have higher rates of substance abuse than the general public, are more likely to continue heavy drinking in later life, smoke tobacco at higher rates than other men, are at greater risk of mental health problems such as major depression and anxiety disorder than other men, and are more likely to commit suicide than other men.
Sexually transmitted diseases are increasing among gay and bisexual men: Most syphilis cases in the United States involve men who have sex with men. Also, the annual number of new HIV infections among gay and bisexual males 13 to 29 years old jumped 34 percent between 2006 and 2009, the most recent data that CDC provides. Men who have sex with men account for 4 percent of the population, according to the CDC, but they account for 61 percent, or 29,300, new HIV diagnoses each year.
The CDC tends to link these problems to forces outside of the gay individual and gay community — particularly homophobia and anti-gay discrimination, known in the medical community as “social stressors.”
“As long as we have homophobia,” says Dr. Ilan Meyer, a researcher and senior scholar at the Williams Institute for Sexual Orientation Law and Public Policy at UCLA’s School of Law, “we’ll see these patterns continue.”
In 1995, Meyer devised a now widely accepted theory to explain these LGBT mental and physical health disparities — the “minority stress model.” The respected researcher placed much blame on American society, writing, “Stigma, prejudice and discrimination create a hostile and stressful social environment that causes mental health problems.”
The CDC and many gay-health experts embraced Meyer’s model — and gay-rights leaders often use it when slamming their political opponents.
“If you are told you should not be who you are,” explains gay-rights activist and Courage Campaign founder Rick Jacobs, “then I’m not surprised that when you get the chance to be who you are, there are some explosions.”
But today other experts, though still overshadowed by the widely promoted “minority stress model,” question how Meyer’s theory is used by health experts and activists — and particularly the strong underlying message of victimhood it communicates to gay men.
“People make choices,” says Thomas S. Weinberg, a sociology professor at Buffalo State College, who wrote the 1994 book Gay Men, Drinking and Alcoholism. Weinberg steps outside the mainstream view to explain what is hurting gay well-being: Personal choices, he controversially says, are “more important than stress models.”
Some have begun to argue that health experts, gay-rights leaders and gay individuals should take an unblinking look at their own contributions to gay men’s health disparities.
“All the sociological factors are just an explanation after the fact,” argues iconoclastic AIDS Healthcare Foundation president Michael Weinstein, who agrees with Weinberg. “It’s an excuse. It may even be a valid one, but it’s still an excuse.”
“It’s not outside of us but within us if real change is going to happen,” says Brandon, who was bullied in middle school and now is spearheading a fledgling LGBT self-empowerment campaign called I Am Love. “I don’t deny the fact that those studies are out there, but none of that matters to me. I don’t let any of those [social stressors] disempower me.”
For Brandon and others, the new gay frontier is no longer solely a fight for equal rights.
Lucas John is a 29-year-old man-about-town who created the gay gossip blog WeHo Confidential. He moved to heavily gay West Hollywood from West Covina when he was 22, looking to be among his own and to find a special guy.
Seven years later, he’s utterly disillusioned with the gay scene in L.A. and West Hollywood. “There’s no such thing as love in L.A.,” John says. “It’s almost entirely gone. It’s a great place to be single. It’s not a great place if you want to find love.”
Gregarious and quick-witted, John is still seeking that special guy. His social routine, however, often centers on looking for hookups online, sometimes having unprotected sex, and drinking and partying with friends looking for good times, casual sex and, often, a sugar daddy to pay the bar tab at night’s end.
“When I was younger, I thought I could sleep my way into being loved,” John says, “and that’s just not how it works. … People who think they can sleep around and get ahead are delusional. It doesn’t happen. But there are many people who are willing to take advantage of those people and then discard them.”
John often feels angry, lonely and confused. Asked if his actions and choices in friends may contribute to his lack of success in finding love, the talkative gossip blogger goes uncharacteristically quiet.
Tony Sweet is a 42-year-old radio personality who grew up in Kansas and moved to L.A. 10 years ago. In the Midwest, Christian ministers, pushing the notion that homosexuality is a sin, were highly influential in forming public opinion. He never paid much attention to them. “I knew God has big plans for me,” Sweet says. “I never thought, ‘God hates me because I’m gay.’?”
Sweet, openly gay for years, did, however, develop an eating disorder in his 20s. “I felt I had to look a certain way and live up to certain expectations,” he says. “To me, we aren’t helping our community all that much because we’re not accepting of certain ways we dress or what we do for a job. It stems from not being self-accepting.”
Sweet publicly expresses a view that, at least for now, is a no-no in the gay world: He’s felt more pressure and more stress from people in the gay community in Southern California than he did in Kansas — among bigoted, organized-religion adherents.
Matthew Mishory is a 30-year-old filmmaker and L.A. native. He’s partnered and lives in West Hollywood. “Life can be difficult,” he says, “and it’s helpful to have someone help you through those challenges.” He adds, “I think it’s a great thing to be in love. When I hear people say that’s impossible for them, I think that’s foolish.”
Mishory surrounds himself with both straight and gay friends, and says the “vast majority” are looking for stable, long-term relationships. His unhappy view of the L.A. gay scene is that “too many gay men are competing with each other and tearing each other down, but life is not a competition.”
Andrew Extein is a 27-year-old social worker from Florida, living in Silver Lake and working with gay youths. Extein usually stays away from West Hollywood, one of the world’s gay meccas. When he does go there, he says, he rarely has a good time.
Extein’s impressions of WeHo are the last thing most local boosters and gay residents would say: “It’s a very scary place. It’s like a Disneyland for gay people. My friends and I end up depressed by the end of the night. It’s not very life-affirming.”
He finds it “very difficult to connect to people there. West Hollywood represents all the bad parts about the gay community. It emphasizes all the drinking and drugs and what you’re wearing and how you look. It’s scary because it feels like I should be that way, but I’m not. So it makes me feel as if something is wrong with me.”
Extein says that in West Hollywood, and even in Silver Lake on occasion, there’s pressure to “fit in” and particularly to drink heavily. “If you don’t drink,” he says, “you’re basically ostracized.”
Extein created a website called MASC Project, which examines certain gay men’s obsessions with masculinity. He sees urban gay culture as pushing a party-life conformity upon its inhabitants. This, he says, clashes with what is sought by those with a hankering for real community — a safe place to live and thrive.
“People think that if they don’t fit in here,” Extein says, “then where will they fit in? So they try really hard to fit in, but it doesn’t always make them feel happy.”
Not much of a drinker, and not much of a follower, Extein finds his mind sometimes wandering into “dark places.” His blue moods, though, have nothing to do with the stress of being a sexual minority. “It’s more about the gay world than being gay,” he says.
Extein is hoping that influencers in the gay community will speak up. “We need leaders to talk about these things,” he says.
These four gay men’s thoughts and experiences are not uncommon, especially among those coming of age in their 20s — the same group that has seen an increase in HIV infections.
The gay-rights movement is still largely focused on problems that arise from its long fight for civil rights: legalizing gay marriage, monitoring homophobic words and deeds by political and religious leaders and, most recently, boycotting Chick-fil-A fast-food restaurants because the chain’s president, Dan Cathy, opposes gay marriage. A number of critics of the traditional gay leadership say these battles don’t directly pertain to the daily well-being of most gay men.
“The issue of a health crisis has been totally replaced by gay marriage, but gay marriage doesn’t have as much relevance to our community,” says AIDS Healthcare’s Weinstein, who’s been fighting for HIV/AIDS prevention and health care since the 1980s. “The civil rights issue is very important, but it’s not that relevant to our everyday lives.”
LGBT health experts have done little research on gay individuals’ internal “social stressors” — the personal attitudes and choices that John, Sweet, Mishory and Extein talk about — that rise from within and which may have more negative effects on gay health and well-being than historic discrimination.
“No study comes to mind,” says Dr. Jason Schneider, former president and current board member of the Washington, D.C.–based Gay & Lesbian Medical Association, an advocacy organization.
Kellan Baker, a highly regarded LGBT health-policy analyst at the Washington, D.C.–based Center for American Progress, can’t think of such an analysis, either. Neither of these experts can name a long-term study that looks into how happy, healthy gay men live and make choices — knowledge that could be a valuable tool.
That’s astonishes many people, since “positive psychology,” which emphasizes discovering and employing healthy behaviors that make people happy before they develop mental illness, has become hugely popular since the late 1990s.
“We don’t have enough research on what it means to be healthy,” says nationally recognized sex addiction expert and L.A. therapist Robert Weiss, who wrote Cruise Control: Understanding Sex Addiction in Gay Men. “We should know what a life of a healthy gay man or lesbian looks like from age 19 to 50.”
Harvard University undertook just such a study for all men, not gay men — its widely cited Grant Study. Launched in 1938, it has tracked the health and well-being of more than 260 men throughout their lives. But Weiss says that when it comes to gay men, research dollars from the federal government, mental health organizations and the medical industry are funneled largely into gay pathology rather than well-being. The big bucks, he says, are tied to pharmaceutical cures for what ails gays, not prevention.
“It’s hard to get attention or money for LGBT health,” says Baker, who worked on the federal “Healthy People 2020” plan, a national blueprint for improving health among all Americans. But, he laments, “There’s no coherent research agenda” among gay leaders and a great dearth of research. Baker takes direct aim at the established gay-rights movement, saying that gay men’s mental and physical health is a low priority among gay political influencers.
A landmark 2011 report on the health of the LGBT community by the national Institute of Medicine noted that gays have “unique health experiences, but as a nation, we do not know exactly what these experiences and needs are.” The report found that not enough research has been attempted or data collected — echoing Schneider, Weiss and Baker.
Yet Schneider, of the Gay & Lesbian Medical Association, is firmly in the conventional-wisdom camp, preferring to talk about Ilan Meyer’s minority stress model and gay health-care politics — with their focus on outside forces. “It’s very easy to come off as, ‘All LGBT people are sick,’?” he says, “and right-wing organizations use that against us. So we have to be careful, and note that most gay men are healthy.”
As for a gay leader who is challenging this conventional wisdom, Schneider says, “I don’t think we have that person talking that way now.”
Cary Harrison, a syndicated radio talk show host heard on KPFK’s “Go Harrison” and a longtime resident of West Hollywood, says, “A lot of our culture is based on window dressing because it’s something we can sell pretty easily, and we can sell our victimhood pretty easily.” He’d love to see a Tony Robbins–type character “for gay people, so we can recapture the wonderful spirit we all have in ourselves. We have such an innate, incomparable power and I’d love to see us get that back. We’re capable of extraordinary things.”
Why do gay men have higher rates of substance abuse, depression, suicide, smoking and sexually transmitted disease — creating a subgroup that is less happy and healthy than the general population?
The Institute of Medicine’s “The Health of Lesbian, Gay, Bisexual and Transgender People: Building a Foundation for Better Understanding,” a 2011 review of numerous major studies, noted that heavy drug or alcohol use — common in the gay culture preceding sex — is a risk factor for HIV transmissions.
Simply put, people who get too high lose their judgment and have unprotected sex, known in gay culture as “barebacking.”
The panel also mentions Meyer’s minority stress model, citing societal discrimination as an explanation for mental health problems among gay men. Meyer, when asked if gay men themselves play a role in their mental and physical health troubles, responds, “I don’t like to put it that way.” He avoids discussing the notion that decades of focus among gays on their victimization by the outside world might be a piece of the problem.
From the late 1970s to the early ’90s, Buffalo State College sociology professor Thomas S. Weinberg conducted a longitudinal study on the drinking habits of gay men in Southern California. Compared with today, it was an era of heightened homophobia. At the study’s end, Weinberg rejected the widely promoted idea that a homophobic society was driving gay men to excessive drink. Instead, he found, abuse of alcohol was far more affected by a man’s own choice — the friends he kept.
“It’s basically a subcultural thing,” Weinberg says, “and so much of gay culture is steeped in alcohol.”
His longitudinal findings, after tracking people for more than a decade, made Weinberg a strong proponent of “reference group theory,” which says that our close friends and associates become strong reference points for how we should conduct our lives.
If a 28-year-old gay man hangs out with heavy drinkers, for example, over time there’s a good chance he’ll mimic his friends. Conversely, if the 28-year-old socializes with people who don’t emphasize drinking, there’s a good chance he’ll drink moderately over the years, if at all.
Beverly Hills psychologist Alan Downs, in his well-received book The Velvet Rage: Overcoming the Pain of Growing Up Gay in a Straight Man’s World, which offers ways for gay men to live more authentic and healthier lives, urges gay men to “carefully guard and assess those individuals you allow into your inner circle of intimacy. Their influence is monumental.”
Young guys who run with a promiscuous crowd in Los Angeles or West Hollywood and who engage in barebacking — two high-risk factors for getting HIV — are setting a norm for themselves and others, although they may not realize it. Weinberg argues that, as long as they choose that crowd, chances are good that these young men will act like their peers — dramatically upping the chances they will become HIV-positive.
And once that happens, life alters dramatically. AIDS Healthcare’s Weinstein notes that HIV treatment is “serious chemotherapy” and not “just a matter of popping a pill, and I don’t know anyone who got infected who just said, ‘It’s nothing.’ There are a lot of psychological effects in which people ask, ‘Will anyone love me?’ ‘What will I tell my mother?’ ‘What will I tell my friends?’ ‘What do I tell a date?’ ‘Do I want to have a relationship with someone who’s [HIV]-negative?’?”
Weinstein and Weinberg are relatively rare voices. But as Weinberg explains, “Choice is very important. We choose our friends and relationships.”
On a hot, bright day in Studio City, James Brandon sits in the shade outside the Aroma Café with friend Nic Arnzen. For six years, Brandon and Arnzen have been touring the world with Terrence McNally’s play Corpus Christi, which posits Jesus as a gay man living in modern-day Texas. Arnzen is the director and a cast member. Brandon plays Jesus.
Arnzen lives with a partner and their two adopted children, and Brandon lives in an American midcentury home with his boyfriend in Sherman Oaks. The two are editing a documentary about the play’s world-tour experiences, titled Corpus Christi: Playing With Redemption, while preparing to open the play in the Midwest. Amidst this, they are launching the “self-empowerment” campaign I Am Love.
The two men exemplify friends whose influence upon one other has been positive. Through their play, their documentary and their new campaign, they hope to reduce homophobia in the religious world, and perhaps improve life a bit for all.
Over the years, Brandon and Arnzen began noticing that McNally’s play was having an emotional, even spiritual, effect on cast members and some in the heavily LGBT audiences. After the play, people openly discussed love, self-acceptance and forgiveness — messages heard from Jesus’ character in the play.
Brandon and Arnzen wanted the larger gay community to benefit from such healing and spiritual concepts, but knew that religious leaders’ decades of attacks on gays had driven many of them away from forms of spirituality. They decided to confront anti-gay religious attitudes with love, not antagonism.
“Our community has been pioneers in love,” Brandon says. “We’ve insisted on loving someone of the same sex despite many people telling us we were sick or wrong. Now we have to love our enemies. It’s not just needed but necessary. If we want any real change in our own lives and in our community, we have to love. That’s when the real change will happen — when the gay community has more self-love.”
Corpus Christi has drawn protests from religious groups, and Brandon regularly receives letters warning him that he’s going to hell. None of that fazes him — he writes back, telling them he understands their passion, and that they are in his prayers.
“It’s not an easy path, at first, to live a more authentic, conscious path,” Brandon says. “We have the opportunity to make an impact in this world. Why are we here? Just to be miserable? No. It’s to be happy and give back to the world. To go against that goes against your true nature of being.”
Many religious leaders, such as Rev. Jerry Falwell, TV evangelist Pat Robertson and influential evangelical writer and radio host James Dobson, among others, have used God’s “word” as proof that gays are sinners and lead unnatural lives.
But for decades gays and lesbians have turned their lives around aided by spiritual concepts, most notably those of Alcoholics Anonymous, which has thrived in gay communities in West Hollywood, Los Angeles and elsewhere.
Toby Johnson, the Austin-based writer of the award-winning book Gay Spirituality, tells the Weekly that spirituality can be especially helpful in guiding gay men to treat themselves and each other with more respect. “What the spiritual traditions offer is a sense of meaning in life for everyone,” Johnson says. “Things matter. God, or a higher power, loves you, and that matters. If you don’t have meaning, then nothing matters.”
Johnson isn’t shy in arguing that tapping the inner self can lead to more deeply felt sexual relationships: “Gay spirituality can find the spiritual meaning of sex,” Johnson says, “of a way of communing with someone rather than just getting your rocks off.”
Rev. Dr. Neil Thomas, of the Metropolitan Community Church in Los Angeles, a Christian fellowship that specifically reaches out to the LGBT community, says, “We are body, mind and spirit, and we need all those things to be healthy. Too often we separate them, and that leads to unhealthy lives.”
In fact, a new University of Missouri study found that people who reported experiencing higher levels of spirituality also reported higher levels of mental health.
Thomas suggests that gay men, especially those who are suffering, should squarely face themselves in the mirror. “We need to do a reality check of our self-esteem,” he says. “Because if we can’t have a right relationship with ourselves, we can’t have it with others.”
James Langteaux, author of Gay Conversations With God, says gay-rights leaders could be models for the gay population if they adopted the nonviolence methods of Gandhi’s satyagraha, which offers building blocks for cultivating love and respect for yourself and others, including your enemies.
“It’s very counterintuitive, but history has shown it works,” says Langteaux, noting that Dr. Martin Luther King Jr. and the lesser-known gay-rights group Soulforce have used satyagraha. If tapped by the LGBT community, “The anger inside ourselves will evaporate,” he suggests.
Courage Campaign founder Jacobs, who regularly fights gay-rights battles, isn’t sure that adopting the Gandhi model would work in achieving political victories. “It’s certainly something we should see more of in our movement,” Jacobs says. “But in moving a political agenda, you have to be tough.”
Sitting in the backyard of his Sherman Oaks home below a circling hawk, James Brandon recalls how his verbally abusive, alcoholic father struck his mother and sometimes smacked him with a belt. His parents divorced when he was young.
Says Brandon, “I blamed my dad for a lot of my issues and insecurities.”
When Brandon was in middle school and still in the closet, kids bullied him because he came off as gay. His mom gave him Dale Carnegie’s How to Win Friends and Influence People. “It taught me that people do their thing and I can’t stop them,” Brandon says of the classic self-help book.
When he was a senior, his hard-drinking father was diagnosed with pancreatic cancer. Brandon let go of the past and went to the hospital nearly every day. In an act far more personal than any he had experienced with his dad, he gave the dying man comforting massages. They bonded, and his father promised to live long enough to see Brandon graduate. His father watched a video of the high school ceremony. He passed away two days later.
“I was abused as a kid,” Brandon says, “and that’s an easy way to escape from myself and not take responsibility for myself.”
But he rejected the role of victim, and now focuses on making healthy choices.
Brandon is hopeful because gay men as a cultural force “are heading in that direction,” he says. “But more people need to live it — and speak out.”