Understanding Stress in Gay and Bisexual Men: Insights from Dr. John Pachankis
I sat down with Dr. John Pachankis, a psychologist and one of the world’s leading experts on LGBTQ+ mental health (and my former boss) to better understand something I often observe in my gay male clients: the stress they experience from their own community and how that impacts their mental health. Gay and bisexual men navigate a complex landscape of stressors—both from the broader society and from within their own communities. Pachankis has conducted extensive research to understand the unique pressures that shape the well-being of gay and bisexual men. His findings reveal how stress manifests in this population and the ways in which stigma can obscure its true source.
The Layers of Minority Stress
Minority stress refers to the unique stressors that gay and bisexual men experience beyond what heterosexual men face. These stressors begin early in life and can persist across the lifespan. Some of the most common include:
Chronic anxiety about rejection – Many gay and bisexual men develop a hypersensitivity to how others perceive them, often expecting rejection even in neutral situations.
Concealment of sexual orientation – Social and cultural pressures can make it difficult for individuals to live openly, leading to psychological distress.
Discrimination, victimization, and bullying – These experiences, especially in youth, contribute to long-term mental health struggles.
While external stigma is well-documented, Dr. Pachankis’ research also highlights a significant but often overlooked source of stress: intraminority stress—the stress that gay and bisexual men experience in their social and sexual interactions with each other.
The Complexity of Minority Stress
Many gay and bisexual men report that some of their most persistent sources of stress come from interactions within the LGBTQ community. This does not mean the community itself is pathological but rather that stressors emerge from:
Amplified Social and Sexual Pressures
Unlike straight men, who primarily compete for status in heterosexual spaces, gay and bisexual men often find themselves both the subject and object of status competition within a homogenous group. This can intensify pressures around appearance, social standing, and desirability.
The Internalization of Homophobic Stereotypes
Stereotypes about gay men being “catty,” hypersexual, or image-obsessed can become internalized and acted out within the community. This creates an environment where men feel they must conform to limited roles dictated by societal perceptions.
The Collective Impact of Early Life Stress
Many gay and bisexual men grow up experiencing rejection or anticipating discrimination. When a large number of individuals with these early experiences come together, their collective anxieties can magnify, creating an environment where distrust and status anxiety thrive.
The Role of Bisexual Men in Mental Health Disparities
One of the most striking findings from Dr. Pachankis’ work is that bisexual men experience the greatest mental health disparities, particularly in depression, anxiety, and substance use disorders. These disparities appear to be driven by unique challenges bisexual men face, such as:
A lack of acceptance from both heterosexual and gay communities
Higher rates of identity concealment
Persistent invalidation of their sexual orientation
Interestingly, by older adulthood, the mental health gap between gay and straight men diminishes, potentially because mental health in the general population declines over time, while LGBTQ individuals develop stronger resilience.
The Importance of Community and Resilience
Despite these stressors, the LGBTQ community has demonstrated extraordinary resilience throughout history. Gay and bisexual men have continually created innovative and supportive spaces for themselves. However, there are modern challenges to sustaining community, including the decline of physical LGBTQ spaces and the prevalence of dating apps that can sometimes exacerbate feelings of isolation and competition.
Dr. Pachankis emphasizes that while stressors within the LGBTQ community exist, it’s crucial to remember their root cause: homophobic stigma. One of stigma’s most insidious effects is making individuals believe that their own community is the problem rather than the society that marginalizes them. This misplaced blame can further erode community bonds when, in reality, the LGBTQ community’s strength and support are vital protective factors against mental health struggles.
Moving Forward: Supporting Wellbeing and Each Other
To combat these stressors, Dr. Pachankis suggests:
Recognizing the real source of stress – Rather than turning against one another, LGBTQ individuals can unite in understanding how structural stigma shapes their experiences.
Finding supportive role models – Identifying mentors and figures who model healthy, affirming relationships can counteract harmful community dynamics.
Prioritizing genuine connection over competition – Seeking out spaces that foster meaningful relationships rather than reinforcing status-driven anxieties.
The takeaway? It’s not the LGBTQ community that’s pathological—it’s the stigma that has shaped it. By reclaiming narratives of resilience and focusing on collective healing, gay and bisexual men can continue to build spaces that nourish rather than deplete their well-being.
As Dr. Pachankis reminds us, “Don’t be suspicious of your own community. Instead, bond over structural forms of stigma and the ways that stigma compromises mental health.”