A Critique on Progress: The Sociology of Gay Men’s Mental Health in a Period of Social Acceptance and Biomedical Advancement

Research has long indicated that gay men face an excessive burden of mental illness, including anxiety, depression, body dysmorphia, sexual compulsivity, suicidal ideation and addiction. In this paper, we critically review and expand on two theories explaining this health disparity. Minority stress (Meyer, 1995) argues that poor mental health among gay men results from experiencing homophobia. Syndemics (Stall, Friedman, and Catania, 2008) positions mental illness along with HIV and poly-drug use as one of several mutually reinforcing epidemics. However, recently we have witnessed significant progress in the mainstream acceptance of gay men and with biomedical advancements in HIV prevention and care. So are gay men any healthier? Drawing on original findings from several gay men’s qualitative health projects in Canada, we argue that (1) gay men continue to face a substantial mental health burden; (2) that we need to be critical of discourses of ‘progress’ in this story; and (3) research must better account for the socio-structural stressors gay men face. Progress discourses of overcoming homophobia and HIV—propagated in research and the media—can minimize the harms gay men continue to experience (e.g. HIV stigma, treatment side-effects and accessibility, violence, intimacy struggles). Some progress can produce new social opportunities that increase stress, as gay men are expected to easily advance in a ‘tolerant’ society (e.g. marriage) and manage/prevent HIV ‘successfully.’ Research based on the above two theories has focused heavily on quantitatively examining sexual risk behaviour at the detriment of critically investigating neoliberal socio-structural features corrosive to mental well-being, like precarious work, debt, unaffordable housing and limited social and mental health services. We need to understand how gay men can heal from the psychosocial traumas resulting from homophobia and HIV stigma, in a society determined by socio-economic uncertainty, individualistic models of risk management and ‘self-care’, and inaccessible health services.