Depression is something many people face, but research consistently shows that gay, bi, and queer men experience higher rates of depression than the general population. At Tom of P-Town Health, we think it’s important to talk openly about why this happens, what you can do if you’re struggling, and what resources are available.
Why Are Rates Higher in MSM?
Depression doesn’t come out of nowhere — it’s shaped by both biology and life experience. For men who have sex with men (MSM), several factors increase risk:
Minority stress: Living in a society where stigma, discrimination, or rejection still exist adds chronic stress to daily life.
Family rejection: Some men grow up in environments where being gay wasn’t accepted, leaving long-term scars on self-worth.
Isolation and body image pressures: Social dynamics in the gay community can sometimes emphasize perfection or exclusion, which can worsen feelings of loneliness.
Higher rates of trauma and substance use: Both can directly increase vulnerability to depression.
The good news: Depression is treatable. Many men get better with the right support.
What Can You Do About It?
If you think you may be depressed, know that you’re not alone and help is out there. A few steps to consider:
Talk to a trusted provider. Most primary care providers are trained to diagnose and manage straightforward depression.
Therapy works. Talking with a mental health professional can help you develop coping tools and shift the way you see yourself and your world.
SSRIs are highly effective for many people. These are common antidepressants that work by balancing serotonin, a “feel-good” brain chemical.
When SSRIs Haven’t Worked
Sometimes, people try one or two SSRIs and don’t feel better. This doesn’t mean you can’t be helped — it may be a matter of how your body processes medications.
Here’s the simple version: your liver is equipped with a set of “workers” called cytochromes that break down medications. Most people’s workers are pretty typical, but some people are born with versions that work faster or slower than average. If you have one of these unique setups, certain antidepressants may never reach the right level in your system — or may build up too much.
That’s where genetic testing comes in. A quick cheek swab can reveal how your body is likely to process different psychiatric medications. This helps guide you and your provider toward the antidepressants most likely to work for you.
Resources & Support
The Trevor Project (for LGBTQ+ youth and young adults): thetrevorproject.org
NAMI (National Alliance on Mental Illness): nami.org
Local therapists and support groups familiar with LGBTQ+ mental health
Tom of P-Town Health: We offer pharmacogenomic testing (the genetic testing described above) to help match you with the right medication, along with full primary care and support tailored for MSM.
Final Word
If you’re feeling low, hopeless, or stuck, know that your feelings are valid — and that help exists. Depression is common, treatable, and nothing to be ashamed of.
At Tom of P-Town Health, we’re here to help you find the treatment path that works for you — whether that’s therapy, medication, genetic testing, or a mix of approaches
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