Gay Men


Therapists Talk 
Shrink Rap 


    Michael E. Holtby, LCSW, BCD

Gay & Bisexual Men

Reasons Gay Men Seek Psychotherapy

Should I See a Gay Therapist?

Other Resources on the Web

Forty+ Years of Experience:

Used with permission of the Advocate, Copyright 1989  Cartoon used with permission from the Advocate, Copyright 1989.

On June 28th, 1969 the police raided the Stonewall Inn, a gay bar in Greenwich Village. In this era the police routinely rousted homosexuals with tickets for jay walking, public indecency, resisting arrest etc. Bar patrons were often hauled off in a paddy wagon, only to release them after hours at the police station. On this hot summer night, fed up with the abuse, and with tensions running especially high due to the death just days earlier of Judy Garland, a drag queen named Silvia Rivera threw a bottle at a police officer. A riot ensued which lasted for three days. The crystallization of the gay rights movement was galvanized with this event. Soon afterwards chapters of the Gay Liberation Front sprang up around the country.

A month later I entered a gay bar for the first time as a part of an urban training project for social workers. That Fall I began my graduate fieldwork with the University of Washington School of social work, and given the task of reaching a hard-to-reach population. I chose Seattle's Gay Liberation Front, and the gay community. Upon graduation all the gay therapists were still in the closet in the early seventies -- so everywhere I worked I was referred all the gay clients.

In 1977 when I started my private practice in Denver, the same year the Gay Community Center was founded (since renamed The Center). I worked closely with Phil Nash, the Center's first Director, and was part of the Center's Mental Health Advisory Board which trained the phone counselors. Since that time a large portion of my caseload has remained with gay men, and I run two on-going psychotherapy groups for gay men.  

In the quarter century I have been a therapist I have seen well over 2,000 gay men as clients.

* For the years 1998, 2000, 2001, 2002 & 2003: Selected as "Reader's Choice" for psychotherapist by the readers of Out Front, Colorado's largest gay publication.

* PFLAG (Parents & Friends of Lesbians & Gays) 2001 Community Service Award for work within the GLBT community in Denver since 1977.

* Honored by the Denver City Council for GLBT Community Service within Denver, 2001.

The Reasons Gay Men Seek Psychotherapy:

A recent study sighted in The Advocate (4/1/97) found that 42% gays and lesbians seek mental health services. I surveyed the reasons gay men have sought my services with a sample of 200 and found the following breakdown: (the percentages don't total 100% because it was typical for more than one category to apply; for instance depression which was caused by a relationship breakup).

Presenting Problem

% of 200 cases
Depression 39%
HIV-Related Issues 37%
Self-esteem & Singles Issues 31%
Couples Counseling 24%
Relationship Breakups 18%
Drugs and Alcohol Abuse/Dependency 16%
Coming Out 10%
Sexual Addictions 7%

Should I See a Gay Therapist?A University of Washington doctoral candidate, Nancy Nystrom found some disturbing evidence that many experiences for gays and lesbians seeking therapy are highly negative:


They encountered a homophobic therapist. 46%
Their sexuality was not acknowledged or was dismissed. 34%
The therapist attempted to "cure" them. 10%
The therapist made derogatory comments. 7%
There was inappropriate sexual behavior. 3%
From The Advocate, April 1, 1997, Issue 730, pp. 20.


These results certainly indicate reason for caution and some alarm when seeking psychotherapy if you are gay. This is particularly true when using an HMO or PPO (managed health care organization). You call a 1-800 number, talk with someone out of state, and they refer you to someone they don't know. They base it on zip code, on the rationale that the best person for you to see lives close by. If you are a gay man this is a poor criteria to go by. You need someone with extensive background and experience with gay clients. Does that person have to be gay themselves? Obviously, being straight, I don't think so. It may be an absolute necessity for your own comfort level. However, I haven't found it to be an issue with the vast majority of my clients, as I know Denver's gay community, resources and people very well. There is a joke that at one time or another I've seen almost everyone in the gay community in my consulting room. Certainly 2,000 gay men is but a small fraction of the estimated 60-80,000 gay men in the metropolitan area of Denver. But if you are unsure, ask your friends. Someone you know has likely been to see me over the past twenty years.


"I had the opportunity to read your paper "Three Decades in the Gay Community as a Straight Therapist"  Journal of Gay & Lesbian Social Services, Vol. 16, #2, Nov 2, 2004, for my social work foundation class at East Tennessee State University. I am so completely moved by you and your support of the gay community, especially during a time in our history when homosexuality was still considered a psychopathology and many gay therapists themselves were unable to come out of the closet and openly advertise themselves as a safe place for gays and lesbians to seek help. Your work with folks during the AIDS crisis is also admirable, and as someone who lost a number of friends in the mid 80's I can only imagine what that must have been like to facilitate support groups for this population.  I subsequently found your website and have to say, I love the way you present yourself with both warmth and strong boundaries, especially around the way you set up your fee scale."    10/23/2012

Beth E. Barber, MSW Intern, Graduate Student Success Specialist, School of Graduate Studies


For further information see the following websites:

Gay Yellow Pages

My friend and colleague in Manhattan, Michael Shernoff, MSW has a number of relevant and interesting articles on his web site, for example, "Chronically Single Gay Men in Search of True Love."

Also see Sexual Addictions:

Patrick Carnes Site

On Line Sex Addict Organization



Last messed with February 23, 2016

Copyright(c) 2001 Michael E. Holtby, LCSW. All rights reserved.