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Real Talk: The Issues Gay Men Are Working Through

Articles, Answers, and Assistance from Dr. Swift

Speak with Dr. Swift and learn more about how these and many other issues are overcome with the support of group therapy.

  • As a clinical psychologist who has worked with gay men for over four decades, I realize that the biggest underlying issue for gay and queer men is LONELINESS: The feeling of being cut off from a deeper sense of belonging to the world and to ourselves. Receiving the message that you do not belong, at an early age, penetrates deeply to our core. I think we tend to underestimate the trauma of being profoundly different and having to hide it. Some of us were not physically abused, but we were psychologically mistreated- itself a strong form of abuse.

    When you grow up having to bury or sideline the deepest feelings of your heart and soul, you can become used to being a performer- the ultimate achiever, the gym stud or the big wage earner. You can also choose to give up, avoiding relationships and career satisfactions.  It is too easy to become cut off from deeper connections with other men, but, even worse, detached from our own needs and feelings.

    One of the best ways of starting to drop the metaphorical “metal plates” that protect our inner self is to join a group that offers you encouragement to express yourself authentically and helps you learn how to connect with other guys on a deeper level. In my groups as we do the hard work of looking at our disconnection, we also bring in a playful spirit.  We have a lot to offer and it is time to get going.

  • As queer and gay men most of us grew up with the feeling that there was something wrong with us- we were not straight or masculine or confident enough. The shame we felt about being different was not only attached to our hidden sexual identity, but suffused our whole sense of self. Even as you have grown out of your need to hide your attraction to other guys, you probably feel the residue of shame attaching to other aspects of your being.

    Years of looking over our shoulder to see how others are judging us leaves with us a tendency to keep seeing ourselves through the eyes of other men. We are left with the feeling that we are NOT ENOUGH.

    The answer to the question of what is wrong with you is simple: NOTHING. At your core you are full of love and vitality even if you have picked up some bad or self-defeating habits along the way. Group and individual therapy can help you catch that critical internal voice before it settles in to bully you. Therapy can help you see how you maintain the wall you built around your heart in order to survive. You can learn how to be tender with yourself as you do the hard work of undoing patterns that protect, but defeat you. Let’s get going.

  • Many of us grew up knowing that we were very different from the person society and our parents wanted us to be. We started attacking ourselves for being gay or for being less masculine or attractive than the ideal images portrayed in the media.  We have internalized negative messages from our fathers, our siblings, our peers and our culture. Some of us were lucky to grow up without having to compare ourselves on Facebook to the curated stories of other men.  

    You might believe you are not good enough for love, not attractive enough for sex, or not smart enough for work promotions. Maybe you don’t think you are fun enough.  

    In group we use cognitive reframing techniques to help you replace your most distorted and damaging thoughts with more realistic assessments.  The belief “Older men are invisible in the gay world,” can be replaced by changing your perspective. You have a lot to offer as an experienced and loving gay man. Blurting out some of the horrible stories you tell yourself and finding that the other gay men in the room do not fall off their chairs in horror, helps to reduce your feelings of shame.  I remember one client who was mortified that he loved to imagine himself as a woman being topped by a man.  The group encouraged him to de-shame that thought and helped him to see that what he actually wanted was to be a gay male bottom.  Once he made that transition there was no stopping him.

    Sometimes you learn a lot by hearing other gay men talk about their own harsh internal critical voices. You can see how those criticisms don’t make sense. It leaves you with the question: Maybe my own internal critic is out of touch as well. Once you can share your own harsh inner voices, they begin to soften.  

    In accepting other men’s honesty about their imperfections, you can begin to create more realistic standards for yourself.  You can learn that being “rejected” is not the worst thing in the world. We help you develop the resilience to move on quickly from setbacks

  • One of the most common reasons guys join my gay men’s therapy groups is that they need support and feedback while making major transitions in their life.  Men from across the country have contacted me before moving to New York so that they could join a group to ease their transition into a new life and cushion themselves against feelings of isolation.

    Men who have just broken up with a long-term partner or have been ghosted by someone they were dating often reach out for group support.  Men who are changing jobs or careers find great solace in having a regular place to gather once a week

    Group becomes a safe place to express your anxieties as you branch out to meet new men and join new communities.  You can get some straight feedback about how you come across from your fellow group members. You may be inspired by seeing the courage other men in your group show in challenging themselves to reach some of their social and work goals. Group can help you begin taking manageable steps for socializing in new situations. We can catch you when you feel thwarted or unaccepted.

    Being in group, you have a big healthy family that cares about you and your concerns, and roots for you.  With support, you can take your first wobbly steps forward and eventually become bolder and more grounded.  We can help you learn new skills for approaching, engaging and deepening connections with men you like. Maybe you need help setting boundaries or balancing between your needs and those of others.  Or maybe we can help you stop worrying about how you come across to others

  • I GET IT!

    I already know what it is like to grow up gay in a world that isn’t always kind. I understand what it is like to feel rejected, to overcome shame and the trauma of keeping my identity a secret until I was nearing 30. I’ve done my own work and have developed the tools to help you figure out heartbreak, career changes and building a community where you can thrive.

    Seeing an older gay therapist who is comfortable with his identity can be apowerful reminder that you can experience loving sex, purpose, fun and community at any stage of life. Younger gay men often see me as a role model who has a full and meaningful life with a husband and a vibrant gay practice.

    As an older male therapist, I have seen everything. I have been tested and seasoned by guiding my clients through many of the great tragedies and movements of the last decades: including helping clients with their grief and terror during the AIDS crisis, and the anxieties and uncertainties which emerged from the 911 terror attacks and its aftermath.

    I have also aided clients connect deeply both before and after the era of marriage equality and the age of Black Lives Matter. I can offer you a sense of perspective based on my experience with loss and joy during the many seasons of my life. When I first started practicing in NYC, I helped gay men meet each other through Village Voice ads, now I assist my clients in figuring out how to handle the dating apps and hookup sites like GRINDR. Whether you are trying to understand hook up culture or are seeking a long-term relationship, I can use my own dating and romantic experience, and those of my clients over the past decades, to help you find what works best for you.

    I enjoy being a mentor and life coach for gay men who did not always have

    the best modeling from their own fathers. You can benefit from compassion and understanding as you work to recover from the challenges of growing up with a straight father, who did not have the emotional capacity to understand you, and recover from the hurtful cultural messages about your value in society.

  • As we gay and queer men grow older, many of us have to tackle the dragon of shame about aging in a youth culture. We have been listening for decades to messages from the media and seeing posts on social media glorifying youth and beauty.

    I have encountered many single gay men who thought their romantic gay lives were finished when they passed the fifty-year mark.  A little sagging of the pecs, a little bulge in the belly, and it is all over.  Many of us feel that our marketability and lovability are directly correlated with having a tight and trim body and an unwrinkled face. But there is hope.

    I find that group therapy is particularly helpful for older gay men. I like to have a mix of ages in my groups so that the members can hear a wide variety of perspectives. We listen as younger group members and our contemporaries, some of whom are not chasing their youthful selves, open up about their inner critical voices and how they cope with them.   

    In group we focus on:

    • Defining ourselves by our inner qualities of wisdom, resilience, and perspective rather than our surface attributes.

    • Finding people who are aging with confidence and hearing about their point of view.

    • Learning that attractiveness comes from the sparkle and spirit of the person beyond the contours of the body.

    • Seeing ourselves and our actions through our own eyes; putting less focus on how others see us. It is counterproductive at any age to judge yourself by how you think other people see you.  Remember others don’t see YOU, just the fantasy they project onto you.

    • Countering our sense of invisibility by getting actively engaged in mentoring younger men, or working side by side with others who are committed to a cause. This reduces the time we spend on navel gazing.

  • Dating can be frustrating—especially when you’re serious about finding a real connection. Even the most insightful gay men can fall into the same dead-end patterns without realizing why.

    The culprit is often the unconscious myths we bring to dating—beliefs shaped by culture, past hurts, or self-protection. These assumptions can sabotage potential before it has a chance to grow.

    Myth #1: Chemistry is everything. Yes, attraction matters—but intense chemistry can sometimes signal anxiety or unresolved wounds, not compatibility. Healthy relationships often begin quietly, with stability and trust that build over time.

    Myth #2: He must check every box. Holding out for someone who’s perfect on paper can be a way of avoiding real vulnerability. Relationships thrive not because two perfect people meet, but because two imperfect people choose to grow together.

    Myth #3: Monogamy is outdated. While open relationships can be valid and healthy, wanting exclusivity doesn’t make you needy or old-fashioned. The key is knowing what you want and finding someone who shares your values.

    Myth #4: It should just “click.” Great relationships don’t always start with fireworks. Expecting ease over effort can lead you to a pattern of ghosting people, chasing highs, giving up too soon while missing the slow burn of something genuine intimacy.

    Changing these patterns starts with questioning the beliefs we’ve absorbed. Where did they come from? Are they helping—or holding us back? Letting go of these myths doesn’t mean

    settling. It means making room for love that’s grounded, mutual, and genuine. Mr. Right might not come in the package you expected—but he might be closer than you think.

  • You may have met your career goals, but feel a need to get more out of life. Perhaps you have a romantic partner and friends, but you have the feeling that there is something missing. Maybe you have had trouble finding a suitable partner.  Group and individual therapy can help gay men sort out the underlying issues.

    I have some questions we would consider in your therapy:

    • Do you have a clear sense of purpose in life beyond the specifics of your job?  What is your higher purpose in this world

    • Have you assessed recently what is most meaningful to you? Have you questioned whether your underlying values may have shifted by this point in your life? Maybe they have changed and you have not realigned your life to meet your most important needs.

    • Is your career choice allowing you to express your deepest values and passions? 

    • Are your current relationships meeting your needs for satisfying connections? 

    • Is there some way in which you need to go deeper in some of your friendships and romantic connections, but you don’t know how to get there?

    • What is your level of engagement with your community? 

    • Do you feel a need for more adventure, but lack a healthy way to proceed?

    • How are you expressing your creativity in your current life?  Research has shown that unexpressed creativity is one of the most underrated sources of pain in this world.

    • Have you set some specific goals so you can see your progress toward new growth?

    Having great success in life can be very satisfying, but that might not be enough to meet all your needs for a full life.

    Maybe it is time to take stock and explore some of these vital questions with a supportive group of men who are asking similar questions in their own lives. Let’s get going.

  • Attachment styles shape how we connect in relationships—and for gay men, they’re influenced not just by early family dynamics but also by growing up in a world that hasn’t always embraced us.

    Originally focused on parent-child bonds, attachment theory now helps explain adult relationship patterns. The four main styles—secure, anxious, avoidant, and fearful-avoidant—appear in all types of couples, including gay ones. Secure individuals are comfortable with both closeness and independence. Anxious types often fear abandonment and crave reassurance. Avoidant people tend to distance themselves when intimacy feels threatening. Fearful-avoidant (or disorganized) individuals alternate between seeking closeness and pushing it away, often due to past trauma.

    In gay relationships, these styles show up in unique ways. An anxious man may fear rejection for being gay and need constant affirmation. An avoidant partner might pull back during conflict, especially if intimacy reminds him of being shamed in the past. A secure partner usually brings emotional steadiness, openness, and trust.

    Many gay men grow up facing rejection and internalize homophobia, which compounds difficulties with attachment. Coming out experiences—especially the reactions of parents—can deeply impact the security of our long-term connections. Supportive families are linked to healthier attachment, while rejection tends to reinforce fear and avoidance.

    There is good news: Attachment isn’t set in stone. Research shows many gay men shift toward more secure styles over time, especially through therapy, self-awareness, and affirming relationships. With growth comes “differentiation”—the ability to stay close while maintaining a strong sense of self.

    Understanding your own attachment style—and recognizing it in others—can help you avoid taking things personally, better manage conflict, and choose partners whose needs align with yours. It’s not just about healing old wounds; it’s about building real, lasting connection.


If you are ready to grow, heal, and thrive, let’s get started!