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couples counseling for gay men

Sound Familiar?

Antonio finally met the love of his life!!!  He knew it, his friends knew it, his family knew it.  Everyone was supportive.  As the two of them marched toward their wedding day, they remained sure and steady in their love for another.   AAAAAAAAnnnnnnnnnd…issues came up from time to time.  They seemed to have different ideas about monogamy.  They seemed to have different ideas about the degree to which their parents would be involved with their family.  They seemed to not see eye-to-eye about shared bank accounts and who held the pursestrings for financial expenditures.  Friends and family were quick to tell them this was “normal,” and they were probably right if by that they meant that these couples issues are “commonly occurring.”  But they still wanted help from someone talking all of this through.  But who?  Weren’t therapists for broken relationships only?

Brian and Aaron had been trying for a baby for so long!!!  Or at least it felt that way to them.  Subsequently, once their surrogate got pregnant, both assumed that once the baby arrived, they would be one big happy family. Unfortunately, since the birth of the baby, Brian can’t get seem to get out of his head about how things don’t feel as happy as he wanted, how the idea of being parents is more frightening than exciting, and how he’s nervous about all of the little parenting things he never seemed to think about prior to the arrival of their bundle of joy.  To make matters worse, Aaron is literally having the opposite experience — to him, everything seems filled with wonder.  How can they get through this together?

Max and Sam are the envy of most of their friends.  They’re stylish, always seem to have more than enough money, and even through a regular brunch soiree every month at their swanky pad in the Central West End of St. Louis.  What is less obvious to everyone else, however, is that their 6-year relationship has been characterized by countless break-ups and make-ups, often fueled by infidelity, including the kind they both agreed was okay and the kind that one or both agreed was not okay.  Those who were aware of this type of reality about their relationship were either part of the infidelity and thus here today and gone tomorrow, or, conversysel, those who were very close to them and thus felt reluctant to confront them for fear of injuring the relationship.  Max and Sam both agreed that they love each other, and want to figure this out.  But they also both felt so much internal and exteranl pressure to be the “model gay couple” for their social circles, to include friends, family, church, and civic life.  Off a recent night out that turned south, neither is sure they can make it for another go-round.

The Importance of Psychotherapy for Gay Men and Gay Male Couples in St. Louis

As a society, we have come a long way in accepting the LGBTQ+ community. Despite the progress made, there are still plenty of challenges faced by gay men in St. Louis and across the United States. Prejudice, discrimination, and stigmatization have all been shown to take their toll, leading to mental health issues and other negative consequences on the well-being of individuals. At the same time, there is also some good news!  Studies also show that gay couples have unique challenges which can be addressed and improved through couples therapy. However, many gay men and couples remain underserved by the mental health community.  There are a number of barriers to therapy such as practical obstacles like limited time or money, limited information and worries about treatment efficacy, questions about cultural impacts such as whether attendance to couples therapy may acceptance within the LGBTQ+ community, and the notion that many gay men are often resilient in the face of challenges on their own — i.e., learned coping mechanisms which have been vital for their survival may actually impede them from asking for help when it’s time. 

The Challenge of Mental Health for Gay Men

The prevalence of mental health issues within the LGBTQ+ population is higher compared to the general population. According to a study from the National Alliance on Mental Illness, up to 50.2% of LGBTQ+ individuals have a diagnosable mental illness compared to only 5.5% of the general population (in 2021).  That same study also showed that 13% of general population young adults aged 18-25 experienced thoughts of suicide each year, while 41% of LGBTQ youth did.  Another study from the American Psychological Association found that stigma and prejudice based on sexual orientation can lead to depression, anxiety disorders, substance abuse, and even suicide. The truth is that the daily discrimination a gay man faces can lead to significant mental health repercussions. Seeking out therapy can help individuals work through the challenges and develop coping mechanisms, ultimately leading to happier and healthier lives.Of course, their increased vulnerability to mental health issues cannot be separated from the stress and stigma stemming from living in a society where they are not fully accepted, and/or where they may face additional barriers to obtaining therapy which might mitigate such issues.  

The Benefits of Couples Therapy

Just like with any other couples, gay couples have needs for love and safety.  Also just like all couples, gay couples are prone to challenges, and some of they may be unique to their sexual orienation. For example:

  • When both partners are of the same gender, prototypical characteristics of that gender may be exaggerated in the relationship. This may be experienced positively or negatively.
  • Partners in same-sex relationships may feel unable to be open about their relationship with friends, colleagues, and family, potentially leaving the couple isolated and deprived of a support network.
  • The nature of monogamy, relationships, and polyamory tend to be unique in some portions of LGBTQ+ culture, and thus may not be easily or fully understood by themselves or others.

However, it seems worth noting that these and other challenges are often understudied and underappreciated. For instance, according to a study published in the Journal of LGBT Issues in Counseling, gay couples are often faced with issues such as internalized homophobia, coming out, and dealing with family members who struggle to accept them.  Seeking help from a therapist who is non-judgmental and specifically trained in LGBTQ+ issues can make it easier to work through these problems. St. Louis Gay Couples Therapy at Change, Inc. offers a safe and supportive environment where couples can discuss issues such as communication, sex, and intimacy, leading to healthier and stronger relationships.

Help for Now

If you’re a gay man or a gay couple considering counseling, even if you’re not yet ready to come to couples counseling just yet, here are some good reminders for you right where you are.

  • You’re a big boy: Bear in mind that the responsibility for your own feelings and actions always lies with you.  This does not mean that you could be in any situation and remain impervious to what’s happening — of course you are impacted by your partner and their behavior!  The point is simply that you’re in charge of where you go from there.  
  • 3 words — communication, communication, communication: Most people struggle to communicate their feelings frankly, directly, and authentically in at least some situations, and especially with intimate partners.  To the degree that you can, explain to your partner what your needs are (“I need alone time with you this evening — I’d really like that.”) rather than expecting them to read your tea leaves (“Everyone who loves me already knows what I like.  What’s wrong with you?”).  If you can’t do this, it may be time to talk with someone you can trust to help you find your way there.
  • Did we say “communcation” already?: There is no such thing as being too intentional about your relationships (at least, not that we’ve seen yet)!  Consider putting an appointment on your mutual calendars each month to have a nice dinner together (whether that’s fast food or fine dining) and talk through anything that’s troubling you.  What’s better, make it a commitment to save your talks about what’s troubling you until this specific time, so that the rest of the month you’re free to enjoy one another in the safety of knowing time for the other stuff is coming.  And by the way, if some of them aren’t important enough to remember by the time your regular talk comes around, they’re probably worth letting go!
  • What’s in a name?  A lot!!!: Do not call one another names, or intentionally or maliciously go after one another’s weak points in arguments.  The urge to do this is understandable, but the impact is usually pretty devastating.  Keep it above the belt, at least in this area! 😉
  • A spade is a spade.:  We can call manure roses, but it’s still manure.  Destructive is destructive.  If your intimate or other relationships contain recurring themes of excessive fighting, violence, unnecessary drama, name-calling, lashing out, cheating, etc. — it’s time to get help or get out (or get help getting out).  Now.
  • Speaking of…There is no shame in asking for help, and in fact, most successful people and couples are among the first to admit that the degree to which they are successful is strongly informed by how frequently they’ve done just that.  

The Bottom Line

Gay men and couples deserve access to mental health services that address their specific needs. Mental health struggles and relationship challenges can be significantly impacting on gay men’s lives. It’s time for us to change the narrative and recognize the need for providing mental health support and therapy to help the LGBTQ+ community work through these issues. With support and tools to manage their mental health and relationships, they can thrive and live authentic lives.

At Change, Inc. St. Louis Counseling, our therapists aren’t just expert counselors – they’re agents of change!  Not only can we help gay couples with their relationship issues, we can help you learn to live more with more happiness and purpose!  We can help you build new and lasting support systems, restructure your new life for the better, and get you on the road to healthy, vibrant living!

Looking for St. Louis Gay Men’s Couples Counseling or Counseling for Gay Men and Couples in St. Louis?  

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(314) 669-6242

ST. LOUIS COunseling Locations


Change, Inc. South Hampton & 44:

3460 Hampton Avenue, Suite 204

St. Louis, MO 63139 



Monday through Friday // 9a to 3p

Saturday // 12p to 3p

Contacts received before 3pm:

  • returned the same business day

Contacts received after 3pm or on the Sundays:

  • returned the next business day

314-669-6242 / 877-5-CHANGE (524-2643)




10am to 9pm