What Should Gay Men Talk About in Therapy? Insights from a West Hollywood Therapist

You’ve taken the leap: you’ve found a therapist and scheduled your first session. Now what? We’ve heard time and time again that therapy is beneficial for our mental health, but what does that look like in practice? What exactly should you talk about when you’re in that room? While each therapist may have their own approach, there are certain themes and areas that, from my perspective as a gay therapist in West Hollywood, I strongly encourage gay men to explore during therapy. Here are some key topics to consider.

Your Sex Life

No matter where you are in your journey as a gay man, your sexuality is a central part of who you are—and it should be part of your therapy. Even if coming out felt easy, or if it seems like a thing of the past, it’s important to examine how you feel about your sexuality in the present. All gay men, regardless of how confident or comfortable they may seem, wrestle with some form of internalized homophobia. Even us therapists are not immune. These feelings can manifest in various ways: maybe you feel discomfort or shame around your desires, or perhaps you find yourself overcompensating by indulging in hookup apps or excessive pornography consumption. Exploring these topics in therapy is crucial for your emotional health. Understanding how these behaviors or patterns are affecting your mental and emotional well-being can lead to greater self-awareness and, ultimately, healthier relationships with yourself and others.

For example, many gay men find themselves using hookup apps as a way to seek validation or fill emotional voids, rather than focusing on more meaningful connections. Addressing how these platforms shape your self-worth can be an essential part of therapy, helping you reconnect with the idea that your value isn't dependent on others' opinions or on fleeting physical encounters. Similarly, reflecting on the role pornography plays in your life—whether it feels like a tool for release or a source of shame—can shed light on deeper issues related to intimacy, self-esteem, and emotional connection.

Your Upbringing

It may seem cliché, but it’s undeniably true: we are shaped by our childhood experiences. If you want to understand who you are today, you need to explore your past. Our early experiences with family and the environment around us influence our sense of self, our values, and the patterns we follow in relationships. For gay men, this often involves examining our relationship with our fathers. Fathers, whether we want to admit it or not, are often our first models of masculinity. But what happens when we don’t conform to the traditional male archetype? For many gay men, the relationship with their fathers can feel strained, confusing, or distant. This dynamic often sets the stage for struggles with self-acceptance or feelings of inadequacy, as society typically defines masculinity in ways that feel out of reach for those who don't fit that mold.

In therapy, it’s crucial to unpack how your relationship with your father (or other significant male figures) shaped your understanding of gender and masculinity. You might have been told, either directly or indirectly, that to be a man means to be tough, dominant, or unemotional. As a gay man, you may have felt that these traits didn't align with who you are, leading to inner conflict or feelings of rejection. Exploring these issues in therapy allows you to redefine masculinity on your own terms, creating space for a more authentic and liberated version of yourself.

In addition to your relationship with your father, it's also important to explore your relationship with gender in general. Gay men, in particular, may feel disconnected from traditional gender expectations, which can leave them questioning their identity or sense of belonging. Therapy offers a safe space to explore how your gender expression aligns with—or challenges—the societal standards imposed on you.

Your Therapist

This one might seem unusual, but it’s incredibly important: talk about how you feel toward your therapist. Many people think of therapists as blank slates, as objective observers who remain emotionally distant. However, therapists are human too, and it’s helpful for you to explore your emotional responses to them. How you feel about your therapist can reveal a lot about your attachment style and underlying emotional patterns. Do you see your therapist as a warm, empathetic figure who embodies the mother you always longed for, or perhaps as a cold, judgmental figure that reminds you of a distant father? These feelings are not just “side issues” that should be ignored—they are vital pieces of information that can help you understand how you relate to others in your life.

Sometimes, clients project unresolved feelings from past relationships onto their therapists. This is a normal part of the therapeutic process, known as “transference.” In some cases, this can be a helpful way to uncover deeper emotional wounds and work through old patterns of thinking and relating. On the flip side, your therapist may also trigger feelings of admiration, trust, or respect. These emotions, too, can inform the work you’re doing in therapy. For instance, feeling safe with your therapist may signal an increased ability to trust others, which can be explored in greater depth.

Your Resistance

Change is hard. Human beings tend to hold onto what’s familiar, even if that “familiar” is harmful or limiting. Therapy, by its very nature, disrupts the status quo. You’ve taken the step of showing up for your sessions, but that doesn’t mean you won’t encounter resistance along the way. In fact, resistance is a natural and expected part of the process. Many people feel the need to please their therapist or present an ideal version of themselves in the therapy room. This can create tension between your desire to change and your fear of what that change might look like.

It’s important to acknowledge and discuss your resistance in therapy. You don’t have to feel enthusiastic about every session. It’s okay to feel ambivalent or even frustrated at times. In fact, these feelings can be an opportunity to explore what’s holding you back from making progress. Are you afraid of confronting painful emotions? Do you feel unworthy of healing or change? By identifying and working through your resistance, you can increase your chances of overcoming the barriers that have held you back for so long.

Gay Therapist in West Hollywood

As a gay therapist in West Hollywood, I understand that the topics above are just a starting point. Therapy is a highly personal process, and it’s essential that you bring what’s most pressing and important to you into the room. The ideas I’ve shared are meant to help guide you, but they’re not exhaustive. Every person’s experience is unique, and the therapy process will unfold differently for each individual.

Ultimately, the key to successful therapy is consistency. Showing up week after week, even when it feels difficult, is often half the battle. It’s also crucial to find a therapist who feels like a good fit for you. A strong therapeutic relationship is one of the most important factors in making progress. If you haven’t already taken the first step toward therapy, I encourage you to reach out for a complimentary consultation. The right therapist can help you unlock the tools and insights you need to move forward with confidence and self-compassion.

Remember, therapy is a journey, and it’s okay to take it one step at a time. You don’t have to have all the answers right now. What matters is that you’re willing to explore, learn, and grow.What Gay Men Talk About in Therapy: Insights from a West Hollywood Therapist