older gay men suicide

Suicide in the United States has surged to its highest level in nearly thirty years. Although this rise was particularly steep for women, it increased substantially for all middle-aged Americans, a group whose suicide rate had been stable or falling since the 1950s.

The majority of gay/bi men maintain good mental health but compared to other men they are at greater risk for mental health problems. One group of researchers found that 12% of urban gay and bisexual men have attempted suicide, a rate three times higher than the overall rate for American men. Almost half reported multiple attempts. One common theme underlies most successful suicides: a sense of hopelessness.

 

Predicament suicide

Some psychiatrists have described predicament suicide, in the absence of a diagnosable mental condition, as circumstances they face from which they cannot find an acceptable escape, such as financial loss or forced marriages. A decision to come out in midlife might represent such a predicament; older men may feel they are sacrificing everything they once valued and feeling there is no one with whom they can speak about it.

Dr. Whitney Carlson, a Seattle-based geriatric psychiatrist says,

“Some individuals decide this is as far as they want the road to take them. Many of them are completely rational and accurate in their assessment of their situations. If they are lucky, they will cross paths with someone who can offer hope. For some, this does not represent depression but perhaps, rational choice.”

Most research on suicide has been done on youth with an increasing emphasis in recent years on bullying, but very little research has explored gay, middle-aged men and suicide.

Several things account for mental health issues for older gay men:

  • Homophobia, stigma, and discrimination
  • Social isolation
  • Lack of trust in healthcare providers
  • Lower income
  • Alcoholism and illegal drug use
  • HIV

One study found that the age of serious suicide attempts by gay/bi men coincided with major coming out milestones. At whatever age a person first begins to seriously question their sexual orientation, that conflict has been implicated in the lead up to the suicide attempt. When coming out milestones are reached at a later age, the first suicide attempt for gay/bi/questioning men occurred at an older age.

 

Getting to the right resources

Most gay and bi men can cope successfully if they have access to the right resources. Therapists who are knowledgeable and affirming provide helpful therapeutic experiences, while counseling from therapists who focus on changing sexual orientation or encourage hiding it are unhelpful and sometimes damaging. People who seek counseling from religious advisors who considered homosexuality sinful have a higher risk of suicide than those who counsel with affirming religious groups.

A recent study found that strict conformity to masculine norms had implications for negative mental health outcomes, including depression, anxiety, substance abuse, and poor body image. The three characteristics most closely associated with poor outcomes were self-reliance, power over women, and sexual promiscuity. Boys are taught to be self-reliant by gender police who continuously remind them to take it like a man when they transgress from this norm. For gay men, this is often accompanied by a sense of shame: I am bad, therefore, I don’t deserve help.

A consistent correlation exists between race and socioeconomic factors. Those from a racial minority or living in poverty have poorer outcomes and higher risks of successful suicide.

Many of the challenges that lead gay/bi/questioning men to consider suicide are not immutable. As more and more people have come out in recent years, social attitudes toward homosexuality have changed albeit with significant backlash. One of the most necessary changes is to deconstruct the requirement for self-reliance and reconstruct a new sense of masculinity.

 

Coming out is a process

As I describe in my book Finally Out: Letting Go of Living Finally Out: Letting Go of Living StraightStraight, coming out is not an event but a process. Not everyone has to come out to every person in every circumstance. Having a supportive group of family and friends is very important. When families are not accepting, developing a “family of choice” may be essential. The Internet has helped men isolated in rural areas or cultures with strong prohibitions against homosexuality, and it allows for an anonymous discussion of questions concerning sexuality.

Medications may be indicated particularly if there is significant insomnia or a failure to function in most areas of one’s life. Counseling may be helpful but choose carefully. A good therapist will not impose their values on their counselees. Care-seekers are often intimidated by their perception of an imbalance of power in the counseling relationship, but you have a right to interview the therapist about their attitudes and training before making a commitment to therapy.

For those struggling with conflicts about sexual orientation, reach out to someone who can offer hope.

15 COMMENTS

  1. I don’t know if anyone is still reading this, but I find this discussion very relevant to myself. I’m a 53 year old man in the central US, gay, very isolated and lonely. Most of my hobbies and interests, such as mechanical work and motorcycle riding, are traditionally “straight” things, so most gay men don’t find me interesting to talk to, yet straight men whose friendship I’d enjoy understandably put up a bit of a barrier when they find out I’m gay – much the same as they might feel uncomfortable getting too friendly with a single woman they’re not attracted to because they don’t want to create expectations of something they don’t want.

    When Michael mentions finding pleasure and fulfillment from within, I can understand this point, but this is somewhat dependent on having a significant amount of money. Yes, if you can buy nice stuff, take trips or enjoy having adventures, you can do a lot to salve over any negative feelings you might be having. I can see both sides of that because ten years ago I was better off financially than I am now.

    Relative to some of the advice given, if you can afford a therapist or have a friend who cares to listen, yeah, that probably helps. As for social groups, I’ve attempted to link up with, for instance, a gay motorcycle riding club in a distant city (because there’s nothing like this near me), traveling 250 miles in hopes of finding people with similar interests – thinking it might be fun even if I could only make it there a few times a year. What I got was a “who the hell are you” attitude that made me feel more lonely than I would have felt if I had been by myself. The ones at the top of the club pecking order all had fancy riding gear and $30,000 custom bikes. It was all of the BS of a gay bar, but just adapted to motorcycles.

    The main reason I’m writing this is in case someone similar might see it and we could possibly develop a friendship. But I’d be glad to talk to anyone who’d like to comment.

  2. Thanks Loren. I just saw your reply. I don’t disagree with your suggestions. I’ve found meaning in my work as an historian and have participated in social groups for older gay men and I have met men online. I go to a great gay therapist periodically with whom I am completely honest, including about my wish to find a way to end my life. What I don’t have is friends. I do try to interact with the men I meet, but they treat me like a sort of therapist as they describe their latest sexual escapades or unburden themselves to me in texts and occasional phone calls about their personal doubts and fears. They aren’t able to make me feel like i’m heard when I explain my feelings, though I don’t even hint at my suicidal thoughts with them. The more sane and balanced gay men I meet are coupled and understandably want to socialize with other gay male couples. They politely decline my social invitations. Without the prospect of sex, I can’t get any men to spend any time with me. I’m not going to have sex with men I’m not sexually interested in for the sake of getting a man to meet me. I still have some sexual desires but not for the men I meet. Strangely enough, these men express an interest in sex even as they let me know that they don’t actually find me attractive. They only want sex with me because I’m available. I have good health and might go on like this for years but I feel as if I’m finished with life. I’ve lived a full life in many ways, including having several meaningful sexual relationships..one lasted for 7 years. I’ve learned important lessons about being human and living in the world. I feel a sense of having completed the challenges of life and am grateful for those experiences. I see being able to choose to end my life as a reward for having made it this far. Am I just afraid of facing one more new challenge, namely, learning how to face the final stages of my life alone? I know that no one wants to face this reality, but I can’t see what I would gain by learning how to remain independent until I’ve reached some arbitrary age when it would be ‘acceptable’ to society for me to die. The prospect of mere survival isn’t enough. If there was a sure-fire way that I could end my life quickly and predictably, I’d go for it. It’s only the prospect of surviving any attempts that keeps me from trying. I don’t expect the world to change to suit me, but I can’t see how I could ever enjoy my place in the world. Thanks for providing this forum as a place where I can openly acknowledge my feelings.

  3. I think there can be times when suicide is rational, for example, when someone is facing a terminal, painful illness with no hope of recovery. Many of us would agree that a person suffering like that might justifiably begin to think of suicide as a way to end that awful pain.

    Loneliness and depression often occur together, but they are not the same thing, as I wrote in an article for Psychology Today called, “Loneliness is a Killer, ” https://www.psychologytoday.com/blog/finally-out/201712/loneliness-is-killer-why-dont-we-talk-about-it

    But loneliness and depression are not like chronic illnesses for which there is nothing that can be done. This is why, in these situations, suicide may LOOK rational but it is not rational because both conditions need not be permanent and, therefore, as hopeless as they appear. These conditions only APPEAR that they will go on forever, but if one can hold on and make some changes, the pain can subside.

    The three things one must do are:
    1. Become identified with a larger group – social, religious, political, Alcoholics Anonymous or anything that gives your life meaning

    2. Become a part of a smaller group with frequent, unplanned interactions – For older gay men, Prime Timers Worldwide, for example, often provides those opportunities, but there are many others as well

    3. Find a chum, someone with whom you can bare your soul and share your secrets. In some cases, it may mean a therapist, at least for a while.
    But what I detect in your comment, Matt, is a negative mindset that says, “I’ve tried all that. None of those things will help. It’s pointless.” It certainly can FEEL that way. But somewhere out there is another human being who is looking for you, too. But in order to find him/her, you must begin to believe that he/she is out there, somewhere.

  4. I think that suicide can be rational. I’m not depressed, but I have no desire to continue to live either. My friends are all far away and I have little in common with them anymore, the only sexual relationship available are casual/anonymous hookups, and I spend almost all my time alone. I’m ignored at gay social events or meet men who are deeply troubled and need far more than I could ever give them. If anyone cared about me or needed me in any way I might feel differently. I don’t see the point in struggling with my health and finances just to reach some arbitrary number of years. Isn’t it better that I control the circumstances of my death while I’m still able to do so?

  5. Michael,

    So pleased to hear. What all of us struggle with when we consider coming out are the stereotypes. We grow up surrounded by them and internalize them. Then we compare who we are to that standard, which results in a lot of guilt and shame. But shame doesn’t survive in the presence of those who accept us for who we really are. Safe travels.

  6. I found that as I got older that my greatest happiness came from within-I absolutely positively let nothing or no-one bother me. I go on vacations by myself, buy things for myself, enjoy things more than when I was younger; sure I would love to have someone, but then again, who’s to say that that’s the ultimate “prize”. I had a Fabulous doctor who helped me re-shape my thinking process an make it work more efficiently for me, to be happy, be more full of life, to love myself, because thats what really matter… I will be leaving on yet another adventure soon, I can’t wait… ))

  7. maybe you could use a picture of older gay guys to go with story. This is a big part of the problem in gay society. We cannot even have a conversation about older gays without the misrepresenting them with young gay guys.

  8. BWright and Michael O’Hanlon

    Dr. Salber has asked me to respond to both of you and I will do so. Both comments are very important and I want to answer them with a thoughtful response and that will take a bit longer than I have today. But the bottom line for both of you is that there is hope. Depression is treatable. The two most important things to find joy in later life are 1. Finding a sense of something that is meaningful to do, 2. Connecting with people who accept you.

    We’ll talk more about both in a later message. I also have some references to some other essays I’ve written, and at the risk of sounding like I’m promoting myself to much, some of these answers are in my book, FINALLY OUT: LETTING GO OF LIVING STRAIGHT. Chapter 11 is all about aging and how to get through it.

    Loren Olson

    • As promised, I want to respond to the previous posts from BWright and Michael O’Hanlon because these are important questions that I have been asked about many times. Neither of you are at all unique in what you have experienced.

      When I turned sixty years old, I also went through a difficult time for some of the same reasons you’ve mentioned. I had lost my mother, step-father, and a brother within six months, and some friends had died. I needed a knee and a shoulder replacement. My career had plateaued and I thought it was on the decline. I had some difficulty with erectile dysfunction. All I could see for the future was a series of continued losses.

      Then after I spoke in Houston, a man raised his hands in the air and said, “I’m 82 and this is the best time in my life.” I thought, What does he know that I need to know? One of my favorite sayings (sometimes attributed to Buddha) is: Pain is inevitable; suffering is optional. In other words, I couldn’t change the fact that I was sixty and that I had experienced many losses, but I was suffering because that was all I could think about. I began to re-focus my thinking on age as an adventure with opportunities I had never had and may not have again.

      One of the “opportunities” is the power to re-shape our thinking. We can deconstruct an old, outdated value system and develop a new one consistent with the person we believe that we are, not one based on others’ expectations of us. I wrote about it in this essay in Psychology Today.

      Sometimes we think of coming out as an event, but it is a process. I don’t believe we must come out to everyone in every circumstance. Being honest about our sexual orientation is liberating for us personally but it can damage relationships that are important. BW, since you’re 65, your parents must be in their 80s. They lived in an era when gay men and women were sent to prison and considered deviant and predatory. Coming out to them may have unintended consequences for them and for you. I appreciate your wish to be honest with them; they may even already suspect it. But once it is out in the open, it demands a response, and you have no control over what that response might be. You have been considering this for years; they only just would begin to think about it.

      In considering a decision like this, where risks and outcomes are uncertain, we tend to magnify the negative and minimize the positive. It is certainly possible that your parents might respond, “We love you anyway you are.” But there is no guarantee. No optimal decision exists, but each of us must decide for ourselves what is a satisfactory resolution, how far and to whom to come out. You have already experienced a lot of losses. Do you wish to risk the loss of your parents’ support at a time when you really need some?

      Financial and medical problems are one of the major source of difficulty for us as we grow older. I’ve been both poor and financially secure, and I can tell you that financial security does not guarantee happiness. I am absolutely convinced that happiness during our later years depends primarily (after our basic needs are met) upon having something that gives your life meaning and having friends (gay or straight) who accept us as we are.

      Doctors are just people and we are as diverse as the rest of the population. Two things are critical: he/she is well-trained and that you feel you connect with them. Men less than women talk about their depressions, but a good doctor is one place to start. All medications have risks and the more meds you take, the higher the risks. A doctor cannot possibly remember all the drug interactions and less frequent side-effects. Patients must advocate for themselves. A good place to check for drug interactions can be found here. I refer to it frequently when I treat patients. Having a companion go to your medical appointments with you will also result in better medical care.

      Many of the things you mentioned, BWright, are considered “non-specific symptoms,” meaning they could be attributed to many things. Depression could account for some; medications for others. And there are other possibilities as well. This can make treating them somewhat complicated, but treatment is possible once the cause(s) are discovered.

      Struggling with prostate problems and erectile dysfunction (ED) are indeed a potential curse/pain but don’t suffer needlessly. See your doctor about the prostate problems. While medical problems and medications can cause some of the problems related to ED, often the problems are psychological, too. At the first sign of some difficulty with erections, men often begin to worry that they are losing their ability to function sexually, and then the worrying about the problem becomes an even bigger problem. I have addressed this in Finally Out Tips. But important research shows that while sex drive, ejaculation and erections may diminish as we age, sexual satisfaction can remain constant. The important message is that good sex does not demand that we have a world-class erection!

      Suicide sometimes begins to seem rational when faced with a serious predicament, but it is a permanent solution to what in most cases is a temporary problem. I can’t tell you what the solutions are, BWright, but I can tell you that I believe there are solutions although sometimes finding them can be painfully slow.

      Having the right persons to talk to is critical. Your primary care physician can be a good one, but is important that your doctor accept your sexual orientation. If your doctor doesn’t know or doesn’t accept your sexuality, he/she will give you bad advice. Here is a resource for finding a supportive health care provider. Younger physicians may be more open and affirming about sexual orientation, but not necessarily. The same things hold true for finding a supportive counselor. The Association of LGBTQ Psychiatrists also has a referral directory.

      Michael, most of us who are older have had the experience of either feeling we were sitting on the sidelines in the LGBTQ community or have been invisible to them. For many of us, dancing the night away and drinking excessively has lost its charm. We need gay spaces, where we can talk together and hear each other. Many larger communities have options for that. One international organization that provides these opportunities is Prime Timers Worldwide, with about 80 local chapters; they also have an independent group for those who live too far away from chapters. Another online resource to find connections is on Facebook, which also might be a good place for you, BWright, to find someone to chat with.

      I would also like to try to dispel a myth about younger/older men. Not all young gay men who like older men are looking for a “sugar daddy” to take care of them, and not all older men who like younger men are looking for a “trophy partner.” Age can be a factor in sexual orientation. I would take exception to your young friend’s statement “younger faeries often band together to defend themselves.” Older gay men are not predators, at least the majority, and young “faeries” have nothing to protect themselves from; my husband is fifteen years younger than me and we’ve been together for thirty years. And many of these younger men who like older men, prefer to be in the presence of older men, as one said to me, “I like older men because they have rounded corners.” We do have a bias in our culture and a focus on youth, but part of that is because those of us who are older have not raised our voices and said, “Hey, I’m queer, too. Notice me!”

      Gay, straight or other, ageism is a factor because of stereotypes. Stereotypes exist in a world of “those other people.” They exist when one outside group attempts to define another. One characteristic of the “other” is elevated to master status and generalized to an entire population; it is the basis of all prejudice. But we are also the victims of those stereotypes because we have internalized them, too. If we believe that as older gay men and women we’re on a period of decline to nothingness, we are our own victims of the stereotype.

      I am 74 now. When I was young, 74 was considered very old. But now, I am considered a survivor, and I have a life expectancy of another 12 years. I feel an urgency of time, but it allows me to choose to do things I really want to and not do other things that I once thought I had to do. I have moved things from my bucket list to an un-bucket list. I no longer feel pressured to climb the ladder to the top. I don’t go to cocktail parties unless I know I’m going to like the people who are there. I don’t need to “network,” to find people who can move me further up the ladder. I don’t sit through boring lectures. I don’t read lengthy essays unless they really have something important to say. I hope you’re still reading this one. Make this the best time in your life.

  9. as an older Austrlian man who came out in his 40s my early expreices of queer culture were largely postive as I marvelled about how men formed relationships across ethnic and age barriers . I have recently tuned 60 and I find myself becoming more and more invisible in the youth obsessed English speaking cultures I know. Thankfully this is not the same in Latin and Asian countries or even in Europe generally.

    At a number of recent events even some of my younger close gay friends ignored me in the pursuit of the younger prettier and more mobile.
    These events have included radical faery gatherings festivals and social weekends despite making a considerable effort on each occasion in such ways as cost sharing cooking, volunteer working transport and or teaching for free

    i asked a younger fairy friend about this -he said younger faeries often band together to defend themselves from unwelcome sexual attentions from older faeries

    have you considered depression in older gay men is caused by rejection and /or ageism in the gay community

    regards Eureka

  10. This hit the nail on it’s head.. At 65 years of age my mental being is reshaping . On one hand I wish to announce to my parents that I am and desire to become gay, on the other hand I wish not to disclose my feelings for the fear of being totally rejected or disinherited. I got trapped in the finance crisis and lost a 30 year old business and then my home, after that my health unexpectantly took a turn. I lost my hearing over night at 55, within the time frame of the business and home loss. I was left with out Insurance coverage , I had no income and was denied both unemployment and disability! The stress of that led to HBP and health issues. I had to resort to the state’s Medicare for low income. I also had to take a early retirement to draw the SS at 62. A loss of about $550 to $700 per month and that was ordered because of SSI. I am thankful having my vehicle paid for before this happened and my living contents, but downsizing including selling personal items at a great loss. I can not take another form of work/employment because of my hearing and now HBP related medical issues. My cardiologist treated me lake a free clinic street person and prescribed medication that made matters most with side effects including depression, weigh gain, insomnia, weakness, and non energetic. Only through an ER visit the attending ER doctor asked what meds I was prescribed, after unveiling the meds, He said “this meds are killing you ” Thank god that called for a different primary Care doctor, with his guidance I am recovering . NOW it’s the man curse of the prostrate and ED. which is even more depressing ! So I have not ruled out suicide and think about it often, I can not bare the thought of hurting my parent or my brothers as well some friends. This message really acknowledge that yes there is a MAJOR issue among the older gay/bi/trans/ community. The problems of just surviving living accommodations, food, medical services and medications is overwhelming at times.. But importantly having the right person to just talk to !

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