How Do I Know If I Need Therapy?

Summary: Therapy is a real commitment, so it’s understandable if you want to think carefully before jumping in. It’s also important that you believe you can benefit from it.

To help you figure this out, take a few minutes to read through the material below. Over the years, we’ve found that men experiencing unwanted homosexuality tend to face the issues described here. Some men face just a few of these issues while other men face many of them. Everyone faces them unique ways.

If you’re experiencing some of these issues, working with a Center for Gender Wholeness therapist could be helpful. We’ve become very adept in helping men with these kinds of concerns. The more of these issues you’re experiencing, the more strongly you should consider therapy and the more likely you are to benefit from it. Most of these issues are long lasting and do not tend to go away on their own.

Distress Over Sexuality

    • Confusion over what to do about your homosexuality
    • Strong or even overwhelming homosexual feelings
    • Wanting out of a gay lifestyle
    • Conflict between your sexuality and your values, goals, or faith
    • Conflict in your relationship with God
    • Difficulty holding onto your faith

Problems Regarding Gender

Psychological and Emotional Issues

Abuse and Trauma

    • Memories or suspicions of sexual abuse
    • Sexual experiences during childhood
    • Memories or suspicions of physical or emotional abuse (including bullying)
    • Traumatic losses of friends or loved ones
    • Posttraumatic disturbance
    • Dissociation

Relationship Difficulties

    • Isolation and loneliness
    • Conflicts with your spouse
    • Conflicts with your parents
    • Concern about the future of your family
    • Difficulty being sexual with your opposite-sex partner
    • Wanting to marry an opposite-sex partner but feeling unprepared to do so

Contact us for a FREE 30-minute consultation with one of our licensed therapists if you would like to further explore whether therapy is right for you.

Gender Shame

Shame is an ongoing sense of being fundamentally bad, inadequate, defective, or unworthy. Shame can become woven into a person’s sense of who they are. Over time, shame can become a core facet of their identity. Shame can become attached specifically to masculinity when a boy internalizes from his environment any of the following messages: males are bad, it is bad to be male, it is bad for me to be male, or I am bad at being male. READ MORE ABOUT SHAME.

Gender Double Binds

A double bind is a situation where there is no good way out—where there is pain or trouble no matter what you do. You’re damned if you do and damned if you don’t. In its most pure form, a double bind occurs when a person is given two messages or commands that contradict or conflict with each other in such a way that responding appropriately to one prevents an appropriate response to the other. When a boy or a man experiences contradictory messages about males and being male—and he has no way to resolve the contradiction—he’s in a gender double bind. Below are three examples of the many different ways this can happen.

    • Example One: A boy comes to believe that he is incapable of becoming a normal man and that he’ll be shamed if he tries. But he also believes that he’ll be worthless if he doesn’t become like them. His choice is shame or worthlessness.

    • Example Two: A boy feels an aching need for friendship and acceptance from other boys. But he is unable to form connections with other boys either because he can’t relate to them, they bully him, or his parent won’t allow him to. He is faced with either the pain of an unmet need or the distress associated with trying to fulfill it.

    • Example Three: A mother discourages her son from being like his father and the other males in the family and encourages his more gentle nature and behavior. This alienates him from the other males. But he intuitively knows he belongs among the males. He faces the choice of being alienated from his own gender or contradicting and disappointing his mother.
      Individual therapy can help you becoming free from gender double binds.

Gender Imperatives

Many men with same–sex attraction tend to become fixated or obsessed with certain male traits. Often they consider these attributes to be necessary in order to be truly masculine or to be considered attractive, desirable, good, valuable, loveable, or complete as a man. When they see someone with the trait—or when they think about the trait—they are prone to experience powerful feelings of pain, longing, curiosity, envy, or lust. Reports from men with same-sex attraction suggest that this fixation can begin in childhood, although it may not emerge until adolescence or even later. These obsessions tend to become inflexible and unrealistic and can remain unchanged over many years. These obsessions are called “gender imperatives.”

Gender imperatives seem to form in response to masculine traits men with same-sex attraction see in the males around us but consider themselves to be lacking in. The dissimilarity and incongruity they sense in relation to these masculine traits becomes a critical factor differentiating them from the males around them. Typically, they tell themselves the story that these differences make them inferior or wrong, which creates pain and longing. They may tell themselves that, in order to be truly worthy or whole as a boy or man, they must possess those qualities. But they also see themselves as incapable of sufficiently obtaining or developing the required traits.

Self-observation and personal reflection can help you recognize your gender imperatives. CGW therapists are trained to help you desexualize and decrease the intensity of your imperatives.

Gender Incongruity

Gender incongruity is a sense of being incompatible with, or not conforming to, your internalized definition of masculinity. Gender shame, gender double binds, and gender imperatives can cause men to see themselves as being at odds or out–of–sync with what they believe a man is supposed to be.

Men with gender incongruity look at other men and think, “I am not like them and they are not like me. I am different and that difference makes me less.” It’s likely that nearly all men on occasion feel like they don’t fully measure up to their masculine ideal. But gender incongruity is much deeper than just not fully measuring up. It’s a pervasive sense that you’re lacking in vital qualities or capacities that are essential for masculinity. And it includes a belief that there is no way to sufficiently obtain or grow into these qualities or capacities.

Difficulty in relationships with other men

Painful, frightening, or alienating experiences with other males can lead boys to pull away from their father, brother, peers, and other males, breaking or preventing the normal affiliations and creating a state of “disaffiliation.” Elizabeth Moberly and Joseph Nicolosi describe a situation called “defensive detachment” in which a boy not only pulls away, but also puts up an unconscious block against the possibility of ever reconnecting. Men need connection with other men; it’s core and non–negotiable need. So if a man is detached, his natural needs for attachment, resonance, approval, and support will go unmet. And if his defensiveness prevents him from reconnecting, he’ll remain isolated, without support, and his needs may turn into longings and cravings.

Negative stereotypes of boys and men can contribute to same–sex disaffiliation. Not all men with same–sex attraction have negative views of other men, but many do. These stereotypes may have been formed directly from bad personal experiences with other boys or men early in childhood. Or they might have been caused by anti–male complaints and criticisms from females around the young boy. The distance from other men that is created by defensive detachment perpetuates negative stereotypes because it prevents the man who experiences it from getting to know what other men are really like. They only know their ugly side. Holding onto negative stereotypes alienates these men from their peers, which prevents them from fulfilling core needs.

Unhealthy Responses to Women

Men with same-sex attraction often describe unhealthy relationships with women that may be grouped into four broad categories: oppositional, avoidant, enmeshed, and comfortable. Men may respond to women with feelings, impulses, and behaviors from just one of these categories or from two or more of these categories, depending on the situation. As you read the descriptions below, consider if any of it fits for you.

Men who become oppositional tend to reject women and push them away. They may do so out of feelings of resentment, dislike, disgust, or even hatred. Or they may do so in reaction to feeling threatened and endangered by women. Some men are completely conscious and blatant about their antipathy toward females. For others, negative feelings toward women may show up only in subtle behaviors and thoughts of which they are barely aware. And some men may be completely unconscious of their opposition.

Men who are avoidant of women tend to experience feelings of fear and anxiety, which may cause them to keep their distance. Or they may simply feel apathetic and indifferent toward women, perhaps treating them as if they don’t exist.

Men who are enmeshed with women tend to feel needy or dependent on women’s support and approval. They may subordinate themselves to women, allowing themselves to be controlled by them. The dependency may go the other direction as well, as in the case where an elderly mother is dependent on her son for assistance in ways that disrupt his ability to live his own life. And the man may be bound to maintain this situation by tremendous feelings of guilt. If he tries to free himself from the entanglement, his guilt overwhelms him and he gives in.

Men who are comfortable with women tend to seek out females and female settings as sources of security and consolation. In this case, “comfortable” means something more than simply being at ease with women. It implies an over–familiarity and over–resonance with them, sharing interests and perspectives, or feeling included as “one of the girls.” And it often includes using women and female settings as places of resort and safety.

Gender Distortion

Many men with same-sex attraction describe distorted perspectives or beliefs about women. They may develop beliefs about women that are not accurate for women as a whole, even if they may be true about the women within their own families. For example, they may view all women as dangerous or downright evil—as cruel, vindictive abusers. They may see them as needy and engulfing, manipulative and cajoling. Or they may see women generally as being stupid and weak or as just more trouble than they’re worth—moody, complaining, and whining. On the other hand, they may idealize women, viewing them as good, pure, or even sacred. Or they may look to them as protectors or providers.

Men with same-sex attraction may also develop incorrect or immature perceptions of themselves in relation to women. They may see themselves as needy and weak in their relationships with women or as undesirable, vulnerable, and inferior to women. They may feel small and incapable of handling the demands of an intimate opposite–sex relationship. On the other extreme, they may see themselves as being superior to females—as far better or somehow right.

These perspectives of women can impact a man’s sense of gender. For many men with same-sex attraction, females were the predominant influence in their lives growing up. Women provided them with role modeling and friendship while the men in their lives may have had little impact on them. This may have left these men without a clear sense of genderedness—the roles and differences between men and women may seem ambiguous.


General Anxiety

Anxiety can take many forms and affect people in many different ways. As you review the anxiety symptom checklist below, write down the symptoms you identify with. Also, consider how often, how long, and how intensely you experience those symptoms.

    • Feeling anxious or worried and having difficulty controlling the worry. This might be about one specific thing or about a number of different concerns.

    • Feeling restless, keyed up, or on edge

    • Getting tired or fatigued easily

    • Having a difficult time concentrating or finding that your mind goes blank

    • Being easily irritated

    • Holding tension in your body

    • Having difficulty falling or staying asleep or waking in the morning not feeling rested

If you’ve experienced three or more of these symptoms within the past few months, you should consider seeking help from a psychotherapist, particularly if the symptom has been distressing or debilitating.

Social Anxiety

Fear of social situations can make it very difficult for people to fulfill their needs for closeness with others. Review the list below in the same way you reviewed the list above, identifying the symptoms that fit you and noticing the frequency, length, and intensity of each symptom you acknowledge.

    • You fear being embarrassed or humiliated in a social situation (particularly with unfamiliar people) or a situation in which you believe your performance is being observed or scrutinized

    • You experience anxiety or panic when you are in such situations

    • You try to avoid these types of social or performance situations out of fear of becoming anxious

    • These problems interfere with your daily routine, your social life, or your schooling or occupation

If these symptoms fit you, you should strongly consider contacting a psychotherapist for help.


Depression may result from unresolved childhood issues, current life circumstances, or chemical imbalances in the brain. Depression can take a few different forms depending on the number of symptoms and how long they last. As you review the depression symptom list below, notice the symptoms that fit you. Consider how often, how long, and how intensely you experience these symptoms.

    • Feeling depressed, sad, or empty often or all the time, or frequently tearful

    • Lack of interest in pleasurable activities

    • Decrease or increase in appetite or significant weight loss (not due to dieting) or weight gain

    • Difficulties with sleeping: either unable to sleep or sleeping too much

    • Moving very slowly, like you are in slow motion; or being agitated and moving around restlessly

    • Feeling fatigued or without energy

    • Feeling worthless or guilty

    • Having difficulty thinking or making decisions

    • Thinking about death or suicide

The more of these symptoms you experience and the more severe or long lasting these symptoms are, the more important it is for you to seek professional help. Even checking two of these symptoms could indicate a need for help if the symptoms are distressing, debilitating, or long lasting.

Sexual Compulsion or Addiction

Sexual addiction is the loss of control of sexual behavior, which then becomes worse over time. People with extreme sexual addiction literally cannot stop the continual intensification of their sexual acting out, even when their behavior has cost them their job, relationships, financial security, and even their freedom.

Compulsive sexual behavior is a little different from sexual addiction in that it isn’t unmanageable in the way sexual addiction is. Although people with sexual compulsivity usually cannot stop their sexual behavior without help, the behavior doesn’t worsen over time, and its consequences tend not to be as extreme as for the addicted person. Compulsive sexual behavior may remain essentially the same for many years. Even so, it can still be a serious obstacle to growth.

Addictive and compulsive sexual behaviors can include masturbation, pornography, Internet chat, cruising, sexual activity with other people, engaging in intense romantic relationships, and other behaviors.

Below is a list of symptoms of addictive or compulsive sexual behavior. As you read the list, keep track of how many items you experience in your own life.

    • Unable to stop engaging in relationships or sexual behaviors that you feel are wrong

    • Loss of control over the frequency of your sexual behavior

    • Your sexual behavior becomes more extreme over time because the old behaviors no longer provide the same high

    • Shifting back and forth between feeling that your sexual problem is out of control and believing you have it under control

    • Using sexual behavior or relationships on a regular basis to deaden painful feelings or forget your own problems

    • Keeping your sexual behavior or relationships secret and perhaps even lying to cover them up

    • Spending large amounts of time or money pursuing sexual behavior or relationships

    • Making promises to yourself or others that are later broken because of your sexual behavior

    • Life becomes unmanageable because of your sexual behavior—work and family responsibilities are neglected

    • Serious consequences result from your sexual behavior, like the loss of a job, financial distress, the breakup of a marriage, or being arrested

If you are experiencing even a couple of these symptoms, you may be dealing with addictive or compulsive sexual behavior. The more symptoms you have, the more likely it is that you need help to regain control of your sexual behavior.


In their book, Facing Shame, authors Merle Fossum and Marilyn Mason describe this type of shame as “an inner sense of being completely diminished or insufficient as a person. It is the self judging the self.” Toxic shame is commonly distinguished from healthy shame in this way: healthy shame is the knowledge that we have done bad; toxic shame is the belief that we are bad. To quote Fossum and Mason again, “Shame is the ongoing premise that one is fundamentally bad, inadequate, defective, unworthy, or not fully valid as a human being.”

Shame is like a virus that can infect anything. It can contaminate a person’s beliefs and attitudes about their body, personality, family, or job. It can corrupt their perspective on our past and present behaviors and life experiences. It commonly seizes upon people’s weaknesses, but can even attack their strengths and talents. Once the intense feelings of shame have taken hold of something in a person’s life, they lose the ability to think rationally about that part of themself. They see everything through those feelings and obey the shame at all costs. Yes, they obey their shame. They believe it’s the absolute truth, and they do whatever it tells them—they hide, lie, avoid, quit, cover up, keep secrets, and turn down opportunities. This curtails their freedom and makes growth difficult. So breaking the grip of shame is essential to any psychological healing process.

If you are experiencing shame, consider working with a CGW therapist to become free of its effects.

Negative Core Beliefs

Negative core beliefs can be based on a variety of things. Most commonly they are based on a sense of defectiveness, vulnerability, or helplessness and hopelessness. Men with same-sex attraction also tend to have negative core beliefs about their own maleness, about relating with other men, and about women. Below is a list of common negative core beliefs.


    • I am a bad person
    • I am not loveable
    • I only deserve bad things
    • I am a disappointment
    • I am worthless

Vulnerability (Unsafe)

    • I am in danger
    • I can’t protect myself
    • It’s not safe to show my emotions
    • I am misunderstood

Helplessness and Hopelessness

    • I can’t do anything about it
    • I can’t change
    • I’ll never accomplish much
    • I wont ever have good things
    • I will always be alone

My Maleness

    • I am weak
    • I am not masculine enough
    • I am a sissy
    • I don’t look like a man
    • I can’t assert myself
    • I have no power in my life

Relating to Men

    • I can’t trust men
    • Men will reject me
    • I can’t understand men
    • I can only relate with other same-sex attracted men
    • Men are dangerous

Relating with Women

    • I can’t trust women
    • Women are disgusting
    • Women will drain and use me
    • Women are overwhelming
    • It’s bad to want sex with a woman

Body Issues

Some people experience a strong preoccupation with their bodies or with specific bodily features or flaws. Therapists refer to this condition as “body dysmorphic disorder.” Review this list as you did the two previous lists.

    • Excessive concern and shame about a defect or flaw on your face or body that others have either never noticed or have repeatedly told you is just fine or normal

    • Preoccupation with being too fat or too thin, even though others would consider you to be within a normal weight range

    • Excessive worry that your muscles are not big enough, even if others would see you as being muscular, fit, or having a nice physique

    • Going to excessive lengths to hide perceived physical flaws

    • Being preoccupied with trying to get an accurate view of your body and feeling like you can never see it accurately

Body dysmorphic disorder is closely related to obsessive-compulsive disorder (OCD) and can be a particularly difficult problem for men trying to overcome unwanted homosexuality. Men’s feelings about their bodies are often tied to their feelings about their masculinity. So shame, worry, or preoccupation about their bodies can have a devastating impact on how they feel about themselves as men. If you checked any symptoms in the list above, please contact a trained psychotherapist for help.


Obsessive–compulsive tendencies are quite common among men with same–sex attraction and can create severe obstacles to growth. Obsessive-compulsiveness has two sets of symptoms: obsessions and compulsions. These symptoms are listed separately. Some people have both types of symptoms while others only experience one.

Obsessions are thoughts, impulses, or images that seem to come to a person’s mind regularly and are difficult or impossible to get rid of. Make note of the obsession symptoms that apply to you.

    • Preoccupation with being contaminated by body fluids, dirt, germs, insects, animals, sticky substances, a disease, etc.

    • Fear of getting an illness

    • Needing to save or collect things, feeling worried about throwing things away

    • Needing to have things in order, symmetrical, exact, or lined up

    • Having to write perfectly, needing to start over if you make a mistake

    • Feeling excessively afraid about being wrong or bad, having bad thoughts, saying bad things, being punished; dwelling excessively on thoughts about God or religion

    • Fear that you will harm yourself or someone else or worry that you have been or will be responsible for someone being harmed because of your actions

    • Fear that you will do something that you can’t control

    • Having unwanted sexual thoughts that are not enjoyable and that you cannot control

    • Needing to count objects, steps, stairs, or behaviors

    • Worry about saying things wrong or leaving out important details

    • Worry about losing things or making mistakes

    • Being easily bothered by certain sounds or by the texture of things on your skin

    • Excessive superstitious fears or beliefs

Compulsions are behaviors that a person feels unable to stop himself from doing or things that a person has to do in a very specific way. The person may feel driven to do it in response to an obsession, like those listed previously—in other words the obsession drives the person to do the compulsive behavior. He may have to do it so that he can stop feeling anxious about it. Or he might just do it automatically without even thinking about it. Compulsions can either be outward physical behaviors (like washing your hands or checking locks) or internal mental rituals (like counting or thinking through past events over and over again).

Sometimes people don’t recognize that their compulsions are excessive until they take into consideration what other people do or until others tell them that it’s excessive. If you wonder whether some of your behaviors are compulsive, ask someone you trust to give you an honest answer. Write down the symptoms of compulsive behaviors that apply to you.

    • Excessive personal cleanliness and grooming practices, either done frequently or done in a very specific way (hand washing, showering, brushing teeth, shaving, etc.)

    • Excessive cleaning or care of the house, yard, car, or objects; having to clean certain items yourself rather than allowing others to do it, or cleaning or caring for things in a very specific way or using very specific tools or products

    • Avoidance of contamination or germs by avoiding certain objects, staying away from certain places, wearing gloves or special clothing, using excessive protective barriers (like on toilet seats), etc.

    • Checking to be sure you haven’t been harmed or haven’t harmed someone else

    • Checking locks, doors, windows, blinds, light switches, stoves, and other appliances or equipment, etc.

    • Checking yourself for illness or disease

    • Saving useless items, buying or collecting items that you don’t use, or having difficulty getting rid of items that are no longer useful

    • Reading or writing things over and over, having to rewrite something because you made a small mistake, keeping excessive lists or journals

    • Repeating activities or behaviors over and over for no reason other than a feeling of compulsion, repeating something you’ve said several times because you don’t feel heard

    • Counting objects, items, or behaviors

    • Arranging items in specific orders or patterns, compulsively arranging things symmetrically

    • Excessive repetitive thoughts, like prayers or reassuring statements

    • Frequent confessing of bad deeds or wrong behavior, even when those actions are not considered wrong to others

Obsessive–compulsive disorder can be a serious roadblock, but it’s also very treatable. If you checked even a single item in the two previous lists, this could be an indication of obsessive–compulsive tendencies. If you checked a few items on each list, it’s a strong sign that you may be dealing with obsessive-compulsive disorder (OCD). Call to action.

Posttraumatic Disturbance

People who have experienced abuse or other types of traumatic events earlier in their lives sometimes suffer from a variety of difficult symptoms as a result of those experiences. Consider the symptoms below.

    • Recalling traumatic events through flashbacks (which might include images, sounds, or even smells), disturbing dreams, or frightening thoughts related to the events.

    • Reliving painful past events as if they were happening in the present. Sometimes this can even include seeing images from the trauma and experiencing the same feelings.

    • Becoming very upset or disturbed by things that remind you of the trauma. This can include places, people, objects, sounds, and smells. It can include being touched in certain ways or being in certain physical or emotional situations.

    • Avoiding talking or thinking about the trauma or having only vague memories of it.

    • Avoiding places, situations, activities, or people that remind you of the trauma.

    • Feeling a loss of interest in certain activities that you previously enjoyed. These activities may or may not have anything to do with the traumatic events.

    • Being unable to feel certain emotions, such as anger, love, or joy, or having sudden outbursts of irritation or anger.

    • Feeling disconnected or alienated from other people.

    • Not seeing yourself as having a future or being unable to imagine future events, such as a career, being married, seeing your children grow up, or growing old. Expecting yourself to die young.

    • Having difficulty falling asleep or staying asleep because of disturbing thoughts.

    • Having difficulty concentrating because of disturbing thoughts.

    • Being jumpy or easily startled.

    • Being intensely aware of—or sensitive to—your circumstances; being on the constant lookout for danger. This can create anxiety and exhaustion.

Experiencing just a few of these symptoms can make life difficult and detract from a man’s ability to overcome unwanted homosexuality. If you identified one or more of the items above, it would be a good idea for you to consult a therapist. If you marked a few items—especially if you marked higher numbers—we strongly encourage you to seek help from a professional trained in trauma recovery work.


Dissociation can be described as a disruption in consciousness, or a separation of one part of self from other parts. There are many different types of dissociation. The simplest and most common would be “zoning out” and the most complex would be having multiple personalities. Many therapists believe that dissociation is a natural mental mechanism that protects the mind from being overwhelmed by stressful or traumatic circumstances. Dissociation is commonly seen among individuals with post–traumatic disturbance. Make note of any symptoms from the list below that you’ve experienced in the past few months.

    • Losing track of things that have happened, such as arriving somewhere and not remembering what happened on the trip there or not knowing how you got there, not hearing things that were said to you, or not remembering putting on the clothes you are wearing

    • Having objects you don’t remember buying, finding, or being given

    • Feeling like you’re outside your body watching yourself, feeling like your body doesn’t belong to you, or feeling like you’re a robot

    • Feeling like the world around you is not real, having the world appear as foggy or far away, or being in a place you know but having it seem somehow strange or unfamiliar

    • Being accused of lying or of not telling the entire story when you believe you’re telling the whole truth

    • Lacking memories of significant life events or of long periods of time

    • Not recognizing yourself in the mirror

    • Remembering past events with intense clarity and vividness as if it was happening right now

    • Being unsure whether things you remember are real, imagined, or occurred in a dream

    • Zoning out and losing awareness of time or finding that time has passed and you don’t know what you did during that time

    • Acting so different in various situations that you almost feel like you’re two different people

    • Being unsure whether you actually did or said something or just thought about doing or saying it

    • Finding out that you did something you don’t remember doing

    • Hearing voices inside your head talking about what you’re doing or about what you should or shouldn’t do

Each of the symptoms described above is a strong indicator of dissociation. If you acknowledged any of these symptoms, I strongly urge you to seek help from a psychotherapist familiar with these issues and to do so very soon.