Source: Naassom Azevedo / Unsplash

I’ve been living and working in West Hollywood, one of LA’s well-known “gay neighborhoods,” for nearly 15 years. In that time, I’ve known far too many people who have overdosed from drugs or alcohol or who have died by suicide.

Years ago, a young man I once worked with at a popular night club killed himself. From the outside, he appeared to have it all—he was handsome, charming, in good shape and commanded attention wherever he went. Even in the sharing of his death, everyone I spoke to said, “He was so handsome.”

Similar to the others I’ve known who have died or taken their own lives, he embodied the thing most people (especially living in West Hollywood) would consider as ideal: external beauty and strength.

During a recent session, a client of mine told me about a podcast he listened to specifically for gay men. He said that the entire episode was about body image and how the number one, most valuable form of currency among gay men is "looks" or beauty.

But each of us has an inner world, which is so much more than what appears on the outside.

I can’t say what compelled this young man to take his own life, and we cannot know what it’s like to walk in another person’s shoes. But what I do know is self-acceptance and a sense of belonging is what saved my own life since coming out of the closet—experiences you won’t get from external beauty or strength. And if a person is seeking fulfillment through substances or being “seen” externally rather than seeking fulfillment for who they are on the inside, the results can be devastating.

The Importance of Self-Acceptance

Author Brené Brown wrote in her book Daring Greatly: “Because true belonging only happens when we present our authentic, imperfect selves to the world, our sense of belonging can never be greater than our level of self-acceptance.”

This applies to everyone, but being a queer man and part of a culture that validates strength and beauty on the outside, the concept is harder to achieve. It’s one thing to look around and see people through the lens of what they show us on the outside, but another to fully accept and embrace someone wholeheartedly and unconditionally for who they are on the inside. From the conversations I have inside and outside of the therapy room, this is what many gay men feel is missing, especially for those who continue to struggle to accept themselves.

Sadly, most of the people I know who have died while living in Los Angeles have either worked at a gay bar in West Hollywood or have been a part of the community.

The Connection Between the LGBTQ Community and Trauma

A few years ago, I attended a conference for mental health professionals and the keynote presentation was about LGBTQ youth and trauma. During the talk, the connection between trauma, addiction and the LGBTQ community suddenly became clear to me. I had always looked at increased rates of drug and alcohol abuse among people who are LGBTQ through the lens of shame, but in order for us to get a complete picture, we have to be able to see the effects of trauma.

Most of us think of trauma as a rape, murder, death, war or a catastrophic event or natural disaster. And while these are unequivocally traumas, people also experience trauma as daily microaggressions, such as homophobia, transphobia, bullying and time spent in the closet. Any person who has experienced the closet has known shame—and feeling a profound sense of shame about yourself and your identity is trauma.

This also includes the trauma caused by anti-LGBTQ theology. For years, certain religions have failed to accept queer people. And for that reason, the LGBTQ community has had to create alternative spaces to gather, connect, celebrate, and, essentially, worship.

Just this morning, a client told me that growing up, there was “no room” for him to be gay at home—it felt like he could never fully breath. While he’s a 35-year-old adult man, he's only just beginning to process the shame that he internalized from the adults around him in his childhood about being gay. The experience, I told him, is like having a thousand paper cuts and not realizing how painful they feel until you finally jump in the ocean.

For that reason, increased rates of gay men turn to drugs and alcohol to anesthetize the pain of growing up and not being fully seen. There is a distinct difference between tolerance and identity validation. What’s more, there’s a distinct difference between external identity validation and internal identity validation. I can be openly gay and attend all the Pride festivals I want, but if I don’t accept myself on the inside, my paper cuts still hurt.

Mental health advocate and writer Elitsa Dermendzhiyska so poignantly says, “The brain makes no distinction between a broken bone and an aching heart. That’s why social exclusion needs a health warning.”

Making amends where there’s been harm is part of the healing process. The more we can recognize and repair, the more we can prevent future generations from experiencing not only shame, but trauma. And the more we can create room for a young person to cultivate an inner sense of self-acceptance from an early age—which includes feeling welcome, celebrated, and affirmed—the more we will be able to repair.

The most powerful way to teach someone is to embody the very thing we hope to see for their lives. Doing the work of repair now, both individually and collectively, will not only heal our past, but it will help heal the future.

In honor of all lives affected by addiction, mental illness and suicide.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741.