Social anxiety for gay men San Francisco 94102 gay therapist LGBTQ therapy

How does social anxiety affect gay men?

Picture this.  You’re about to go into a mixer for gays in technology.  You’re feeling lightheaded. Your hands are clammy.  Your pulse is racing faster and faster. Self-critical thoughts are running through your head at a rapid pace.  Once you’ve psyched yourself up enough to enter the room you make a beeline for the bar and grab a drink to calm your nerves.

Sound familiar?  

For those that struggle with social anxiety, this is just a day in the life.  

I’m a gay man with social anxiety

Social anxiety is a common condition that many people struggle with.  The symptoms can be alarming because they often are felt in your body as well as your mind.  The rapid heartbeat, sweating and dizziness can resemble other more dangerous medical conditions.

While there are some gay spaces that are safe and welcoming, there are many that are not. Most gay men can recount stories of feeling judged upon entering a gay bar.

What are the symptoms of social anxiety in gay men?  

Social anxiety shows up both psychologically and physically.  Because these symptoms can look like many other more serious health concerns, be sure to check with your doctor if you’re having any of these symptoms.

Physical Symptoms

  • Sweating
  • Clammy hands
  • Upset stomach
  • Rapid heartbeat
  • Dizziness
  • Trembling

Psychological Symptoms

  • Negative thoughts (I’m gross.  I’m a bad person. Nobody likes me, etc.)
  • Fear
  • Disappointment
  • Low self-esteem
  • Self-criticism
  • Isolation
  • Depression

Mental health risks as gay men

There are higher rates of mental health diagnosis in the LGBTQ+ community.  There are many studies that show the depression, anxiety, self-harm, eating disorder and substance misuse rates are higher in the gay community than in our heterosexual counterparts.  

While we’ve made much progress, we’re still in the minority in the United States. There are areas where you may think twice about kissing your partner or holding their hand in public.  This background anxiety can make us more susceptible to other mental health conditions. I say this only to remind you that if you’re struggling with mental health stuff, you’re not alone and you deserve support.

I’m using drugs and alcohol to self-medicate

Feeling anxious in social situations sucks.  Drugs and alcohol are readily available and often socially acceptable forms of self-medication.  There are drawbacks to using drugs and alcohol to cover up feelings of anxiety, or any feelings for that matter.  By numbing yourself out, you’re also depriving yourself of the opportunity to develop better coping skills. And there’s the risk of substance misuse or dependence.  You don’t want to replace one problem with another.

Why is it important to treat social anxiety?  

Social anxiety can get in the way of dating, making friends, networking, moving ahead in your career and finding connections with other people.  If you don’t treat social anxiety, you’ll be at higher risk for other mental health conditions. Because of the stigma around mental health, all too often we suffer in silence.  

Is social anxiety treatable?  

Yes!  There are many treatments options for social anxiety.  As with any mental health concern, there is no one size fits all approach and it may take some work to find the right treatment for you.  But don’t give up.

Practical tips on addressing your social anxiety  

See a therapist.

Find a therapist who works specifically with the LGBTQ+ community around social anxiety. It’s important to work with someone with training and experience working with our community, because your identity and self-esteem are probably connected to your anxiety in a meaningful way.  Just because you’re gay doesn’t mean that you’ll have social anxiety, but it can be a contributing factor.


Mindfulness is a powerful and simple way to help ground your body when you’re feeling anxious.  Luckily today there are many mindfulness tools, apps and books that can help you with this journey.  The benefit of developing a mindfulness practice is that it’s free, doesn’t require hard to use equipment and it’s impactful.

Be careful with self-medication.

It can be tempting to have a few drinks or pop a Xanax before a big social gathering that is causing you anxiety. While this may work for a moment, there is the danger of developing a crutch through drugs and alcohol. If your anxiety is that severe, talk with a mental health professional or your doctor to learn about other options.  There are prescribed medications that can help with this issue and prevent the need for self-medication. The last thing you want to do is develop a dependency on drugs or alcohol to help with social anxiety.

Prescribed medication

There are a number of medications that can help with social anxiety.  If you’re already self-medicating, you have nothing to lose by bringing up the issue with your doctor and learning about all the options available.  Some people are skeptical about taking medication, but know that it’s an option if you choose to explore it.


Exercise is a great tool to help with anxiety and stress.  You can put on your favorite podcast, music or audiobook and walk or run around your neighborhood a few times a week.  This will not only help with your anxiety, but it can be beneficial for your mental health in other ways, too. Walking can also be done in a mindful way and you can combine exercise and mindfulness for a one-two punch.  


It will get easier. Most things typically do with time. As an example, before going to a big networking event, you can take a few deep breaths and remind yourself about your strengths and assets. It’s easy to start the negative spiral downward if you let your mind focus on all of your perceived deficits and shortcomings. Put together a list of your top five strengths and keep it handy for moments of need.  

Action Item

If you struggle with social anxiety, what is one small step that you can take today to find some relief?  Download a mindfulness app, talk with a friend or reach out to a healthcare provider. You don’t have to deal with this on your own.

Tom Bruett

Tom Bruett

Tom Bruett, LMFT is a licensed psychotherapist with an office in San Francisco, CA. Tom feels passionately about helping people have better relationships. The purpose of this blog is not to provide advice or to take the place of working with a mental health professional. For more information please visit the homepage.