Healing Conversations for Men Who Have Sex with Men

Bryson Kelpe is a nurse and a mental health counselor. Currently, he is working on creating a stigma recovery program for people living with HIV and struggling with mental health. Bryson is an American living in Germany with his husband and was crowned Germany’s Mr. Bear in 2020. He was also tested positive for the COVID-19 and shares his experience on what that was like and the work that he is currently doing for the LGBTQ community.    TAKEAWAYS:  [1:20] How did Bryson go from the United States to living in Germany?  [3:25] Bryson recently tested positive for Covid-19. [6:50] How did Bryson become Mr. Bear Germany?  [10:15] Cologne, Germany has a very inclusive rugby scene that Bryson likes to take part in. [12:35] Stigma keeps people from being connected. There is so much stigma around the LGBTQ community, mental health, and HIV that it stops people from being open and honest.  [15:20] In aviation, people are working at all hours of the night, which is not something the human body is used to. Lack of sleep means you’re prone to more mental health disorders.  [17:40] Definition of recovery: You could still be having symptoms, but you’re finding hope.  [19:40] Bryson is working towards a stigma reduction program that will include HIV, PrEP, and mental health. It will be in three languages to make it more accessible.  [22:35] What’s next for Bryson?    RESOURCES:  Bmindful.de Bryson on Instagram Stigma: Notes on the Management of Spoiled Identity by Erving Goffman Div. 44 - APA Divisions   QUOTES:  “There’s a lot of stigma in aviation around mental health and the focus [for me] has been on human factors between the interaction of pilot and machine.”  “The big thing is you recover from the stigma of your diagnosis.”  “Some countries like Austria, a modern country, PrEP is relatively new and unknown even in the provider community.” “Case managers are just worried about your mental health, they don’t care if you went to the dentist or doctor for diabetes.” 

Dr. David Malebranche is a Board Certified Internist and HIV specialist who worked in academia as a clinician-investigator with Emory University’s Division of Medicine from 2001 to 2012. Currently, Dr. David serves as an Associate Professor for the Morehouse School of Medicine. Today’s topic covers Dr. David’s relationship with his father, how to be intimate during the COVID-19 Pandemic, as well as HIV & meth use demographics and what we can do about it.   TAKEAWAYS: [4:00] The book that Dr. David wrote, Standing on His Shoulders, is a tribute to his father. [7:50] Dr. David wanted to finish the book before his father passed away. He was in his 80s when Dr. David was writing it and he really wanted to celebrate his father’s life and wisdom while he was still alive. [8:30] The need for intimacy during the COVID-19 pandemic? [11:10] People would rather take the chance to get HIV or an STI than wear a condom so that they can gain closer intimacy with their partner. [13:30] We need intimacy during these times, but find ways to substitute it for now, whether that be through emotional intimacy or porn. [20:20] Within 20 years, meth use has changed and a new generation has become hooked on it. [26:10] Dr. David is concerned about how COVID-19 is going to highlight the health disparities within the black and black gay men communities. [28:45] Since Dr. David has had the privilege to work with so many young people in his community, what’s currently worrying them and keeping them up at night? [31:50] Dr. David is very optimistic about the future of medicine and where our youth will be taking it.   RESOURCES: Dr. David on Wikipedia Dr. David on Twitter Standing on His Shoulders: What I Learned about Race, Life, and High Expectations from My Haitian Superman Father by Dr. David Malebranche   QUOTES: “The journey and how hard my [Haitian immigrant] father had to work to get to where he was and how he passed that on to me, it wasn’t so much of a curse or some kind of trauma, but more so a blessing.” “The best sexual partner is yourself.” “The concern I have about COVID-19 is not just the physical and health disparities that are going to fall on black communities and black gay men, but also the economic and social isolation/long-term mental health complications that we’re going to see.”

Andrei Dobre has more than 10 years of experience in the non-government sector and is currently working on his PhD in Sociology. He works as a Monitoring and Evaluation Officer for the Romanian Angel Appeal Foundation, which was originally founded by Linda McCartney, Yoko Ono, Barbara Bach, and Olivia Harrison. Andrei discusses how there’s been a chemsex explosion in Romania in just a short amount of time (two years) and he has already lost friends to it.   TAKEAWAYS: [2:55] How did Andrei first get into this work? [6:25] What is the current situation in Bucharest, Romania when it comes to chemsex? [7:25] Andrei has personally lost two friends due to chemsex. [8:55] A lot has changed within two years and the chemsex scene has become much more lively. [10:45] The professionals in the region don’t really know how to help or counsel for this and the LGBTQ community is experiencing a lot of stigma. [12:05] Where does the meth come from in Romania? [13:40] Andrei shares a stat about new HIV cases. This is the first time gay men have appeared second on the list for new HIV cases in Romania. Traditionally, it’s been through heterosexual sex and injected drug users. [15:25] What is gay life like over in Romania? [19:10] Change is slow, but it is happening in Romania! [19:55] How are hookup apps affecting the chemsex scene? [21:10] What kind of programs or help can the LGBTQ community seek during this emerging epidemic? [25:30] Andrei sent out a call to various countries to see who would be interested in partnering up with him to improve the situation in Romania. 15 countries answered that call.   RESOURCES:   Romanian Angel Appeal Foundation   QUOTES: “Romania is more like a transit country and not a producer and all the drug substances are in transit on their way to the west.”  “Things are changing in society. Since 2004, only 1,000-2,000 participants have attended the pride parade. Last year, 15,000 attended.”  “At this moment, we have no professionals and no services developed in Bucharest for this specific target group.” “Neighboring countries, Eastern Europe like Bulgaria, Serbia, Albania, Croatia, Ukraine, told me that they have no services, it is happening, they have a problem, but don’t know what to do.”

Philip McCabe is a Speaker, Health Educator, and Addiction Professional to LGBTQ communities. He is currently the President at NALGAP inc, which is the National Association for Lesbian, Gay, Bisexual, and Transgender Addiction Professionals and their Allies. Philip often speaks on the topics of sexual health, consent, and what it means to safely explore your kinks as someone in recovery. Philip shares what you need to know about BDSM, kink play, and some of the warning signs to be aware of.    TAKEAWAYS:  [1:35] How did Philip get involved in kink awareness?  [5:25] Philip defines what BDSM is.  [9:40] Is kink or BDSM problematic behavior?  [11:55] Where do you draw the line between kink behavior vs. domestic violence or abuse?  [13:40] How can you practice BDSM safely?  [15:35] What do the phrases, ‘Safe, Sane, and Consensual’ and ‘Risk, Aware, Consensual’ mean?  [17:35] What precautions does someone need to take into account when engaging in these activities?  [21:50] How can a newly sober person regain an interesting and engaging sex life?  [26:40] How can people in this lifestyle talk to their healthcare providers about it?  [31:55] Therapists, addiction counselors, social workers, and more need to have a better understanding of the range of human sexuality.    RESOURCES:  Nalgap.org Gaycounselor.com Philip on LinkedIn Recovery in the Lifestyle National Coalition for Sexual Freedom Kink Aware Professionals   QUOTES:  “Like any other part of the LGBTQ community, we are still evolving and we still have to learn how to support each other.”  “If the partner is not willing to have a conversation or not willing to have a discussion with you about what your boundaries are or limits are, that’s a red flag to me.”  “It takes time and I think people get impatient. We sometimes ask people to do a 90-day abstinence from masturbation just to reboot and resettle.”  “Just because there is a mark on the body, we don’t want to jump to the conclusion that it was domestic violence.”

Kekoa Kealoha is the PrEP Navigator at the Hawai’i Island HIV/AIDs Foundation and a recovering meth addict. Although Hawai’i is considered a low HIV incident state, there is still an epidemic going on that is fueled further by the meth problem in Hawai’i. An estimate showed that 6 out of 10 people in the Hawai’ian state hospital have experienced meth. Kekoa shares some of his insights as to what is going on in his community and the work that he is doing to create more awareness and best practices.    TAKEAWAYS:  [1:40] What does Kekoa do as a PrEP navigator?  [4:25] Hawai’i is considered to be a low HIV incident state. However, on Kekoa’s island, there are between 8-12 people that contract HIV every year. The capital, Honolulu, has about 30-60 cases per year.  [5:20] Unfortunately, the meth epidemic fuels the HIV epidemic. It affects the entire community, not just the gay male community.  [7:50] Meth has become a criminal justice problem vs. a public health problem.  [10:05] The native Hawai’ian pacific islander population is the most likely to be diagnosed with late-stage HIV or AIDs. The state is missing their mark on early prevention and education for diseases not just with HIV, but with heart disease, diabetes, and more.  [14:45] Kekoa and his team are working with Hawai’i to Zero (h20), which is an initiative to end the stigma of HIV, to test and diagnose, and have no HIV-related deaths.  [16:35] The meth source is coming from both Mexico, Asia, and homemade on the island.  [21:00] What worries Kekoa the most about his community?  [22:30] What gives Kekoa hope?    RESOURCES:  Hihaf.org Negativemovement.org Email Kekoa: Contact@NegativeMovement.org Health.hawaii.gov   QUOTES:  “6 out of 10 people in the Hawaiian state hospital have experienced meth.”  “The community seems content in keeping the meth epidemic a criminal justice problem and not a public health problem.”  “Hawai’i has the lowest rate of HIV transmission through injection-drug use and we also have the oldest state-wide needle exchange program in the country.”  “What gives me hope is working with younger generations because they don’t have the same stigma attached to HIV. When I give education to young people, it’s a clean slate with them.” 

Dr. David Fawcett talks to Dr. Rob Weiss about sex addiction and chem sex in men. Dr. Weiss dives into why we shouldn’t separate the relationship with drugs and sex in therapy because they are often combined and need to be addressed together. He also believes there’s a lot of benefit for hosting gay and straight clients together because the commonality of being men can open up a big dialogue and he believes that for most people in therapy, the biggest thing we are seeking is a real and meaningful connection.   TAKEAWAYS: [2:40] Dr. Rob didn’t realize in the very beginning how drug addiction is so closely linked with sex addiction. We have to look at both, not either/or. [3:55] How does Dr. Rob see the effect of trauma play into these addictions later in life? [6:50] Gay and transgender people struggle a lot with their relationship to sex, and culturally we still haven’t gotten to openly talk about these issues. [9:35] Dr. David has seen two worlds collide in a beautiful way. Gay men had their reservations/thoughts about straight men and vice versa. By sharing group therapy sessions together, a real dialogue has begun to open up between them where it’s just men sharing their experiences and trauma. [11:55] Dr. Rob shares a story about a man who hated what turned him on, but when he did drugs, he was able to indulge in these sexual interests. The work Dr. Rob does has a lot to do with helping people come to peace with their sexual desires. [12:40] Seeking Integrity gets a lot of clients that have a misunderstanding that treatment and addiction are about ‘curing’ unwanted attractions, but it’s about self-acceptance. [16:50] Dr. David breaks down why alcohol is a drug. [21:25] So many people that Dr. David and Dr. Rob treat are looking for a connection and use drugs to fill it, but in reality, they create more emptiness. [25:45] There’s so much more to you than your bodies. As you get older, you’re just not going to get noticed that much and it can be very hurtful to the ego or identify about yourself.   RESOURCES: Seekingintegrity.com Cruise Control: Understanding Sex Addiction in Gay Men by Dr. Robert Weiss Sexandrelationshiphealing.com Email Rob: Rob@SeekingIntegrity.com   QUOTES:  “People are what grounds us, not substances or behaviors.” “Which one defines your entire life more? Being male or being gay? Man trumps gay every time.” “To define sessions as ‘gay’ or ‘straight’ is to sort of like saying why don’t we have a program for African American men or Asian men? There’s so much in common being a man struggling with sexual issues.” “Our work is a lot about teaching a person to come to peace or celebrate their sexuality without having to use drugs and alcohol.”

Scott Brassart is the Director of Content Development at Seeking Integrity and has worked alongside Dr. David for the last two years. As a gay man himself, Scott discusses the prominent drug use in the gay community, the stigma behind sex recovery, the shame, and trauma young LGBTQ members experience, and opens up a conversation on how to develop healthy sexual patterns while in recovery.   TAKEAWAYS: [1:25] Scott shares his story about his struggles with addiction and his journey to sobriety. [3:15] Does the LGBTQ community have a greater tolerance for drug use than the heterosexual community? The answer is yes, and no. [6:55] When beginning a journey into sex recovery, it can be very difficult for gay men to get the right treatment. Gay men tend to be sexually liberal and will rebel against anyone trying to control or put boundaries around their sex lives. [8:50] When Scott got sober, he didn’t know what to do with himself. His addiction was his one and only hobby at that point and he had nothing else in his life. [11:45] Sex addiction is a bit different than a drug addiction. If you do drugs, you’ve relapsed. If you have sex, you have to treat it more like an eating disorder. You have to learn how to have sex in healthy ways so that you don’t spiral out of control. [13:35] People in the LGBTQ community experience a lot of shame and this shame can be used as fuel towards unhealthy and addictive behavior. [16:55] Any child who has been bullied over their sexual orientation holds a lot of shame. This can get compounded and turned into trauma, and that will affect them throughout their adult life. [19:30] Growing up as a young boy in Indiana, Scott always felt out of place. He had no romantic or sexual development while in school because of how conservative his community was. [22:25] What are some of the benefits (and disadvantages) of joining a gay-only or gay-friendly group meetings? [28:15] Like everything else, there are really good therapists and really terrible therapists out there. If you’re curious about seeking help, try a therapist out and see how it feels.     RESOURCES: Seekingintegrity.com Scott on LinkedIn   QUOTES: “Gay and lesbian people have higher rates of addiction than heterosexual people. I think that may be shame-related more than anything else.” “If you’ve tried to cut back or quit altogether [with sex] and you failed, and you’ve done that multiple times, you’ve lost control.” “If it’s out of control and it’s ruining your life, maybe you should do something about it.” “Growing up gay in America, even today is traumatic and early life trauma breeds shame.”

Leon Knoops has been an Outreach Worker, Researcher, and Trainer at the Mainline Foundation since 2006. He has focused his efforts on important research in Amsterdam’s gay and bisexual men and their connection to crystal meth.    Sjef Pelsser is also an Outreach Worker at the Mainline Foundation and uses his own experience within the worldwide chemsex scene to talk openly about this topic and share his account of what’s happening right now in the Netherlands.    TAKEAWAYS:  [2:40] What is Mainline Foundation’s International mission? [3:20] Leon and Sjef share their personal experiences with the chemsex scene and explain why their Chemsex Project is so important to Mainline’s mission.   [7:05] The chemsex scene is relatively new in Amsterdam. Leon spent time interviewing gay men who had experience with crystal meth, which most of them would take in a private setting (not at parties). However, it was in 2014-2015 where Leon really saw a lot of these individuals lose control and become addicted. [11:15] Not too long ago it was really difficult to find crystal meth due to the difficulty of transporting it, but this is now becoming less and less true. They still do not know which European country it originates from.  [12:45] the Netherlands is known to be a more sexually liberal country, but according to Leon and Sjef the dynamic is changing and the Dutch are not as tolerant as they claim to be.  [17:50] Leon and Sjef currently lead an anonymous support group for those seeking more information and are looking to recover. The biggest thing is to just listen to their stories and pass no judgment on what they’ve been through.  [22:40] Why do men experience a relapse in their recovery journey? It’s difficult finding a partner who wants to have sex without the use of drugs or a party lifestyle. They are lonely and isolated because they feel like their social circle will shame them.  [25:00] Where would Leon and Sjef like to be in five years?    RESOURCES:  Mainline.nl Sexntina.nl Leon on LinkedIn   QUOTES:  “Research from 2018 shows that 85% of the Dutch population accept gay men, but when you start to talk about two gay men holding hands/kissing, 1 in 3 Dutch find it disgusting.”  “When guys show up to the support group for the first time, we are only listening and asking questions. They become so relieved.”  “In this relapse context, most of the time it’s about loneliness and when you’re lonely, it is very easy to connect with someone via gay apps.”  “If the guys ask for help, we can easily get in touch with a professional and it’s a very important and new way to get people the help.”

Butch McKay, of OASIS and the Positive Living Conference, joins the show today to talk about ways we can reduce stigma and set examples of creating a safe space in the community. Butch is a major force in the work with HIV, has stayed true to a promise he made to a dear friend that he will use every day as a way to help others that suffer. Butch also discusses how the Positive Living Conference started and continues to grow, the groups still most affected by HIV stigma and what we can do about it, and an inside look at how we need support in the legal system more than ever.   TAKEAWAYS: [2:26] Butch got involved in HIV work 32 about years ago, as a result of a promise he made to his best friend who was the first person he lost to the complications of AIDS. He became a clinic host, and with Dr. Michael Saag as his mentor, realized this was an area he wanted to spend his energy to help people. [7:30] Butch saw a need for education and services in the North Florida area, and decided to start the Positive Living Conference in 1997. He sought dynamic speakers to speak the science in layman's terms, and advocate Martin Delaney came (for way less money than his usual fee) to educate the audience so hungry for his knowledge. [11:16] This year was the largest attendance, with 457 people registered to attend. They have also had as high as 27 states represented in the past, with countries such as Canada and Mexico in the mix. 97% of the attendees are living with HIV and AIDS, and the others are experts or partners. They have also been known as a training ground for speakers, and are proud to be a safe space for people to speak their voice. [18:34] It is quite miraculous in the past decades of where we have come medically, but stigma is still a major problem. [19:16] One of the hardest groups still affected by stigma is heterosexual women. [22:30] Those affected with HIV unfortunately still experience unfair sentences in legal matters, along with bails too high for themselves or their families to afford. [25:54] The largest population of African Americans live in the south, and that is an area where stigma and religion play a role that leads to a large number of people being impacted with a lack of resources. [27:17] Butch would like to see more education and sensitivity in the community towards those with HIV, along with proper training for public defenders so they can better represent their clients.   RESOURCES: Dr. Michael Saag Positive Living Conference OASIS Project Inform The AIDS Memorial U=U   QUOTES: ● “We did a lot of things in those days, it was called survival.” ● “It’s so good to know that we have come so far and we have to think of the sacrifices of the people that gave everything, including their lives.” ● “Stigma is very real, but I do think a lot of it is internalized now.” ● “We can all play a part in educating those around us, and ourselves as well.”

Psychologist and Author Walt Odets, Ph.D., joins the show this week to share some insight from over 30 years of writing extensively about the psychological and social issues of gay men, immersing himself in the gay community, and practicing with his own clients. Walt has authored two books, Out of the Shadows in 2019, and In the Shadow of the Epidemic in 1995.   TAKEAWAYS: [1:31] Walt has had over 24,000 hours sitting with men affected by HIV, letting them actually be and express themselves. From the notes he took in his practice and what has emerged from his 1995 book, In the Shadow of the Epidemic, comes his new book, Out of the Shadows. He realized the shame and isolation felt by these men had to be talked about, and people really needed to know what it means to survive for a gay man. [8:20] Walt sees a common belief of “I’m not the kind of person to get HIV”, from the younger generation. Denying the possibility of HIV is a way of also denying the consequences, and just how important it is that we still focus on this epidemic. [10:13] The tremendous amount of stigmatization and intra community hostility is not helpful for anyone. [15:09] Three key tenants for a gay man healing from the shame and stigma of HIV are: developing self-acceptance, building confidence, and realizing who they really are in the world and what they have to offer from living authentically. [19:38] When professionals work on helping someone with their addiction, they know that there needs to be a new tool to have in place, otherwise a relapse may occur. [25:20] Walt names a few things that will increase the level and quality of connection in the community: real relationships not just based on sex, using apps correctly, and older men mentoring younger men.   RESOURCES: Walt Odets Grindr SCRUFF In the Shadow of the Epidemic Out of the Shadows   QUOTES: ● “I sit with a lot of pain.” ● “There is still a well of grief that is not expressed.” ● “It’s self-acceptance that allows confidence, which then allows us to be ourselves.” ● “Shame is about not wanting to be seen by others.”