Condomless sex and sex under the influence of drugs or alcohol are often the result of underlying social issues like internalized homophobia, lack of self-esteem, social isolation, and lack of peer acceptance. Clients may not immediately mention their body image concerns in a therapeutic relationship, but risky sexual behavior is a prominent warning sign. Knowing when to intervene with a client can be difficult.
Instead, a supportive therapist can allow gay men to confront their self-judgment and determine whether and how to dismantle it. As with any mental health struggle, the role of a behavioral health counselor is not to “fix” a client’s body image issues.
