Searching for a therapist from the community and in-network: A qualitative exploration of gay and bisexual men’s mental health care navigation.

Abstract

Gay and bisexual men experience disproportionate rates mental health challenges including for depression, suicidality and substance use disorders. At the same time, they may face unique barriers to seeking mental health care that is lesbian, gay, bisexual, transgender and queer+ (LGBTQ)-affirming. In this study, we describe and analyze gay and bisexual men's mental health care navigation, with a focus on identifying challenges that arose when seeking care. Between July and September of 2023, 24 individuals participated in in-depth interviews via video-conferencing software. Interviews were transcribed and analyzed using a reflexive thematic approach. Participants reported challenges navigating insurance networks, which often engendered frustration and emotional upset. Participants desired mental health providers that could provide affirming and culturally tailored care, with a preference for providers from the LGBTQ+ community and from their racial or ethnic background. Such needs were complicated by narrow provider networks, limited resources and provider directories replete with inaccuracies and unavailable providers. Participants also highlighted cost-related challenges, including high out-of-pocket costs associated with care and treatment limitations that restricted access to care. Finally, participants reported programing and resources that helped bridge the payment gap or made accessing care more convenient, including community and employer-offered mental health programming, primary care provider-delivered care and telehealth utilization. Our findings support that gay and bisexual men experience challenges when seeking mental health care that also affect the broader population, but may be magnified for this population, particularly for men of color seeking care from a smaller subset of providers prepared to deliver culturally tailored and affirming care to LGBTQ+ individuals. (PsycInfo Database Record (c) 2026 APA, all rights reserved).