In Roman mythology, the god Janus is portrayed with two faces - one looking to the future and another into the past. In the black community, and particularly in the black gay community, the subject of depression is a significant factor affecting the mental health and well being of black gay men.
While possessing faces like Janus, young 13 to 22 years, the intervening years late 20s to early 40s, and older - over 40 - black gay men have more than the two perspectives to contend with. And, while many of the factors which contribute to depression are still real and present, those who are young black gay men have another view to be acknowledged and taken into account as a way of addressing some fundamental issues which lead to suicidal ideation and the rising numbers of HIV infection.
The results of studies and academic papers published by eminent researchers continue to confirm that depression in black gay men is caused by among other reasons, stigma, discrimination, homophobia, racism, low self-esteem and self-confidence, to name a few. These, researchers argue, are contributing factors to many black gay men who contract HIV.
While these factors are undisputed, looking at the present face of the young black gay community and face of HIV infection, with an eye cast on the future, a new concern surfaces.
Many were not even born when AIDS stalked the black gay community and decimated its ranks. Many of these young black gay men are aware of the prevailing tropes and have learned to navigate and ignore them, becoming in some ways oblivious to them - as white noise.
Instead they are finding themselves foundering in a gay community that is not what it seems. This duplicity is leading many into confusion and unable to relate, into depression. While they are demonstrably strong against the usual suspects, which tend to want to oppress them and make them less than, and against which they have somehow developed an immunity, they seem to be powerless against the expectation of belonging to a gay community that is fragmented, divisive, unwelcoming, and untrustworthy.
It is in this community that they find the overt feminization, the attention to fashion, and the fragility of relationships governed by societal expectations of masculinity and how muscular or buff a person is, or a combination of the two, which make many question if this is what being gay is all about. Many young black gay men neither see nor have many positive role models in the wider society; those who have dared come out are vilified and denigrated.
On one hand, many feel helpless and trapped: they don't associate with the sniping, bitchiness and fleeting attention, and the absence of substance. On the other hand, they who have turned to the identifiable gay communities for support, have become disillusioned and disappointed, and are unable to return to their families because there, homophobia, stigma and discrimination - evils they had managed to escape, if only in their minds for protection - still persist and against which they have undeveloped defense or coping mechanisms.
Today, more than ever before, there are at least four faces of depression in black gay men. There is the young black gay man to whom being gay is "no big thing" since among many of his generation there is more acceptance. A black gay young man in this community is likely demoralized when he looks for a sense of belonging where he could trust and see more for himself for the future. He soon realizes that the community is deficient.
Another is the black gay man, in his late 20s to early 40s, who has survived and weathered many storms. He plods through life, from one decade to another, battling various issues and struggling against the lethargy, the malaise and persistent feeling of not fitting in, yet, he holds out hope for a brighter day.
There is the black gay man who is gray, has health issues: cardiac, diabetes, prostate, pulmonary, kidney and, if he is HIV positive, the range of opportunistic infections against which constantly wages a war of survival. This older black gay man is forced to face - or is in denial of - his failing or diminishing sexual prowess and virility, and his social networks are shrinking or have become shrunken through age attrition. If he lives alone he is likely dealing with feelings of loneliness and isolation. If he lives in a living facility, he is surrounded by some of those men and women in his age group who still carry the stigma, discrimination and homophobia against which he fought when he was young, from which he fled, and which he faces once again. To him, nothing much has changed.
Finally, there is the face of the black gay man who took all the precautions and has remained HIV negative, but is plunged into depression when he contemplates a future where many of his social networks have died from AIDS. He is reduced to loneliness, because he cannot and do not have the energy to try to recreate networks where his memories are strong and there exists a huge gap in experiences.
In a Facebook post on a discussion of depression in young black gay men, Cleo Manago, founder and CEO of the AmASSI Centers for Wellness, Education and Culture, and founder and national organizer of the Black Men's Xchange, two organizations working for black male empowerment, says, that any approach to countering conditions that lead to depression in this community must address it methodologically from a cultural, "restorational" and informed perspective. According to Manago, most of the recent same-gender loving (SGL) black folks who committed suicide did not do so because of religion, dual living (the down low) and stigma.
He cites the recent suicides of Joseph Jefferson, an out gay identified young black activist in New York, where his sexuality identity was not a challenge, and Aiyisha Hassan, the Howard University graduate in Los Angeles. In his Facebook post, Manago refers to a 19-year-old black gay man from Denver, Colorado, who had expressed suicidal tendencies. This young man, Manago says, has very supportive Christian parents.
"As a matter of fact, Hassan's father is a Black affirming Christian minister. What Ayisha, Joseph, and the young man in Denver didn't have was a community that made them proud, just the opposite," Manago says.
He adds that if the black gay community focuses seriously on the improvement of its community, that is, the "leadership" and resources as American citizens, and builds the self-concept of same-gender-loving black people, regardless of stigma or religion, less of them would self-destruct.
"Every week, and I mean every week, I hear from young SGL folks who are fine with their sexuality, but not with what presents itself as their Black "gay" community. That's depressing! We need to fix that," Manago says.
Black men who have sex with men and are attracted to other men need to have a less toxic, more reliable, self-respecting and resourceful community, which could only be achieved through concentrated and determined energy, instruction and guidance, he says. The result of this social and cultural shift: these men are likely to become focused and self-respecting enough to hold those usually self-appointed "leadership" figures, that keep failing it, especially on the HIV; accountable.
"Stigma, so-called homophobia and dual life [the down low] living are not the main issues assaulting this community. That's an old school, dated perspective still had by the 40 pluses (in age), but now (unlike when we were younger) it exist alongside a litany of pro-gay media messages, celebrities, organizations, "out" athletes. But little to none of this affirms, restores or heals Black people, including SGL Black people. These days gay is all over the place and very affirmed in many spaces. Yet, again, this typically does not affirm Black people. Studies have been done by the Kaiser Family Foundation and others reaffirming that Black folks are no more so-called homophobic than anybody else. But everybody else is not Black, with a particular experience and history resulting in generations of untreated trauma that must finally be engaged, understood and addressed. Any approach to our collective healing that's not doing this will not be (and has not been) effective," Manago concludes.
At the other end of the age spectrum, another face which confronts the black gay community is of those who are growing older, who are over 40 years old, the maturing baby boomer generation who have witnessed the devastation of AIDS on their family and friends, role models and cultural icons.
An Aug 25 Baltimore Sun article "Aging with AIDS: An epidemic's changing face" painted a dire picture of growing old with HIV in the age of AIDS. It reminds readers, those who are old enough and experienced the dark days of the 1908s and those who are too young to know, that once the face of HIV and AIDS was a death sentence.
But beginning in the 1990s, with the development of powerful antiretroviral drugs, that began to change. AIDS became a manageable, chronic illness rather than an invariably fatal disorder. Today, people infected with the virus are living longer even as their numbers have grown and the rate of new infections has declined. AIDS, once associated primarily with people in their 20s and 30s, is now a disease in which more than a third of victims are in their 50s, 60s and even 70s."
Aging of the AIDS population has presented new challenges to physicians and public health officials. Not nearly enough is known about the long-term effects of the highly active antiretroviral drugs that allow people with AIDS to live for decades or longer, nor are the physical and social effects of aging on people with AIDS well understood. Meanwhile, the problems associated with providing elder care for people with AIDS and the training of their caregivers and social service professionals are becoming ever more urgent. Moreover, health professionals must find ways to reduce the growing racial and class disparities among older AIDS victims. African-Americans, for example, are 12 times more likely than whites to become infected with the AIDS virus, and Latinos are five times more likely.
One of the most significant changes brought about by the aging of the AIDS population is the way the virus is transmitted from person to person. Where once the primary transmission routes were through homosexual sex between gay men or by the sharing of infected needles among intravenous drug users, today the majority of new infections occur through heterosexual sex, because older people tend to have sex with people their own age.
Most of these new infections result from unprotected sex between the partners or former partners of intravenous drug users and uninfected people who do not even realize they are at risk. Nationally, nearly one-fifth of people 55 or older who were living with HIV in 2009 did not know they were infected.
The rapidly changing dynamic of the epidemic due to the aging of the AIDS population requires an equally dramatic change in the way older people think about the disease. Until recently, people in their 50s and 60s believed they were at little risk of contracting the virus. But that's no longer a safe assumption.