The Steam Room is broadcast on GaySA Radio every Wednesday from 19:00 to 21:00, and is brought to you by the National Department of Health’s Phila programme.

The Phila programme encourages all South Africans to be inspired to live, and is about keeping fit, knowing about your health and body, eating well and taking action about your health in general.

In episode 6 of the Steam Room, we delve a bit deeper – so to speak – and speak about the mental and sexual health issues relating to men who have sex with men.

Is there a link between mental health and sexual health?

Tom Budge, a Gauteng-based hypnotherapist, believes that mental health and sexual health are inextricably intertwined.

“We’re like a three-legged stool, really. We stand on a floor of spirituality. The three legs that form the pillars of who we are as human beings are intellect, our emotions and our sexuality. Those three need to be in balance if that stool is going to be at all useful. If one leg is broken or missing, or one leg is too long or too short, that’s just not going to work. ”

Budge says that one needs to make sure that there is balance in terms of sexuality, intellectuality and one’s emotional life.

Pierre Brouard, Deputy Director at the University of Pretoria’s Centre for Sexualities, AIDS and Gender, agrees and says that for many people who form a part of the LGBTQI+ community, long-standing self-esteem issues may be the result of discrimination throughout a person’s life, and may lead to mental health issues later on.

Feelings of isolation, alienation, depression and anxiety may all contribute to problems in a person’s sexual life. Contrarily, an affirming and mutually satisfying sex life contributes to mental wellbeing, which suggests a very powerful link between mental and sexual health.

Bruce Little, Content Creator at the Anova Health Institute, confirms that feelings of isolation and depression could also lead to substance abuse, risky sexual behaviour, or a combination of both.

How do mental health issues manifest in sexual health issues?

Many factors are involved when mental and sexual health issues crop up, says Budge. There may be issues of struggling with affirmation, and basic brain chemistry, like the amount of dopamine in our systems also play a role. If sexual engagement provides the only way one feels good about oneself, it may lead to obsessive sexual behaviour to chase an short-lived emotional high.

How should mental and sexual health issues be addressed?

Bruce Little says that the first step to treating mental health issues is an acknowledgement of the issues, followed by taking responsibility for them and reaching out to get treatment. Little advises that individuals who experience mental health issues seek long-term solutions for underlying mental health issues like loneliness, instead of getting short-term sexual gratification by hooking up. Intimacy and sexual encounters should also reaffirm a positive sense of self-worth.

Budge believes that balance is of key importance as it pertains to mental and sexual health issues.

“If one is sexually continent, then you’re using your sexuality as a part of who you are. It is neither obsessive, nor is there any guilt about it,” says Budge.

Pierre Brouard says that undoing years of negative conditioning does not come easy, but that individual psychotherapy may be a good start. Support groups, medications and seeing a mental health professional can be helpful. At the grassroots level, positive and affirming relationships with friends, family and partners, a sense of connection, and an accepting community could also be a form of treatment.

In the age of social media and dating apps, judgment is often at the order of the day, and Brouard recommends that people who find that these spaces negatively impact their mental health should look elsewhere for affirmation and community. Brouard says that while searching for balance is important, resilience in the face of adversity and seeking support from those that you are close with helps on the continuing journey of seeking balance in your life.

Where should you seek help with mental and sexual health issues?

A wide range of experts and different therapies is available to those who seek help with mental health issues. Hypnosis, which Tom Budge has used with great success, can allow a person to find their character and nature and the safety zone in which one is allowed to be a human being.

Alternative mental health therapies are another treatment option. Peter Furstenberg is a trained facilitator of LEGO® SERIOUS PLAY®. The Playful Men workshop, which uses Lego as a method of therapy, taps into childhood methods of play and highlights the common issues that men experience.

Because men are more likely to remain silent about issues and problems, the workshop provides an avenue for men to open up about the things that bother them. While unconventional, this method of therapy taps into people’s inherent playful nature. Harnessing a method that is fun turns it into purposeful play that brings abstract issues and concepts into a three-dimensional sphere where they can be discussed.

What is the link between age and mental and sexual health in the LGBTQI+ community?

Budge describes a bell curve in terms of age and mental and sexual health. Before a young person comes out of the closet, there is often a lot of anxiety about the topic, which disappears once a person has come out and made their peace.

The flip side of this, according to Budge, is that aging is a difficult process in the gay community. Very often, accomplishment, wealth and material acquisition are played off against youthfulness, beauty and physical attributes. Older men may feel a sense of desperation for emotional connection, while their physical prowess can’t compete with that of younger men. This may lead to older men being shunned from the gay community, leading to issues with loneliness.

With that being said, older men possess something that they have acquired with age: grace. This is a magnetic characteristic that often inspires the younger gay community. Counter-intuitively, older men may have to go back into the closet in old age, as assisted living facilities are often not geared, may not understand or may be judgmental of homosexuality.

Who to contact

If you find yourself struggling with issues relating to mental and sexual health, please check out the following organisations:

The South African Depression and Anxiety Group

The Mankind Project

The Centre for Sexualities, AIDS and Gender

Mental health is a topic that isn’t discussed nearly as much as it should be. Reaching out to organisations and individuals that accept you, support you and can assist you is an indispensable part of your sexual and general wellbeing.

Click on the player below to listen to our full discussion about mental and sexual health on Episode 6 of the Steam Room, brought to you by the National Department of Health’s Phila programme.