Gynecomastia and its psychological impact

June 23, 2014

By Merle Yost LMFT

When a man or boy discovers they are afflicted by gynecomastia, it often has a major psychological impact on their emotional being and sense of self. We are highly cultured to believe that breasts belong on women. Anything looking like breasts means is supposed to be a female characteristic. While there is a subset of men who find having female-like characteristics exciting or pleasurable, the majority of males find it antithetical to their sense of being male.

For those dealing with it at adolescent onset, gynecomastia happens at the worst possible moment. The boy is just starting to mature; the deepening of his voice, the increased hair growth and suddenly his chest is doing something strange, something unexpected and certainly unwanted. It confuses him. At first he wonders if he is sick or if there is something wrong with him. Until recently, he was in a world of isolation. The Internet has provided possible answers and reduces isolation. But it is likely that it is much too shameful to really talk to anyone about it.

Watch an online workshop for men diagnosed with gynecomastia:

Watch Bumps On The Road >

For most boys and girls, the changing body is deeply private. The more education that a parent provides, the easier it is to move through this transition to physical adulthood. If there is an open relationship with the parents, a boy can talk about what is happening. Unfortunately for most, gynecomastia is an unfamiliar condition and parents them self may be alarmed, dismissiveng or even humiliating when faced with the problem. Fathers and sometimes mothers can even reject a son that who somehow does not match their internalized picture of what a boy/man should be or look like.

Because of this feared rejection, many boys will suffer in silence. They will may retreat from family, friends, social and athletic activities out of a fear of being discovered they areas being somehow less of a man. At the very time it would be useful to reach out for support from trusted people, it does not happen and this can begin initiate a life long pattern of social isolation and distrust.

For most boys, this fear of rejection or humiliation from family is not based on reality. Most parents want their kids to be happy. They will do what they can with whatever means that they can to resolve the issue. Because most parents have limited knowledge about gynecomastia, they will defer to their doctor, who may or may not have much more information than the parents.

From a psychological perspective, it is important to take the feelings of these young men seriously. He is will be taking a huge risk and being incredibly vulnerable to expose something so personal. It is important that his risk be honored and dealt with in a serious way. Jokes, diminishing it as fantasy or the condition being some how not important is really damaging to a young man’s self-esteem and body consciousness.

Adult onset gynecomastia is a very different experience for most men. They have had a long time to be familiar with their male bodies. Hopefully the adult male has come to some terms with his masculinity and is emotionally secure. Thus the development of gynecomastia can be just another change to be accepted or changed, but it is not a reflection or diminishing of his manhood. If a man is not secure, it can be devastating and provide another reason for self-loathing and criticism.

While surgery is a cure for the physical condition, gynecomastia may bring to light some emotional concerns that need to be addressed. Boys and men can find an external feature that they can focus on that becomes the cause of their internal pain. There were studies showing that vets coming back from war with physical injuries did better than some that did not. If there is a physical wound, then there is justification to acknowledge pain; if it is inside, then it cannot be acknowledged or justified.

Changing the body is an important part of healing for many men and boys, but it is often not the only issue. There needs to be attention paid to the healing of the mind as well.


Gynecomastia In The Press

Read the latestselected press articles relating to gynecomastia here.
Links are to the online article when available.
[PDF] is archived article in PDF format.

New York Times A Surgeon Who Caters to Men's Concerns (Oct 31, 2008)

Newsweek Why Some Men Grow Breasts - [PDF]

USN&WR: Boys Who Grow Breasts: What They Can Do (Sep 19, 2007) - [PDF]

USN&WR: He Carried a Burden on His Chest (Sep 19, 2007) - [PDF]

Web MD: Male Breast Enlargement May Be Common (Sep 19, 2007) - [PDF]

People Magazine: One Boy's Private Shame (Sep 3, 2007) - [PDF]

Kansas City Star: Males Are Turning To Reduction Surgery (Jul 30, 2007)

Out Now Magazine: A Man With Natural Female Breasts (Jul, 2007) - [PDF]

NY Daily News: Bye-bye breasts, hello wonderful new life (Apr 7, 2007) - [PDF]

Times Online Life & Style: How I got rid of my 'moobs' (Feb 5, 2007) - [PDF]

Yahoo News: Male Cosmetic Surgery (Jan 14, 2007) - [PDF]

Star Tribune: Hormone imbalances and medications... (Oct 10, 2006) - [PDF]

Contra Costa Times: The Metamorphosis (Sep 25, 2006) - [PDF]

National Geographic News interviews Merle Yost (Aug 11, 2006) - [PDF]

Now Magazine: My breasts made my life hell (Oct 13, 2004) - [PDF]

LA Times: When men's chests cause shame (Dec 8, 2003)

MSN Sympatico: Teen boys struggling with gynecomastia (Nov 6, 2003) - [PDF]

Details Magazine: Are Your Breasts Bigger Than Hers? [cover]

National Post: Interview with Merle Yost (2002) - [PDF]


Gynecomastia - Merle Yost

Australian TV documentary clip about gynecomastia and Merle Yost's experience with his second surgery.

My Boob's and Me

A segment on gynecomastia featuring Merle.

TV News Clip on Breast Reduction

North CarolinaTV news clip from WLOS-TV in Asheville, NC about gynecomastia and breast reduction surgery, interviewing Merle Yost of See


Counseling vs. Psychotherapy, or a Rationale for the Transformational Work of Psychotherapy


I do a lot of training of new therapists and when I meet them, I have discovered that many do not really understand the difference between counseling and psychotherapy. Much of what passes for psychotherapy is actually counseling. Unfortunately, most are not educated to know the difference. If therapists don't know the difference, how are consumers supposed to know? I will try to make some distinctions here so people seeking help will understand the difference and be better informed.


The counselor's main goal is to make the clients feel better. He rarely challenges them outside of very restricted parameters. The counselor works hard to make sure the clients like him. He does not dig into the past in a way that would be painful; he is less interested in the past and more interested in stopping any bad or destructive current behavior. As in addiction counseling, there is an underlying fear that going too deep will cause relapse, and thus destroy any fragile recovery. There is a lot of advice giving and varying amounts of psycho-education.


Psychotherapy includes all of the above, and also includes the underpinning philosophy that healing requires uncovering the underlying pain/trauma that is causing the dysfunction. Also, there is less focus on making sure the clients like the therapist. Of course, there should be a good therapeutic alliance. However, the therapist must be willing to take risks for healing to happen. Going into the pain, especially its source is essential if transformation is to take place.

So, the job of the psychotherapist is to assist the clients into going deep inside themselves, to help reconnect to those downloaded beliefs and values, especially the ones that are at odds with other parts of themselves and their goals. Also, the psychotherapist helps clients get to the over broad conclusions, reached so long ago, that are keeping them from receiving or getting love. This takes time and the willingness to assist the clients into going in to the pain and staying long enough to transform it into something new.


A child has two primary tasks growing up. One is to absorb the love of her parents so she feels secure in the world. The second task is to make sense of the world; to take all the data she encounters and organize them into a workable interface with the world.

A child is formed in the container of the parents' relationship. The parents' relationship is his model for being in a relationship, and his individual relationship with each parent is the model for being in relationship with others of that gender. Also, how a child ingrains the love that the parent offers is key to how he looks for love and loves himself.

As a baby, the child swallows everything that is put into her mouth because she is too young to know or understand what is good or bad for her. She does the same with values and beliefs from family and society. These swallowed beliefs and values make up a large part of the organization that she uses to understand the world and make sense of it.

Experience is the other big teacher for a child. If a child burns his finger on the stove, he learns that this is not a good thing to do. Unfortunately a child often makes overly broad conclusions from these experiences before he has enough information to make generalizations about the world. For instance, a 4-year-old boy does not get to wear the shirt that he really wanted to wear. He concludes that he never gets what he wants or that his mother does not love him because he is unlovable. From an adult perspective, both conclusions are silly, but to a child with limited experiences, they make sense and can easily become the foundation for how he sees the world and his place in it.

Therapist and client get to spend a lot of time looking at those early models for relationships, to reexamine the ideas of what relationships of all types really look like. This often means letting go of a lot of fantasies about how relationships work.

Psychotherapy takes time, it takes a lot of trust and it takes willingness to face and work through pain. A psychotherapist is a guide and companion on that journey. The results can be rewarding but like most things that are good for us, there is pain involved.

In my experience, psychotherapists that have done a lot of work on themselves are much more likely to do psychotherapy rather than just counseling.


If a therapist is not willing to assist in going into the pain and trauma, he probably is a counselor. If you want a counselor rather than a psychotherapist, that is certainly okay, as long as you are aware of the differences and set your expectations accordingly.

While a counselor may make you feel good, healing will not be as easy to achieve. I will use the analogy of Swedish massage vs. physical therapy. One will make you feel good briefly, while the other addresses the underlying issues and will likely cause pain while solving the problem, rather than just masking it temporarily.

Men With Herpes


Why have I chosen to focus an entire section on gay men with herpes? On the net there is a lot of consolidated information about having herpes. Not much of it is specifically about gay men with herpes and even less on lesbians with herpes. So I have decided to put together a resource guide for gay men that will help them explore the issues specific to them. I think many will get a lot out of it, but it is intentionally directed toward gay men and men that have sex with men.

I hope that you find this part of my site useful.

Now That You Know


“Hey doc, this odd rash on my dick (ass or my sore throat) just won’t go away. What is wrong? Do I need an antibiotic?”

Watch an online workshop for men just diagnosed with Herpes:

“No, you have herpes, everyone does, so just forget about it and don’t have sex when you have an outbreak.”


This is a typical conversation that many men have with their doctors. The guy is just pushed out of the office and the doctor goes on as if he just told him the sky is blue. For many men it seems that is fine and they never think more about it. For others it is a devastating loss of purity, cleanliness, and sexual viability.

Many ads on the Internet and profiles, say “Disease Free” or “Clean” and UB2. Few people who engage in sex with more than one lifetime partner are disease free and will certainly not stay that way. There are way too many STD’s that you can get through casual sexual contact that may or may not have any external or visible signs.

HPV has over 200 varieties, some of which cause cancer in women and some have been linked to cancer of the throat in men. HSV I and II can appear anywhere on the body. Given how long they have been around there is surprisingly little that is really known, and there is no cure for them.

HSV I better known as oral herpes is increasingly being diagnosed both anally and on the genitals. HSV II is commonly known as genital herpes is very common in the throats of gay men. If you are going to be sexually active it is part of the risk, like any of the common STD’s. What is different is that herpes sticks around.

Getting an HSV diagnosis is not the end of the world. For men who have a conscience and who attempt to do no harm it can be devastating. Gay men have lived with the threat of HIV for so long and the stigma that goes with it that getting an HSV diagnosis can feel like the same kind of life-ending or at least sex-ending forecast. Feeling toxic is common. It is also not true. If so, then 80-90% of the US population is toxic. You are in good company and being honest with yourself and others is important and healing.

Indeed there is a similar process of acceptance that a man diagnosed with HIV and HSV go through. I have adapted the classic Kübler-Ross stages for men with HSV.

Stages of Acceptance

Elisabeth Kübler-Ross (1969) concluded that people progress through the following five stages when facing their own possible death or other important emotional losses.

The stages are denial, bargaining, guilt, anger, and acceptance. There is no particular order to these stages, although they can follow an ordered pattern. These can be applied to an HSV diagnosis and may help an individual understand why they are feeling or acting in a particular way.


This isn't happening to me, it can't happen, it's not true. For you and for many others recently diagnosed with HSV, impulsive assertions that the test must be wrong, or a mix-up of test results would be a natural and normal first reaction. In most cases you would seek additional testing, just as you would seek second medical opinions. In time, after additional tests were conducted, and the tests continued to produce positive results, some acceptance would hopefully begin to take place.

Some issues of acceptance are choices in antiviral drug use, episodic or suppressive, and/or support services.


As people with an incurable condition come to terms with their situation, they may create bargaining strategies with their personal god or a high power or themselves.

I will never have sex again if this just goes away. I will stop having gay sex. I won’t get fucked any more.


All of these have to do with some manner of shame/guilt about sex and or gay sex in particular. This in the best case will help a gay man resolve any unconfronted issues about being gay and/or gay sex.

(Suggested reading: The Velvet Rage by Alan Downs)


Why is this happening to me? I hate this world and all the people in it! I hate my life and myself. Anger can display itself in acting out behaviors that can take on the form of acting out excess behaviors. Overeating, indiscriminate sexual interactions, and impulsive and aggressive behaviors toward others can all be indicators of anger. Anger is okay, but hurting others is not. This is a disease, and it's not a just, fair world. HSV does not pick or choose and it does not discriminate.

These acting out behaviors can result in isolation. We all need social interactions. HSV support groups -- there are a few around -- are a great way to talk to others that truly understand and to hear others peoples’ journeys.

One view of depression is that it anger turned inward.


Poor me, I will never have sex again. Everyone experiences depression now and then, some more than others. We have a tendency as people to try to blame it on something. Herpes is convenient just like being too bald, or having too short of a dick etc. There is always something to blame it on.

There are many ways to deal with depression, such as exercise, talking with others, talking with an understanding professional. Working on the underlying causes of feeling bad about ones self is always useful. A little depression is useful. A lot of depression is not. If you get really low and/or really isolated, then get some help, professional or otherwise.


I have herpes, my life and sex life will continue. I cannot be as unconscious about sex as perhaps I would like, but I am okay, I will experience sex and love in the future. It is a virus; it does not make me a bad person. I am not dirty and I will not infect everyone I come into contact with. I am a healthy normal man.

Rules of the Sex Game

These are fair rules for a person with any conscience to use as they navigate casual sex. 

Not everyone operates by these rules.

  1. Just Say No

    If you have a HSV outbreak or feel one coming on; do not have sexual contact until the tingling sensation is gone or the lesions are completely healed. HPV is so common most sexually active people have it as well, but don’t know it.

  2. If Asked, Tell the Truth

    With casual hook ups few people take the time to discuss birth control let alone STD’s. There is the assumption that you are both educated about STD’s and aware of the risks. The use of alcohol or drugs can make people act without thinking about the bigger picture. If asked you tell the truth. 

  3. Wait, Then Tell

    People who are potential partners, boy/girl friends or even just friends, you disclose up front. Which means you don’t have sex until you have the conversation.

  4. How To Tell

    The conversation happens when you are both clothed, in a place that there can be an easy exit and no drama. This maybe an opportunity for some education, but there is space for the other person to say no or take the time to learn more. 


Disclosing that you have HSV or HPV can lead to rejection. People get rejected for all kinds of reasons. Most people seem to want to be unconscious about sex and telling them that you have an STD makes you and the sex too real. It moves it out of the fantasy spectrum. So what you will have really been guilty of is destroying the fantasy and that is often the reason for the rejection. If they reject you because of it, they are not really interested in you. You deserve someone that is really interested in you if you are going to put the time and effort to having sex with them.

Move on to the next one. Take heart that you can look at yourself in the mirror and sleep well.

Links of Interest

A Social Work Perspective


Support Groups

General Information

Dating Sites

Gay Specific Information

HPV Information

Bi/Gay Heterosexually Married Men

Early in my psychotherapy practice, I was overwhelmed by a number of bi and gay heterosexually-married men looking for help in dealing with feelings that they most desperately wanted to go away.


Watch The Sex Addiction Myth >

Despite the proliferation of religious-based pseudo-psychologists, the power to change sexual orientation is not within the capabilities of a psychotherapist, or even an individual. Coming to terms with who you really are is the challenge goal of life. Some of these men leave their wives.  Many do not. Each must choose the path he can live with.

There are many bi and gay men in heterosexual relationships and marriages.  The "men seeking men" categories on Craigslist and various cell phone “gay dating apps” are full of anonymous ads looking for sex and sometimes love. 

The gay community has been dramatically impacted by formerly married men. There have been estimates that as much as 80% of the AIDS generation — those out gay men born primarily in the 1940s through 60’s — has died, and closeted men who went into heterosexual marriages missed the slaughter of the epidemic. Thus, they make up a disproportionate number of the current older gay community.

Brokeback Mountain was a watershed movie for many of these men, because they saw their story, and for the first time, many felt they were not alone.

This article is an attempt to share some of the knowledge gained over the years working with this population, in hopes of making the journey easier for the men who are now trying to come to terms with themselves. It is sad that in 2018, men still don’t know who they are or still believe that in order to be loved, they have to deny who they are.


Internalized homophobia is the biggest issue for bi and gay heterosexually married men. Raised in a heterosexual world, they are different and often they know why, from an early age. They have spent a lifetime being the person others wanted them to be. In an attempt to fit in, be safe, and be accepted by society, they have rejected and hidden who they are. To be gay or even bi, and out, would make them unacceptable to themselves and society, in their perspective.

In most cultures, shame and guilt are a large aspect of sexuality. Shame is feeling badly about who we are, while guilt is feeling badly about what we have done or might want to do. For most people, there is an overlap between shame/guilt and sex/sexuality, as they are deeply intertwined. In order to be truly out and healthy as a gay or bi man, some of that shame and or guilt must be faced directly and worked through. To be happy in life, it is necessary to work through as much of the shame and guilt that you have downloaded as you possibly can.

The Internet, tea rooms (public bathrooms where men have sex), bathhouses, and adult bookstores are full of men who have not come to terms with their sexuality, nor with the shame about who they are. They are lost in their erotic feelings of sex, while desperately trying to avoid any real intimacy that would force them to really look at themselves and feel acceptance. Burying the shame of being gay can only bring more pain when they make poor choices in partners or do other self-punishing things.

Spending time alone and being engaged in the community are both required to move through the process of redefining who men are, as humans and gay. It takes time and effort to move through the self-loathing and self-hate. To be healthy, both sexually and emotionally, it is necessary to move beyond just the erotic as the prime motivation for male-to-male sex, and understand that love is also the foundation of being gay.

Too many bi and straight men want the fun of gay sex without any of the work or responsibility of gay relationships or membership in the gay community. They cannot really value a gay relationship equally, because they have been socialized to believe that marriage or other serious relationships require being with a woman. To be in the wrong relationship for one’s sexual orientation also means a lack of profound sexual attraction or excitement with their partner. Gay men can perform sexual acts with women, just as straight men have been having sex with men forever (think of prison as just one example). It is not the same as having sex with the appropriate gender for a man’s sexual orientation. One reason that makes the physical sex is an age-old issue for men: the separation of sex and intimacy. Men are not socialized to combine the two. One version is the whore/Madonna complex: "Sex is dirty and therefore not to be done with someone I love." For many men, when someone else starts to get very close emotionally, all or most sexual desire dissipates. If your model for intimacy is a parent who has consumed and overwhelmed you, it has been the effect of emotional incest by the mother. With this experience, being loved is a bad thing, since you risk being consumed and overwhelmed, both psychologically and emotionally. By staying on a solely erotic or sexualized level, the risks and perceived “threat” of real intimacy are minimized. It is also possible to eroticize being consumed and overwhelmed by the other. This usually results in some degree of emotional and/or sexual masochism in their sexual expression.

Men coming out after ending a heterosexual marriage often rush out and look for their fantasy man/boy. They are in the heat of their long-suppressed adolescent lust, often mistake that for love, and rush into a relationship. Too many men, as they start to come out, find the "perfect" young man who fulfills all their fantasies, at least on a physical level, and think that they have truly fallen in love. They invest time, and often a lot of money, into keeping the boy. (I am using "boy" as the description of a younger man in an older/younger relationship between two males of legal age.) Most of these dalliances end in sadness, if not tragedy. Many men have wasted a huge amount, if not all, of their retirement savings on this sort of "love." Eventually, they may retreat back into the closet and make huge generalizations about what it means to be gay, thereby solidifying their internalized homophobia. They run away, stop trying and stop growing.

This type of disillusioning experience is the equivalent of being three years old and stubbing your toe on a door. It might cause you to decide that all doors are dangerous, and that you must never go through one again. The journey of coming out really begins when you start telling people who you really are, and facing the possible rejection. This coming out is a rite of passage for an "out" gay man, and it is one that was avoided by men who got married and have instead played the "fit in and belong” game.

Even for an adult, the beginning of the coming out process can take place within an adolescent mindset. Adolescents do not make the best decisions, and neither will a man coming out who lacks basic information or guidance. Being gay, homosexual, or queer is about the healthy combination of love and sexual attraction. Sexual orientation is the unification of the heart and the genitals. Sex and love are not about sexual orientation in themselves; they are about lust and sexual expression. As a man comes out, he enters that painful exciting stage of an adolescent. He is finally experiencing what many of his heterosexual peers did in junior high, high school and college. That adolescent exploration, at that actual age, if short changed, can be damaging to the man and relationships he will attempt afterwards.

Intimacy is at the core of attraction. Regardless of sexual orientation, with enough intimacy, there can be sexually connection. This is how gay men have had sexual relationships with women; as they get to these deep levels of trust and exposing themselves, and this is the definition of intimacy. Consequently, they are able to perform sexually. But that does not change their sexual orientation. Straight men can have the same experience with another man. In a healthy relationship, it is important to not confuse this deep intimacy with sexual orientation. Most heterosexually married gay men report having to think about having sex with man in order to orgasm in their sexual relationships with women. Sex and relationships are complicated enough when it is the right sexual orientation match. Being in the wrong gender match just makes it harder for all involved.

A gay man who has been married to a woman should wait at least two years after the divorce is finalized before getting into a serious same-sex relationship. That time is needed to reorganize and absorb one’s real identity. Being in a relationship right away interrupts that process. We get to know ourselves best when we are alone. Starting a serious relationship before the minimum two-year maturation period is over is a distraction from oneself, especially early on. Being gay is different from being straight. It is not just a matter of having a different hole to use. There is a very important process that must take place so that a man is able to fully be present in a relationship. A gay identity is not easy, especially for a man who is used to all the societal privilege of being heterosexually married.

There is the healing from the divorce. There is financial recovery. There is the discovery of a different world with different rules and players. There is moving beyond an adolescent fantasy of every available sexual permutation. There is a new set of values that relate to a different paradigm. There is facing the self-hatred that comes from being gay in a straight world. The process of discovery and healing never stops, but it does get much easier to face and deal with and can become an exciting part of being alive and growing.

This section assumes that all men are truly all gay or all straight, even if the “bi” label is a famous red herring. What about the spectrum range of sexual orientation? Kinsey 4s?


1) There are the guys that just don’t know. They have totally bought into their childhood programming. Also, they may not be emotionally or psychologically developed enough to know who they are. Kids, by and large, do what they are told and what is expected of them. They don’t think about it too much. It is after they form into a person, develop a sense of self and begin individuating that they can begin to discern who they are and what they want. Consequently, they get married, go to college, join the military, do whatever their programming has dictated because it just never occurred to them that who they are might be different from what they were told. He will either stumble across a guy that he falls in love or lust with, or have a form of mid-life crisis. It will be at this point in his life that he finally realizes that he is unhappy. Suddenly, he sees that his life is not fulfilling, and he then begins to search inside of himself and start the process where he will hopefully figure out what is missing.

2) Some men acknowledge that they have had feelings for other boys and men while growing up, and may have even had several sexual experiences, but feel that they cannot still be loved and be gay. They may continue to have sex on the side or not, but they feel like impostors while they do what is expected of them, even as they die inside. By reducing these feelings to quick hook-ups, mostly one time encounters, they can avoid the risk of falling in love or dealing with the messy parts of themselves. It is playing Russian Roulette with themselves and their lives. But they are determined to protect the public life they have built, and often go to great extremes to do so. (Just Google “Republican politician” “outed” “gay”)

3) Another possibility is that, as a boy, he was sexually abused. Whether he identified what happened as abuse or not, he uses those feelings as the basis for the belief that he would not be having those feelings towards men if it had not happened to him. This man is deeply ashamed and full of self-loathing. He desperately wants to be normal, and is angry about what was done to him as child and how it is keeping him from feeling or being normal.

Gay boys are more likely than straight boys to be sexually abused[TC1] . Because they know they are different and in an effort to not reveal who they are, they tend to be loners or at least more withdrawn. When an older male shows interest, it can be a trap. The gay boy is looking for recognition and validation and like any boy, wants to be seen as sexually attractive. Kids generally trust adults in authority; that is how they are trained. When that trust is betrayed, it has life long consequences.

4) Societal pressure plays a central role for many. Fear of rejection by family, a loss of inheritance, a religious belief in damnation, and even the real threat of death, all can contribute to choosing to live the life “they” expect, instead of the one that fits. Kids are socialized that family is the most important thing in the world. Many families, churches and societies teach the child that what they, the family, church, society, etc. think of them is more important than what they think about themselves. This perspective can become the centerpiece of a person’s life. If they are unable to step outside of it, they will marry, have the expected kids, and do the things expected of them, no matter the cost to themselves, their wife or children.

5) Any and all of the above factors are frequently tied to a religious belief that homosexuality is wrong. A common part of the self-hatred that makes up the core of how a gay man or boy may sees himself comes from buying into the belief system that who you is bad by nature. When a religion tells its believers to hate themselves for being who they are, it is a criminal, egregious abuse of power, and creates unnecessary pain in the world.


When an older male sexually abuses a boy, the boy can be psychosexually stuck at the age when the abuse happened. There are many men who have sex with other men compulsively, because they are trying to replay and somehow resolve this childhood abuse. They may very well be heterosexual, they are often married, love their wives and enjoy sex with them, but they have this drive inside of them to recreate the experience of the abuse. It is called a repetition compulsion. They will not be clear about their sexual orientation until they go into therapy and resolve the sexual abuse. If the experience was pleasurable, this can create confusion about their sexual orientation. Most men know their sexual orientation, but when these feelings come up, they don’t know what to do with them or how to categorize them. Stress can be a trigger for these feelings to emerge as they go into a younger place psychologically and the pleasure of the experience became a bypass to dealing with the stress in the moment. Regardless of sexual orientation, it is necessary to work through these experiences and get to the unpleasant feelings buried beneath the pleasure, so that the psychosexual part of the adult can mature to match the physical age.

Many gay men that were sexually abused will tell you they are happy it happened. They call it ‘starting early.’ However, they are much more likely to not be in a relationship, be sexually compulsive, and prone to BDSM sexual relationships with little in the way of intimacy. For more information, read the article on this site called: Shedding Light on the Sexual Abuse of Boys and the Men They Become.


For some men, emotions and feelings are a foreign concept. Men are not taught that having a variety of emotions is also masculine, nor are they supported in developing an emotional vocabulary as they mature. Without this, a man cannot acknowledge or manage his emotions. As a result, it is likely he will not be happy in any relationship. Society has made women the keeper of feelings for men, women, and their relationships. Everyone suffers as a consequence.

Feelings start as a thought, which is also felt in the body. Then the brain translates the feelings through the downloaded programming. Memories are feelings that are stored in the body. Letting those feelings move through the body is the path to healing and release.

Feelings and emotions can feel good or bad, but they are never irrelevant or invalid. Trying to control them is usually a losing battle. While men have traditionally been taught to ignore and suppress their feelings, a man’s actual job is to learn to manage his emotions, come to understand them so that he can learn more about himself and from his experiences with others in the world. How we feel when we are with someone, even casually, tells us a great deal about that person. Deciphering this puzzle, of understanding “what does my reaction to them mean?” can make the experience of being in the world much easier, not to mention more interesting.

Again, psychotherapy may be needed to assist in discovering the emotional self. It can speed up the journey and make the process easier. It helps to have an ally and sounding board. The discovery, work, and feelings are the individual’s, but having a mentor on the road will make the journey faster and much less lonely.


Coming out means potentially losing a lot. It is possible to lose one’s family (both immediate and extended), friends, home, job, etc. Coming out never happens without some cost. At the very least, one’s self-image must be reinvented.

This transformation requires a substantial part of one’s self-image be changed, and part of that process is to grieve losses. Each person grieves in his own way, but the traditional stages of grief apply to most:

Denial: I am not different. This will be easy. Nothing will change except that I am having sex with men rather than women. A relationship is a relationship; there are just different parts involved. No one needs to know. Who I have sex with is private and no one else’s business.

Anger: This is not fair. This should not be happening to me. It messes up everything. People will not like me anymore. They will only see that I am gay, and I can’t handle that. Why me? I did not ask for this. I don’t want it. I won’t do it.

Bargaining: I will only tell a few people. I will only have sex or be gay when I am out of town. I will only get sucked or do the fucking because that means I am not gay, and I am still a man. I am not like ‘them.’

Depression: I don’t see a way to be happy. I can’t be gay. I can’t come out. I can’t stand this lie anymore. It is killing me. There is no happy ending for me.

Acceptance: It won’t be easy, but I will do what I have to do. I want a chance to be happy; I want to be who I really am. I am worth it. People who love me will love me, no matter who I love.

The potential losses can include real loss of social status, relatives and friends, jobs, money and church/religion or community. Each loss has its own process and consequence. Some men pay higher prices to be who they really are and to live in integrity. For the vast majority, the journey is worth the price, and they become much better human beings and happier people. But it is crucial that the stages of grief be felt and expressed in whatever way is appropriate for each individual.


  • Writing/journaling

  • Meditation/prayer

  • Support groups

  • Psychotherapy/counseling

  • Reading others’ stories

  • Art

  • Physical expression of feelings


With every loss, there is a gain. In this case, the gains include a truer sense of self, a sense of rightness with being in the world, and most importantly, learning who really loves us for who we are, not who they thought we were or who they wanted us to be. So, be sure to celebrate the gains. It is like graduating. We should always take time to celebrate the good that comes, just as we need to acknowledge the losses.


There are moments, days, months, and even years when we much spent time alone. At the end of any relationship, and especially the end of a long-term one, it is imperative that time be taken to re-discover you. To be in any new relationship requires that a certain amount of reorganization of an individual take place, in order to be part of a couple. When the relationship ends though divorce, death, or separation, it is necessary to take a new inventory to see who you are now, because the person who existed before the relationship is no longer there. You have changed. You have more life experience, and you now see the world through a different set of experiences. This is the time to figure out who you have become, so that when you are ready to be in a couple again, you will know who, and what, you are bringing to this new relationship.


  • Live alone, if possible

  • Writing/journaling

  • Meditation/prayer

  • Psychotherapy

  • Art

  • Travel alone


There is nothing fun about divorce. It is painful for everyone involved. Most men are glad to move on with their lives. By the time they decide to divorce, they just want it to be over. Many men feel a lot of guilt about their divorce when it involves coming out, and often give away all of their assets to compensate for this guilt. It is important to be fair, but not to "give away the farm." Depending on the couple’s ages when the divorce happens, there can be custody and childcare issues, and retirement and property settlements.

Sometimes, the wife attempts to play the sexual orientation card in the divorce, and it can be really ugly. That sweet woman you married may turn out to be your worst nightmare.

Be sure to get the best, most experienced divorce lawyer you can afford, especially someone local that understands the courts, the judges, and the local prejudices and approaches. There is little to no advantage to stretching this out. Get it done as quickly and fairly as possible, but get it done. Your new life cannot really begin until the old one is finished. Until you are divorced, you cannot fully grieve or move on with your life.

There are many rationales for continuing the marriage on paper only. "She needs the health insurance" is a popular one. If you were straight and divorcing or separating from a wife, the new female partner would not tolerate your continuing to be married, and frankly, neither should your future male partner. While you may no longer be emotionally tied to your wife, the piece of paper that binds you to her is an energetic link that keeps you from being free and available for another. It is ultimately saying "my gay life is not as important as my straight life or commitment."


In some ways, it is much easier to be exclusively straight or gay than truly bisexual. The old joke is that if you are bisexual, you have twice the chance of a date on Saturday night. The real punch line is: but only if you are in the closet. Bisexuals find much less acceptance than men on either end of the Kinsey scale. What I mean by "bisexual" is a man who is both emotionally and sexually attracted to both sexes and able to be in love with either gender.

Many "straight" men, in my observation, can have sex with men. For them it is easy—there are no potential ‘love’ emotions involved, and since they are with a man, they can rationalize that it is not cheating. It is just sex, getting off, nothing more. A term for this is ‘hetero-flexible’ and a newer one, ‘mostly straight.” These men are not really bisexual.

Most bisexual men remain married to women. The payoffs and privileges in this society are so great for being straight that there is less incentive for these men to take on the extra stress and issues of being in an exclusively gay relationship.

Recently, there has also been an increase in the number of men (and women) in open and polyamorous relationships. This allows them to work on multiple relationships as a way of trying to get their various needs met. To be honest about whom you are and your life is acting with integrity.

At the core of insecurity for men and women whose partner is bisexual is the question: "How can I satisfy the needs of my bisexual partner if I am not everything that they want or need?" The fallacy here is that any one person can ever completely satisfy every need of another. When we choose to be in a relationship, particularly a monogamous relationship, we are agreeing that the other person meets enough of our needs to be happy. We choose to give up some things in order to reach a deeper place with one partner. If a man cannot be happy in a monogamous relationship, and knows it, then he should perhaps not be in that relationship. He should be clear from the beginning that he is only interested in an open or polyamorous relationship. Honest conversations in the beginning about what the relationship means and represents will save a lot of pain and betrayal later. And heterosexuals and gay people may not know they are unhappy with a monogamous relationship until they are older or come to know themselves better. All relationships are renegotiable. It may or may not mean the end of the relationship, however, it is honest and both parties get a vote.

Many men attempt to have it both ways by having sex or relationships on the side without their wives’ knowledge. Hiding a relationship is to have shame about it. Being married to a woman while having the man on the side sends a message that the male relationship is about sex, not love. Infidelity does not destroy relationships, dishonesty does.

I would add here something like> Studies have already shown that gay and lesbian couples see “fidelity” as an openly negotiable item in establishing a relationship. Heterosexual couples, by contrast, too often accept the assumption of monogamy without an honest discussion of human nature and needs….frequently leading to tears.

Also, many of these people discovering they’re poly are only just figuring it out, after they jump into a traditional relationship. Hard to say many of them *know* up front what they want……getting off topic, anyway….


These describe a man who is emotionally and sexually attracted to women and at the same time, enjoys occasional sex with another man. Such men are confident in their sexual orientation, but open to pleasure and contact from another man who attracts their attention. A lot of the men who solicit sex from other men fall into this category. They may be getting little to no sex from their wives, and by having sex with another man, there is no chance of emotional entanglements. They don’t feel like it is cheating. In addition, sex itself between men is different. A straight man might take a different role with another man or get sexual needs met that are not happening in their relationship. Gay men can focus on other men’s bodies in a different, and more knowledgeable way than women when having sex with men. Straight men have reported that they find the way that gay men look at and enjoy their bodies to be very different from what women do. These men are not bisexual, and they are not gay. They simply have some type of homosexual sex, occasionally or frequently, and enjoy it.


What is a man? This is a question that haunts all men—straight, gay, bi, and transsexual. We strive to answer it as best we can, given whatever role models we grew up with. The answer, whatever the sexual orientation, can be complicated. One of society’s prejudices against gay men is that because they supposedly do not procreate, gay men are not really men. The ability to procreate is fundamental for many religions and communities. Straight couples without children can also face a very similar prejudice.

While most people have moved beyond the "John Wayne, strong, tough, unfeeling" stereotype of manhood, each man must still find his own definition of being a man. Can you be anally penetrated, or perform oral sex on a man, and still be a man? To accept or come to terms with what it means to be a gay man will likely require grieving what you thought makes a man. As we let go of our fantasies and ideas about who we are, and grieve those, then we can see what will fill that empty space.

For most men, being in a relationship with another man emotionally, sexually, and physically means that you do not have defined gender roles, either sexually or functionally. Most men in gay relationships are, to some degree, sexually versatile. Also, who cooks, washes the dishes, cleans the house, or does the yard work has to all be negotiated. It is not just assumed, based upon gender, what each person’s role is going to be. Does doing tasks that are traditionally women’s roles make you only a partial man? Being a man is about knowing and expressing all the parts of you, the masculine as well as the feminine. Being the top and the bottom, however defined, is about a fully integrated you and how you choose to express that. Being gay is an empowering journey, one with fewer set societal rules, and more room for creative exploration. It is the journey, the self-growth that is one of the great benefits of coming out and being in a relationship with another man. Straight men, all too often, do not challenged to truly look at themselves and their programming and figure out what being a man really means to them.


With the legalization of gay marriage, some of the limitations imposed on gay relationships have changed. On the upside, there is legal recognition of the relationships. Spousal benefits, power of attorney, inheritance and all of the 200-plus legal benefits of being married now apply to gay couples. This is recognition of increased societal acceptance and social standing.

However, there are downsides as well. The battle inside the gay community from its emergence as a social/political movement has been acceptance versus integration. Being on the outside, and yet with a degree of acceptance, has allowed the community and its relationships to bypass a great deal of socialization towards conformity. In emphasizing the differences, it meant that playing by society’s rules didn’t apply. Once marriage became legal, many of the downloaded traditional beliefs about relationships and marriage have now come into play. Straight people have been dealing with this for centuries. They are programmed from the beginning about what it means to be married. A big breakthrough in society was when straight people could just live together as a couple without censure, but just in recent decades. Many have very successful long-term relationships that are never formally legalized. Couples who marry after many years of living together can sometimes divorce. This is because while they were unmarried, they had found a way to side-step those societal downloads, and yet, in the moment they said, “I do, “ all of those downloads about what it means to be married entered the relationship. For some, the relationship just gets better. For others, it can fall apart quickly. It all depends on what unconscious beliefs about being married are inside their psyches.

The same is true for gay couples. Mattison and McWhorter’s groundbreaking book, The Male Couple, documented patterns in the journey of male couples, nearly 35 years ago, when the idea of gay marriage was unimaginable. They interviewed male couples who had had been together from one to sixty more years to determine how it was different, and what stages they went through. Now that marriage is part of our vocabulary, gay men are going to be more impacted by that same socialization of what it means to be “married” as their straight counterparts. Thus, we have lost some of our advantage and differentness that allowed us to redefine ourselves outside of the system. Formerly heterosexually married men will likely deeply understand this and yet, based on their internalized homophobia, their own family downloads could sabotage their relationship with a man as well. This is why it is important to look at and work through as much of the internal shame of being gay as possible. The process is life-long, but it does get easier. Shame can show up in the most painful of ways, often in unconscious ways.

Alan Down’s The Velvet Rage should be required reading for every gay man. While not a perfect book, it is excellent at showing the unconscious ways that shame impacts our lives.

To better understand your downloads, read my book: Facing the Truth of Your Life. We are taught very little about how we became us and. So much misinformation is passed on generation after generation. Coming out is another chance to really figure out whom we are, where we came from and where can go from here.


Shame is a poor substitute for self-esteem. Men who post personal ads without showing their face are telling you they are ashamed of being gay. If the ads are just dicks or naked pictures with no faces, they are telling you that to them, being gay is just about sex. Is their online profile picture current? Is your picture current? If the profile picture is ten years or 40 pounds out of date, then the posters are lying to you and themselves. Is the picture of them with a girl? They really could not find a picture of themselves alone? Is the picture from 200 feet away? Do they wear sunglasses or wear a hat that obscures their faces? They are telling you they have not accepted themselves, so they are not ready to be in a relationship. Frankly they might not be ready for sex either. Guys that hide behind body parts or body shots have not fully created a three-dimensional self-image of being gay.

The Internet is certainly the method of choice now for hook-ups (finding sexual partners) and relationships. When reading profiles, read between the lines. Look for what is not there. Ask questions. If a question is asked and it doesn’t get answered, that is a bad sign. The same thing can and will happen in a relationship or hook-up. What else are they not telling you? Secrets are shame pockets. Beware of them as they will come back and haunt you. Lack of disclosure is telling you they are full of shame. Believe them. Move on, otherwise they are likely to dump their shame on you.

Is there more than a one-sentence description in the profile, or is all of the description about the kind of sex they are seeking or the kind of body they are looking for? I call the latter "parts shopping." They are not looking for a person; they are looking for the fantasy parts that will make them happy, at least for ten minutes or so. Having boyfriend who is only pretty will not make you happy. It might distract you for a while, but over time, it won’t work. There has to be more to the person and the relationship than the external appearance.

Pictures in a profile should be updated at least yearly. In the cell phone era, it is easy enough to take a new picture.


Life for everyone is unpredictable with twists and turns on the journey. Figuring out who we are, coming to terms with that, finding a way to be okay with whatever choices we make is just part of life. But it is essential to understand, that while most will not face this particular detour on the road, we all have to make adjustments as we learn more about ourselves. So compassion for you, for what you did not know about you or the pain you were unable or unwilling to face is in order. I suggest liberal doses until you are just willing to meet whatever it is you have to face without self-punishment, shame or humiliation.

This part of your journey is survivable and perhaps one of the more critical growing experiences of your life. It is time to own who you are and come home to being the person you were meant to be.

Links of Interest

For Men And Their Wives


  • Boston

  • Berkeley

  • NYC (Yahoo Groups page)
    (email group owner for info on NYC support group)

  • Seattle

  • Australia

  • HOW (Husbands Out to Wives)- If you meet our qualifications (gay/bi- married man who is out to, or committed to come out to his wife) and if you are interested in joining HOW, send a note to using your confidential email address for further details about the group and instructions for joining.


Bed Death: Sexless Relationship

Usually the initial attraction between any couple is sexual. The heat of discovery and newness can keep a couple’s sex life very active for some time. As time passes the sexual relationship changes and hopefully matures. That initial rush fades and the need to deepen or move on becomes stronger. Whether you deepen into intimacy or move to the next rush has a lot to do with your comfort with intimacy, sexual history, and your beliefs about relationships.

Certainly, in the vast majority of relationships the frequency of sexual play decreases as the length of the relationship increases. It is a natural progression of aging, changing of priorities and having less time. But what happens in a relationship that the sex stops all together? Why does this happen? Are there others in sexless marriages? What can be done about it?

In my experience, I have found sexless marriages to be all too common. The marital bed becomes a cold, passionless hiding place, signifying what is missing in the relationship rather than being the deepest expression of love and intimacy. Regardless of the sexual orientation of the couple, bed death can and does happen.

Intimacy is the big bad word here. Once the rush is gone, you have to discover who you are in bed with. Your partner is not a fantasy, but a person, with needs, wants, desires and their own opinions, and sex drive. Once the projection passes (projection is seeing someone as you want or need to see them rather than experiencing them as who they really are) you are in bed with a person, not just a body. Once a partner has ceased being a distraction they become a mirror for seeing ones self. Do you like your partner? Have you taken the time to find out who they really are? Many women and gay men complain that they feel like a “hole that his/her partner cums in”. Their needs and wants are irrelevant. In short they are objectified. Consequently, the partner begins to withhold sex. It is used both as a weapon and a punishment. There are usually reasons on both sides for a sexless marriage to evolve.

What follows is a brief discussion of some of the issues that can lead to BED DEATH.

Withholding sex, consciously or unconsciously is often a sign of a power imbalance in the relationship. The partner with less money, or with less control in whatever form who feels that their value is tied to sexual output, will use sex to assert themselves. It may be the only way that they can say no or get attention. If it is unconscious, then they may simply lose their desire for sex, or get sick. Men may not be able to get or sustain an erection.

Babies are frequently a sex life killer. Too tired! Not enough time! You are starting to feel too much like your parents (and they certainly never had sex). These are all great reasons, however, remember each other. Babies need an incredible amount attention, certainly everything that you can give them, but you must make the effort to create time for just the two of you, even if it is just to hold each other or exchange massages. Staying connected through touch and remembering that you are a couple who still need sex and each other is important.

Anger is another great way to kill sex in a relationship. If the hurts and misunderstandings are not being addressed in some manner, they will show up in your sex life. Sex, at its most basic, is a form of communication. However, it can not be the only one or the relationship and your sex life will not work and neither partner will be satisfied.

If your partner has been sexually abused, this can create major problems in the relationship. After the initial rush of the relationship, suddenly, things may be too hot, to much intimacy. This may spell danger. Sex may bring up anxiety, terror, depression or dissociation. If your partner had mentioned a sex abuse history and you are noticing problems around sex, support them in seeing a therapist. Therapy is not a quick fix. However, it can help heal the wounds. Depending upon what abuse happened and when, the partner may never completely recover. I will cover sexual abuse in future articles in greater depth. This is a major problem and one that you can not fix for them no matter how much you love them or how safe you are.

One of the most common reasons that I have seen lead to less or no sex is fear of rejection. The longer that you are with someone and the deeper you depend upon them the greater the ability to hurt and be hurt. For most people opening themselves in a very intimate way, while exciting can also bring up anxiety, fear and be unable to deal with the venerability that emerges. It is common to want your partner to know what you need when you need it without you having to say what that is. Nice fantasy, that is not the way that it works. So expressing sexual interest in the other opens us to possible rejection of the most subtle and unconscious kind. Two people, both fearful of rejection, may never get to sex because the possible rejection is too painful to risk.

Many people, both men and women, have never bothered to learn about sex. Good lasting sex with a long term partner requires patience, exploration and risk taking. If one or both partners are too shy, embarrassed or immature to talk about sex, this can lead to Bed Death. Like most things in life, communication is the key to a happy, long lasting sex life and relationship. Buy a book, perhaps the Joy of Sex, it is a good start. Read it together. It is a great conversation starter. Who knows where it will lead?

The bottom line is that a sexless marriage may be a symptom of many things. The longer the relationship the more effort that a couple has to take to make sure they are staying sexually alive. It may be a cliche, but its true: If you don’t use it you lose it. If you keep the fire alive there can be great rewards of intimacy available to you and your relationship. Let your sexual intimacy die and while the love may remain the passion will move on.



Did you consider have a conversation with your partner/spouse, saying that it is okay if they is no longer interested in being sexual but how are you going to go about getting your needs met?

It is common for women to loose interest in sex post menopause but it does not negate their responsibility to meet the needs of their partner. Men also loose interest in sex and because of illness, medication, etc. The point is to do confront what is going on in a honest way, rather than hiding. Dishonesty ends relationships, not infidelity. Outside sex does not have to be in the others face. The point is so that there cannot be any later nonsense about being cheated on. It is not cheating, it is how the two of you are managing and choosing to be in relationship with each other.

It would also be a wake up call to your partner that you are not dead and that there is more to being in a relationship than living in the same house.

Shedding Light on the Sexual Abuse of Boys and the Men They Become


What is sexual abuse?

“Sexual abuse refers to any sexual assault or sexual exploitation of a child or adolescent. Sexual abuse is an issue of power and control. The essence of child sexual abuse is the exploitation of a child for the purpose of satisfying an adult.”

Watch a Merle Talk for partners or family members of men who were sexually abused as children:

Watch Because You Care >


How as a society do we create or allow sexual abuse?

There are several factors that are the basis for creating the atmosphere that allows child abuse:

My Beds

I am your yesterday, today and tomorrow
I was with you in the beginning and I will be there in the end
I am sorry for the pain you experienced on me
I am safe now
Come Home

• Seeing children as property: As long as they are seen and treated as possessions they are vulnerable to being objectified and used to meet an adults needs.

• Teaching children they are helpless and not to question authority: This is a set up to keep them powerless and consequently to create victims. If they see themselves as powerless children, this self-belief will often carry forward into adulthood.

• Sexual entitlement: Adults who feel that they are entitled to whatever they want or need to satisfy them sexually, regardless of whom or what it hurts. This is a rationalization that leads to abuse, rape, and other many crimes.

• Shroud of secrecy around sex: Probably the major reason that children are used to meet adults’ sexual needs is the shroud around sex and sexuality that we have created in our society. Many believe that if we teach children the truth about the mechanics of sex, we are telling them to have sex. Congress has repeatedly denied funds for a major research study on the sexuality of Americans because it doesn’t want any information published that would contradict its fantasies about sex and sexuality. Information is considered dangerous, and in a sense, it is. It destroys myths, it allows people to make choices, and permits them to grow up and act as adults rather than keep them as shameful children around sex and sensuality.

What is the problem?

“Men who were raped or sexually abused as children face a unique set of problems. For men, identifying particular acts as abusive is especially difficult because men are expected to be able to protect themselves. Admitting to a situation in which they were unable to do so is tantamount to denying their masculinity. Disclosing an abusive sexual experience also is difficult. If the sexual contact was with a woman, the man's motives become suspect because men are expected to value sexual contact with women. If the unwanted sexual contact was with another male, the man is told that this contact has altered his sexual orientation. Men who have been raped or abused face another problem as well in that abuse and rape are historically defined as an act that men perpetrate against females.”

How is sexual abuse of boys seen?

Since boys are socialized that to be men, they cannot be victims, they have a tendency to either minimize abuse or deny it all together. Hazing, sexual initiation, and punishment are often used as rationalizations for abusing boys. If a 15-year-old girl has sex with a 32-year-old man, we call that rape or abuse. Reverse the gender and suddenly the boy is lucky to be initiated. It is easier for many to identify abuse if the boy is really young. Forced exposure and body and genital examinations are humiliations and teach children to be ashamed of their bodies. Punishing a child with sexual overtones is a set up for shame and masochism.

As a society, we finally have begun to talk about sexual abuse. While the majority of the discussion has been about sexually abused girls, we are slowly beginning to acknowledge and discuss the sexual abuse of boys. Many men are dysfunctional because they were used as sexual objects, are too ashamed to admit it, and have never been able to understand why it hurt and confused them so much. This is a very difficult topic for many people. I encourage you to continue reading this and to ask questions. I will do my best to answer them or refer you to some place that can.

Five Responses to Childhood Sexual Abuse

When diagnosing or treating men sexually abused as children, it is essential to remember that there can be at least five different responses to being sexually abused.

A male can exhibit several of these responses, which can also be triggered by covert abuse, such as emotional incest and boundary-crossing.

People who were sexually abused as children are psycho-sexually arrested at the age of the abuse. It is possible that they can create other channels to express their sexuality, but at the core, until the abuse is addressed, the sexual response is that of the wounded child.


Very much like an animal that has been attacked and overpowered, a common response is to stop struggling and appear compliant. While the external demeanor seems calm and passive, the internal system is on full alert, terrified and overwhelmed. While there is alertness to the possibility of an escape, should it appear, the goal is to survive. However, the system is overloaded, and if the trauma is not discharged, it will lead to PTSD and other symptoms. The perpetrator will see compliance as agreement and project whatever their fantasy is onto the child, but survival is the key driver.

Occluded memory/repression/dissociation/repression

There is still controversy about occluded memory. There is a difference between planted memories and repressed memories. If the child is unable to process, make sense of, or feel the experience, they can repress it, dissociate, split, and do anything to avoid experiencing the feelings and “drowning” in them. Screen memories are common. This method of survival can be a substitute for the actual experience of abuse: putting something in place to directly block the horror of the experience that is not directly connected to the abuse.

An example of this would be a boy sexually abused in his bed at night who developed a screen memory. Instead of remembering the abuse, he had a fear/phobia of tall buildings. When he would look up at tall buildings, he would almost pass out. It was irrational, disturbing, and made no sense. When he worked on the fear of looking up at tall buildings, suddenly the suppressed memory of the abuse emerged.

Eroticized shame – eroticizing shameful feelings in order to tolerate them.

Eroticized shame is also common response to sexual abuse. If there are pleasurable feelings during the abuse experience, the downloaded shame from the perpetrator can be combined with the pleasure. Eroticizing the shame can become a survival strategy. As therapists and adults, we don’t like to think that children or adults experience pleasure during abuse, but it can and does happen.

Since the abuse is often a first sexual experience with another person, that dynamic can become the foundation of their sexual response. Our first sexual experience imprints on us what sex is about and can have a lasting impact.

Focusing on shame/humiliation

This is the experiencing of the horror of the abuse without any processing or resolution. There is just pain, a sense of being overwhelmed, and extreme distress. This response is what we most often expect from sexual abuse victims. As therapists and adults, we don’t like to think that children or adults experience pleasure during abuse, but it can and does happen.

Eroticized anger

When the shame and humiliation of sexual abuse turns to rage, then the response is eroticized anger. This can be expressed through behaviors that are controlling, abusive, raging, bullying, and/or sadistic. The response to abuse turns the sexual act into revenge and an expression of internal pain.

Men that were emotionally incested are often angry at their partners, because of the earlier emotional intrusion that they cannot understand or come to terms with. The anger is a way of pushing back against any perceived or potential intrusion.

Abusing another is never justified, but it is encountered all too commonly in relationships.

The Impact of Sexual Abuse: Short and Long Term

After a boy has been sexually abused, generally there is a change in his personality. Behavioral changes can range from withdrawal, unusual acting out, to being very aggressive and violent. The world has become a more threatening place and he is more vulnerable. He is trying to defend himself.

There are likely to be emotional changes as well. An open, out-going boy may suddenly become quiet, passive, and invisible. It may be obvious that he no longer feels good about himself. He has a self-perception of being damaged or broken. His sense of personal power has been taken away.

Often there are physical signs of sexual abuse as well. There may be physical damage from any forced penetration, such as anal tears, resulting in constipation or encopresis. Sleep disturbances such as nightmares, regressive behaviors such as bed-wetting or loss of bowel control, and anxiety or the sudden appearance of phobias may also occur. Any sudden and dramatic change in behavior or mood in a child should be investigated and understood.

There are both short- and long-term effects on boys who have been abused. In the short term, you may see inappropriate sexual behavior, sexually assaulting other children, hypersexuality, and gender confusion. Longer-term effects can include depression, physical ailments, negative effects on self-esteem or their sense of self, or a negative impact on interpersonal relationships. An inability to trust or feel safe with others, especially when intimacy is involved, is often the result of having been sexually abused. A boy’s sexuality is going to be impacted. Most victims get stuck at their sexual emotional age at the time of the initial assault. The assault and subsequent feelings are what represent sex to them.

In my experience with working with bisexual and gay men that are heterosexually married, I have found that many of them were sexually abused as children, usually by a male. They rationalize that the reason that they are sexually attracted to men is because they were assaulted as a child, and they conclude that if that had not happened, they would not be attracted to men.

There is no evidence that this is true. It is mental gymnastics to avoid dealing with the attraction to men. This is a very difficult outlook for many men to escape, but it is important to confront their feelings so they may come to terms with the abuse, the abuser, and their own sexuality.

The last major long-term effect is a tendency toward addictive behaviors. It is common for men in treatment programs or in a 12-step program of some kind to have to deal with the issues of sexual abuse as they are trying to deal with the addiction. The substance or behavior has been a method of self medication for the man to avoid the feeling that he is still carrying around inside.

In my experience, many men that have been labeled as sexual addicts are, in reality, experiencing a repetition compulsion. The circumstances of the initial abuse so stimulated them that their young bodies and minds were unable to process or contain the overwhelming sensations. Consequently, they froze inside, and they associate sex and sexual feelings with these overwhelming sensations; often they feel a power imbalance is part of sex, so they attempt to recreate the situation in an effort to complete the gestalt—they are trying to complete this unfinished experience. The child parts of the men are trying to find a way out of the loop they are in, and to the outside world this often looks like sexual addiction. The acting out behavior could start as a repetition compulsion and turn into an addiction as well.

When a boy has been sexually assaulted, his life changes forever. There can be small to extreme changes in behaviors, moods, and attitudes about people, himself and the world. These feelings do not go away and the impact is not minor, regardless of how the boy appears to be taking it. Children do what they need to do to survive. They may feel that their survival depends upon hiding the experience at all costs. Treatment is the only solution to really recovering. Left untreated, the wounds follow the man into adulthood and impact his relationships with everyone. Admitting the pain is terrible, but the victim stands to gain a life without the pain of the abuse. Men can and do heal from childhood sexual abuse.

Women as Perpetrators

Men who had sex with women when they were still young boys are often told that they were lucky to be initiated so young. It is sometimes viewed as a rite of passage that makes him a man. In reality, there is no better way to cripple a boy/man emotionally.

A situation with a 15-year-old girl having sex with a 30-year-old man would be recognized pretty clearly as sexual abuse. There is the belief that girls mature faster than boys. Why then, would we assume that a 15-year-old boy would be more emotional ready to handle sex than a 15-year-old girl?

The movie Summer of '42 is often seen as a picture glorifying sex between an older woman and a teenage boy. Upon closer examination, he is overwhelmed and confused by the experience. It was not a good or ‘man making’ experience.

We have only begun talking about and acknowledging female perpetrators in the past few years. They were thought to be the rare event, the exception to the rule. As the cloak of secrecy has been peeled back, we are discovering that female perpetrators are not uncommon. For several years, I cut stories out of the newspaper about female perpetrators. In a majority of the cases, it was the husband and wife, dad and mom, acting in concert, to molest their children. The most recent statistics that I have seen support this sampling as being representative of the overall population.

There are four basic ways that women sexually abuse boys: overt, covert, a sexual violation, or boundary crossing. Abuse can easily include more than one type.

Overt abuse is similar to what we think of as typical sexual abuse. With a female as the perpetrator, this might involve oral sex, intercourse, masturbation, fondling, or sexual punishments.

Covert abuse is more difficult to observe. It can include voyeurism, exposure, seductive touching, sexualized hugs, kissing on the mouth in a sexual way, extended nursing that satisfies a sexual need of the mother, or flirting with a male child, possibly to shame or make the woman’s husband/partner jealous.

The sexual violation of a child means the invasion of privacy in a sexual area of the body. This may include enemas, bathing together, washing the child beyond a reasonable age, obsessive cleaning of the foreskin, squeezing pimples, intrusive questions about bodily functions (especially bowel movements), or any activity in which the adult is using the child to fulfill a sexual or erotic desire.

Boundary crossing, which is an essential part of all sexual abuse, deserves special mention because it may be limited to emotional incest, or it may be as complete a violation as a women substituting a boy for a divorced, deceased, or simply absent husband. This includes using the boy as a confidant about personal or sexual issues. Mom complaining that dad “…was a lousy fuck last night” is boundary crossing just as much as the 14-year-old baby sitter fondling her four-year-old charge.

The result of this abuse by a woman can be a false sense of power, inflating the boy to believe that he is more powerful than he really is. He is led into the false belief that he is in control, not realizing or understanding that he is being used and controlled.

Conversely, the abuse can also lead to a feeling of worthlessness. The boy inhales the message that “I have no value, my body is all that has value or what I can do for others.” There is no personal sense of value or worthiness.

Watch a Merle Talk for victims of emotional incest:

The boy is eventually going to feel abandoned, and will likely feel betrayed. The woman or girl was not there for him in the first place. When he realizes this, then his picture of what has occurred will change dramatically. After the inflation comes the deflation from the withdrawal and realization that what happened was not about him, that he was only being used. All of this results in rage—rage about the impact upon their sexuality, rage about being used, rage about how it has messed up his relationships with other women, and rage at not being able to really trust or let anyone get really close.

It was an overwhelming experience and the boy was incapable of processing or understanding what had happened to him. He freezes inside, or simply pushes the memory so far to the background that he can’t touch it. Unfortunately, he is shutting off an essential part of himself that will need to be reclaimed before he is able to trust and heal. So the adult is left with fears of intimacy and loads of insecurity.

For many men, the most devastating blow is the impact upon their relationships with women. The abuse experience can leave them ambivalent about sex and about women. While it cannot change their sexual orientation, it will leave them deeply conflicted. Being close to a woman is likely to bring up old unresolved feelings, which get in the way of having a real relationship in the here and now.

This is a brief overview of the kinds of abuse that some women do to boys and the impact that abuse can have on the boys as they become men. If you have any questions, please send me an email and I will do my best to answer them.

Impact on Relationships


The impact of the childhood sexual abuse on the interpersonal relationships of men is the last area about which I will write. Relationships are probably the most affected area of their lives. A boy that is sexual abused understandably distrusts both the sex of the offender as well as the parents or adults that did not protect him from the offender.

A man who was victimized as a child will often live the life of a victim, unless he is treated. He will unconsciously set himself up to be the victim time and time again. He will probably not see the circumstances, or if he does, will be unable to do anything to stop it. No matter how promising the job or situation, in a short time he will be a victim. Someone will be after him or everyone will be against him. In relationships, he will pick partners who victimize him, or he will pull to be the victim if the partner does not cooperate. It is the lens though which he sees the world, and until the abuse is addressed, it will not change or get better. Childhood experiences can set the tone for a life time.


Memory is a key issue in child abuse. Some men have very clear memories of being abused. They can tell you how, when, and who. For others the memory is repressed in some way. There may be a screen memory covering the actual abuse; for instance, a memory of footsteps, a larger-than-life figure, and then a memory of leaving their body. The memory of the abuse is repressed, tucked away, because it is too painful and has more feelings than the boy can handle. These feelings can be reactivated through being touched in a certain way, triggered by being in a certain situation, or even provoked by a smell that takes him back to that moment when it happened. For some, the memories come flooding back, while for others, it may be a piece of the experience or dark images. The mind will let in what it can handle at the time.

Memory is not perfect. In all circumstances, our memory is framed by the way that we understand the world and how we believe it operates at that time. The younger the child, the less data or experience that he has had to explain the events and their meanings. It is possible to put two things together that in a broader context would be completely unrelated. As a therapist, it is my job to honor the client’s feelings and give him a place to express them, not judge whether those feelings are correct. The fact that he has the feeling is enough. My goal is to heal the wound and move through the feelings rather than create a victim.

Acting Out

Men often try to cope with the pain of sexual abuse through acting out. One method of acting out is to have psychosomatic or recurring illnesses. The child’s strategy is based on the belief that if he is sick, then he is less attractive. It also gives him more attention from others, potentially keeping him safe from the perpetrator(s).

Other forms of acting out include self mutilation, suicide attempts, repetition compulsions, or re-enactment of the abuse. I have seen many men repeatedly, unconsciously attempt to re-enact the abuse they experienced as a child. One man was in a public bathroom as a boy and a man approached him, exposed himself, and masturbated in front of him, to climax. The boy grew into a man and spent years going from bathroom to bathroom, recreating this scene. Unconsciously, he is attempting to resolve the feelings that so overwhelmed him. Consciously, he is recreating the high of the initial sexual experience that came to represent sexual feelings to him. All of these behaviors impact his relationships and his ability to form and keep them.


A primary complaint that brings couples into therapy is sexual problems in the relationship. This is frequently a sign that one or both partners have a history of sexual abuse. When asked about their sexual history, most men in this situation remember clearly their sexual experiences as a child. However, they are emotionally disconnected from the experience, or think that it was normal for a child to be used for others’ sexual pleasure.

In such a relationship, the partner who was abused as boy learned to survive the experience and the feelings by disconnecting from sexual emotions, so sex became an experience of having an orgasm and nothing more. Meanwhile, his partner is starving for emotional intimacy. The one who was abused has no idea what his partner wants, and if he gets too close to emotional/sexual intimacy, it scares him to death.

Some of the results of a history of sexual abuse can include rigid, mechanical sex; loss of sexual feeling or arousal as the victim approaches sexual contact; sexual promiscuity or sexual anorexia; sexual addiction; or taboos against sex at certain times of day, certain places or in certain positions. One man was forced to into submissive sexual postures with his father, trapped between his powerful legs. Anytime that he feels trapped during sex, the sexual abuse feelings are triggered. Another example would be if the abuse happened in the living room as a child, it may be a difficult, if not impossible, for the victim, as an adult, to have sex in the living room.

Probably the most common experience for a man who has been abused is leaving his body during sex. This can be just fantasizing in his head during sex, to completely leaving the room. His body may still be there, but his conscious self has left, gone into hiding, because something about this situation feels unsafe. This is an example of dissociation.

Relationships with Women

A heterosexual boy who has been sexually abused by a woman will believe that women are only interested in his body, that he is an object of their satisfaction. This leads to distrusting women. He both loves and hates women. He both wants to be intimate, yet at the same time, is terrified to do so. Even if the abuser was a man, the abuse can destroy the boy’s ability to trust anyone sexually. Remember psychosexually, he is probably very young—it is common to be stuck at the emotional age when the abuse happened. Any adult trying to be sexual with him is a threat. This may not be conscious, but it can sabotage a relationship.

Relationships with Men

A boy that is molested by a male will likely avoid relationships with men. Men are seen as potential abusers. All men want is sex. Men cannot be trusted. These are all beliefs that a boy can have about men while growing up. I believe that a lot of the homophobia that exists today is the confusion of pedophilia with homosexuality. The vast majority of pedophiles identify as heterosexual. Mom, dad, and relatives are the most common perpetrators. Unfortunately, we have tried to scare children with the belief that the strange man on the corner is going to hurt them. While it does happen, homosexuals are not the problem and are simply victimized as well in the process. Consequently, men who were sexually abused as children often have a difficult time having relationships with other men. They have to trust the others to be friends.

Sexual Orientation

While sexual abuse can impact relationships with both men and women, it is particularly difficult for boys that are gay who are molested by men. This can really impact their acceptance of their sexual orientation. I have worked a lot with bisexual and gay men who are heterosexually married. In at least 80% of the cases, the man was sexually abused as a child. This sets up a dilemma for the boy-man. He concludes that the only reason that he has sexual feelings for men is because he was molested. He believes that if he had not been molested, then he would not have those feelings.

This is a difficult dilemma for many men to resolve. They marry, hoping the feelings will go away. However, something is missing or they are acting out with men on the side, never coming to terms with their sexuality. When and if they do, it often ends in divorce and many destroyed relationships. A wonderful book on the topic of gay and bi married men and the effect on their relationships is The Other Side of the Closet, by Amity Buxton. It is presented mostly from the spouse’s point of view, but it is very insightful for both partners. Being sexually abused as a child does not change the sexual orientation of the child, but it can confuse and delay the natural psychosexual development of a child until the abuse is addressed and healed.

Internal Process

A man who was abused as child is wounded. He feels broken or empty inside. He believes that he is unfit to be loved. Either he is unable to get into a relationship or he chooses relationships where he will be used, abused, or in some way continue to be a victim. No amount of love from the outside can fill that hole or emptiness inside. No amount of distractions, like sex, work, or eating will make the feeling disappear for more than a short time. The wound has to be confronted and healed from the inside.

The Body

Because the child's body has been assaulted, it is often the body that is used to discourage further attacks. I have already described using illnesses, but in this case, I am talking about body building, weight gain, or anorexia as method of making the body unattractive, trying to make it either disappear or be so intimidating that no one would dare to attack. A body builder may look better than someone who is overweight, but the built body can be just as much of a defense against intimacy as obesity or emaciation. One difference is that there may be support or acknowledgment for the body building; consequently, it may be harder to get past the body armor to get close to the feelings. I am not saying that body building is bad. I think that it can be a useful tool to help a man feel better about himself, but if it is the basis of his sense of safety, then there may be a problem.


Finally, here is list a series of symptoms that frequently show up for different men. All are methods of coping and trying to deal with the feelings. They include dissociation, body shyness, excessive clothing, cleanliness compulsion, anxiety, panic attacks, chronic depression, and shame.

I want to elaborate on the role shame plays, particularly eroticized shame. Depending upon the experience, boys can experience significant pleasure during the abuse experience. These feelings of pleasure may be combined with shame, guilt, embarrassment, pain, humiliation, confusion, and disgust. Not every boy has all of these feelings, but they usually have some combination of them. Given that the abuse is often the first sexual experience that the boy has had, he is imprinted with this potent combination of pleasure and shame. Under normal circumstances these emotions and sensations would not be combined. If they are sufficiently combined in the abuse experience, then the boy is programmed to believe that they should always be combined in sex. Shame is one of the more intense emotions that we experience, and combined with sexual pleasure, it is incredibly powerful. For most people, this is not a particularly healthy or desirable route to sex and pleasure. Sexual abuse is not the only way to combine these experiences, but it is a common route.


Briefly, I want to say a few things about treatment and recovery from sexual abuse. It is possible. The earlier that treatment begins, the better. It is never too late to heal. Recovering from sexual abuse is not fast, nor particularly easy. There are a lot of pain and feelings that have to emerge and be expressed on the road to recovery. The goal is to recover your childhood, reclaim your body, and heal your self-identity.

Watch a Merle Talk about the treatment of men sexually abused as children:

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"Male Child Sex Abuse Therapist"

With Merle Yost, Author of Facing the Truth of Your Life

Find a competent psychotherapist, preferably one who has experience working with male victims of sexual abuse. Just because a therapist works with women who were sexually abused does not mean he is experienced or competent working with male victims of sexual abuse. While there is a lot of overlap in treatment, there are substantial differences as well. Individual psychotherapy is the best place to start. Group therapy in addition to individual is very healing, but group work alone is not enough.

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In Closing

The article is a combination of my 25 years of experience in working with male survivors. I have also consolidated information from Mic Hunters Books and Michael Lew’s Books. Please read their books for more detailed information. When looking for a therapist, I strongly encourage you to find an EMDR therapist in your area. You can start your search at

All quotations are taken from : Hunter, Mic (Ed.). (1990). The Sexually Abused Male, Vol. 1: Prevalence, Impact & Treatment. Lexington, MA.: Lexington Books

Merle Yost is available for speaking engagements and workshops:

He has both a two hour and a 7 hour workshop available also called: Shedding Light on the Sexual Abuse of Boys and the Men They Become. Click here for more information.

Open Relationships

One of the issues that I get frequent questions about is open vs. closed relationships. This used to be more of an issue for men, both married and single. Men often want the option of having additional sexual partners. As women are having affairs in ever increasing numbers, it is challenging the fantasy that we have been programmed with since childhood about relationships and marriage. Women are increasing considering this an option for themselves. It is making us as a society ask: What is the definition of a marriage or relationship? Does it include monogamy?

With gay men and women demanding the right to marry, it is forcing us as a society to examine our beliefs and values about marriage. So far, it is a monologue by the religious right. All other voices are being buried under their assault. Regardless of the law of the land, people and relationships will continue to evolve.

One of my strongest beliefs is that dishonesty breaks up relationships, not infidelity. The betrayal is in not telling the truth or in hiding. Trust is what must be restored. Trust is difficult to reestablish and for many relationships, impossible. Trust is the fabric upon which we build relationships. Without trust, there is at best a shaky, fragile foundation.

Most men and some women are able to separate emotional vs. physical fidelity. When caught in an affair or tryst, he will exclaim, ‘it was just sex, it did not mean anything.’ For someone who cannot or who chooses not to separate these fidelities, this statement does not make sense and is insulting, no matter how true it is for the other partner.

When choosing a partner it is very important to discuss issues like monogamy. Gay men have had more experience in this area. Not being as restrained by the social programming, they have had more opportunity to explore alternative relationships. Increasingly couples of all types are finding new ways to define relationships. For example, in the area of money, it was assumed that couples after marriage would combine their money, and it would become our money. However, in the 90’s, many couples are keeping their money separate. While in part this is an acknowledgment of divorce statistics, it is also a redefinition of what marriage is and how it is to be configured. The possibilities are only limited by the imagination of the partners.

The key to a successful open relationship is the agreement. How is this going to be open? What are the rules? When can you seek other partners? I have known many bisexual men to only have sex outside of their marriages with other men. Women other than their wives are off limits. The reverse is often true for straight men with bisexual wives. Threeways and outside relationships with other women is okay, other men may be too threatening. For some people one night stands are okay. No repeat encounters that could lead to an emotional attachment. Whatever the couple agrees to is okay. Living up to the agreement both in spirit and to the letter keeps the trust in place and the relationship together.

Another issue is the security of the couple. If jealousy or insecurity is a part of the mix an open relationship will not work. Open relationships requires more trust and more security than closed relationships. That is why it is not for everybody. If you are clear that you are not interested in an traditional relationship, it is imperative that you have a partner that holds the same belief and value system. Otherwise it’s an open invitation to divorce.

Sexually transmitted diseases are appropriately a major concern. HIV, herpes and syphilis are just a few of the things that can be brought home. Agreements and actions about protected sex will make this a safer and more relaxed process for all involved. Sex is fun, but it is not worth risking your life for or the life of your partner. If you don’t know what protected-safer sex is, find out.

As in most issues for couples, communication and trust is the foundation for working through problems and having a healthy relationship.


Recreating Family at Work

The family that we grow up in has a profound impact upon how we see the world. They teach us either directly or indirectly how to make sense of the world around us. Even though we generally grow up, move away and create our own lives, we still have a tendency to look at the world through the lens of perception that our family taught us.

The workplace becomes our artificial family. While we always have a choice about where we work, once we have made that choice we often have little or no control over whom we work with. Overall, we spend more time with our coworkers than with our families.

The boss becomes the parent, the coworkers become siblings and the direct reports become the children. It is not always this simple, just as families are not so simple.

If you had a negative relationship with a parent or parents, you will more likely have a negative experience with your bosses or superiors. Likewise, if you had a positive relationship with your parents you will more than likely have a positive relationship with your boss. This is not true in every case.

While not everyone recreates his/her family at work it is a common practice. Look around you, do you see your mother, father, siblings, extended family in some way. It might be a look, similar habits, gestures, personalities or temperament. Any of these can trigger a family reaction, without you even realizing it.

What can you do about it? There is a lot, actually. The first step is to see if you can recognize any of your family patterns at work. Are you having the same conversations about work that you did about being home with your parents? Pay attention and check out your responses and thought processes.

If you find your self with your family around you, the first step is to recognize that you can not see your co-workers clearly as long as you are projecting your family or a member of your family unto them. After you recognize the behavior, only then do you have the opportunity to begin seeing them differently and have a real relationship with them.

Visualize the other person and say, ’You are not my." Say it several times. Breathe deeply each time. Make sure that your feet are solidly on the floor. The next step is to find a way to separate the family member form the co-worker. Visualize them both, but create a barrier between them. Build a wall, put a mote, anything that creates separation between them that you hold on to. The last part of this process is to again look at your co-worker and begin looking at how they are different from who they remind you of. You have already figured out how they are the same, put some conscious effort into seeing how they are different.

Another approach is to get to know the co-worker better. As you get closer to them it is harder for your unconscious to confuse them with your family member. What you are looking for is a new perspective on this person, so that you have a greater range of ways to respond to him/her. In the beginning you may need to remind yourself that this is not the family member and that you can choose to respond differently. With a little practice it gets easier.

If you find that you are doing this a lot and these simple methods are not helping, you may need to seek professional help to work through your family of origin issues. In my years of seeing clients both as a therapist and as a consultant, I have seen this destroy many jobs and work relationships. Usually, if you have a serious problem with this behavior changing jobs will not help. You will just find another place that while on the surface it may look different, will be the same thing all over again.