Black churches in the USA constitute a significant source of the homophobia that pervades black communities. This theologically-driven homophobia is reinforced by the anti-homosexual rhetoric of black nationalism. Drawing on a variety of sources, this paper discusses the sources of homophobia within black communities, and its impact upon self-esteem, social relationships and physical health. Religion-based homophobia and black nationalism point to wider structures which have influenced their emergence, including racism, patriarchy and capitalism. It is vital for US black churches and communities to understand and transcend their longstanding resistance to openly addressing complex, painful issues of sexuality and embrace healthier definitions of black manhood.