Exploring a Dutch paradox: an ethnographic investigation of gay men's mental health

Cult Health Sex. 2014;16(2):105-19. doi: 10.1080/13691058.2013.841290. Epub 2013 Nov 18.


Despite the Netherlands' reputation as a world leader with respect to gay rights, homosexual Dutch men have much higher rates of mood disorders, anxiety disorders and suicide attempts than heterosexual Dutch men. Epidemiologists report similar disparities elsewhere in Western Europe and North America. These findings have been the focus of a blossoming psychological literature, inspired by minority stress theory and deploying quantitative methods. Our investigation aims to complement this body of work by adopting an ethnographic approach. Drawing from fieldwork conducted in the Netherlands from 2009 to 2010, we explore sociocultural and contextual factors that have received relatively little attention with respect to gay mental health. In the Netherlands - considered a model for gay equality - how can one understand high rates of psychiatric disorders among gay men? This study points to heteronormativity, complex dynamics involving long-term relationships and processes within gay subcultures as key issues. Notwithstanding their putative socioeconomic, legal and political equality, gay men struggled - at various stages of the life cycle - with internalised norms that they found difficult to fulfil. The desire to embody these ideals, and structural constraints in meeting them, could be potent sources of disappointment and distress.

MeSH terms

  • Adult
  • Anthropology, Cultural
  • Civil Rights*
  • Homosexuality, Male / psychology*
  • Humans
  • Male
  • Men / psychology*
  • Mental Health*
  • Middle Aged
  • Minority Groups / psychology*
  • Netherlands
  • Qualitative Research
  • Self Concept*
  • Social Conformity*
  • Social Stigma*