Michael - The Truth May Not Set You Free: Being Gay, Married, and HIV Positive

By Jeff Levy, LCSW

Reprinted from Positively Aware, March/April 2008, pp. 40-43.
http://positivelyaware.com/2008/08_02/michael.html

I'm here because my doctor referred me to you," Michael* said quietly, haltingly, and with his eyes on the floor. "He said I should be in your group." Since I facilitated a number of groups, I asked Michael which of the groups he was thinking of joining. After listing them for him, he finally nodded when I talked about the group for married and formerly married gay and bisexual men.

As we continued to talk, I learned that Michael was 45 years old and had been married for the past 25 years to his wife, Virginia. They had three children: Allison who was 21 and in college, Sam who was 16, and Casey who was 9. The family lived in a neighborhood on the far southwest side of Chicago in what Michael described as modest, middle class, and mostly Catholic. His two younger children attended Catholic school and his oldest was in college in central Illinois.

Michael worked as a graphic designer and his wife was a manager at a downtown department store. "Everything looks completely 'normal' on the outside, but I feel like I can barely function," he said. "I feel trapped. Scared. Alone. I told my doctor all of this and he said I should see you and be in your group."

I didn't need to do much prompting as Michael shared more of his story. He said he knew he was most likely gay from the time he was a little boy. But growing up when he did and where he did (also on Chicago's southwest side), he believed he could not share with anyone that he had these feelings. He met his wife when they were both in college and they became best friends. He shared with her that he thought he might be gay, but Virginia came to love Michael and believed if they loved each other enough, his past feelings for men would pass. And so they married and, according to Michael, had never spoken of his disclosure since.

Michael's sexual attraction to other men did not end, however, with the marriage. For several years he reported he was monogamous. But after Allison's birth, his desire to be sexual with men increased and he began to search out anonymous sexual encounters at bookstores and in forest preserves. This behavior continued sporadically until the birth of his youngest child.

After Casey was born, Michael and Virginia stopped being sexual with one another and Michael's sexual behavior with men increased dramatically. "I started using the Internet to find sex, going to other men's homes, meeting in hotels, and I still used bookstores and forest preserves," he said. "I also started leaving work in the middle of the day to hook up with strangers. Over those years I contracted STD's five or six times. I know Virginia knew about it, but she never said anything and I never explained. Sometimes I'd come home late at night and she'd never ask why." He stopped briefly and then continued. "I felt worse and worse about myself and, the worse I felt, the more I had sex with men. It was a horrible cycle."

Because of his children, worries about finances, and his concern for Virginia, Michael didn't feel as though he could leave his marriage-and he wasn't even sure he wanted to. He knew he didn't want to hurt the people he loved, yet he also felt as though he couldn't keep living with such secrecy and deception. He felt trapped and didn't know how he could ever extricate himself.

He added: "I knew I was putting myself at risk for more STD's and possibly HIV, but that didn't stop me. I used to think that if I got HIV, I would feel relieved because then I would have to tell Virginia everything and finally, she would know the truth and I would be 'free'." He didn't want to seroconvert, but a part of him thought this would necessitate conversation with Virginia and they would be required to address what he had been hiding for so many years.

And then it happened. Michael wasn't feeling well and he went to his doctor for what he thought was a cold or the flu. He shared he had been having unprotected sex and had been engaging in fairly high-risk sexual behaviors. His doctor suggested an HIV test. Michael agreed and learned that he was HIV-positive. He panicked and drove around aimlessly for hours. He eventually returned home and remained silent. Despite his previous thoughts about telling Virginia everything, he said nothing and tried to continue with his life as usual.

The pressure built and when Virginia asked about his most recent medical appointments, he disclosed everything to her. Everything. She cried, screamed, accused, and then returned to silence. Nothing changed. Michael did not pursue communication with Virginia or she with him. He was in the same position he was in prior to seroconverting. His doctor referred him to my group.

You're not alone
Live Oak, the agency in which I work, is located in Chicago's Lakeview neighborhood (also known as Boystown for its large gay population and bar scene). We have a general mental health practice, but specialize in work with LGBT individuals and families. Much of the work I do is with gay and bisexual men. I started doing groups for married and formerly married gay and bisexual men five years ago.

To date, over 50 men have gone through these groups. Michael's story is not atypical. Though details may vary, and only a small percentage of the married/formerly married gay and bisexual men with whom I have worked are HIV-positive, the underlying issues are very similar. And while individual therapy is helpful, group therapy has had a greater impact reducing isolation and building confidence.

The double closet
Many married or formerly married gay/bisexual men report feeling as though they are living "doubly closeted" lives-and that they are caught between two worlds that are not accepting of them.

Because they identify as gay or bisexual, they do not feel a full connection with friends and family who identify as heterosexual. Fearing negative consequences, many do not disclose their non-heterosexual orientation.

And the gay community judges them as somehow not being fully "gay" or "gay enough" if they are married to a woman. Consequently, there is pressure to not be "out" about being gay or bisexual with heterosexual friends and to not be "out" about being married when meeting other gay or bisexual men.

This "doubly closeted" existence creates an extreme amount of isolation, secrecy, and shame. The lack of acceptance from any community maintains a sense of "stuckness" and of being trapped.

There are a number of ways married gay or bisexual men choose to negotiate their lives. Three more common strategies are: Don't Ask, Don't Tell; Mixed Orientation Marriages, Open Marriages and/or Polyamorous Relationships; and Separation and/or Divorce. No one way is suggested as better or worse than another, though sometimes one strategy serves as a springboard for another.

Don't ask, don't tell
Some gay or bisexual married men enter covert agreements with their wives that their sexual attraction, sexual activities, and sexual interests will not be discussed. Although a wife may suspect certain behaviors of her husband, she doesn't ask. And though a husband may suspect that his wife suspects, he does not tell. This may even be the case with Michael and Virginia. It is not uncommon with couples when a husband has come out as gay or bisexual at one point in the marriage and the disclosure is not met with any type of resolution or conclusion that a "don't ask, don't tell" policy evolves.

Michael and Virginia, and other couples who adopt this strategy believe that as long as nothing is discussed or made overt, no one will be hurt, no changes will be necessary, and family life can remain status quo. In some cases, couples are able to negotiate this arrangement with minimal negative impact.

In other cases, and in my experience with the men with whom I have worked, maintaining this "secret" creates a toxic family environment. Family members know something is not being discussed. Relationships are more distant and superficial. Parents and children are more careful. And sadly, fathers tend to be less available to their children because on some level, they have removed themselves emotionally from the family.

Mixed orientation marriages, open marriages and/or polyamorous relationships

Michael didn't enter group therapy with me immediately. Instead, he participated in individual therapy for a number of weeks and eventually entered a group with other married and formerly married gay/bisexual men. Slowly, he began to discuss his sexual attraction and sexual behaviors more overtly with me and with other men.

He continued to be sexual in the ways he had been before. Eventually though, he met men with whom his intention was to have anonymous sex, but these encounters evolved into on-going relationships. Michael's "Don't Ask, Don't Tell" arrangement changed when Virginia learned about these relationships. With Michael being more open about his sexual orientation, their relationship became what is commonly referred to as a "mixed orientation marriage"-loosely defined as a marriage comprised of individuals with different sexual orientations-Michael identified as gay, and Virginia as straight.

Michael told Virginia he had no intention of divorcing her, but wanted to stay married and continue to have sexual/romantic relationships with men. Not all mixed orientation marriages are open. Some men and women acknowledge the difference in their orientations and continue to have sex only with each other. Others in mixed orientation marriages choose celibacy. While Virginia didn't like the idea of an open marriage, for her it was better than losing Michael and the family they had created together so she agreed to open the relationship. In this case, however, "open" meant only that Michael could see other men. There was no discussion of Virginia having relationships outside their marriage.

Other couples have defined an open marriage differently, with both spouses having the ability to date and/or develop a secondary relationship outside of their primary marriage. Still other couples have addressed a husband's disclosure of being gay or bisexual by inviting other partners into the primary relationship (polyamory). In my experience, some wives are initially receptive to polyamory in an effort to "save" the marriage. Over time for some couples, this arrangement becomes limiting as either the husband or wife meets someone with whom they would like to have a primary relationship. At times such as this, an open or polyamorous relationship may lead to separation and/or divorce.

Separation or divorce
Other couples determine that it is not in either spouse's best interest, or in the best interest of the children, for them to remain married. These couples may separate indefinitely, they may separate knowing that eventually they will divorce, or they may separate and file for divorce simultaneously.

For many men with whom I have worked, this is the most feared arrangement. Such a decision requires some explanation to children, extended family, friends and, in some instances, co-workers. There are also significant financial implications for couples that choose this strategy.

Many times, it is the fear of disclosure (of judgment, shame, and ostracism) in combination with the financial fear (of maintaining two households) that impedes gay and bisexual married men from moving toward this arrangement. In some instances, husband and wife share resources that if they divorced, would cause hardship for one member of the couple.

In Michael's case, for example, he was receiving health insurance through his wife's employer. As a self-employed graphic designer, if they were to divorce and he tried to acquire a policy for individual health insurance, he would most certainly be rejected due to his HIV status. And though he may be eligible for subsidized programs through the state (ICHIP in Illinois, for example), the cost to him both for his premium and then for his medications would be prohibitive.

In addition to the more practical or logistical concerns of separation or divorce, the emotional journey, even in the best of circumstances, is difficult and challenging. Both spouses are in a position to "start over" and, for some, this is a formidable task. For gay or bisexual men, the challenge is to move into a community they have previously denied themselves. They struggle with trying to attach old rules to new partners/circumstances, while learning new rules at the same time.

For Michael and other HIV-positive married and formerly married gay or bisexual men, there are "double or triple-disclosure" decisions: when to share about being gay or bisexual, when to share about being married, and when to share about being HIV-positive. For some men, these challenges foster the status quo of marriage. Others see these as difficult but surmountable.

Choices
What I have learned from these men is that there is no one universal journey gay and bisexual, married, and HIV-positive men should pursue. I have been surprised when men share frustrating experiences with psychotherapists-many of whom adopt a dichotomous strategy for conceptualizing intervention: either help gay or bisexual married men stay married to their wives or help gay or bisexual married men separate and divorce.

Men who have had such experiences are typically wary of me when we first meet. What is my agenda-they wonder. Am I invested in helping them remain married despite their sexual attraction to men, or am I invested in helping them divorce despite their desire to stay married at all costs?

I have had gay and bisexual men begin therapy with me insisting they will never divorce who ultimately decide to divorce. I have also, however, worked with gay and bisexual men who came to me seeking to divorce but then decided to remain married. I have found that the one agenda I do support is the agenda of increased authenticity, though this may manifest differently for each man-and may even manifest differently for the same man at different periods of time in his life.

Towards healing
Michael's shame, secrecy, and isolation were the result of judgment, prejudice, and oppression. For Michael, gay, married, and HIV-positive, "full disclosure" in all circumstances, all relationships, and all contexts felt, and actually was, dangerous, fraught with both real and imagined negative consequences. Our work together involved an exploration of possibilities and experimentation with authenticity. And Michael evidenced great courage as he tackled these challenges.

Initially, Michael experimented by being more authentic in his relationship with me. He shared more about himself, his history and his feelings. Having an opportunity to share parts of himself he had never shared was scary but empowering at the same time. If he could fully be himself in the presence of another person and have that person accept him, he could move closer to accepting himself. As long as he kept "secrets"-as long as he was inauthentic-he could continue to believe that if people found out who he "really" was (gay, HIV-positive, someone who had anonymous sex, etc.), they would reject him. As Michael shared more, and as he experienced acceptance, he became more confident to further experiment with authenticity.

In group therapy, Michael continued to risk sharing more of himself. And, he was rewarded with others sharing more of themselves. In fact, others shared feelings, behaviors, and histories that were so similar to Michael's that he felt validated and, for perhaps the first time in his life, he felt connected to other people fully. His self-confidence grew and he became willing to share more honestly-even when he feared negative consequences.

Finally Michael took more risks with Virginia. He shared more about his love for her, his desire not to hurt her, and his desire to pursue his feelings for men. Though Virginia felt betrayed and uncertain about her own future, they actually became closer to one another than they had been in years. Surprised by his renewed friendship with Virginia, Michael felt less shame, more pride, and an even lesser need to keep secrets.

While Michael experienced primarily positive consequences as a result of being more honest and authentic, this is not the case for all men in his circumstances. Many gay and bisexual married men have had greater conflict with their wives/ex-wives, children, extended family, and friends as they become more truthful. For some, their fears of rejection have been confirmed as loved ones cut off contact or limit contact considerably. There are instances when these initial reactions soften and over time, relationships are restored and strengthened.

There are also instances when prior relationships cannot be maintained. In cases of divorce, the relationship between husband and ex-wife may be extremely strained and acrimonious. Even in these instances, however, most married and formerly married gay and bisexual men report that honesty brings some sense of relief, improved self-confidence, and a sense of hopefulness for what may come.

Michael continues to face daily decisions about how to live his life. While Virginia knows almost everything, his children know only that he is gay and not that he is HIV-positive. And, he remains ambivalent about his desire to divorce-still dealing with a sense of being trapped. Even with an ambiguous future, however, Michael feels less shame and a greater sense of pride. He recently shared: "Being more truthful has been my strongest antidote."

*Michael's story is a composite of the stories of married, gay or bisexual, and HIV-positive men with whom I have worked. His name and the names of his family members are not actual client names. His situation has been constructed from the common challenges faced by these men and their families.