‘That horrible nasty void’: suicidality, internalised homophobia and lived experience among gay, bisexual, queer and questioning men

Sexual minority individuals continue to experience elevated rates of suicidality compared to heterosexual populations. Research suggests that experiences of prejudice, rejection and inequality related to sexual orientation may become internalised, contributing to psychological distress commonly described as internalised homophobia (IH). This study explores how suicidality is experienced and narrated by gay, bisexual, queer and questioning (GBQ+) men, and examines whether and how IH can be identified within these narratives. In-depth narrative interviews were conducted with ten GBQ+ men receiving care from the National Health Service (NHS) outpatient mental health services in a rural county in England. Analysis followed a psychoanalytically informed, reflexive narrative approach, incorporating repeated engagement with transcripts, reflexive journalling and interpretive discussion. Six key narratives were identified, tracing participants’ accounts from early relational and social experiences to their internal worlds and suicidal states of mind. Participants described a complex interplay between sexuality, adverse experiences and suicidality, often involving shame, self-attack and repudiation of desire. Three suicidal states of mind were developed through cross-case narrative analysis, extending psychoanalytic understandings of suicidality. IH was interpreted as one important process among several, alongside trauma, relational adversity and broader psychosocial contexts. The findings contribute to qualitative understandings of suicidality among GBQ+ men.