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A Gay Therapist Discusses Gay Men and Tattoos: Ritual and Meaning

Stylish young man in cap sitting behind table in summer cafe
(This model is not necessarily gay, but gay men can imbue their tattoos with great meaning.)

In my private practice as a psychotherapist who specializes in working with gay men, it was a surprise to me when several years into my practice I noticed a pattern that gay men like to talk about how the tattoos they have hold special, even profound meaning for them. When I first opened my private practice in psychotherapy (and later added services in life/business coaching), I wouldn’t have predicted that, but I learned things over time about the feelings that so many guys share in common. Their tattoos become topics of conversation, especially in summer months when guys are wearing short-sleeves, tank-tops, or shorts. They start talking about when they got them, and the emotional attachment they have to what feelings, experiences, and values their tattoos mean to them, and it becomes relevant to their therapy for whatever we are working on, such as self-esteem, relationships, philosophical/existential “outlook” on life, and dreams/goals. I guess straight people and lesbians also have meaningful tattoos, but since my practice focuses on gay men’s needs, I hear about tattoos in that context.

It was that way for me. After my “turning 40” crisis, which I admit I had like so many other guys, I lost some inhibitions about a lot of things, especially my opinions. I got into counseling and therapy during the height of the AIDS crisis, because I wanted to speak up and help out. Getting older helped me to do more of that, because the people I care about deserve our attention and intervention. So I wanted a tattoo because I thought they looked hot but also for their meaning. At the time of the Iraq war, Bill Clinton said that we need to focus on our similarities, rather than our differences. I thought about this, and designed a tattoo that combined the symbols of some of the major religions/cultures of the world: a cross, a yin-yang, a Star of David, and the sun (for paganism). It ended up looking also like a nautical star, that gives direction and guidance. My second one, a few years later, was of two dragons that face each other, because my husband and I were both born in the Year of the Dragon (1964) in the Chinese zodiac. It also has some tribal elements, and a Libra symbol in my favorite color, blue. The dragons face each other in a mirror image because that also represents “self-reflection”, which is symbolic of what I do as a therapist, to help people self-reflect on themselves and decide what changes in their thinking, outlook, and behavior will make their lives better.

With clients, there have been similar stories about how their personal values have then been represented graphically in their tattoo design. One client described very eloquently how the black tribal symbol design made him feel at one with the HIV community after his diagnosis, and it was part of his coping with that, that felt positive and encouraging. Another client had various initials of people who were key in his life. Another had a couple of symbols that reminded him of his own strength, resilience, and triumph over an abusive past.  Others have adopted the “toxic” symbol as way of defying their HIV diagnosis, and signaling to others that they will not be silenced in a stigma about HIV status.  Others yet have symbols that support them in drug/alcohol recovery, that remind them to use their program and cognitive tools to cope with triggers or relapse risk just by seeing the visual cue of their tatt on their body.

When we talk about gay men in therapy, it has to be in a certain culturally-affirmative context. Gay men actually tap into a lot of “masculine perspective” energy, whether it’s how we approach work, our homes, money, health (especially fitness and muscularity), and of course sexuality. While we have a lot in common with straight men and that whole “men are from Mars, women are from Venus” thing, gay men put their own spin on traditionally masculine things like muscularity and tattoos (and cars, too). While tatts are not everyone’s cup of tea, others have said that a cool tattoo can make any guy sexier and bolder, in that he is asserting his personality visually with “the art of the body”. It’s also sexy in that tattoos are only removable with great difficulty, so it’s a commitment, and having the strength of your convictions to make a permanent commitment to a visually-expressed idea that has profound meaning for a person can be sexy in itself; it’s the strength of that commitment and standing up for what you believe in, which gay men need after a lifetime of growing up with anti-gay sentiment all around us in political rhetoric, laws, bullying, and other oppression.

Just the act of getting a tattoo can be an empowering act of defiance, a triumph over uncertainty or a diminished sense of self. Just like our clothes, our hair, our facial hair, and other personal style expressions, the tattoo is more profound because we “wear it” all the time, even at our most naked, our most vulnerable, as a symbol(s) of the values in ourselves that we find enduring. When gay men find ways like this that are fun and sexy and also help underscore our sense of self-empowerment, we are not just living, we are thriving. Gotta love that!

Have you talked about your tattoos in therapy? Or have you openly “processed” your thoughts about getting one? Like I said, sometimes the right choice is not to do it, but I’ve been so moved by the stories I hear from guys I work with about the meaning and the self-validation they get from theirs, that I’m impressed, inspired, and admiring of their self-reflection. This can only help them move toward whatever their goals are in therapy.


(For more information on working in therapy or coaching with Ken Howard, LCSW & Associates at, call/text 310-339-5778 or email  Services available in office in Los Angeles, or via phone/webcam to anywhere in the United States, or the world.)

1 thought on “A Gay Therapist Discusses Gay Men and Tattoos: Ritual and Meaning”

  1. I’m gay, and I find tattoos ugly. I have yet to see a human body that in my eyes looked better for the addition of ink. As for ‘standing up for what I believe in’, two things: one, I don’t need a tattoo to do that, and two, some of the things I believed in 20 years ago are very different to what I believe now. But then, maybe that’s why so many are in therapy.


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