Why Can't I Stay Hard Anymore? A Gay Man's Guide to Erectile Dysfunction

What if anal sex simply isn't part of the sex you want? In this episode, Ken Howard, LCSW, CST, explores "sides"—gay men who prefer sexual expression without anal intercourse—and credits psychologist and certified sex therapist Dr. Joe Kort for originating and developing the term. Ken reframes being a side not as an absence of sexuality, but as one valid choice within a broad erotic repertoire. He discusses consent, pleasure, sexual health, and the important difference between a genuine preference and avoidance driven by fear, pain, shame, or missing information. The goal is not to steer anyone toward a particular sexual act; it is sexual self-empowerment: understanding your desires, boundaries, health, and options well enough to make choices that truly belong to you.

Many gay men prepare financially for retirement, yet still feel uncertain about what they are retiring into. Ken Howard, LCSW, CST, explores the "blueprint gap": reaching later life without an inherited picture of what a satisfying retirement should contain. Traditional retirement narratives often assume children, grandchildren, lifelong heterosexual marriage, and an extended family prepared to provide companionship and care—assumptions that may never have applied to gay men. This episode examines retirement identity, chosen family, purpose after work, financial security, LGBTQ+-affirming long-term care, and the AIDS-era loss of elders who might have modeled aging for subsequent generations. Ken offers reflective questions and practical ways to begin building a later life around connection, creativity, community, safety, and personal meaning.

What happens when a long-term gay couple is no longer fully monogamous—but neither partner feels entirely comfortable calling the relationship open? Ken Howard, LCSW, CST explores the emotional territory between monogamy and consensual non-monogamy: relationships that change gradually, sexual agreements that make sense intellectually but remain difficult emotionally, and the difference between genuine acceptance and reluctant permission. This episode examines erotic grief, aging, changing desire, hookup-app use, fear of losing a shared life, and the difficult conversations couples sometimes avoid. Rather than arguing that one relationship structure is superior, Ken encourages gay male couples to build relationships deliberately—with honesty, mutual awareness, emotional respect, and agreements that can evolve as their lives change. To learn more about therapy for gay men and gay male couples in California, or coaching services available worldwide, visit GayTherapyLA.com.

In Part 2 of Five Love Languages Reimagined for Gay Men, Ken Howard, LCSW, CST explores why receiving gifts and physical touch can mean far more than they seem. Gifts may communicate that your partner stayed in your mind; touch can offer comfort, safety, and belonging without needing to lead to sex. Ken connects these everyday moments to attachment, the histories gay men bring into relationships, and a central question for couples: does the way I'm loving you actually feel like love to you?

The five love languages can be useful—but for gay men, they often carry deeper psychological meaning. In Part 1 of this two-part episode, Ken Howard, LCSW, CST, reimagines the familiar framework through the lived experiences of gay men. He explores why words of affirmation can be about being seen, why acts of service can become a way of earning closeness, and why quality time is less about hours together than genuine emotional presence. The deeper question is not simply how we express love. It's why certain expressions of love make our nervous system feel safe, valued, and connected. Part 2 will cover receiving gifts, physical touch, and the attachment psychology beneath the five love languages.

Many successful gay men appear to have everything: thriving careers, financial security, meaningful accomplishments, and lives that others admire. Yet beneath that success, many quietly wonder whether they are truly lovable—or simply valued for what they achieve. In this episode, Ken Howard, LCSW, CST, explores why professional success often fails to create emotional security. Drawing on more than 34 years of working with gay men, he explains how childhood experiences of monitoring ourselves, adapting to others' expectations, and earning acceptance can lead to a lifelong belief that love must be continually earned through performance. Topics include: Why success and emotional security are not the same The difference between admiration and genuine intimacy How childhood adaptation becomes adult achievement Why many high-achieving gay men still fear rejection The hidden cost of always appearing strong and capable How emotional visibility creates deeper relationships Why vulnerability—not perfection—is what builds lasting intimacy If you've ever felt admired but not truly known, accomplished but still insecure, or worried that people would lose interest if you stopped performing, this episode offers a compassionate psychological framework for understanding why—and how genuine emotional security can begin to grow.

Have you ever opened Instagram only to discover your friends got together without you? Within seconds, your mind may begin asking painful questions: Did they forget me? Did they not want me there? What's wrong with me? In this episode, Ken Howard, LCSW, CST, explores why social exclusion hurts so deeply—and why the real wound often isn't the missed invitation itself, but the meaning we attach to it. Drawing on more than 30 years of experience working with gay men, Ken explains how childhood experiences of feeling different, monitoring ourselves, and searching for acceptance can shape our adult friendships, social lives, and sense of belonging. Topics include: Why being left out feels so painful The difference between facts and assumptions Why social media amplifies feelings of exclusion Why many gay men are waiting to be chosen instead of building connection The difference between friendship and validation How to stop organizing your self-worth around other people's invitations What genuine belonging actually looks like If you've ever wondered why a missed dinner, party, or group trip feels so much bigger than it "should," this episode offers a compassionate psychological framework for understanding what's really happening—and how to build relationships where you no longer have to wonder whether you belong.

Many gay men believe their struggles stem from anxiety, loneliness, dating frustrations, low self-esteem, or difficult relationships. But underneath many of these challenges lies a quieter and often overlooked pattern: self-abandonment. In this episode, Ken Howard, LCSW, CST, explores how gay men learn to disconnect from their feelings, needs, boundaries, anger, instincts, and even their dignity in order to preserve connection, approval, desirability, or emotional safety. Drawing from more than 30 years of clinical work, Ken explains how childhood experiences of conditional acceptance, invisibility, bullying, and self-monitoring can evolve into adult patterns of self-suppression that quietly erode self-respect and intimacy. Topics include: What self-abandonment actually is Why many gay men learn to prioritize acceptance over authenticity How self-abandonment masquerades as maturity, patience, and understanding The hidden resentment created by chronic self-suppression Nine common forms of self-abandonment in everyday life How to set boundaries without guilt The difference between healthy compromise and self-betrayal Why authentic relationships require self-respect If you've ever found yourself laughing off hurt feelings, staying too long in one-sided relationships, over-explaining your boundaries, suppressing your anger, or making yourself smaller to keep the peace, this episode offers a framework for understanding what's happening—and how to begin reconnecting with yourself.

Why does Donald Trump continue to inspire such fierce loyalty among millions of Americans? In this special episode of the Gay Therapy LA Podcast, Ken Howard, LCSW, CST, steps outside his usual focus on gay men's mental health to examine a broader psychological question: what emotional needs does authoritarian communication fulfill? Drawing on more than three decades as a psychotherapist, Ken explores why certainty can feel more persuasive than complexity during periods of rapid social change, economic anxiety, and cultural uncertainty. He discusses how fear seeks emotional containment, why simple narratives can outperform nuanced explanations, and why people often respond to emotional regulation as much as they do to policy. Rather than debating politics, this episode examines the psychology that makes authoritarian messaging so compelling—and why understanding these emotional dynamics may be one of the best protections against manipulation. If you've ever wondered why facts alone often fail to change minds, or why confident leaders can inspire devotion despite contradictions, this episode offers a psychological framework for understanding one of the defining political phenomena of our time.

Why can't I stay hard anymore? Ken Howard, LCSW, CST, explores the real causes of erectile dysfunction in gay men—and what actually helps beyond pills, panic, and self-criticism.