Problems in our community’

Confronting issues like drug use, risky sexual behavior and depression among gay men often involves sensitive topics — judgment, limiting sexual liberation, attempting to appear “normal” to mainstream society — and Cox knows that plenty of gay activists tackling issues like these have been maligned as moralistic assimilationists.

“I’m not anti-partying in the traditional sense,” Cox said. “I think the point is not that we don’t have a good time. It’s that when we see something is not working, we need to stop.

“Well being is about gay men building lives they value so much that they won’t want to put them at risk,” Cox said.

Robert Weiss, clinical director of the Sexual Recovery Institute in Los Angeles, agreed that calling attention to underlying crises among gay men is at times intimidating.

“I think it’s very, very difficult for those of us in the field of mental health and substance abuse to talk about the problems in our community,” said Weiss, who is also the author of “Cruise Control: Understanding Sex Addiction in Gay Men.”

“It’s hard for us because there’s a lot of sensitivity to being positive about the community,” he said.

Nevertheless, Weiss notes that multiple studies show higher rates of substance abuse among gay men than the general population, and adds, “I have no doubt in my mind that there is more acting out in other addictive ways,” such as sexually.

But determining whether depression leads gay men to act out sexually, or whether an abundance of sexual activity creates a depressing set of circumstances, is as difficult as answering whether a chicken or egg comes first, Weiss said.

“If you spend three to four hours a week, five nights a week online looking for sex, then the weekends in a bathhouse, you’re not going to feel so good,” Weiss said. “The behavior itself is very isolating, alienating and leaves people feeling hopeless.

“I have certainly seen men who appeared quite depressed, but once they stopped acting out and gained some sense of hope that they can live differently, then they’re not as depressed.”