

































COLUMBIA SOCIAL WORK REVIEW, VOL. XIX  |   103   

Mereces Todo Lo 
Bonito: Queer Latinx 
Mental Health 
Professionals and 
Gay Latino Identity 
Development
XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   105   

Xavier Salas is a graduate of Columbia University School of Social 
Work focusing on LGBTQ+ Latinx issues, Chicanx identity, and mental 
health disparities. His research explores the intersections of culture, 
sexuality, and mental health. He aspires to specialize in trauma-focused 
care and human sexuality, advocating for inclusive policies and culturally 
competent therapy for queer Latinx individuals.

INSPIRATION
As a Mexican-American gay man, I have navigated the complexities 
of identity—balancing my Latinx heritage with the need to live 
authentically. Throughout my journey, I realized the profound impact 
of representation in mental health, especially for LGBTQ+ Latinx 
individuals. Too often, we lack professionals who truly understand 
the intersectionality of our identities, leaving us to struggle with our 
sense of self in isolation. This paper is my call to action—to highlight 
the importance of recruiting and retaining queer Latinx mental health 
professionals who can guide others in navigating their paths to self-
acceptance.

The need for this work has never been more urgent. With the current 
administration’s relentless opposition to DEI efforts and the increasing 
marginalization of LGBTQ+ rights, we are witnessing firsthand the 
dangers of invisibility. It is more crucial than ever to build a future where 
diverse voices are heard and valued.

As the poet Pablo Neruda once said, "Podrán cortar todas las flores, pero 
no podrán detener la primavera." ("They can cut all the flowers, but they 
cannot stop the spring.") This paper is my contribution to ensuring that 
our community’s resilience and potential continue to bloom, no matter 
the obstacles in our path.

XAVIER 
SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   107   106  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

MERECES TODO LO BONITO

ABSTRACT
This research explains the critical need to diversify queer Latinx mental 
health professionals to support the healthy formation of gay male 
Latinos’ sexual identity. Gay male Latinos go through unique difficulties 
in their process of identity formation, shaped by cultural concepts such 
as familismo, machismo, and religion, and economic constraints that 
hinder access to helpful care. These obstacles fuel greater mental health 
risks, including depression, anxiety, and internalized homophobia. 
The underrepresentation of queer Latinx professionals in mental 
health, however, is not an isolated issue—it is a symptom of a broader 
breakdown in the system: Other groups of marginalized individuals are 
also often unable to access culturally competent care. Increased diversity 
in the mental health field is essential not only for gay Latino men but also 
for other LGBTQ+ and BIPOC individuals who face similar disparities. 

Queer Latinx mental health professionals bring with them distinct lived 
experiences that enrich therapeutic relationships, deepen client outcomes, 
and strengthen research, policy, and clinical practice by interrupting 
prevailing Eurocentric models of therapy. These benefits are undermined 
by political efforts to dismantle diversity, equity, and inclusion (DEI) 
initiatives, further stigmatizing communities in need of affirming care. 
Despite these challenges, interventions such as pipeline programs, 
policy activism, and community organizing provide options for attaining 
and sustaining diversity in mental health. Committing to recruit and 
retain queer Latinx mental health professionals allows us to bring about 
systemwide change that benefits not just gay male Latinos but the mental 
health field as a whole. As the saying goes, “Mereces todo lo bonito”—
you deserve everything beautiful—and that begins with access to care 
that understands, knows, and confirms identity. 

“Our brown skin does not limit us but empowers us for greatness.” 
—Brian Saucedo

XAVIER SALAS

MERECES TODO LO BONITO: QUEER LATINX 
MENTAL HEALTH PROFESSIONALS AND GAY 
LATINO IDENTITY DEVELOPMENT
Many clients, particularly gay Latino men, have challenges finding the 
right mental health professional to meet their needs, as effective therapy 
requires both cultural competence and an understanding of sexual 
identity development. This research examines the unique challenges that 
gay male Latinos face during sexual identity development and the lack 
of queer Latinx mental health professionals who can provide identity-
affirming, culturally competent care. Overall, this research seeks to 
answer the following three questions:
1. What are the specific issues for gay male Latinos in sexual identity 

formation?
2. How does a dearth of queer Latinx mental health professionals 

impact services for this population?
3. What are the potential implications of increasing the visibility of 

queer Latinx professionals in the mental health profession?

Sexual identity refers to one’s lifelong sense of self as a sexual being 
within cultural categories (Levy, 2009). Cultural and socioeconomic 
factors shape sexual identity development for Latino gay men, 
influenced by family, religion, and traditional norms such as machismo, 
caballerismo, and familismo. Machismo is defined as “a set of values, 
attitudes, and beliefs about masculinity, or what it is to be a man” 
(Nuñez et al., 2016, p. 3) and caballerismo is “comprised of chivalry, 
familial ties, and is associated with emotional connectedness” (Rivera 
et al., 2021, p. 3). In alignment with caballerismo, familismo is where 
the “higher emphasis is placed on the family unit in terms of respect, 
support, obligation, and reference” (Valdivieso-Mora et al., 2016, p. 1). 

The cultural and socioeconomic factors that shape sexual identity 
development for gay Latino men are unique and require culturally 
competent care practices. The scarcity of queer Latinx mental health 
professionals limits access to empathetic and culturally informed 



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   109   108  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

care. Overburdened mental health systems can lead to incomplete 
sexual identity development and internalized homophobia. This 
underrepresentation is problematic, especially given the high levels of 
mental health challenges within the LGBTQ+ community. As a result, 
culturally relevant support becomes vital. 

To fully grasp the impact of this underrepresentation, it is crucial to 
examine theoretical models that address sexual identity development. 
These theoretical models help to describe individuals transitioning 
through identities in sociocultural contexts and provide an underlying 
structure that we can apply to analyze the facilitators and inhibitors of 
integration into one’s identity. From the use of these frameworks, we can 
better appreciate the intersection and effects of cultural values, family, 
and external societal pressures upon the lives of gay Latino men. 

Theoretical models, like the Developmental Model of the Closet, 
examine the role of concealing minority sexual orientations and its effect 
on identity development (Cass, 1984). Cass’s (1984) six-stage model 
delineates the movement from identity confusion to identity synthesis, 
where a homosexual identity becomes integrated into the broader self-
concept. Queerness disrupts traditional sexual identities with fluidity and 
inclusivity (Heasley & Crane, 2003). This upheaval defies strict social 
norms, provoking resistance from conservative institutions that preserve 
binary understandings of gender and sexuality (Wade & Ferree, 2015). In 
considering the critique of the gender binary, it becomes clear how it falls 
short of an artificially established ideology. Nevertheless, this critique 
also facilitates an expanded system that legitimates multiple identities 
and experiences, gradually expanding the sphere for self-expression and 
acceptance among queer and mainstream communities (Butler, 1990).

This research aims to add to the literature regarding gay male Latinos’ 
difficulties in sexual identity formation, while highlighting the important 
role queer Latinx mental health professionals can have in the process. 
Gay male Latinos face unique challenges based on cultural, religious, 
and economic considerations that contribute to high rates of mental 
health stressors. Increasing the number of queer Latinx mental health 

professionals promotes gay male Latinos’ mental well-being through 
tighter therapeutic relationships, role modeling, and intersectional, 
identity-congruent care. Furthermore, this research highlights the 
importance of cultural competence in mental health and demands greater 
representation of queer Latinx professionals, ensuring gay Latinos 
receive the affirming care they deserve. 
 
THE UNIQUE CHALLENGES FACED BY 
GAY LATINO MEN IN SEXUAL IDENTITY 
DEVELOPMENT

CULTURAL FACTORS

Gay male Latinos face unique challenges with sexual identity 
development due to traditional Latinx gender norms like machismo and 
caballerismo. As Rosenberg et al. (2024) states, people identifying with 
these norms are more likely to self-identify as exclusively heterosexual 
rather than gay, bisexual, or queer. Sexual identity development may 
involve efforts to align with community and family expectations. Gay 
Latino men may avoid openly identifying as GBQ (gay, bisexual, queer) 
to conform to machismo’s emphasis on hypermasculinity, prioritizing 
acceptance within their cultural environment. Moreover, emotional 
responsibility in the form of caballerismo may lead individuals to 
conceal their GBQ identity to uphold family values that conflict with 
nonheteronormative orientations. 

Machismo and caballerismo are institutionally embedded in Latinx 
family structures, religious ideology, and cultural imperatives, which 
collectively constitute a complex environment for the construction 
of sexual identity. Machismo emphasizes strength, superiority, and 
heterosexual masculinity, and is often promoted by fathers and father 
figures who want their sons to meet these standards. Conversely, 
caballerismo, which calls for responsibility, honor, and respect, creates 
a sense of obligation to maintain family unity by not engaging in any 
form of activity that may cause perceived shame. Cultural norms, such 
as machismo, familismo, and heterosexism, provide the context for the 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   111   110  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

process of coming out, and may result in feelings of rejection and the use 
of coping mechanisms such as alcohol and other drugs (Gerena, 2021a). 
This triad of gender roles, familial duty, and societal expectations may 
lead to deeply internalized homophobia, complicating or inhibiting the 
integration of identity (Meyer, 2003).

Additional complexities that emerge in the development of individual 
identity include family and religious institutions. Family, central 
to Latino culture, often lacks support for LGBTQ+ identities, 
particularly when influenced by spiritual institutions like the Catholic 
Church. Religious beliefs, especially within Catholic and Evangelical 
communities, often promote heteronormativity as a moral and spiritual 
duty, intensifying the intrapsychic conflict experienced by gay Latino 
men. Garcia (2014) states that this lack of support may present 
challenges for gay Latino men in finding a balance between their sexual 
identity and their cultural and religious traditions. 

Culturally competent care addresses such a set of complexities, reducing 
health disparities and improving patient satisfaction. Collaboration 
with bilingual and bicultural professionals helps avoid issues such as 
misdiagnosis and less inclusive or responsive services. Patients who 
receive culturally sensitive care have shown higher satisfaction rates, 
with better long-term outcomes (Moyce et al., 2022; Robles et al., 2020).

For this reason, mental health professionals working with Latino gay 
men should be aware of the cultural factors affecting this population. 
Culturally sensitive care may help promote the healthy development 
of sexual identity for this population and decrease the impact of 
traditional norms. By integrating cultural sensitivity into the therapeutic 
relationship, mental health professionals can establish trust, validate lived 
experiences, and address the particular stressors of Latino gay men, such 
as familismo, religious context, and expectations of masculinity. This not 
only enhances treatment participation in mental health, but also enables 
individuals to navigate their identities more assertively and resiliently. 

 

SOCIOECONOMIC FACTORS

Socioeconomic factors strongly influence the mental health and identity 
development of Latino gay men. Poverty, immigration status, and 
education affect individuals’ access to mental health services and shape 
their identities. As such, challenges can arise when an individual tries 
reconciling gay and Latino identities within rigid familial and cultural 
expectations that are encased in strong patriarchal and gender roles and 
often accompanied by identity confusion, isolation, and internalized 
homophobia (Zea et al., 2003). Negotiation strategies for managing 
socioeconomic factors within these intersectional identities are common, 
alongside feelings of exclusion and isolation. 

While cultural expectations shape self-identity and social acceptance, 
financial and structural barriers limit access to affirming mental 
health care, compounding the challenges faced by Latino gay men 
(Meyer, 2003). Economic barriers further exacerbate mental health 
disparities among Latino gay men, including a lack of insurance; limited 
geographic access to affirming providers, particularly in rural areas; 
and complicating factors such as transportation and immigration status. 
These barriers contribute to the underuse of mental health services by 
Latinos, with Latino gay men suffering higher psychiatric distress due 
to intersectional oppressions (Gerena, 2021a). The mental health system 
has prevented Latinx people from gaining adequate access to resources in 
a wide-ranging scope. Disparities tied to race and socioeconomic status 
worsen the problem, particularly within rural areas where mental health 
resources are scarce (McGregor et al., 2019; Moyce et al., 2022).

For some Latino gay men from immigrant families, balancing sexual 
identity with acceptance from their family involves “moral management” 
strategies, meaning they subtly challenge their parents about negative 
views while focusing on educational and career successes (Ocampo, 
2013). These approaches are generally aligned with the aforementioned 
traditional Latinx gender constructs of machismo and caballerismo, 
which serve as both obstacles and resources in negotiating cultural 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   113   112  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

and familial expectations. Machismo’s emphasis on masculinity and 
toughness may lead some Latino gay men to take on hypermasculine 
habits, or to repress sexual identity in the interest of maintaining familial 
respect. Conversely, caballerismo’s emphasis on duty, fidelity, and 
emotional connection allows these men to re-create their sexual identity 
on terms that highlight factors including being good sons and providers, 
and that their successes in school and/or career are part of their family 
duty. These values enable them to court parental approval and gradually 
work on the conversations that challenge strict gender and sexual 
expectations. 

The intersection of racial and socioeconomic challenges, including 
discrimination and marginalization, along with overlapping identities 
in race, ethnicity, and sexual orientation, underscore the need for 
culturally competent or adapted mental health services that reflect the 
lived experiences of this population. Despite the negative effects of these 
challenges, resiliencies and support networks play an important role 
in helping participants make informed and positive decisions in their 
identity development within the Latino gay male community (Harper et 
al., 2016).

Issues such as the intersectionality of multiple marginalized identities 
place Latino gay men in peculiarly challenging positions that impact 
their mental health outcomes. These intersecting identities often 
exacerbate feelings of exclusion and isolation due to the discrimination 
perpetuated by mainstream society, but most notably from within their 
own ethnic and LGBTQ+ communities. This intersectionality leads to 
different mental health challenges that demand a deeper understanding 
of their experiences. A thorough examination of the deeper layers of 
identity may yield a more specific picture of how Latino gay men 
navigate the dynamics of their mental health, family dynamics, and 
cultural expectations; it also points to the need for tailored mental health 
interventions.

Latino gay men often face what scholars describe as “double minority 
stress,” the intersectional effect of racial and sexual minority identities 

that exacerbates dangers to mental health (Salas et al., 2023). They 
frequently traverse a cultural terrain where homophobia is present within 
Latinx communities and where they also face racism in LGBTQ+ spaces, 
resulting in a loss of their sense of belonging (Velez et al., 2019). Within 
their families, acceptance can be conditional, with some relatives able to 
tolerate their identity as long as it is not ostentatious, thus maintaining 
their sense of invisibility (Morales-Chicas & Cokley, 2021). Other Latino 
gay men feel that their lived experiences of being Latino are frequently 
reduced to a caricature in predominantly white LGBTQ+ spaces, where 
they are seen as objects of racial fetishization or tokenization, leaving 
them feeling out of place (Han & Ayala, 2018). These stressors lead 
to elevated levels of depression, anxiety, and substance use among 
Latino gay men—rates significantly higher than in their white LGBTQ+ 
counterparts (Díaz et al., 2022). These combined factors contribute to the 
limited ability to obtain culturally competent services for their mental 
health needs, magnifying an already inequitable gap (Zea et al., 2003). 
An intersectional lens filtering in the cultural, family, and systemic 
contexts of gay Latino males’ experiences will be critical to dealing with 
these challenges. 

MENTAL HEALTH IMPLICATIONS

Gay Latino men suffer from potentially serious health and psychological 
problems because of discrimination at the intersection of racism, 
cultural norms, and family rejection (Díaz et al., 2001). These hardships 
often manifest as substance dependence, risky sexual behaviors, and 
psychiatric distress (Meyer, 2003). Racism within LGBTQ+ communities 
exacerbates low self-esteem, leading to higher levels of depression and 
anxiety compared to their white peers (Santos & VanDaalen, 2016). 
Racialized stereotypes perpetuate body dissatisfaction, anabolic steroid 
misuse, and eating disorders. Disrespectful treatment by and mistrust 
of the medical system further increase health disparities and decrease 
access to care (Le et al., 2024). Societal and familial pressures—in the 
form of the fear of ostracism or internalized shame—faced by gay Latino 
men increase their degree of emotional distress and raise the risk of 
depression and suicidal ideation (Tajón, 2009). These challenges are best 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   115   114  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

addressed through a comprehensive approach in which intersectional 
experiences are considered and culturally competent mental health care is 
promoted.

The intersection of ethnic and sexual minority statuses means gay 
Latino men bear a heavier burden of stigma and discrimination from 
both mainstream society and the Latino community, often resulting in a 
higher prevalence of psychiatric distress. Cultural stigma also contributes 
to the underuse of mental health services, which can worsen untreated 
conditions and threaten long-term well-being (Gerena, 2021b).

Cultural norms enforcing heterosexual conformity, coupled with 
discrimination and stigma against LGBTQ+ individuals, increase 
psychiatric distress and the prevalence of psychiatric disorders (Yarber 
& Sayad, 2018). Family rejection, particularly from fathers, seriously 
impacts mental health, increasing anxiety, depression, suicidal ideation; 
substance use as a coping mechanism; and difficulty forming long-term 
healthy relationships due to internalized homonegativity.
 
THE ROLE OF QUEER LATINX MENTAL 
HEALTH PROFESSIONALS IN SEXUAL 
IDENTITY DEVELOPMENT
THE IMPORTANCE OF AFFIRMATIVE THERAPY

Affirmative therapy is an essential component in the treatment of 
members of the LGBTQ+ community, particularly gay Latino males. 
It contributes to positive identity development and decreases stigma. 
It is a form of psychotherapy aimed at confirming and advocating on 
issues affecting minorities in sexual and gender identity (Hinrichs & 
Donaldson, 2017). This framework helps to navigate the intersections of 
ethnic, cultural, and sexual identities to address mental health. Coming 
out is especially challenging for gay Latino men due to cultural and 
family factors such as machismo, caballerismo, and familismo. All these 
cultural pressures can contribute to significant fear of rejection and 
opposition to nonconformity with traditional gender role expectations. 

All this means that therapists must build a solid working alliance with 
their clients by promoting trust, practicing cultural competence, and 
confirming the client’s intersecting identities. A robust therapeutic 
alliance here involves the creation of a safe, nonjudgmental environment 
where the client is heard and validated, and the use of culturally 
responsive interventions that respect the client’s values and experiences 
(Johnson, 2012). This builds rapport and encourages open discussion 
about identity, family, and mental health concerns. 

Research indicates that understanding a client’s coming out narrative 
strengthens the therapeutic relationship—the sense of trust, collaboration, 
and emotional connection between a client and therapist—and therapy 
satisfaction, which refers to the client’s perception of how well therapy 
meets their needs and promotes personal growth (Bachelor, 1995; 
Bordin, 1979). In this regard, a minority stress-focused cognitive 
behavioral therapy (CBT) treatment tool called the ESTEEM intervention 
decreased anxiety and substance use for Latino gay and bisexual men, 
underscoring the importance of culturally tailored treatments (Keefe et 
al., 2023). By addressing minority stress and anchoring cultural identity, 
this intervention likely established trust, validation, and rapport—
essential elements that strengthen the therapeutic alliance. Similarly, 
culturally adapted CBT in the case of a depressed gay Latino adolescent 
improved depressive symptoms and family dynamics by integrating 
values from culture and self-hood (Duarté-Vélez et al., 2010). This 
culturally responsive intervention not only addressed clinical concerns 
but also created a safe space for identity exploration, solidifying the 
client-therapist alliance and resulting in greater therapy satisfaction. 

While the definition and validation of affirmative therapy are still 
elusive, there is empirical support for its efficacy in addressing the 
needs of LGBTQ+ individuals from racial and ethnic minorities. 
Studies have shown that affirmative therapy techniques—such as 
fostering positive identity development, validating cultural values, and 
addressing experiences of discrimination—lead to improved mental 
health outcomes, including reduced depression, anxiety, and internalized 
homophobia (Crisp & McCave, 2007). Therefore, future research should 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   117   116  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

focus on refining and validating affirmative methods to determine their 
continued efficacy and cultural competence among racial and ethnic 
minorities (Johnson, 2012).

THE LIMITATIONS OF CURRENT MENTAL 
HEALTH SERVICES

Gay Latino males face disparities in access to mental health services 
due to a lack of cultural competency from therapists who are not Latinx. 
Barriers include the limited availability of culturally and linguistically 
appropriate services and institutional mistrust. Integrated care remains 
limited due to the lack of standard measures and empirical research (Bhui 
et al., 2007; McGregor et al., 2019).

These challenges stem largely from cultural misalignment, language 
barriers, and resource limitations. Many mental health assessments fail to 
account for the unique experiences of gay Latino men. Besides the lack 
of access to Spanish-language services and bilingual providers, financial 
constraints serve as additional barriers to obtaining high-quality mental 
health care (Aguilar-Gaxiola et al., 2012; Cerezo et al., 2020; Moyce et 
al., 2022). Gay Latino males’ mistrust of mental health care is rooted in 
discrimination, compounded by providers’ inadequate training in cultural 
humility and intersectionality (Dawes et al., 2023). Barriers related to the 
cost of care and a lack of appropriate LGBTQ+ cultural competency are 
also associated with limitations in access to services for this demographic 
group (Aguilar-Gaxiola et al., 2012; Fish et al., 2022).

Immigration further exacerbates the social isolation and barriers to 
health services faced by Latinx people, requiring culturally competent 
approaches in social work (Furman et al., 2009). For the majority 
of Latinx immigrants, poor language skills, deportation fear, and 
unawareness of available services are some of the factors that lead them 
to feel excluded and deny them access to vital mental health services. 
Undocumented individuals also tend to avoid visiting healthcare 
providers due to suspicion or legal concerns.

Solutions may involve enhancing provider cultural competence through 

training in immigration-related stressors, acculturation problems, and 
intersectional sexual and cultural identities. Increased access to services 
may involve the creation of bilingual mental health services, recruitment 
of diverse providers, and culturally competent outreach among 
immigrant communities. Policy-level advocacy to reduce disparities 
must work on healthcare coverage for undocumented people, funding 
for community-based organizations that serve immigrant and LGBTQ+ 
communities, and protecting vulnerable populations from healthcare 
discrimination.  
 
THE NEED FOR AND BENEFITS OF QUEER 
LATINX MENTAL HEALTH PROFESSIONALS
Queer Latinx mental health professionals play an important role in the 
development of trust and understanding among gay Latino men. Their 
shared cultural and sexual identity builds stronger therapeutic alliances, 
leading to culturally relevant care (Gerena, 2021b; Gerena & Rodriguez, 
2023). Gay Latino men often face a tension between familismo and 
their sexual identity. This tension occurs when the desire to preserve 
traditional family roles collides with the expression of sexual orientation 
without restraint, leading to emotional tension and fear of rejection. 
Social workers must be culturally sensitive, assess family support, and 
promote open communication to decrease stigma and improve mental 
health. This is particularly pertinent in light of the reality that machismo 
as a cultural phenomenon attached to conventional masculine dominance 
and pride tends to reinforce stringent gender roles, which accumulate 
internalized homophobia and social isolation (Gerena, 2021b). 

Through providing safe spaces, inclusive language, and respect for 
client identities, queer Latinx professionals normalize discussions of 
sexual orientation and trauma while ensuring confidentiality (Gerena & 
Rodriguez, 2023). The acceptance of gay Latino men by their fathers 
is particularly significant, making family dynamics an important area 
for professionals to master, in addition to cultural competence (Gerena, 
2021a). This acceptance is significant because fathers may express 
traditional patriarchal values in Latino households, where masculinity 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   119   118  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

and gender are valued. For gay Latino men, acceptance by their fathers 
can affirm their identity, reduce internalized homophobia, and make them 
feel more valuable as people. Good father-son relationships have been 
linked with improved mental health status, including lower depression 
and anxiety rates (Morales et al., 2012). Fathers who openly declare 
acceptance of their sons can also affect broader family acceptance, a 
ripple effect that strengthens family bonds and reduces stigma. 

ENHANCING CULTURAL COMPETENCY

Cultural competency among health professionals is essential for 
enhancing the quality of care in diverse populations, including gay 
Latino males. Queer Latinx professionals offer insight into cultural 
nuances, using their own experiences to foster empathy and challenge 
stereotypes, thereby making care more culturally competent (Rosenberg 
et al., 2024). Awareness of these challenges helps clinicians provide safe 
environments for gay Latino men to explore their personal experiences 
without shame (Rosenberg et al., 2024). Lived experiences of queer 
Latinx professionals enhance rapport-building and strengthen patient-
provider relationships, reducing health disparities. 

Provider training should include knowledge of belief systems and 
culturally sensitive care planning that fosters improved collaboration 
with clients and families (Bhui et al., 2007). Increasing workforce 
diversity in terms of bilingual and bicultural professionals is critical. 
Pipeline programs are needed to address the shortage of providers 
familiar with the needs of diverse communities (Aguilar-Gaxiola et al., 
2012). Language access and tracking inequities are additional strategies 
that promote health equity (Flórez et al., 2021).

The significance of culturally competent care is widely acknowledged. 
Providing a specific example of a successful culturally adapted mental 
health intervention can illustrate its impact in practice. For instance, the 
chief emphasis in narrative therapy for gay Latino men is to develop 
the skills necessary to help the client reframe his experiences of cultural 
conflict and familial rejection, by building strength and resilience. 
Similarly, traditional healing practices, such as curanderismo (a holistic 

healing practice), could be included, or community leaders, such as 
promotores (community mental health workers), could be brought 
into mainstream mental health care to help bridge the gap between 
mainstream services and cultural beliefs. This could make interventions 
more acceptable and accessible to Latino clients (Cutshall, 2024; 
Johnson et al., 2013). These culturally adapted therapeutic approaches, 
incorporated with affirmative therapy, allow a deeper understanding of 
how mental health care can be adapted to meet the needs of gay Latino 
men, showing in practice what culturally competent care looks like and 
how it can improve mental health outcomes.

Queer Latinx professionals are integral to improving cultural 
competency, therapeutic relationships, and culturally relevant care. 
In addition to institutionalizing cultural competence education for all 
providers, increasing the availability of such professionals would lead to 
better health outcomes and greater equity for gay Latino men and other 
underserved groups. 
 
PROMOTING POSITIVE ROLE MODELS

Gay Latino males and other marginalized communities depend on 
positive role models for self-acceptance and growth. Individuals relate 
better to those who share their cultural and sexual identity, which fosters 
a sense of belonging and raises self-esteem (Zea et al., 2003). Queer 
Latinx mental health professionals can serve as powerful role models by 
demonstrating how to integrate sexual identity with cultural expectations 
while overcoming internalized homophobia. 

One important element in the therapeutic relationship is managing 
transference and countertransference. The feelings a client may hold 
toward their role models can be transferred onto the therapist. While this 
positive attitude can be helpful, it must be carefully managed to maintain 
balance in the therapeutic relationship. The therapist should recognize 
countertransference and use supervision and self-reflection to manage 
these dynamics.

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   121   120  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

IMPROVING MENTAL HEALTH OUTCOMES

Representation in mental health settings fosters trust between service 
recipients and providers. Greater representation among professionals—
especially those who have similar backgrounds to or share a language 
with their clients—creates an atmosphere of greater inclusiveness and 
better outcomes for Latino patients (Flórez et al., 2021). While the 
evidence for effectiveness continues to evolve, cultural competency 
training has been associated with positive staff attitudes and clinician 
satisfaction. However, further research is needed to assess its impact on 
patient outcomes (Bhui et al., 2007).

Quantifiable statistics regarding the number of queer Latinx mental 
health providers, compared with the higher rates of mental health 
issues in LGBTQ+ Latinx populations, might create demand for more 
practitioners within this area. Although demand for culturally competent 
care is growing across LGBTQ+ communities, very few practicing 
mental health professionals identify as LGBTQ+ or Latinx. According 
to the American Psychological Association (2022a), less than 5% of the 
psychology workforce is composed of Latinx individuals; still fewer are 
LGBT. These low numbers, arguably, have contributed to disparities in 
mental health outcomes, with LGBTQ+ Latinx individuals having higher 
rates of major depressive disorder, generalized anxiety, and suicidal 
ideation than their white counterparts (National Center for HIV, Viral 
Hepatitis, STD, and TB Prevention, 2021). Increasing the number of 
queer Latinx practitioners may help bridge these disparities and improve 
overall mental health outcomes.

BROADER IMPACTS OF INCREASED QUEER 
LATINX MENTAL HEALTH PROFESSIONALS

An increased presence of queer Latinx mental health professionals 
extends beyond individualized care to influence research, policy, and 
clinical practice in a meaningful manner. Their unique standpoints 
enhance an understanding of the intersectionality of culture, sexuality, 
and mental health, creating more representative and inclusive research. 

Scholarship from queer Latinx scholars tends to encapsulate the 
multifaceted experiences of gay Latino men, addressing gaps in the 
literature and combating dominant discourses that overlook their specific 
mental health issues (Salgado et al., 2022). By producing culturally 
relevant research, these researchers are helping create evidence-
based interventions that are tailored to the lived experiences of their 
communities, ultimately improving mental health outcomes on a larger 
scale. 

In terms of policy, queer Latinx mental health professionals have an 
important part to play in shaping legislative agendas to dismantle 
structural impediments to mental health care. Through experience and 
clinical awareness, they can highlight the unique issues gay Latino men 
face, while encouraging policymakers to place culturally attuned care 
and workforce diversity at the forefront. Their work played a crucial 
role in the enactment of bills such as the Mental Health Workforce and 
Language Access Act of 2023, which allocates funds to recruit bilingual 
and bicultural mental health professionals and to increase culturally 
appropriate services (Rodriguez & Santiago, 2023). Additionally, their 
leadership positions in professional organizations—such as the National 
Latinx Psychological Association and the APA’s Division 44 (Society for 
the Psychology of Sexual Orientation and Gender Diversity)—expand 
queer Latinx voices in state and national policymaking. In becoming 
directly engaged with these causes, queer Latinx professionals drive 
systemic change toward greater inclusivity and accessibility of mental 
healthcare. 

This policy work has already shown positive effects. For example, in 
its first year, the Mental Health Workforce and Language Access Act 
has assisted more than 200 new bilingual mental health professionals 
employed in federally qualified health centers, increasing service 
availability for Latinx communities (Rodriguez & Santiago, 2024). In 
another example, California and New York made a direct investment in 
workforce diversity initiatives and reported a 15% rate of growth in the 
number of Latinx-identified mental health professionals in public health 
settings, contributing to improved patient satisfaction and engagement 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   123   122  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

in therapy (Sanchez et al., 2024). Furthermore, organizations such as 
the National Latinx Psychological Association stepped up mentorship 
efforts, resulting in a 20% boost in Latinx applicants to graduate mental 
health training programs (American Psychological Association [APA], 
2024). These preliminary results reflect the actual returns on policy 
investment—bridging gaps and creating a more representative mental 
health workforce.  

Growth in the number of queer Latinx mental health professionals leads 
to a broader cultural shift in mental health organizations. Their presence 
disrupts the traditional Eurocentric models of therapy through the 
introduction of models that emphasize collectivism over individualistic 
values, intersectionality, and culturally affirming approaches. When 
queer Latinx mental health professionals are included as educators and 
mentors in training curricula, they equip future practitioners to work 
with diverse populations, reducing the stigma that keeps gay Latino 
men from seeking care (Gonzalez et al., 2021). Their leadership within 
health systems also fosters organizational change that promotes equity, 
including by implementing inclusive intake assessments and developing 
trauma-informed, LGBTQ+-affirmative treatment plans.

Through their influence on practice, policy, and research, queer Latinx 
mental health professionals play a radical role in reshaping mental health 
care to improve therapeutic outcomes at the individual level. They also 
instigate change at the systemic level that improves outcomes among 
broader LGBTQ+ Latinx communities.

 
POTENTIAL CRITICISMS

Cultural competence training alone cannot address the mental health 
needs of gay Latino men. Lived experience provides a higher level of 
insight that cannot be replaced with training. Queer Latinx mental health 
professionals possess a unique perspective that facilitates increased trust, 
reduces fears of cultural misunderstandings, and enhances therapeutic 
rapport (Morales et al., 2021). Evidence-based literature states that 
clients from marginalized communities are more willing to disclose 

personal problems to therapists from the same cultural background, 
leading to better treatment acceptance and outcomes (Santos & Valdez, 
2020). 

Critics argue that prioritizing representation in mental health treatment 
can enable racial or ethnic matching in ways that minimize client 
choice or put up unnecessary barriers to care. The goal is not exclusion; 
rather, it is to ensure that LGBTQ+ Latinx clients can access providers 
who understand their unique issues. The APA (2022a) emphasizes that 
representative diversity for mental health professions is a matter not 
of preference but of equity, given it directly influences disparities in 
access and quality of care. Moreover, when mental health professionals 
have meaningful cultural similarities with clients, they are better able to 
address the intersectional experience of discrimination, rejection by the 
family, and internalized stigma (Guzmán et al., 2019).

Rather than suggesting that gay Latino men can only be treated by queer 
Latinx mental health professionals, the emphasis should be placed on 
getting more such professionals into practice to ensure equal access 
to culturally competent care. By integrating recruitment and retention 
strategies for these professionals, mental health centers can move beyond 
superficial cultural competence gestures and toward a systemic approach 
that meets the needs of gay Latino men. 
 
STRATEGIES FOR INCREASING THE 
NUMBER OF QUEER LATINX MENTAL 
HEALTH PROFESSIONALS
EDUCATION AND TRAINING

Delivering culturally competent care to gay Latino males (or any other 
LGBTQ+ individuals) requires an expansion of recruitment and training 
programs for queer Latinx mental health professionals. These programs 
should prioritize the development of queer Latinx professionals in a way 
that allows them to deliver culturally competent and trauma-sensitive 
care with an understanding of intersectional identities in service delivery 
to LGBTQ+ individuals.

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   125   124  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

The inclusion of more queer Latinx professionals creates avenues for 
systems of inclusivity and equity within the profession that may inspire 
future generations and provide the profession with increasingly diverse 
perspectives. Success in these programs will depend on an inclusive 
organizational culture, external pressures like continuing education 
requirements, and strong leadership (Fish et al., 2022). Furthermore, 
mentors are imperative for supporting queer Latinx professionals in 
their career paths by offering advice and a sense of community. These 
initiatives are important in helping the mental health system become 
more inclusive and improving outcomes for LGBTQ+ Latinx clients. 
 
POLICY RECOMMENDATIONS

Recent legislation, including the Mental Health Workforce and Language 
Access Act of 2023 and the CARE for Mental Health Professionals Act, 
introduced in 2023, provides critical opportunities to advance diversity 
in the mental health workforce. The Mental Health Workforce and 
Language Access Act aims to improve language access in mental health 
care by authorizing grants to recruit professionals who speak languages 
other than English and promote culturally competent care. The CARE 
Act, if enacted, will strengthen the mental health workforce through 
practices across state lines and by including in the workforce essential 
but often marginalized groups, such as queer Latinx professionals, who 
are necessary to provide culturally sensitive care.

These acts also offer financial resources to support the recruitment and 
retention of queer Latinx students in mental health professions, creating 
more inclusive work environments. For example, professionals who are 
queer and Latinx can join institutions like the National Association of 
Social Workers (NASW) or the APA, either individually or in groups, 
to advocate for policy changes. They may also be able to secure grants 
to promote diversity within the mental health workforce overall and 
specifically within their profession.

In this vein, organizations and authorities can make a significant 
impact by implementing concrete initiatives focused on attracting and 

retaining queer Latinx professionals. Pipeline programs such as Mental 
and Behavioral Health Education and Training and the Health Careers 
Opportunity Program, both funded by the U.S. Health Resources and 
Services Administration, have successfully recruited underrepresented 
groups into health careers through financial aid, culturally sensitive 
training, and mentorship (Nivet et al., 2016). Meanwhile, more far-
reaching enforcement of laws offering incentives to hire bilingual and 
bicultural mental health therapists could lead to gains like those seen in 
New York and California. Active hiring and retention focus on expanding 
mental health care system services, similar to international initiatives like 
Canada’s Promoting Health Equity: Mental Health of Black Canadians 
Fund (Public Health Agency of Canada, 2023). These examples indicate 
the need for collaboration between educational institutions, government 
agencies, and professional organizations to facilitate a diverse workforce. 
 
COUNTERING ANTI-DEI EFFORTS

Despite recent anti–diversity, equity, and inclusion (DEI) efforts, 
such as the U.S. administration’s rescissions of federal funding, there 
remains potential—and a necessity—to continue with policies that 
enable the recruitment and retention of queer Latinx mental health 
professionals. Some state and federal organizations and nonprofits can 
still independently implement internal policies to promote workplace 
diversity (Williams et al., 2023). The NASW and the APA can enhance 
scholarship and mentorship programs aimed at underrepresented groups 
without intervention from the government. Foundations such as the 
Robert Wood Johnson Foundation and KFF remain committed to healthy 
equity programs that facilitate hiring and retaining diverse mental health 
practitioners (García & Hardy, 2024).

Public agencies may face legal and political difficulties in embracing 
explicit DEI efforts, but they can prioritize inclusive recruitment in other 
ways. For instance, language-access policies remain legally permitted 
under Title VI of the Civil Rights Act of 1964, and clinics and hospitals 
can rationalize the hiring of bilingual and bicultural providers as a 
requirement for effective patient care (Sanchez et al., 2022). Similarly, 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   127   126  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

belonging, and access to vital support as individuals navigate their 
sexual and cultural identities. Through activists, local LGBTQ+ 
organizations provide safe spaces, counseling, peer support, and 
educational workshops, all specifically geared toward the needs of gay 
male Latinos. By addressing stigma, these resources help create an 
environment where individuals can thrive and reach their full potential. 
This is further supported by local programs, including pride movements, 
cultural festivals, and affirming church services, that provide LGBTQ+ 
individuals with opportunities for connection and mutual support. These 
spaces also enable discussions on salient issues affecting gay Latino 
males. 

Family support is also crucial. When families are accepting, it can 
have a significantly positive impact on a person’s mental health. 
Educating family members on LGBTQ+ issues and calling for free, 
open conversations will cultivate understanding and close these gaps—
specifically, the lack of culturally informed understanding about sexual 
identity, mental health stigma, and misconceptions rooted in traditional 
values. Collaborations among mental health workers, community 
organizations, and local advocates are necessary to develop effective 
support systems: These partnerships enable the creation of culturally 
relevant programs and services that address the diverse needs of gay 
Latino men, helping them build confidence and resilience in their 
identities. 

Community organizations serve an immensely important function in 
the mental health of gay Latino men through a myriad of services: peer 
mentoring, advocacy, and legal support. In this light, peer mentoring 
programs offer them the opportunity to interact with others who may 
share similar experiences and provide advice to alleviate loneliness. 
Advocacy efforts led by community organizations help reduce stigma 
and promote systemic changes to guarantee LGBTQ+ people’s rights 
and access to care, These organizations may also provide legal support, 
particularly in cases involving discrimination or immigration, which may 
be harmful to mental health (Meyer, 2003). Successful collaborations 
between mental health providers and community organizations have 

some states with strong labor protections, like California and New 
York, have persisted in promoting the hiring of diverse mental health 
professionals even in the wake of shifting federal policies (Rodriguez 
& Nguyen, 2024). Other health institutions have also embraced DEI 
principles within cultural competency and workplace development, 
giving programs new titles to suit evolving legal mandates while 
retaining their impact. 

For job seekers pursuing employment in mental health programs amid 
anti-DEI efforts, personal narratives and anecdotes remain powerful 
weapons. Most organizations continue to allow personal statements in 
resumes, where job seekers can articulate how their own experiences and 
unique identities serve the field. This allows queer Latinx job seekers 
to highlight the strengths of their backgrounds and activism without 
explicitly using DEI terminology (Perez et al., 2023). Lastly, professional 
networks within affinity groups such as the National Latino Behavioral 
Health Association or the LGBTQ+ Health Equity Initiative (American 
Public Health Association) can establish systems of support independent 
of formal DEI efforts so that mentorship and community-building are 
sustained no matter the policy shifts. 

As DEI policy is increasingly curtailed, policymakers, advocacy 
organizations, and mental health institutions must come together in 
pursuit of flexible solutions for serving underrepresented professionals. 
With access to private funding, legal defense of language access policies, 
and narrative capacities in hiring and admission processes, stakeholders 
can continue to incentivize a diversified mental health workforce. 
These efforts not only circumvent anti-DEI policies but also affirm the 
determination and priority of representation in mental health care. 

COMMUNITY ENGAGEMENT AND SUPPORT

Community engagement and support resources help heal and validate 
the experiences of gay Latino men, particularly in fostering positive 
sexual identity development. These resources offer encouragement, 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   129   128  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

services, typically because of language barriers, lack of enough 
culturally competent providers, and fears of discrimination in healthcare 
centers (Crisp & McCave, 2007). As such, the population tends to 
have disproportionately high rates of depression, anxiety, and suicidal 
ideation. Yet despite these issues, the current mental health system 
remains considerably unresponsive to them. 

Queer Latinx mental health professionals are crucial to closing these 
gaps. Due to their identity, they can build credibility, provide culturally 
affirming treatment, and validate the sexual identities of gay Latino men 
in ways that traditional practitioners cannot. They can provide affirmative 
therapy without fear of rejection. Furthermore, their policy campaigning 
and research help supplement institutional initiatives toward culturally 
sensitive and adaptive mental health interventions addressing Latinx 
LGBTQ+ issues. 

However, such progress is under immediate threat by the current 
presidential administration’s reversal of DEI policies. Diversification of 
mental health personnel is being undone through funding policies that 
limit culturally competent training and discourage hiring queer Latinx 
mental health professionals. The trend places affirming care out of reach 
and exacerbates the existing disparities in mental health care, particularly 
among already underresourced, marginalized communities. Without 
active resistance, these political measures will create further significant 
barriers to care for gay Latino men. 

More urgently than ever, schools, policymakers, and community-based 
organizations must move to protect and expand programs that support 
queer Latinx mental health professionals. That involves maintaining 
pipeline initiatives, advocating for funding protections, and creating 
community-based interventions that provide direct support to LGBTQ+ 
Latinx individuals. Representation in mental health care is not a 
privilege; it is a necessity. Investing in representation ensures that the 
next generations of gay Latino men receive the culturally affirming care 
they will need. 

shown that culturally relevant care works. For example, joint efforts 
between LGBTQ+ community centers and healthcare providers have 
established various culturally adapted programs and workshops for 
counseling, where issues like internalized homophobia and identity 
development can be evaluated in a nonjudgmental setting (Crisp & 
McCave, 2007). This helps build a continuous network of support where 
the mental, emotional, and legal needs of gay male Latinos are addressed.

Case studies of LGBTQ+-affirming community interventions offer proof 
of the positive impact of these programs for gay male Latino mental 
and health outcomes. For instance, O’Donnell, Sánchez, and Grant 
(2021) explored the role of mentoring in Latinx adolescents, and they 
demonstrated that mentoring can build trust and improve psychological 
well-being, such as lowering anxiety and depression. The contribution of 
their work was that it found positive mentoring relationships to be best 
in fostering self-esteem and emotional resilience among Latinx youth, 
including sexuality minority youth. Another study, Familias con Orgullo, 
had a family center intervention focus to improve communication and 
eradicate depressive symptoms among Latinx sexual minority youth 
(Estrada et al., 2024). The intervention, by the way of family counseling 
and education, helped families become more accepting of their LGBTQ+ 
children and reduce mental health problems such as depression. These 
studies emphasize the importance culturally appropriate interventions to 
enhance mental health and reduce internalized homophobia, loneliness, 
and conflict in interpersonal relationships among gay Latino men. 
 
CONCLUSION
Psychological well-being issues in gay Latino men are products of 
intersecting economic, cultural, and structural barriers that render sexual 
identity complex to form. Cultural values of familismo, machismo, 
and caballerismo, combined with religious conservatism, result in 
internalized homophobia, family rejection, and financial inequalities. 
There is also a limit to gay Latino men’s ability to seek affirmative 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   131   130  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

REFERENCES 

Aguilar-Gaxiola, A., Loera, G., Méndez, L., & Sala, M. (2012). Community-defined solutions for 
Latino mental health care disparities: California Reducing Disparities Project, Latino Strategic 
Planning Workgroup population report. UC Davis. https://health.ucdavis.edu/media-resources/
crhd/documents/pdfs/community-defined-solutions-latino-mental-health-care-disparities-exec-
summary.pdf

American Psychological Association (APA). (2022a). Demographics of the U.S. psychology 
workforce: Findings from the 2021 National Workforce Survey. https://www.apa.org/workforce/
data-tools/demographics

APA. (2022b). Equity, diversity, and inclusion in psychology: Addressing disparities in mental health 
care. APA Press.

American Psychological Association (2024). Diversity, equity and inclusion strategic plan. https://
www.psychiatry.org/getmedia/174552a4-fadf-43f0-b816-4abf3ff81ca2/APA-DEI-Strategic-Plan.
pdf

Bachelor, A. (1995). Clients’ perception of the therapeutic alliance: A qualitative analysis. Journal of 
Counseling Psychology, 42(3), 323–337. https://doi.org/10.1037/0022-0167.42.3.323

Bhui, K., Warfa, N., Edonya, P., McKenzie, K., & Bhugra, D. (2007). Cultural competence in mental 
health care: A review of model evaluations. BMC Health Services Research, 7(15), 1–10. https://
doi.org/10.1186/1472-6963-7-15

Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. 
Psychotherapy: Theory, Research & Practice, 16(3), 252–260. https://doi.org/10.1037/h0085885 

Butler, J. (1990). Gender trouble: Feminism and the subversion of identity. Routledge. 

Camarena, J., & Rutter, P. A. (2015). Decolonizing sex: A multicultural and gay affirmative approach 
to counseling with African American and Latino men who have sex with men. Journal of LGBT 
Issues in Counseling, 9(1), 57–68. https://doi.org/10.1080/15538605.2014.997330 

Cass, V. C. (1984). Homosexual identity formation: Testing a theoretical model. Journal of Sex 
Research, 20(2), 143–167. https://doi.org/10.1080/00224498409551214 

Cerezo, A., Camarena, J., & Ramirez, A. (2020). Latinx sexual and gender minority mental health. 
In E. Rothblum (Ed.), The Oxford handbook of sexual and gender minority mental health (pp. 
186–198). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780190067991.013.17 

Crisp, C., & McCave, E. L. (2007). The application of queer theory to anti-oppressive social work 
practice. Affilia, 22(1), 33–44. 

Cutshall, C. (2024). The case for curanderismo: A path to culturally competent healthcare for 
Hispanic populations in the U.S. The Agora, 2(1). https://agora.scholasticahq.com/article/116876-
the-case-for-curanderismo-a-path-to-culturally-competent-healthcare-for-hispanic-populations-in-
the-u-s

Dawes, H. C., Williams, D. Y., Klein, L., Forte, A. B., Gibbs, D. J., Wood, B., Hirst, L. E., & Hall, 
W. J. (2023). Experiences of queer people of color in mental health care and substance use 
treatment: A systematic review. Journal of the Society for Social Work and Research, 14(3), 
721–755. https://doi.org/10.1086/721454 

This work is not just about statistics, policy changes, or workforce 
development—it is about real people. It is about a young Latino boy 
sitting in church, praying for his socially unacceptable feelings to 
disappear. It is about a teenager who rehearses his coming-out speech a 
hundred times but never finds the courage to say it aloud. It is about the 
man who has spent years hiding, only to realize he has been hiding from 
himself. These individuals deserve to see mental health professionals 
who understand and affirm them, and a world that embraces them. This 
paper is a call to action, a plea to ensure that no gay Latino man ever 
feels alone in this journey.

At last, mereces todo lo bonito—you deserve everything beautiful. Gay 
Latino men deserve mental health care that understands them, honors 
their struggles, and supports them toward healing. A fortification of queer 
Latinx mental health professionals’ visibility is not just a move toward 
equity—it is a prerequisite for justice. The fight for representation in 
mental health persists, to ensure that every single one of those individuals 
has access to practitioners who fully understand and care for them.

“There are millions of us, and we’re strong and we’re loved. You 
don’t have to sacrifice being Latino or being LGBT to be part of both 

communities.”—Ruben Gonzales
 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   133   132  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

Díaz, R. M., Ayala, G., Bein, E., Henne, J., & Marin, B. V. (2001). The impact of homophobia, 
poverty, and racism on the mental health of gay and bisexual Latino men: Findings from 
three U.S. cities. American Journal of Public Health, 91(6), 927–932. https://doi.org/10.2105/
AJPH.91.6.927 

Díaz, R. M., Ryan, G. W., & Sánchez, J. (2022). The impact of intersectional discrimination on 
mental health among Latino gay men. American Journal of Public Health, 112(5), 734–742.

Duarté-Vélez, Y., Bernal, G., & Bonilla, K. (2010). Culturally adapted cognitive-behavior therapy: 
Integrating sexual, spiritual, and family identities in an evidence-based treatment of a depressed 
Latino adolescent. Journal of Clinical Psychology, 66(8), 895–906. https://doi.org/10.1002/
jclp.20710

Estrada, Y., Lozano, A., Tapia, M. I., Fernández, A., Harkness, A., Scott, D., Lee, T. K., Rahman, 
A., & Prado, G. (2024). Familias con Orgullo: Pilot Study of a Family Intervention for Latinx 
Sexual Minority Youth to Prevent Drug Use, Sexual Risk Behavior, and Depressive Symptoms. 
Prevention science : the official journal of the Society for Prevention Research, 25(7), 1079–1090. 
https://doi.org/10.1007/s11121-024-01724-4 

Fish, J. N., King-Marshall, E. C., Williams, N. D., Aparicio, E. M., Tralka, H. M., & Boekeloo, B. O. 
(2022). What motivates community mental and behavioral health organizations to participate in 
LGBTQ+ cultural competency trainings? American Journal of Orthopsychiatry, 92(6), 647–656. 
https://doi.org/10.1037/ort0000641 

Flórez, K. R., Abbu, K. A., Hossain, F., Wills, A., & Breslau, J. (2021, June 8). A meta-analysis 
of mental health among Latino adults: Elucidating disparities from differences. medRxiv 
2021.06.04.21255741. https://doi.org/10.1101/2021.06.04.21255741 

Furman, R., Negi, N. J., Iwamoto, D. K., Rowan, D., Shukraft, A., & Gragg, J. (2009). Social work 
practice with Latinos: Key issues for social workers. Social Work, 54(2), 167–174. https://doi.
org/10.1093/sw/54.2.167 

Garcia, B. C. (2014). The development of a Latino gay identity (2nd ed.). Routledge.

García, E., & Hardy, T. (2024). Health equity investments in mental health: Strategies for inclusive 
workforce development. Journal of Public Health Policy, 45(1), 78–92.

Gerena, C. E. (2021a). The coming out experience of Latino gay men. Families in 
Society: The Journal of Contemporary Social Services, 104(2), 101–110. https://doi.
org/10.1177/10443894211039836

Gerena, C. E. (2021b). Navigating culture and sexuality: What social workers need to know. Journal 
of Ethnic & Cultural Diversity in Social Work, 32(5), 261–267. https://doi.org/10.1080/15313204
.2021.1986447 

Gerena, C. E., & Rodriguez, J. (2023). Latino gay men asylum seekers and their mental health. 
Journal of Ethnic & Cultural Diversity in Social Work, 1(6). https://doi.org/10.1080/15313204.20
23.2286458 

Gonzalez, L. M., Pérez, R. M., & Torres, A. (2021). Culturally affirming mental health interventions 
for Latinx LGBTQ+ populations: A clinical framework. Journal of Latinx Psychology, 9(3), 
212–228.

Guzmán, R., Chávez, K., & Rivera, L. (2019). Intersecting identities in psychotherapy: The impact 
of shared cultural experiences on treatment outcomes. Journal of Latinx Psychology, 7(2), 
112–129.

Han, C., & Ayala, G. (2018). Racialized sexual discrimination and mental health among Latino gay 
and bisexual men. Culture, Health & Sexuality, 20(1), 1–15.

Harper, G. W., Wade, R. M., & Pass, K. M. (2016). LGBTQ people of color. In A. E. Goldberg (Ed.), 
The SAGE encyclopedia of LGBTQ studies (2nd ed., pp. 706–710). SAGE Publications.

Heasley, R., & Crane, B. (2003). Sexual lives: A reader on the theories and realities of human 
sexualities. McGraw-Hill.

Hinrichs, K. L. M., & Donaldson, W. (2017). Recommendations for use of affirmative psychotherapy 
with LGBT older adults. Journal of Clinical Psychology, 73(8), 945–953. https://doi.org/10.1002/
jclp.22505 

Johnson, C. M., Sharkey, J. R., Dean, W. R., St John, J. A., & Castillo, M. (2013). Promotoras as 
research partners to engage health disparity communities. Journal of the Academy of Nutrition 
and Dietetics, 113(5), 638–642. https://doi.org/10.1016/j.jand.2012.11.014 

Johnson, S. D. (2012). Gay affirmative psychotherapy with lesbian, gay, and bisexual individuals: 
Implications for contemporary psychotherapy research. American Journal of Orthopsychiatry, 
82(4), 516–522. https://doi.org/10.1111/j.1939-0025.2012.01180.x 

Keefe, J. R., Rodriguez-Seijas, C., Jackson, S. D., Bränström, R., Harkness, A., Safren, S. A., 
Hatzenbuehler, M. L., & Pachankis, J. E. (2023). Moderators of LGBQ-affirmative cognitive 
behavioral therapy: ESTEEM is especially effective among Black and Latino sexual minority 
men. Journal of Consulting and Clinical Psychology, 91(3), 150–164. https://doi.org/10.1037/
ccp0000799 

Le, T. P., Teran, M., & Wang, M. Q. (2024). Latinx sexual minority men, psychological well-
being, racial sociopolitical involvement, and discomfort in LGBT community. Journal of Latinx 
Psychology, 12(1), 63–78. https://doi.org/10.1037/lat0000242 

Levy, D. L. (2009). Gay and lesbian identity development: An overview for social workers. 
Journal of Human Behavior in the Social Environment, 19(8), 978–993. https://doi.
org/10.1080/10911350903126866

McGregor, B., Belton, A., Henry, T. L., Wrenn, G., & Holden, K. B. (2019). Improving behavioral 
health equity through cultural competence training of health care providers. Ethnicity & Disease, 
29(2), 359–364. https://doi.org/10.18865/ed.29.s2.359 

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual 
populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. 
https://doi.org/10.1037/0033-2909.129.5.674 

Morales, E. S., Corbin-Gutierrez, E. N., & Wang, S. C. (2012). The role of fathers in the 
psychological well-being of gay Latino men: Navigating cultural expectations and identity 
acceptance. Journal of Latino Psychology, 1(1), 1–15. 

Morales, J., García, E., & López, M. (2021). Culturally responsive therapy for LGBTQ+ Latinx 
clients: Bridging the gap between need and access. Journal of Multicultural Counseling and 
Development, 49(4), 287–305.

Morales-Chicas, J., & Cokley, K. (2021). Family acceptance and mental health among Latino 
LGBTQ+ individuals: The role of cultural values. Journal of Multicultural Counseling and 
Development, 49(1), 22–38.

Moyce, S., Thompson, S., Metcalf, M., Velazquez, M., Aghbashian, E., Sisson, N., & Claudio, D. 
(2022). Rural Hispanic perceptions of mental health: A qualitative study. Journal of Transcultural 
Nursing, 33(3), 346–354. https://doi.org/10.1177/10436596211070592 

MERECES TODO LO BONITO XAVIER SALAS



COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII  |   135   134  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXIII

National Center for HIV, Viral Hepatitis, STD, and TB Prevention. (2021). Youth risk behavior 
surveillance system (YRBSS) data summary & trends report: 2011-2021. Centers for Disease 
Control and Prevention. https://stacks.cdc.gov/view/cdc/124928/cdc_124928_DS1.pdf

Nivet, M. A., Castillo-Page, L., & Conrad, S. S. (2016). A diversity and inclusion framework 
for medical education. Academic Medicine, 97(1), 1031. https://doi.org/10.1097/
acm.0000000000001120 

Nuñez, A., González, P., Talavera, G. A., Sanchez-Johnsen, L., Roesch, S. C., Davis, S. M., 
Arguelles, W., Womack, V. Y., Ostrovsky, N. W., Ojeda, L., Penedo, F. J., & Gallo, L. C. (2016). 
Machismo, marianismo, and negative cognitive-emotional factors: Findings from the Hispanic 
Community Health Study/Study of Latinos Sociocultural Ancillary Study. Journal of Latina/o 
Psychology, 4(4), 202–217. https://doi.org/10.1037/lat0000050 

Ocampo, A. C. (2013). The gay second generation: Sexual identity and family relations of Filipino 
and Latino gay men. Journal of Ethnic and Migration Studies, 40(1), 155-173. https://doi.org/10.1
080/1369183x.2013.849567 

O’Donnell, A. J., Sánchez, B., & Grant, K. E. (2021). Latinx adolescents’ trust in adults: A precursor 
to psychological well-being via mentoring relational quality and self-esteem. Journal of 
Community Psychology. https://doi.org/10.1002/jcop.22748 

Perez, M., Solis, C., & Rivera, J. (2023). The power of narrative: How personal stories shape 
admissions and hiring in the face of DEI rollbacks. Journal of Diversity in Higher Education, 
16(3), 211–227.

Public Health Agency of Canada (2023). Promoting Health Equity: Mental Health of Black 
Canadians Fund. Government of Canada. https://www.canada.ca/en/public-health/services/
funding-opportunities/grant-contribution-funding-opportunities/promoting-health-equity-mental-
health-black-canadians-fund.html

Rivera, D. B., Brady, J. P., & Blashill, A. J. (2021). Traditional machismo, caballerismo, and the pre-
exposure prophylaxis (PrEP) cascade among a sample of Latino sexual minority men. Journal of 
Sex Research, 58(1), 21–28. https://doi.org/10.1080/00224499.2020.1743961

Robles, Y. P., Page, K. R., Krawczyk, N., Bucay-Harari, L., & Castillo-Salgado, C. (2020). Mental 
health needs of an emerging Latino community. The Journal of Behavioral Health Services & 
Research, 47(3), 388–398. https://doi.org/10.1007/s11414-020-09688-3 

Rodriguez, D., & Nguyen, P. (2024). State-level resilience in DEI policy: Examining workforce 
incentives in California and New York. Policy & Politics, 52(2), 134–150.

Rodriguez, M., & Santiago, J. (2023). Advancing diversity in the mental health workforce: The role 
of policy in shaping inclusive care. American Journal of Public Health, 113(5), 401–409.

Rodriguez, M., & Santiago, J. (2024). The impact of the mental health workforce and language 
access act on bilingual mental health services. Journal of Public Health Policy, 45(2), 112–128. 

Rosenberg, B. A., Dillon, F. R., Eklund, A., & Ebersole, R. (2024). Traditional machismo, 
caballerismo, and sexual identity development among Latino sexual minority men. Journal of 
Latinx Psychology, 12(4), 362–374. https://doi.org/10.1037/lat0000259 

Salas, L. M., Radcliffe, J., & D’Augelli, A. R. (2023). Double minority stress and mental health 
outcomes among Latinx sexual minorities. Journal of Latinx Psychology, 11(2), 125–140.

Salgado, C., Rivera, J., & Lopez, D. (2022). Intersectional approaches to LGBTQ+ Latinx mental 
health: Expanding research and practice. Journal of LGBTQ Issues in Counseling, 16(2), 98–117.

Sanchez, B., Lopez, A., & Torres, R. (2022). Language access as a civil right: Implications for 
mental health workforce policies. Journal of Health Disparities Research and Practice, 15(4), 
89–105.

Sanchez, B., Lopez, A., & Torres, R. (2024). Workforce diversity initiatives and their effect on 
Latinx representation in mental health professions. Journal of Health Disparities Research and 
Practice, 16(1), 89–105. 

Santos, C. E., & VanDaalen, R. A. (2016). The associations of racial/ethnic discrimination and 
LGBT-related discrimination with mental health: A prospective intersectional approach. Journal 
of Counseling Psychology, 63(5), 531–542.

Santos, R., & Valdez, M. (2020). Barriers and facilitators to mental health care among queer Latinx 
individuals: The role of therapist cultural competence. Journal of LGBT Issues in Counseling, 
14(3), 198–215.

Tajón, M. M. (2009). Identity development of Latino gay men [Doctoral dissertation, Antioch 
University]. https://aura.antioch.edu/etds/128 

Valdivieso-Mora, E., Peet, C. L., Garnier-Villarreal, M., Salazar-Villanea, M., & Johnson, D. K. 
(2016). A systematic review of the relationship between familism and mental health outcomes 
in Latino population. Frontiers in Psychology, 7(1632), 1–13. https://doi.org/10.3389/
fpsyg.2016.01632 

Velez, B. L., Moradi, B., & DeBlaere, C. (2019). Discrimination, oppression, and health outcomes 
among Latinx sexual minorities: A systematic review. The Counseling Psychologist, 47(3), 
307–345.

Wade, L., & Ferree, M. M. (2015). Gender: Ideas, interactions, institutions. W. W. Norton. 

Williams, K., Patel, R., & Chang, Y. (2023). The future of DEI in mental health: Navigating 
policy changes and institutional responses. American Journal of Community Psychology, 62(4), 
301–319.

Yarber, W. L., & Sayad, B. W. (2018). Human sexuality: Diversity in contemporary America (10th 
ed.). McGraw-Hill. 

Zea, M. C., Reisen, C. A., & Bianchi, F. T. (2003). Barriers to accessing mental health services 
among Latino sexual minorities. Psychology of Sexual Orientation and Gender Diversity, 7(4), 
452–463.

MERECES TODO LO BONITO XAVIER SALAS


