This is kind of at the intersection of 2 genres I seldom read: non-fiction about LGBT issues, and popular psychology. The former genre is something I've just never paid much attention to, the latter is something I've actively ignored from my own snobby contempt (I still remember rolling my eyes every afternoon as a kid when my mom would put on Oprah).
Anyway, the basic underlying assumption of this book-- that gay men specifically have a spate of psychological issues which follow them throughout the full duration of their lives, not from being gay, but from everything around being gay, i.e. hiding a part of yourself, the sense of woundedness and insecurity and shame and confusion and really, just intense anger which that hiding brings on, and which is NOT addressed or remedied or really in anyway even sincerely acknowledged even after most gay men come out of the closet... that basic premise, is in my opinion, valid.
What Downs is pointing to in this book is the numerous ways that those dark, deeply embedded emotions can well up throughout a gay man's life (even in the lives of guys who have been out for decades and who have very seemingly happy, succesful lives) in ways which are destructive both to himself and to those around him. To be sure, this is a hopelessly essentialist view of gay life (more on that in a bit), yet, speaking as a gay man, I found that the early parts of the book, which describe some of the major emotional swings which young gay men move through, to be frighteningly and I mean FRIGHTENINGLY accurate, especially describing what it's like emotionally for most males up to the time when they completely realize they are gay. There were moments when reading this I physically shuddered being reminded of what it's like to be deeply in denial and profoundly closeted, as much to yourself as to the world around you. The first third of this is going to probably be a deeply insightful but also deeply unfun trip down memory lane for most young gay men who read it.
Unfortunately, the second two parts of the book, which recount the "stages" (it wouldn't be pop psychology without "stages" would it?) which out gay men go through becomes far too narrow a descriptive filter, at least in my opinion. I can maybe, maaaaaybe buy the idea that the psychological experience for most (probably not all) guys being a kid and growing up in the closet at least has a few common emotional themes which you could reasonably generalize about. Maybe. But life is just vastly more complicated than his cute little 3 stage schema, and there are profound cultural and socio-economic pressures which obviously can't really be hinted at in a work like this.
In fact, the socio-economic (really, the generational) issue of this book is probably the strongest mark against it. Downs himself has had a lucrative, deeply successful career, in the corporate world (he's an 80's child, afterall), as a therapist and as a writer, even when in the throws of personal tragedy as he reveals in the books kind of obnoxious pseudo-memoirish final chapter.
Downs is a high priced therapist for "powergays;" gay men who have a lot of disposable income to burn, who own multiple houses stocked with nice things and who take regular vacations to exotic locales. This is obviously a cliche, but almost every "story" and example in his book features gay men who are, from the point of view of an educated gay millennial currently struggling to find a career path that will even pay a humane wage, so obscenely well-off as to be almost repulsive, and Downs himself reinforces the idea of this obscene wealth on almost every page. It's almost like he's gloating at the rarified social circles he travels in and the high powered management and exective types that he treats. Obviously, a lot of that is generational; this book feels like it was written by someone for whom the last 10-15 years of socio-economic history in this country simply never happened to. I can't imagine someone in his position even realizing that many young gay men in this country will probably never be able to afford to purchase a single home, much less multiple ones in sheik locales.
His sheer inability to consider any outside factor in his analysis of what plagues gay men is of course a necessity of the genre he's writing in, but it's also just so incredibly limited and so patently ignorant of how our countries socio-economic insecurity can contribute to individual insecurity, especially for young gay men (who as he smartly points out, aren't generally the most secure people to begin with) is a depressing omission. Parts of his observations are brilliant and scathing, but enough of it seems so utterly out of touch with modern American socio-economics, really with any kind of material consideration for the generation of gay men who are coming up behind him, and who have a litany of economic anxieties to worry about on top of all the dense psychological baggage of being gay, that the book ultimately fails to persuade very much once it gets past "stage 1." Forget finding the gay Oprah, what we need is the gay Karl Marx.