The sexual dysfunction problems I see among homosexual men are very similar to those experienced by heterosexual men. Homosexual men though have traditional factors at play that may make overcoming a sexual problem in a partnered situation more difficult than for a heterosexual male in his traditional relationship.
If a gay man has difficulty achieving an erection or experiences premature ejaculation, and he travels in circles that pursue a promiscuous lifestyle, anxiety about his sexual dysfunction in that environment makes it very difficult for him to perform.
For premature ejaculation, for instance, I prescribe self-stimulation exercises to help men overcome their problem by themselves first, with the goal to then incorporate their partner into helping them transition into a more successful, partnered, sexual experience. With men in an intimate relationship, gay or straight, that is a quite easy transition. Partners take the time and engage in emotionally and physically intimate acts to create sexual arousal and desire and learn to dial up that arousal together gradually to achieve a longer lasting arousing sexual experience with each other.
Even in superficial heterosexual dating situations it is often possible to practice the transition from self-stimulation exercises to partner involvement without the partner even knowing that that is what is happening. For gay men, however, who expect to transition their new arousal modulation skills to casual dating or in semi-public places with people watching, I problem solve to identify appropriate transitional practice opportunities that will help them build confidence and remove the problem once and for all.