IN A CITY of erotic permission and sexual shape-shifting, it is easy to suppose that a sort of utopia has now been achieved and that sexual shame is a relic of a less-enlightened past. I am not sure that this utopia of eros came close to being realized even in the city's wilder decades; I am sure that the San Francisco we find ourselves in today is a drastically different town – richer and stuffier, its erotic culture largely a self-parody and its bohemianism consisting mainly of ritual and reflex, as in a parade or mime show – from the city whose cheap housing and Barbary Coast aura attracted misfits, beats, and off-beats in the rise-of-suburbia decades following the close of World War II.

Chief among those immigrants, of course, were the sexual outsiders who came to be known as gay. Gay was no better than an awkward word even at the height of its usage and influence 20 years ago, and – at least as an aesthetic matter – one did not mind its being superseded by such livelier terms as queer and homo, or folded into acronyms like the graceless-though-inclusive LGBT, as the 1980s melted into the 1990s. Still, gay meant and continues to mean something those other formulations do not, and when the word is used naturally and without apology or qualification, as in Alan Downs's excellent new book The Velvet Rage: Overcoming the Pain of Growing Up Gay in a Straight Man's World (Da Capo, $23), we are reminded that gay tells a story of identity that rises like a rock from the sloshing, misty bogs of moment-to-moment sex acts.

Gay, though nominally a sex-neutral descriptor, carries a strong connotation of maleness, and Downs, a clinical psychologist, is quite plain about addressing himself to men – to gay men, whose difficult journey from secretive shame to self-acceptance and authenticity he believes to be "universal ... in the western world and perhaps across the globe." Shame is not without social value, of course – if it were, we would not need the word shameless – but there is an immense difference between shame for doing and shame for being. People should regret and repent their wicked deeds, but people who are taught to be ashamed of who they are have been poisoned. To make matters worse, the poison of homophobia is administered at the dawn of life, when it does the greatest and most lasting harm, and it is usually administered by the people a boy cannot help but love and trust, his parents – in particular his father, that primary and haunting model for all boys of what it means to be a man.

It is no surprise, then, that The Velvet Rage is a chronicle of furtive pathos, anger, compensatory fabulousness, despair, sex addiction, and flickerings of hope as its wounded actors make their way by uncertain stages toward a light of authenticity and self-acceptance their culture does not want them to find or even see. In its pages, through anecdotal moments and analytical passages, one is constantly catching glints of people one has known, behaviors one has seen and heard firsthand and often been baffled and hurt by. "Those to whom evil is done / Do evil in return" (Auden's great line from his poem "September 1, 1939") tells us with succinct eloquence the self-evident truth that damaged people who embark on intimacies with other damaged people are likely to find themselves not in bliss but in an environment of exponentially amplified damage: a war zone.

It is a wonder, given this simple, fearsome psychological math, that gay men find any kind of satisfaction and stability in life. Yet many do. Although acknowledging and accepting one's homosexuality has long been (and, despite much phony, self-congratulatory liberalism among baby-boom parents, I suspect remains) an extended test of strength and will against the forces of masculine convention, victory arrives for the determined and the lucky as liberation: freedom from the tyranny of believing that real men can feel and do this but not that; freedom from the fear of being found out as somehow inadequate and bounced from the club of real men by other equally insecure (and savage) real men. Not everyone finds his way to liberation, but far more do than any sober social scientist would dare predict. This is testament to some great capacity in the human heart, some mix of love, courage, blind stubbornness, and resiliency that gay men find because we must find it.

Becoming a man – whatever a man might be – is nice enough, a modest transitional triumph, but the real and much more difficult business for males is to become human beings: emotionally literate, empathetic, self-governing through self-awareness instead of conforming to pack pressure. Downs doesn't quite put it this way, and much of The Velvet Rage makes for somber reading, but it is clear he does not believe all the suffering of gay men must be in vain. The romance of misery is a game for the young, but suffering does deepen understanding, and the understandings it brings, the sympathies for the sufferings of others unlike yet like us are earned and cannot be taken away. Whether we are men or women, those understandings make us human.