An improved understanding of the psychosocial experience of Men who have Sex with Men (MSM) is crucial for creating a scientific reference base for intervention strategies. A study of the coping responses of MSM suggests that most find it difficult to find a comfortable fit between their psychological and emotional needs and the demands of their social environment. This often leads to different stresses in the life course of MSM which demand specific coping strategies. This paper is organized around psychosocial aspects over which MSM experience stress and their coping responses. It is based on a study of 250 case studies of MSM and 4 Focus Group Discussions (FGDs). The paper discusses multiple stressors such as awareness of one’s sexuality, first sexual experience, pressure of marriage, labeling and comments from others, and partner’s marriage. It discusses generic coping responses such as internalization of homophobia as a result of self hatred and unacceptability of one’s sexuality in society, seeking information on sexuality from peers, networks with support groups, coming out, tolerance of discrimination & abuse, accept/neglect labels, social isolation, multiple sexual partners and addictions. It also identifies common emotional responses such as shame, guilt and secrecy of one’s sexuality, fear of being exposed, self hatred, confusion with identity and depression.