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Background This article identifies the roles that gay men with depression ascribe to their chosen general practitioner and considers how they might influence the dynamics of clinical interactions between gay men and their doctors. Methods Forty gay identified men with depression (recruited from high HIV caseload general practices in New South Wales and South Australia) took part in semistructured interviews that were analysed using the principles of thematic analysis. Seventeen men (aged 20–73 years) were HIV positive. Results Five distinct roles were identified: GP as trusted confidant, gentle guide, provider of services, effective conduit, and community peer. Discussion Gay men who have ongoing contact with their GP may expect them to intuitively understand which roles are expected and appropriate to perform in each consultation and over time. General practitioners should consider these changing roles, and take them into account (as appropriate) to achieve open and trusting relationships in the care of their gay male patients.