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The paper is aimed at contributing to an empirically grounded understanding of the psychosocial dynamics that underlie the relation between heteronormative images of masculinity, internalized heterosexism and health behavior of gay men in the global North. It is based on a qualitative interview study that focuses on the consequences of the internalization of dominant images of masculinity for the identity constructions of gay men and their HIV-related sexual risk behavior in Germany. In the paper it will be argued that 1) the tension between the authoritative image of masculinity that is determined by heteronormative discourses one the one hand and the gendered self-image that is shaped and threatened by connotations of a non-masculine homosexuality on the other constitutes a decisive issue of gay identity constructions, 2) a higher sexual risk behavior can be understood as a possible consequence of the internalization of masculine images and its impact on the self-esteem, if the self-image does not match the male ideal, and 3) this may include a paradoxical desire for the imagined masculinity that is experienced as violent with regard to one’s own psychodynamics. Finally, perspectives on gay masculinities that may transgress dominant heteronormative modes of subjectification are discussed.