FOR THE MEN (scroll down for the women’s guide)
“At the moment, I have a great doctor,” says Orlando catalog director Kevin Bee. “We can talk about anything. And we do.”
Bee has avoided a situation that plagues many gay men: how much of our personal lives and sexual history should we share with our doctors? It’s true that specific health concerns occur more frequently in the gay community. These possible problems really should be discussed with medical professionals.
However, coming out to the family doctor is fraught with complications. In urban areas, it’s easier to find gay-friendly medical professionals—people can check local gay publications like Watermark, or go online a search for one. In rural areas—especially areas where your family is also present—the fear can keep some gay men in the medical closet, despite laws that prevent medical staff from divulging patient information.
In fact, Bee opened up to his doctor for purely personal reasons: “I just wanted to be able to answer a potential partner with the correct information.”
It has apparently worked, because Bee and his other half have been together 21 years.
Long-term monogamous couples do face less exposure to health problems than single gay men whose are sexually active.
Here are some of the most important areas all gay men should openly discuss with their general practitioners:
HIV: In June 2008, the Centers for Disease Control reported that HIV infection among young American gay men had risen 12% a year. Perhaps some of this is caused by newly-limited sex education in public schools. Another possible cause is that younger gay men see older HIV-positive friends living longer due to new combinations of medication. “They ignore the fact that these HIV-positive people still die much earlier than normal, and they are plagued with complicated medical issues for the rest of their lives,” commented retired nurse Vi Rearden, who works with several Central Florida charities.
Hepatitis: Hepatitis A and B can cause liver damage and make a person ill for several weeks or months, but other long-term problems are manageable. Both A and B can be prevented by a vaccine, but inoculation should be thoroughly discussed with a medical professional. Hepatitis C can go undiagnosed for years, and people stay infected for life, often suffering serious liver damage as they unwittingly infect others. There is no vaccine for Hepatitis C. A and B can be passed in contaminated food or drink; all three types can be passed through sexual intercourse or sharing needles, and all three are diagnosed with blood tests.
STDs: Besides HIV and hepatitis, sexually active gay men have a higher occurrence of syphilis, gonorrhea, and anal warts.
Depression: Depression has always been high among gay men, often especially when they are shut off from their family and friends. A medical doctor can provide insight and information, as well as referrals to qualified counselors.
Substance abuse: Like depression, substance abuse can be heightened when gay men feel ostracized. However, it usually takes a dramatic event to make someone realize he needs help. If you have a family history, this should be shared with your doctor.
Smoking-related problems: Gay men are 41% more likely to smoke as their straight counterparts, according to Gay.com. This increases the risk of cancer, specifically lung, liver, colon, prostate, and skin cancer. One of the best things a doctor can help a patient do is quit.
Cancer: STDs—like hepatitis and anal warts—increase a gay man’s chances of cancer. So does smoking. There are no thorough statistics, but conventional wisdom would state that since some causes are greater, the probability of cancer is also higher. Regular testing can catch problems early.
However, getting medical attention has even gotten more difficult: “It’s tougher now that so many people have lost their jobs,” says Rearden. “Every time an uninsured gay man has to go to a walk-in clinic, he has to come out of the closet all over again.”
Can this lead to discrimination—even subtly—by the medical personnel treating him?
“That’s possible,” shrugs Rearden, “Likely, we’ll never know.”
“But I say, be brave! Open up, and just tell them.” states Rearden. “Your health needs to outlast the current economy.”
FOR THE WOMEN
Healthcare reform can carry a very different definition when it comes to the education of women’s health and specifically women’s health within the lesbian community. Traditionally, lesbians are underserved when it comes to proper public health education and gaining access to that education. A national survey provided by the Henry J. Kaiser Family Foundation, a non-profit private organization providing non-partisan facts and information about healthcare, stated sexual orientation is among the three most likely topics to be excluded from a sexual education course. It is widely assumed that when sexual orientation is omitted from education, adequate information on lesbian health care can very easily go down the same path.
“Lesbian women’s health is a concern for many women worldwide, but the information available for them on the subject is not as widely spread,” says Dr. Celso Silva, Director of the Center for Fertility Preservation at the University of South Florida in Tampa. “Prevention campaigns, publications and other methods for health care education are not as common as they are for straight women. Their specific health concerns deserve a separate and individualized effort.”
Reproductive Health: When it comes to reproductive health education, lesbians may have unique health disparities, which can lead to health problems that vary greatly from straight women.
“Because a lot of lesbian women don’t conceive, then they are at higher risk for breast cancer and uterine cancer, because pregnancy is one of the factors that will reduce the risk of cancers because the body is not getting that constant estrogen and stimulation through pregnancy,” says Dr. Billie Jean Pace, M.D. at the Altamonte Women’s Center in Altamonte Springs.
That is one reason why the importance of regular physical exams is universal for all women. Although there are medical options that can help offset these diseases, embarrassment or fear is sometimes a factor in not getting satisfactory care.
“Sometimes the sexual preference creates a level of insecurity because of how society perceives certain sexual orientations—and that makes women more hesitant to seek out regular physical exams,” Pace says. “So, in that way, they can have conditions that go on longer and can have a delay in treatment so conditions can be more severe when they are recognized.”
STDs: Generally, lesbians are at risk for the same sexually transmitted diseases as straight women. However, skimping on education to the lesbian community can be one major factor why STDs are transmitted. Dr. Silva said,
“Lesbians can transmit STDs to each other through skin to skin contact, vaginal fluids, menstrual blood and sharing of sex toys,” Silva says. “HPV, herpes and chlamydia are also prevalent in lesbian women. Therefore, it is important that they not only get tested for STDs but also that they practice safe sex.”
According to Pace, many lesbians think their sexual experiences aren’t actually “intercourse” and therefore do not have to be concerned about STDs.
“That is a fallacy,” Pace says, “because STDs can be transmitted between female partners as well. Some women are bisexual so that plays a role too in the transmission.”
Gynecological concerns: Silva contends that while sexual orientation does not directly increase the risk for some health conditions like depression, heart disease, breast cancers, gynecological cancers, polycystic ovarian disease and domestic violence, it’s important to remember that all women are at risk of these things.
Many physicians agree that good general health practices for lesbians are in synch with that of heterosexual women. Heart disease is the leading cause of death in women. Lung cancer, colon cancer, diabetes and hypertension are all diseases that continue to plague women. These diseases refuse to discriminate on the basis of sexual orientation, making it important for all women to gather information from their healthcare providers concerning the basic issues of sexual, reproductive and general health.
Ultimately, the lesbian community is in need of healthcare policies and culturally appropriate information about sexual and reproductive health.
