- Your Health
- Gay Sex Ed
- STD Health
- General Health
- Mental Health
Disclaimer: Unlike the other Pieces on this site, we’re going to approach this topic from a slightly more opinionated position because making the hard and complex choices about who your medical providers are is subjective and based more on “feelings than facts”. But, we will include some information and research from around the country and globe to help guide you in making these decisions. Either way, the final choice is up to you and your comfort/health should be your primary concern.
The main purpose of the Gay Male Journal is to provide you with fact based information to assist you in making decisions about your life, from a gay male perspective. But, we stumbled upon one huge area that most organizations don’t discuss or sometimes even acknowledge; as gay males, finding and maintaining a positive relationship with a medical provider(s) is easier said than done.
This fact becomes more difficult depending on which region of the United States you live in, how comfortable you are being “out” to your doctor, the high level of homophobia exhibited by the medical profession and the overall lack of knowledge held about gay male health issues. And, we must add in the issues of HIV status, race, class, access to insurance and for many, access to proper medical providers at all. We at GMJ recognize that one, some, or all of these are concerns for you, so think of the following as a guide but not a map.
With this being said, let’s begin.
A quick example of this major problem revolves around testing for HIV and other STDs. We’re all told that we have to do it on a regular basis, but the “where” is not discussed as much as it should be. Many are tested at “pop-up” booths at gay pride events, sex parties, street festivals, or mobile testing units. If faced with a positive diagnosis, the guy has to find a doctor for treatment if those testing him are not affiliated with a proper medical office or he is not comfortable, for whatever reasons, seeking services from the likely non-profit that just drew his blood. But, if he had his own primary physician, that he connected with, that knew him, the stress associated with regular testing for any illness lessens as his level of care is increased.
When we are young, positive health, for many, is a given. We run, we fall, we pick ourselves back up. Scrapes and bruises are pretty common for lots of boys and we think nothing of it. But some of us are more prone to illness, infections, allergies and broken bones. So, from early on, we all need to think about our healthcare providers and what type of relationship we want to have with them. This is so important a statement, that you should keep it in mind as you read the rest of this Piece.
The absolute most important question you will need to ask yourself is: HOW DO I WANT TO BE TREATED BY MY MEDICAL TEAM?
Now that we are living in the age of the Affordable Care Act, or so-called Obama Care (FOR NOW), possessing some from of health insurance coverage is mandatory by law. Since you must have the coverage, what you do with it, and your money, should be a concern and priority for you.
Another reason you should think about having a medical team is that if you are sexually active, regular testing for STDs…at least every three (3) months, is much easier if you have one doctor and a good relationship with him/her. If you make the “wrong” choice, you may be stuck in HIV testing hell. Meaning, as a gay male, every test and symptom will be attributed to you being HIV+, even if you are not. But also, a proper physician will advise you about STDs and other illness outbreaks in your city that you should be aware of. For example, New York City has been seeing an almost steady rise in syphilis. This is something that the correct doctor for you would not hesitate to let you know about, and make sure you aren’t only being tested but protecting yourself as well.
Since we mentioned HIV let’s pause here for a moment. Those who are infected or in sexual contact with someone that is or might be, should definitely have a team to assist them with any medical concerns. HIV is a highly manageable illness with proper treatment, medication and overall health and wellness attention. All of this to gain the golden ticket of stabilizing the virus within your body and obtaining the status of “undetectable”. This means that you are highly unlikely to infect others with your illness. Unfortunately, in the United States, too many with HIV have not been able to do this. We hope this guide will help alter this situation. Finally, if you are HIV negative, a proper physician will speak with you about your PREP/PEP options, without judgement.
If we are all lucky enough, we will grow to be members of the Old Queen’s society. This means that we have made it, at least, to the age of 65. But even before then, like around 30, guys will start feeling and seeing the effects of aging. Along with the usual aches and pains, other medical issues may manifest, including diabetes, high cholesterol, high blood pressure, weight gain, dental issues and even cancer. All of these medical issues are treatable and even curable if caught early enough. The last thing you want is to have uncomfortable conversations with a stranger about your swollen prostate.
1) Age is more than just a number.
Unfortunately, sex education for gay males doesn’t exist within the United States of America, and the negative effects are more than obvious on our young men, as well as adults. “In 2010, young gay and bisexual men accounted for an estimated 19% (8,800) of all new HIV infections in the United States and 72% of new HIV infections among youth. These young men were the only age group that showed a significant increase in estimated new infections—22% from 2008 (7,200) through 2010 (8,800). One in four new HIV infections occurs in youth aged 13-24. About 60% of youth infected, don’t know they have HIV and can unknowingly pass it on to others”, says the Centers for Disease Control and Prevention.
Denying this fact, will neither make it go away or assist those that need proper guidance and medical care. But, most teens are too young to choose their own medical providers, which leaves them in the hands of Pediatricians picked by their parents, and for many, by single mothers. If you are a young gay male and reading this site, first off, GOOD FOR YOU!
Secondly, and most importantly, you need to think very carefully and assess your personal situation. If you aren’t “out” or comfortable telling your doctor that you are “out” remember that any information you share with your medical provider may be shared with your parent(s)/guardians. (Under the rules of the Affordable Care Act, so-called Obama Care, most of you are able to stay on your parent’s health plan until the age of 25). Don’t fall prey to others pressuring you to come out if you aren’t ready to do so, and receive all of the attention, positive and negative, that those of us who are out get on a daily basis. HIPAA privacy laws and how they may effect you are located in the How to Find a Doctor: Advanced section.
Your doctor should hold your medical records confidential, but if something serious arises, permission from one of your parents/guardians may be necessary. Our suggestion is to feel out your doctor. Ask about privacy issues and slowly decided if you want him/her to know that you are gay, and possibly sexually active. If you find that you aren’t comfortable with their answers or even afraid that they may disclose this information, trust your gut. Being outed by your doctor happens all across this country to varying degrees of success for the young male. We wouldn’t like for this to lead to you being abused, or even kicked out of your home.
An option is to seek out your local Gay and Lesbian Center, if you have one. Many cities’ GLBT Centers have medical centers and providers that are trained to deal with younger guys. Another benefit of visiting one of these centers is that they will be a physical, interactive support system.
Some quick things to consider and think about 1:
2) It’s a PREP/PEP World! (but don’t throw out the condoms just yet)
There is no way around it, Pre-exposure Prophylaxis (PrEP) and Post-exposure Prophylaxis (PEP) are part of the new normal for sexually active gay males. State governments around the country are finding ways to provide it, for free, to those communities most at risk for contracting HIV. This includes gay males. Both are pharmaceutical treatments for guys that are HIV negative. PrEP is a daily regiment that is found to prevent the contraction of HIV by 92%, says the CDC, but 100% for those taking it 4 times a week or more, as stated in the iPrEx OLE study.
PEP is a temporary (30 day), after exposure treatment, for those that believe they have been exposed to the HIV virus. Even though we cover both of these treatments in great detail on GMJ, it is best if you have a medical provider that is knowledgable about both of these medications. Taking either one is a big decision which shouldn’t be taken likely as STRICT ADHERENCE to these routines deliver the absolute best outcomes and highest results.
3) Sexual activity, contact and behavior
The great thing about the GMJ website is that you don’t have to lie. We don’t ask any uncomfortable questions, in a brightly lit room, with a clip board over our faces, that we peer above every now and again with an obviously judgmental look in our eyes. Your sexual life is your own business. Well, your’s and whomever you share your body with. But, outside, in the real world you will have to answer some tough questions.
Finding a doctor that you’re comfortable discussing your sexual life with is very important as it does greatly impact your overall health, and as gay males, we are more likely to contract certain illnesses and diseases that our straight brothers won’t. HIV, will always be a concern but getting regular tests for other STDs should be a priority. If you feel you cannot discuss what, or who, you stick up your butt, or where you ram your cock, with your medical provider, it will cost you in the end.
Some quick things to consider and think about 2:
4) How big is my rainbow flag, and can they see it from space?
When considering when, where and how to build a medical team, how out you are is going to, at some point, be an issue. If you live in a big city you should be able to find a provider network that is comfortable treating gay males and you’re also very likely to find doctors that are gay themselves. But, since recent studies have shown that most gays do not live in these urban areas, this may not be true for you. And finally, no matter where you live, you may not be ready or comfortable talking about your pink side. This will most likely be one of the hardest things you’ll need to consider when making a choice about your medical care.
Navigating sexual orientation, identity and expression can be difficult when dealing with the medical profession, but we’re all big boys and need to take the issue by the balls. Here are a few questions to ask yourself when seeking a provider. Remember, we cannot give you answers because this is about your comfort and the resources available to you.
Like we stated at the very beginning of this Piece, finding and maintaing a proper medical team is a personal choice. If things go wrong you, and only you, will suffer. If you don’t like your doctor or have issues with the medical practice, you are less likely to visit. As gay males, we must begin to take a smarter approach to our healthcare. This means getting ourselves educated and finding physicians that are partners with us in our healthcare needs. They work for us. But we are responsible for the decisions we make before, during and after a visit.
Studies have shown that the mored educated you are about your body and healthcare needs the better treatment you will receive from the medical community. This doesn’t mean that you must have more formal education from a University, rather that you must be more versed about your personal life and the medical concerns which may effect you. A degree is not needed, just a desire to read and obtain facts about your life.
This Piece was a basic introduction to finding a doctor. It has questions for the average gay male, but if you have HIV, any other chronic medical issues including aging, our Advanced Piece has more information and tips. We highly recommend it for everyone though.