The purpose of this website, and every article published on it, is to help you become better educated about your gay male health. Decades worth of studies prove that better educated patients receive better treatment and care from doctors. We cannot increase the number of degrees you have, but we can teach you how to become and stay educated about your body, healthcare and wellbeing so that when you do meet with doctors, you have a better handle on the issues and be a better participant in the conversation and decision making.
As gay males, and some of you also being gay males of colour, we know our lives are not easy and dealing with healthcare providers doesn’t make the day go by faster. We took a look at some of the issues and provided some suggestions to get the most out of your doctors visits.
Let’s jump right to it; there is a lot of homophobia within the medical field. Too much for a group of people that took an oath to help, and do no harm. This may be true for how they treat their straight patients but for us in the GLBT community, we know it’s quite the opposite. Healthcare providers are often reluctant to provide the care we need, and insurance companies pile on with their own discriminatory practices.
“A 2010 report by Lambda Legal found that many GLBT individuals face multiple issues, including disrespectful attitudes and outright refusal of care. Dr. Alexis Chavez, a resident psychiatrist at UC Health and the leader of the first GLBT clinic in Colorado, says the situation has improved over the years, but not as much as she’d like.”
The report revealed that 10 percent of those polled had dealt with harsh language from medical professionals. The same percentage said healthcare professionals refused to touch them. More than 12 percent indicated they were blamed for their health problems. And half of all those who responded to the poll said that they faced some form of discrimination when dealing with healthcare personnel.
Worst of all, this high level of negligence is creating a cyclical paradigm, where the added stress of not receiving care is causing more health problems. And the lack of proper care regarding these health issues is causing more stress. The result of which is causing more heart disease, high blood pressure, and other ailments for members of our community.
Don’t believe that being male is going to make any of this better. It actually makes it worse. A study by Chapman and colleagues found significant differences in attitudes toward gay men by male and female medical and nursing students. Male students had a significantly more negative attitude toward gay men compared with the attitudes of female students.
The GLBT community experiences personal and structural barriers that interfere with our ability to access high-quality care. We also experience health care barriers due to isolation, insufficient social services, and a lack of culturally competent providers.
At the same time, many health care providers (HCPs) experience various barriers to providing GLBT care and need to increase their cultural competence by improving awareness, receptivity, and knowledge. One personal barrier to quality care is stigmatization toward GLBT persons as expressed through HCP prejudices, beliefs, attitudes, and behaviors. Factors such as gender, race, and religious beliefs also influence attitudes toward GLBT health care. The latter is seeing an uptick thanks to American Religious Freedom Laws, which allow medical providers to refuse treatment to GLBT individuals based on religious convictions. These laws are gaining traction in other nations across the Western world.
“Improving health outcomes and reducing health disparities are an important part of the HCP’s role. Yet, many HCPs lack the significant knowledge, skills, and cultural competencies needed to provide quality GLBT care. Evidence suggests that HCPs continue to receive little or no training to prepare them to manage this vulnerable population. Due to the growing evidence of health disparities and negative health outcomes affecting GLBT populations, the federal government has identified GLBT care and patient outcomes as a major health concern and priority under the Healthy 2020 goals.”(But Trump is the president, so….)
It is impossible to discuss healthcare and not mention race. It is always the elephant in the room that most people don’t want to acknowledge. It is this glaring silence that is literally costing gay Black and Latino males their lives, and we are not just speaking about HIV.
In the U.S., racial and ethnic minorities have higher rates of chronic disease, obesity, and premature death than white people. Black patients in particular have among the worst health outcomes, experiencing higher rates of hypertension and stroke. And Black men have the lowest life expectancy of any demographic group, living on average 4.5 fewer years than white men!
A number of factors contribute to these health disparities, but one problem has been a lack of diversity among physicians. African Americans make up 13% of the U.S. population, but only 4% of U.S. doctors and less than 7% of U.S. medical students. (Of active U.S. doctors in 2013, 48.9% were white, 11.7% were Asian, 4.4% were Hispanic or Latino, and 0.4% were American Indian or Alaska Native.) Research has found that physicians of colour are more likely to treat minority patients and practice in underserved communities. And it has been argued that sharing a racial or cultural background with one’s doctor helps promote communication and trust.”
A second issue regarding Black male healthcare is the, often repeated, stereotype that men of colour care much more about keeping their Macho Card up to-date than keeping doctor’s appointments. Yes, cultural differences do play a role in how individuals and groups define what it means to “be a man” but that doesn’t mean Black men have created a suicide pact.
Men’s concepts of what it means to be a ‘real’ man are generally shaped by traditional masculine role norms, which encourage men to be extremely self-reliant and these norms often affect their health behavior,” says Wizdom Powell Hammond, assistant professor of health behavior and health education at University of North Carolina-Chapel Hill.
“We’ve seen in other studies that men with strong commitment to traditional masculine role norms delay health care because they don’t want to seem weak.”
“But this study shows that the opposite may be true for African-American men. Their delays in getting routine check-ups are attributable more to medical mistrust. Their beliefs about masculinity may not always have a negative impact on their use of health care.”
Trust and communication must be partners in healthcare wellness. “When it came to communication, when we asked, Which doctor would you feel more comfortable with? Which doctor would understand you the best? That’s when we saw a shift.” Dr. Alsan said. Nearly 65% of black respondents and 70% of white respondents reported that a doctor of the same race would understand their concerns best.”
Black men are less likely to seek routine and preventative care than other groups, and increasing their uptake could yield significant health benefits. “Prevention is the unsung hero of medicine,” Dr. Alsan said. “The amount of premature mortality that you can save or spare is quite remarkable with comprehensive preventive intervention.”
Having studies to support statements that people of colour have been making about racism within the medical community is nice, but without significant change and an increase in the number of physicians of colour, patients will need to keep doing the heavy lifting.
If television, cinema, social media and The Human Rights Campaign (HRC) are to be believed, all gay males are white, rich and live fabulous lives. This may be true for some, but it damn sure isn’t for most.
Many GLBT individuals have been suffering from employment inequality for years and possibly decades, which makes us more dependent on insurance coverage for care. The Williams Institute at the UCLA School of Law found that an estimated 23 percent of gay and bisexual American males live below the poverty line.
Demographic characteristics like race, ethnicity, age, and disability provide additional predictors of poverty. African Americans and Hispanics are much more likely to be in poverty than whites and non-Hispanics, for example, in large part because of discrimination in education, the labor market, and the housing market.
Older people are at the highest risk of being in poverty; along with age comes decreased income as people enter retirement or face age-based discrimination. Young adults, who may have taken jobs before completing their education or are in entry-level positions, are more likely to be in poverty than those age 25 or older. Disability, which can serve as a barrier to employment, can put a person or family at risk of poverty. Fluency in the English language also protects from poverty, as it increases educational and employment opportunities.
If, for any one of the above reasons, you have trouble obtaining or retaining employment you might also have severe issues with finding proper healthcare insurance. The United States has a long history of citizens without coverage using emergency rooms for primary care because they cannot afford a traditional doctor. But hospitals cannot provide the level of care and cultural competence that a personal physician should be able to.
The best thing you can do for yourself and the members of your family is to increase your level of patient empowerment. While there is no consensus amongst analysts regarding how best to define ‘patient empowerment’, at the very least, this concept entails an exchange of power. As the patient, here is what this means for you.
- a re-distribution of power between patients and physicians
- patients taking charge of their own health and their interactions with health care professionals, rather than as passive recipients of healthcare
- patients having some level of control over their own health and healthcare decisions/treatments/medications
- patients expecting doctors to share more knowledge and information abut their care
- patients becoming better self-educated about their health and healthcare, as well as cost
Empowerment can occur at different levels (micro, meso, and macro) and patients have different ideas about what it means to ‘take charge’ and ‘be empowered’. Some patients simply want to be given information about their conditions while others want to have full control over all medical decision making. Some empirical evidence suggests that active patient participation in health care is associated with better patient outcomes.
Increasing patients’ roles in health care could affect the quality of care in a number of ways. Firstly, for example, it may lead to patients’ views being better articulated and clinicians being more responsive to patients’ needs and preferences (it is unclear whether this implies a reduction of professional autonomy). Secondly, patients may be able to support the implementation of guidelines and research evidence, which is currently sought mainly by interventions directed at clinicians. Patients can be seen as co-producers of health care, because their decisions and behaviour influence health care provision and its outcomes.
For the most part, when it comes to medical information, doctors and nurses have all of the information and patients must wait until it is shared. At GMJ, we are doing our best to close this gap but the major responsibility still lays with the medical providers.
- Physicians must promote patient education and engagement through improvement in patients’ health literacy. Health literacy is defined as the capacity to seek, understand, and act on health information. The presumption has been that low health literacy means that physician communication is poorly understood, leading to incomplete self-health management and responsibility and incomplete health care utilization.
- It is the responsibility of physicians to proactively enable patients to have more accessible interactions and situations that promote health and well-being.
- Health literacy is the primary responsibility of physicians, given that it is physicians who determine the parameters of the health interaction, including physical setting, available time, communication style, content, modes of information provided, and concepts of sound health care decision crafting and acquiescence.
Just 45 minutes of patient education can improve outcomes for patients with chronic diseases, according to a study in the Journal of the American Osteopathic Association.
Time with doctors
As patients, we don’t get to decide exactly how much time we spend with our doctors. Sometimes they are running late and we are given half the time, and half the attention that our concerns deserve. Also, insurance companies play a large role in the number of patients providers must see, necessitating they see more than they are able to provide proper care.
The 45 minutes study is nice but no doctor’s office is able to provide each and every patient that amount of time for each and every visit.
This statistic depicts the amount of time U.S. physicians spent with each patient, as of 2018. As of that year, five percent of U.S. physicians stated that they spend less than nine minutes with each of their patients. Most of the surveyed physicians – over 60 percent – stated that they spend between 13 and 24 minutes with each patient (less than 1/2 of the 45 minutes needed). More than half of the physicians said that they spend around 30-45 hours per week seeing patients. So, how are physicians spending the rest of their work days?
Researchers from Dartmouth-Hitchcock health system, the American Medical Association (AMA), Sharp End Advisory, and the Australian Institute of Health Innovation observed 57 U.S. providers who practiced cardiology, family medicine, orthopedics, or internal medicine in four states. They observed the physicians for 430 work hours, and 21 of the providers kept journals to log any after-hours work.
The study also found that physicians spent 27 percent of their office day on direct clinical face time with patients and spent 49.2 percent of their office day on EHRs and other desk work. When in the examination room with patients, physicians spent 52.9 percent of their time directly talking with patients and 37 percent of their time on EHR and other desk work.
This website is filled with healthcare information to empower you before, during and after medical visits. We want you to be able to have intelligent conversations with your providers about your care, and thus receive better healthcare outcomes. But, we acknowledge that we are not the only site you may visit and the internet is filled with half-truths, erroneous conclusions, fraud and fear mongering . So, what can you do?
It all starts with the medical provider you choose. We created a guide to help you find, and even break-up with, the best doctor for you.
Do your homework! If you think you have the flu or something more serious, take the time to do a small amount of research. Sometimes this step could even save you a trip to the doctor, but always check to make sure.
Only use information from websites that have VERIFIABLE information in the form of facts, science, studies and LINKS to the actual research (like we do)
Check the dates on articles. The world has changed a lot in the last decade regarding healthcare and this includes major concerns like HIV. If you are reading and relying on an article that is older, you may be getting outdated information. The more current, the better.
Reputable research uses a proper sample size of individuals, no self-reporting data and has been verified by other well known and trusted sources. For example: A study with only 50 people, self-reporting the sizes of their penises is most likely not very accurate.
Don’t be afraid to change your mind or get a second opinion. It is your body and your health. This is not about the doctor’s feelings.
ASK LOTS OF QUESTIONS when visiting your physician. It is your time as much as theirs. Don’t leave the office without having your concerns answered. The best way to do this is to go prepared with a list of your issues and check them off as they are addressed.
Finally, remember that some doctors really are better than others. Bed side manner is a real thing that you must consider. Because racism and homophobia are so ingrained within our society, you might have to travel far to find the right physician for you; but it will be worth it.