Finding a doctor as a gay male

Disclaimer: Unlike the other articles on this site, we will approach this topic from a slightly more opinionated position because making the challenging 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 yours, and your comfort/health should be your primary concern.

FINDING AND MAINTAINING A MEDICAL PROFESSIONAL TEAM

When we are young, good health, for many, is a given. We run, we fall, we pick ourselves back up. Scrapes and bruises are common for many 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 statement is so crucial that you should remember it as you read the rest of this article.

The most important question you must ask yourself is: HOW DO I WANT TO BE TREATED BY MY MEDICAL TEAM? Now that we live in the age of the Affordable Care Act or so-called ObamaCare (FOR NOW), possessing some form of health insurance coverage is more affordable. Since you have the coverage, what you do with it and your money should be your concern and priority.

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. This means that 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 ensure you aren’t only being tested but protecting yourself.

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 “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. 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.

HIV

Since we mentioned HIV, let’s pause here for a moment. Those who are infected or in sexual contact with someone who 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 is to gain the golden ticket of stabilizing the virus within your body and obtaining the status of “undetectable.” This means that you are unable 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 judgment.

A quick example of this significant 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 primary physician he connected with who knew him, the stress associated with regular testing for any illness lessens as his level of care increases.

If we are 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, 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 problems, and even cancer. 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.

THE FIRST STEPS TO BUILDING A MEDICAL TEAM

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 nor assist those who need proper guidance and medical care. But, most teens are too young to choose their 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 can 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 daily. HIPAA privacy laws and how they may affect 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 decide 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 trained to deal with younger guys. Another benefit of visiting one of these centers is that they will be a physical, interactive support system.

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 regimen that is found to prevent the contraction of HIV by 92%, says the CDC, but 100% for those taking it four times a week or more, as stated in the iPrEx OLE study. PEP is a temporary (30-day), after-exposure treatment for those who 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 knowledgeable medical provider about both of these medications. Taking either is a big decision that shouldn’t be taken lightly, as STRICT ADHERENCE to these routines delivers the 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 clipboard over our faces that we peer above now and again with an obviously judgmental look in our eyes. Your sexual life is your own business. Well, yours 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 significant as it dramatically impacts 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.

Here are some quick things to consider and think about 1:

Testicular cancer manifests in young guys and even children. This is a sporadic disease and affects white males disproportionally, but it is important to start getting your balls checked as early as possible and maintain these check-ups regularly.
The Human Papillomavirus (HPV), is the most commonly contracted STD but there is a vaccine which you ideally would get BEFORE becoming sexually active, but can get at any point in your life. This is a HUGE issue for gay males. For most Americans, HPV causes anal cancer in 2 out of every 100,000 people, but for gay males, the rate skyrockets up 44%. All anal cancers are caused by HPV, which is sexually transmitted. This virus also causes some oral cancers.
When you are young, this is the absolute best time to ensure your immunizations are complete and up-to-date. Many colleges require the basics for measles, mumps, chicken pox, meningitis, and even the flu vaccine. But this is also the perfect time to get vaccinated for HEP A/B.
Beginning trips to the doctor at an early age will help to establish a pattern that should last you a lifetime. We’re constantly told that men don’t like to go to the doctor. This myth has shaped far too many, leading to late diagnosis of very curable illnesses…when it is too late. At least when this guy in a white coat and mask sticks his finger up your butt, he’ll be wearing a glove.

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 will be an issue at some point. 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 who 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 answer because this is about your comfort and the resources available.

QUESTIONS TO ASK YOURSELF

Am I out?
Am I comfortable being out to my medical providers?
Would I prefer a male doctor?
Would I prefer a gay male doctor?
Would I prefer a doctor of color?
Would I prefer a gay male doctor of color?
Do I need an HIV specialist?
Do I need a HEP C specialist?
How far am I willing to travel to obtain the type of doctor I prefer?
Do I have the financial resources to pay out of pocket to see a doctor?

Do I have any chronic medical issues that need attending?
Does my family have a history of diabetes, cancer, or other serious illnesses?
If I feel discriminated against, am I willing to find another doctor?
Am I willing to do the work and educate myself to fill in the gaps my doctor may have?
Do I need a full medical facility, an all-in-one, with a dentist, mental health, and other services?
Are there any other cultural, economic, social, or medical issues that trump my gayness?

As stated at the beginning of this piece, finding and maintaining a proper medical team is a personal choice. If things go wrong, you, and only you, will suffer. You are less likely to visit if you don’t like your doctor or have issues with the medical practice. As gay males, we must begin to take a smarter approach to our healthcare. This means getting ourselves educated and finding physicians who are partners with us in our healthcare needs. They work for us. But we are responsible for our decisions before, during, and after a visit.

Studies have shown that the more 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 a more formal education from a University, but rather that you must be more versed about your personal life and the medical concerns that may affect you. A degree is unnecessary; it is 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 or any other chronic medical issues, including aging, our Advanced Piece has more information and tips. We highly recommend it for everyone, though.

Here are some quick things to consider and think about 2:

Many doctors aren’t well versed in gay male health, including treating HIV. So it would be best to walk in, educated and sometimes ready to teach. This is your health we’re talking about. Take it seriously.
If you have not done so, make sure you’ve been vaccinated for HEP A/B. If not, it should be at the top of your to-do list.
Even if you are sexually active, it’s not too late to get vaccinated for HPV. This virus is widespread and is known to not only cause anal warts but also anal/oral cancer. A proper physician for you will not hesitate to give you this shot.
If you’re sexually active, we recommend a basic set of tests for all STDs every three (3) months, NOT JUST HIV. A good tip is to sign all of the consent forms ON DAY ONE and make it as regular as getting on the scale. This way, you won’t have to worry about it, try to remember which ones you were tested for or disclose any activity which could make you prone to contract one STD over another.
From prostate and testicular exams to HIV/HEP C tests and treatments, all of us will need a physician at some point in our lives. Your comfort must be at the forefront of your mind when choosing a doctor, but not to the fact that you’re not being treated for diseases and illnesses. Remember that even though we are gay, illnesses that effect the rest of the human population come our way often, this includes the common cold, flu and even chicken pox.