Are you out to your doctor?

[Daniel]

Please be honest.

This thread title occurred to me after watching the Gay News tonight on our local cable access channel and there was an interview with a man who was HIV postive and a survivor of rectal cancer (there is a Yahoo group which is very helpful to those with this cancer- which- btw- is one that is 90% curable if treated in time).

Here's the deal. If a man is anally active, he should have a pap smear (a simple test which doesn't hurt) done to check out the level of papilloma virus in his body. Why? Because a certain level of virus is a red flag warranting further investigation. Why? Because if pre-cancerous lesions are found, they are easily taken care of. However, once these lesions develop, more aggressive measures have to be taken (surgery- chemo & radiation).

Guess what? A majority of people, both straight and gay have this virus in their system if they are sexually active (there are many strains of it- only a few of them can lead to cancer if undetected and treated). It's the same virus that women get which causes cervical cancer.

Now. If you are sexually and anally active and aren't out to your doctor, you aren't going to be having this conversation with him, are you?

Ok then. Time for a reality check.

Guess what? Young women are now being given a vaccine which deals with this issue re cervical cancer, and it is now being discussed as regards gay men having it as well. One issue to deal with? Your insurance company probably will not pay for it, but younger sexually active men should think about getting it along with the - now standard for gay men- vaccines for hepatitis.

Taking care of your health means being out to the person who can help protect you.

So - are you out to your doctor?

[BenL]

... and about my spouse's trans status.

Thanks for the reminder, Daniel.

There are all sorts of conversations with their doctors that people find too uncomfortable to have. Men who are being treated for high blood pressure or diabetes ought to talk with their pysicians about erectile dysfunction if that's a problem in their sex life. My doctor was more uncomfortable than I was on that one, by the way. He assumend (a bad policy) that at my age I wasn't concerned with that any more, although he tried to word it more diplomatically than that. Get over it, doc.

Folks, it's your body that your physician is taking care of. Speak up. They should have heard it all before they enter private practice. If they haven't, it's about time they do.

[paul]

I'm out to mine too. Last year when I went on an outing spree.

I looked him in the eye and said "I'm gay, you got a problem with that?" :lol: Poor guy (and he's cute too). It was a great relief, he was completely cool about it, said he has several gay patients. He automatically screens me for stuff when I get my cholestoral checked...which is kind of funny since I am monogamous. Still, it's nice to know he cares and is looking out for me. That's a new feeling to actually be cared for regarding something (tgt) I was so afraid to reveal for so many years.

Thanks Daniel, for posting this. Our doctor is probably the most important person for us to be "out" too. For those who might not be, there are lists of gay friendly doctors on line you can google.

[Daniel]

I'm out to mine too. Last year when I went on an outing spree.

I looked him in the eye and said "I'm gay, you got a problem with that?" :lol: Poor guy (and he's cute too). It was a great relief, he was completely cool about it, said he has several gay patients. He automatically screens me for stuff when I get my cholestoral checked...which is kind of funny since I am monogamous. Still, it's nice to know he cares and is looking out for me. That's a new feeling to actually be cared for regarding something (tgt) I was so afraid to reveal for so many years.

Thanks Daniel, for posting this. Our doctor is probably the most important person for us to be "out" too. For those who might not be, there are lists of gay friendly doctors on line you can google.

Oh Paul- that sentence made me laugh. I imagined you at Neiman Marcus buying feather boas and stiletto heels. :lol:

Good for you that you looked your doc in the eye and laid in on the line- and I think it's kinda cool that he tests you for (presumably) HIV and other bugs. Bravo to your doc!

Ben- my Jonathan has encountered a similar situation (we don't have the same doc at the moment) when the good doctor remarked that the knee pain Jonathan had gone in for was simply 'age'.

(Steam coming out of ears)

And you made a great point: no matter our age, we are still- as living breathing souls- interested in erotic connection. I know I am- perhaps even more so- now that I am entering my 5th decade. I want to experience more life- not less! And while it may not be quantity that is the issue as one ages, I know that quality is. :D

[keltic63]

last time I visited my doctor, I talked to him about placing a power of attorney on file with him, so he would know that my PARTNER has that power! So, did I say "hey, I'm gay" ? not exactly, but I think he got the point! so yeah, I'm out to my doctor.

[Daniel]

last time I visited my doctor, I talked to him about placing a power of attorney on file with him, so he would know that my PARTNER has that power! So, did I say "hey, I'm gay" ? not exactly, but I think he got the point! so yeah, I'm out to my doctor.

We have the docs and the my doc knows I'm gay and I've spoken with him about it......Jonathan is on my forms as my spouse etc etc, but I wonder if I need to give him a copy of those docs?

Thanks for bring this up- hadn't thought of that- I see the good doc next week and will ask him/bring them with me.

:running:

[Zerbie]

A community group in my area is holding a special info seminar on doctors and medical care for the LGBT community tomorrow. I've been getting the email announcements (I won't be attending.)

I'm not out as bi to my doc, but in defense of that, it is not relevant either since I'm monogamous with one person for years. Hey, but she *is* cool -- I wore that tee shirt Nate designed a couple years ago, the one that says "I love my LGBT Christian friends," and while she was poking around listening to things, she read it. "Ooh, I just love your shirt!" she effused, and we chatted for a moment about the tragedy of institutionalized homophobia.

There *was* a time when an alternative care practitioner, upon my coming out, went behind my back and told his entire office staff that I was molesting children. !!!???!?!?:eek::mad::mad: I only found out b/c one of his staff was a lesbian girl about my own age. She became so infuriated over what he said about me that she quit, but not before she looked into my file and got my number, and called me up to tell me what was happening. We became friends for a while, and for the next few years we used to hang out occasionally. Really great gal.


...

. My doctor was more uncomfortable than I was on that one, by the way. He assumend (a bad policy) that at my age I wasn't concerned with that any more, although he tried to word it more diplomatically than that. Get over it, doc.
.

Geez louise, the guy sounds like a bit of an idiot. What does he believe? That on their 50th Bday men lose all interest in sex or something? That's ludicrous. How old is your doc, Ben?

My doc's husband (who filled in for her recently during her pregnancy leave) saw me for an appt & a sexual issue was discussed. He raised the question with delicacy and I responded rather openly and perhaps a bit too graphically. He blushed bright red and looked at the floor.
:p Well, he did ask. :rolleyes:



He automatically screens me for stuff when I get my cholestoral checked...which is kind of funny since I am monogamous. Still, it's nice to know he cares and is looking out for me. That's a new feeling to actually be cared for regarding something (tgt) I was so afraid to reveal for so many years.

:love::love::love::love::love:
I'm so glad you're being cared for. And glad for that 'new feeling.' :love::love:


.

Oh Paul- that sentence made me laugh. I imagined you at Neiman Marcus buying feather boas and stiletto heels. :lol:

:p :lol: Danny!!! :lol::lol: You crack me up.
If you & Paul make a shopping date at Neiman's, you MUST invite me to come tag along. That is a Do Not Miss scenario.
:p



Ben- my Jonathan has encountered a similar situation (we don't have the same doc at the moment) when the good doctor remarked that the knee pain Jonathan had gone in for was simply 'age'.

(Steam coming out of ears)

What absolute crap. :mad: That's a good excuse to get lazy and avoid care. Doctors must do their job.

I know someone who had an elderly family member hospitalized in a coma state. They recommended he pull the plug and let her die. He asked if they in fact had checked everything possible. Is there *anything* else this can be, he asked. They said, "Well, it could be an electrolyte imbalance. . . ." He asked if they had checked electrolytes. No. He had to DEMAND that they check. So finally they checked. They were imbalanced. They administered some electrolytes and 15 minutes later his mother woke up and began a conversation.

They nearly had him pull the plug because she was old.

Word to the wise: do NOT accept this kind of ageist bullshit from the medical community. Always, always ask. If you have to, insist. You might save a loved one's life.





And you made a great point: no matter our age, we are still- as living breathing souls- interested in erotic connection. I know I am- perhaps even more so- now that I am entering my 5th decade. I want to experience more life- not less! And while it may not be quantity that is the issue as one ages, I know that quality is. :D

Seriously. I'm a bit surprised Ben's doctor made an assumption that he wouldn't be interested anymore. That seems like a very 18-year-old attitude.

[BenL]

Seriously. I'm a bit surprised Ben's doctor made an assumption that he wouldn't be interested anymore. That seems like a very 18-year-old attitude.

He's younger than I am but in his 50s at least. I figured it said more about his sex life than it did mine. He did prescribe ED meds, though, and would ask at followups how they were working. We changed drugs and doses several times, so he did work with me on it. What most men don't know is that it's often the other meds they take that cause the ED and not just age. But you can't be shy, you have to tell them what you need.

[Daniel]

But you can't be shy, you have to tell them what you need.

You said what has been in the back of my brain since starting this thread: maybe it really comes down to three things....

1) shame

2) shyness

3) internalized homophobia

Anyone of them will keep you silent to your doc. You know- I don't remember the source, but I do remember reading not that long ago that lesbians are less likely to be open with their docs than gay men.

And before I make any ventures into why that might be so, I've love to hear from the gals as to why that rings true, if it does ring true.

Ideas?

[pnggrad79]

I am out to my ob-gyn. She was doing my initial interview and wanted to know how old I was, how many pregnancies I had had, if I was married. I said,
yes. She wanted to know how old HE was. I said, "SHE is 36". She looked at me quizzically and said, "She?" and I smiled, probably blushing, and said, "Yes, my husband is not a husband, she's a wife." She got more puzzled and then came the deer-in-the-headlights look :eek:! She said, "OHHHHHH, I see. So you are a..." I said, "Card carrying lesbian." She tried to to play it off. "Oh, that's ok, my sister is a lesbian." (I love it when they finally "get it", and then all of a sudden they know or are related to gay people) We're everywhere!!! Oh my!!! It's almost like they are saying, "Oh cool, let me see your sixth toe!!!"

Ok, I 'll stop....

[scott snedeker]

Embarassingly I am waaayyy behind the times! I have never done an anal pap smear! Furthe more few of my male gay patients felt comfortable enough to even come out even though they knew I am Gay! (It;s public Knowledge I have published on gay rights in our local newspaper.

Keep momentum going Daniel. There's a mountain that is just starting to move!

[tpdncr4christ]

I don't even regularly see a doctor, let alone be out to him. I've never really had any big medical problems, so I never went to one. Should I? I suppose it makes sense... :rolleyes:

[Zerbie]

Embarassingly I am waaayyy behind the times! I have never done an anal pap smear! Furthe more few of my male gay patients felt comfortable enough to even come out even though they knew I am Gay! (It;s public Knowledge I have published on gay rights in our local newspaper.

Keep momentum going Daniel. There's a mountain that is just starting to move!

:eek:
Scott-eeeee!!!!!

Hey, you're too precious to us to keep getting away with that. Treat your physical health with the same care you treat the psychological stuff.
And maybe you can find a way to make those patients feel safe to discuss sexual health with you, maybe there's a way to safely invite them to share concerns that won't sound threatening, judgmental, or too revealing? I dunno. But if any doctor can do it, you're the one!
:love::love:

[tymejumper]

Oh Paul- that sentence made me laugh. I imagined you at Neiman Marcus buying feather boas and stiletto heels. :lol:



Hillarious! I had the same type of mental picture when I read that!

I am out to my doc. I actually went and got a female doctor so Ellie and I would have the same one and if something were to happen, I would be able to have spouse rights and stuff, becuase she would know who my mate was. That way, they would pretty much have to let me in the hospital also. Its not too bad around here, usually most doctors are good with it.

[Daniel]

Embarassingly I am waaayyy behind the times! I have never done an anal pap smear! Further more few of my male gay patients felt comfortable enough to even come out even though they knew I am Gay! (It's public Knowledge I have published on gay rights in our local newspaper.)


Until I heard about this the other night, I didn't have a clue- and I haven't had a pap smear either. :rolleyes:

I should mention- from what I heard on the broadcast- that those with HIV are more at risk regarding anal cancer. So the same old issues (remember the 80's?) about Safer Sex apply. ;)

And I agree with Zerbie, if anyone can crack the nut in figuring out how to talk to his patients: you can.

[Jennifer5]

I don't go to the doctor very, don't like to go and don't have any real reason to.

I don't have anything to be 'out' about... but I would say, you don't have to be out, but don't hid. If it comes up, or you want to share something, then go for it.... but if you don't want to be out to your doctor and if it doesn't matter, then don't bother.

(it's late, so I didn't read the whole thing.... so just ignor this is it doesn't fit with the flow of the conversation.

[TigerXero]

I'm only 19, but I've come out to my doctor and such. It was when I was 18 and my boyfriend and I first started dating. We wanted to get tested for STDs and such before we would even consider doing anything that might be considered remotely sexual, so I talked to my doctor about it (Pediatrician/Family Doctor I guess), and she's totally cool about it. I'm actually her first gay patient as I've been with her since the start of her practice from a young age. The only other interesting cases she's had are some pregnant girls my age. (I'm at the upper age range of her patients currently... I guess she started with young kids and expanded from there). Anyway, we actually had to do some research as to what to tell the insurance company for why I was getting these test, and I think we found something basically saying sexual exploration or something dealing with my childhood, lol. Anyway, she's totally awesome, much more mature about my situation than my Southern Baptist parents concerning me being gay. (My mom couldn't understand how she was just fine with it... like, she was on the phone with her telling her that... oh, and my mom's the one who insisted I get an STD test anyway b/c we know that being gay = AIDS).

MY QUESTION, though, is do I need to get a pap smear at my age to check on my human papilloma virus status? Obviously in our culture, it's not the norm yet for guys to check on their status, but I figured it could be beneficial, especially since people seemed to be less concerned about it and the complications it causes than they should be. There's no vaccine for guys that I'm aware of, so the best I can do is be aware of our status. I guess I just wanted to see if you think I should check in with my doctor on that.

[Daniel]

MY QUESTION, though, is do I need to get a pap smear at my age to check on my human papilloma virus status? Obviously in our culture, it's not the norm yet for guys to check on their status, but I figured it could be beneficial, especially since people seemed to be less concerned about it and the complications it causes than they should be. There's no vaccine for guys that I'm aware of, so the best I can do is be aware of our status. I guess I just wanted to see if you think I should check in with my doctor on that.

Assuming you've had one partner and haven't had any STD's, I think it would be unlikely that you would need to be tested. That said: ask your doctor- I bet this subject is going to be news to her.

She probably already knows about the vaccine for girls (which is given- ideally- before they are sexually active).

What factors apply? The amount of partners you have have and the STD's you've encountered- if any. The more partners, the greater the risk, the more likelihood of exposure to a bug. If you are totally clean as far a STD's are concerned, you probably have nothing to worry about.

That said: having this conversation with your doctor the next time you see her could be interesting for her- you'll be bringing her up to speed about something she may not be aware of.

Have her read this:

http://www.webmd.com/news/20000531/gay-men-should-be-checked-for-anal-cancer-experts-say

HPV vaccines offer the best hope for keeping anal cancer rates in check in the future, Goldstone says. "Several vaccines are under development, but for now, men need to know that condoms will not protect them against HPV infection, and that genital warts are not the most serious consequence of infection," he says.

Also....

http://www.metrokc.gov/health/glbt/analcancer.htm


Gay and bisexual men, especially those with HIV, are at significantly higher risk for anal cancer than the general population.

Statistics show that the rate for anal cancer in gay and bisexual men (without HIV) is about the same as the rates of cervical cancer in women before pap smears became routine. Routine pap smears have decreased the incidence of cervical cancer from 30-40 per 100,000 women to approximately 8 per 100,000.

The incidence of anal cancer among gay and bisexual men who are long-term HIV survivors has increased greatly. This is probably due in part to the fact that men are now surviving longer with recent effective HIV treatments, and are thus experiencing rising rates of other, previously uncommon cancers.

Anal cancer and cervical cancer are caused by the same viruses-"high risk" varieties of the human papillomavirus (HPV). There are many different strains of HPV-most of which cause harmless warts in various places on the body (e.g., feet, hands, genitals). A few high risk strains of HPV can lead to anal cancer or cervical cancer if not caught and treated early. Most often, though, infection even with those "high risk" strains of HPV doesn't result in cancer.

Men become infected with anal HPV through receptive anal intercourse. One study estimates that approximately 95 percent of gay men with HIV and 65 percent of gay men without HIV have HPV in their anal canals or the surrounding skin.

Recommendations for gay and bisexual men

Recommendations for routine testing of gay and bisexual men are as yet uncertain, as this is an area of ongoing and active research, and no standards have yet been adopted.

What is an anal pap test and how are lesions and warts treated?

Warts are mostly caused by "low risk" strains of HPV that do not lead to cancer. However, they often need to be treated. Treatment usually consists of freezing them with liquid nitrogen, or the use of surgery or cautery.

Anal cancer is caused by "high risk" strains of HPV that can only be detected with an anal Pap test. In this procedure, a health care provider passes a swab into the rectum and collects cells. These cells are then put on a slide that is examined by an experienced pathologist in a lab under a microscope.

It takes many years for pre-cancerous anal lesions to develop into cancer. If the cells show changes of the kind that could lead to cancer, the patient should undergo a thorough rectal exam by an experienced proctologist. If the problem is caught early, before a cancer develops, it can easily be treated in a doctor's office.

Treatment for these anal lesions varies from simple in-office procedures, such as freezing the cells or applying a topical cream, to surgery or biopsy, if the lesions are widespread. Treatment is very effective in removing lesions, but they may come back in the same or other areas, so it is important to continue to have regular screenings. Persons with advanced tumors will often need other treatment.

And lastly....

http://aids.about.com/cs/conditions/a/analpaps.htm

I was surprised to learn that condom use does not stop transmission of HPV.

[pnggrad79]

Tiger,
I believe, and you can take it or ignore it, is that any woman under the age of 25 needs to get vaccinated against HPV whether or not they are sexually active or not. Uterine and Cervical cancer are nothing to play with and to ignore the possibility of you getting it is almost as ludicrous as smoking and thinking you won't get cancer, emphysema, COPD, or a host of other opportunistic diseases. Just something to think about...

[Daniel]

Tiger,
I believe, and you can take it or ignore it, is that any woman under the age of 25 needs to get vaccinated against HPV whether or not they are sexually active or not. Uterine and Cervical cancer are nothing to play with and to ignore the possibility of you getting it is almost as ludicrous as smoking and thinking you won't get cancer, emphysema, COPD, or a host of other opportunistic diseases. Just something to think about...

Woman may have this vaccine covered by their insurance. However, for gay men, while it's been talked about (as the links in my last post showed) since the 2001 or so, it's not covered as far as I know for guys. I heard that it can cost up to $300.

Check with your insurer to be sure.

Of course- does money matter? Yes- but so does one's health. I'm going to see my doc next week and ask him about it myself. He knows I'm gay, but that conversation is going to be one of those coming-out-of-the-closet-even-further talks.

We haven't as yet, talked about sexual matters. Perfect opportunity- you might say.

[TigerXero]

And I totally forgot to call my doctor. Must do. Oh, and I wanted to bump this thread back up to the top since it's important. I shouldn't imagine I have HPV, but I would still want to check. It will be fun to talk to my doctor about anyway since she might not be aware or expecting such a call, lol.

[Daniel]

And I totally forgot to call my doctor. Must do. Oh, and I wanted to bump this thread back up to the top since it's important. I shouldn't imagine I have HPV, but I would still want to check. It will be fun to talk to my doctor about anyway since she might not be aware or expecting such a call, lol.

I made a visit to see my doc yesterday (he's keeping tabs on me regarding tinntius etc- but that is another matter) and we talked- I brought it up- about sexual history (he did his residency here in NYC at the start of the AIDS epidemic). He's straight and could not be more supportive. And seeing that we hadn't had that conversation yet- it felt- for one millisecond- like I was coming out- again. :rolleyes: I mean- on paper- he knew I was gay and have a life-long partner: we just hadn't talked about it.

So Otter- you want to have your consersation with your doc- and my business at hand (you'd think I would have done this already!) is to send him our health-care proxy.

When you are in relationship if another man- and you start doing the documentation thing (hey.....marriage may come sooner that we think, right?), having your doc have the documents he/she needs so that your spouse can make decisions for you if you can't, is a big deal.

[RedneckDyke]

What's a doctor? I have no insurance and haven't been to one in years. My partner gets her diabetes medicine through the county health clinic.

[Daniel]

What's a doctor? I have no insurance and haven't been to one in years. My partner gets her diabetes medicine through the county health clinic.


Which is why we need Health Care in this country that everyone has access to: universal coverage.

What's the figure now? Something like 40 million people have not health care? And in our country? It boggles the mind.