Are you out to your doctor?

[Daniel]

I'm out to my doctor. Are you?

http://cityroom.blogs.nytimes.com/2008/07/23/many-gays-dont-tell-doctors-their-sexuality-study-finds/index.html?hp


Many Gays Don’t Tell Doctors Their Sexuality, Study Finds
By Sewell Chan

A survey of 452 New York City men who had had sex with other men within the past year found that 39 percent had not disclosed their sexual orientation to their doctors, a problem particularly acute among black, Hispanic and Asian men, the city’s Department of Health and Mental Hygiene announced on Wednesday.

Health officials said the survey results had troubling implications for H.I.V. prevention. The survey found, for example, that men who disclosed their sexual activity with other men were twice as likely as men who did not to have been tested for H.I.V. (63 percent versus 36 percent).

The survey found a striking distinction: While 78 percent of the men who had sex with men and identified themselves as homosexual said they had discussed their sexuality with their doctors, none of the men who had sex with men but identified themselves as bisexual had told their doctors.

The survey also found wide racial and ethnic variation in disclosure rates. Sixty percent of black men who had sex with other men said they had not discussed their sex lives with their doctors, compared with 48 percent of Hispanic men, 47 percent of Asian men and 19 percent of white men.

Other differences in disclosure were also observed. Men who were 28 or older were more like than younger men (69 percent vs. 52 percent) to be out to their providers. Those born in the United States were more likely than immigrant men to disclose their practices, and those who were better educated disclosed at higher rates than the less educated.

Dr. Monica Sweeney, the assistant health commissioner for H.I.V. prevention and control, said the findings reflected a strong stigma against homosexuality in minority communities. (About three-quarters of the men in the survey who described themselves as bisexual were black and Hispanic.)

“There is a frequent phenomenon in the black community in which a man who is gay, by the conventional ways that we all know to identify somebody as gay, identifies himself as bisexual,” Dr. Sweeney said, referring to the phenomenon known as the “down low.”

The survey results, published this month in The Archives of Internal Medicine, examined data from the National H.I.V. Behavioral Survey conducted in 2004-5 by the Centers for Disease Control and Prevention. The New York segment of the study involved data from 452 men who were interviewed anonymously at gay bars and clubs, tested for H.I.V., and offered medical and social services as needed.

Officials not only urged patients to be forthcoming about their sexual behavior, but also urged doctors to ask about sexual history.

“Health care providers should screen patients routinely for H.I.V.,” said Dr. Elizabeth Begier, director of H.I.V. epidemiology at the health department. “They should also ask their patients about behavior that may put them at risk. And New Yorkers shouldn’t hesitate to talk openly with their health care providers.”

In a phone interview, Dr. Sweeney said that doctors are often squeamish about asking personal questions.

“When the doctor initiates the subject, no matter how sensitive, most people talk about these things,” said Dr. Sweeney, who is trained in internal medicine and geriatrics. She added that she was not surprised by the survey findings; if anything, she said, she was surprised that the overall disclosure rate — 61 percent — was as high as it was.

Marjorie J. Hill, chief executive of Gay Men’s Health Crisis, a nonprofit advocacy group, offered a similar assessment in a phone interview. “While distressed, I am not at all surprised,” she said of the findings. “Medical providers are not sufficiently trained in outreach and engagement with gay, lesbian, bisexual and transgendered people.”

Outside of obstetrician-gynecologists, she said, “doctors are not encouraged to have conversations about sex."

[RaymondCharlesWoollcombe]

Nope, But when i'm older and have a doctor that i am quite close with than i will come out to Him/Her. :D

Peace and Love
Raymond....:pray:

[Alecto]

I actually don't remember. Then again, I haven't seen my doctor in a few years. I was out to the folks I saw most often at college (when I was there), and since then, I've only really seen other people at the same practice.

How does one even bring that up without being asked? Like...why would I think it to be important if he doesn't?

[Daniel]

I actually don't remember. Then again, I haven't seen my doctor in a few years. I was out to the folks I saw most often at college (when I was there), and since then, I've only really seen other people at the same practice.

How does one even bring that up without being asked? Like...why would I think it to be important if he doesn't?

Fear? Fear that your doc will think less of you? Look down on you?

My doc didn't ask either: I brought it up. He was unfazed (yes- this is NYC- gay people are everywhere). As the article says, docs aren't trained to ask. So, the responsibility for your health is resting in your hands....ahem.....like it always had been. Why wait for him/her to take the intitate? You way wait forever.

Please don't do that! You health is too important for that!

Have you had an HIV test? Has your doc given you one routinely? This is stuff to ask about for starters. You could start there.

It's a bit blunt to say, but the answer to your question is that you have to open you mouth.

Be brave! If you feel uncomfortable with the gay/gal and he/she acts out, find a new doctor!

Bet you will be surprised though. Bet your doc will get with the program right away. They ARE trained to do that you know!

[Alecto]

Not fear so much as awkwardness. I also don't necessarily equate being out to a specific health benefit: I get tested for HIV in places that aren't my general care physician.
Like, I'm pretty sure my doc would be cool, but I literally don't know why I'd tell him (and knowing why would help a lot with the how).

[Daniel]

Not fear so much as awkwardness. I also don't necessarily equate being out to a specific health benefit: I get tested for HIV in places that aren't my general care physician.
Like, I'm pretty sure my doc would be cool, but I literally don't know why I'd tell him (and knowing why would help a lot with the how).

Awkwardness is a sign of fear, don't you think?

So you get tested at another place, but the person who could save your life doesn't know some really important information about you. You're keeping that under wraps.

Not easy to write, but do you think there might be some internalized homophobia lurking about? A little part of you that is ashamed you are gay? For the truth is: you are passing as straight.

A perceptive counselor once told me" "Go ahead and do what needs to be done- if you want to look back later and figure out what the problem was- fine- but the important thing is to go for the solution."

[labguy22]

My husband and I have been fortunate to have the same primary care physician for the past four years. He is aware we are married and always asks after our partner when one of us has a visit.
This is the first doctor that I have told everything to. He's aware of past drug addiction along with a very promiscuous past sex life; it has made all the difference in how our relationship works.
The downside to this is he has decided to leave private practice and now we are left with trying to find another doctor.
Back when I was 25 or so I found an openly gay doctor and saw him for a few visits until my insurance changed.

[u-dog]

Nick,

Have you asked your Physician for a referral? he probably will have a good feel for which of his colleagues will be able to provide the kind of quality care to a gay couple that he has provided.

[Daniel]

My husband and I have been fortunate to have the same primary care physician for the past four years. He is aware we are married and always asks after our partner when one of us has a visit.
This is the first doctor that I have told everything to. He's aware of past drug addiction along with a very promiscuous past sex life; it has made all the difference in how our relationship works.
The downside to this is he has decided to leave private practice and now we are left with trying to find another doctor.
Back when I was 25 or so I found an openly gay doctor and saw him for a few visits until my insurance changed.

That is great that your doc inquires about your partner!

I can identify with you on your doc leaving practice.

The first doctor I had after moving to NYC was a really great Doc- gay too. But I couldn't stay with him because of a change in my insurance. :mad:

My second Doc was straight and specialized in serving performers and was nonplussed about my being gay. Actually asked me when my last HIV test was. And like your guy, he left his practice, retiring a year ago.

Now I have a third doc that is straight and a decade younger than me. We talked about my sexual history on my 4th visit- I brought it up. He listened. Non-plussed as well. Didn't blink an eye.

I've guess I've learned that professionals will act professionally if you give them the chance. If they don't, there are other docs out there. ;)

[Matt Algren]

No, but a) I'm new, and b) I'm not 'active' so it isn't a real concern. It was hard enough to tell him that I was depressed. And that I had assteroids.

[nmwolfboy]

Yep, i'm out to my current doctor. It wasn't difficult since i knew he was gay before i made the first appointment - he's listed in the referral database of the Gay and Lesbian Medical Association (http://www.glma.org/). He's also on the board of our statewide lgbt lobbying group, Equality New Mexico. i've been out to each of my primary physicians since the 1980s.

You're right, Daniel - all you have to do is open up & tell them. But i must also admit that trust in a medical provider is important to me regardless of any issue pertaining to sexuality. If i don't trust their professionalism or medical judgment, i'm only their patient for one visit.

Matt, it was harder for me to bring up my depression that it was my sexuality. Though i did find it funny in a follow-up appointment six weeks after he prescribed an anti-depressant, when my doctor asked in a very clinical yet still avuncular manner, "And how's your libido...are you horny?" All i could do was try not to laugh when the Austin Powers movie question immediately popped into my head, accent and all: "Do i make you horny, baby? Do i? Do i make you...randy?" :lol: Somehow i managed to remain composed and calmly reply "Why, yes. i have felt more interest in the past few weeks."

Pax, :dove:
scott

[Matt Algren]

Yep, i'm out to my current doctor. It wasn't difficult since i knew he was gay before i made the first appointment - he's listed in the referral database of the Gay and Lesbian Medical Association (http://www.glma.org/). He's also on the board of our statewide lgbt lobbying group, Equality New Mexico. i've been out to each of my primary physicians since the 1980s.

You're right, Daniel - all you have to do is open up & tell them. But i must also admit that trust in a medical provider is important to me regardless of any issue pertaining to sexuality. If i don't trust their professionalism or medical judgment, i'm only their patient for one visit.

Matt, it was harder for me to bring up my depression that it was my sexuality. Though i did find it funny in a follow-up appointment six weeks after he prescribed an anti-depressant, when my doctor asked in a very clinical yet still avuncular manner, "And how's your libido...are you horny?" All i could do was try not to laugh when the Austin Powers movie question immediately popped into my head, accent and all: "Do i make you horny, baby? Do i? Do i make you...randy?" :lol: Somehow i managed to remain composed and calmly reply "Why, yes. i have felt more interest in the past few weeks."

Pax, :dove:
scott
Wow, usually it's the opposite. You're lucky.

I actually did the "Oh by the way" thing as he was walking out the door. The nurse came in to give me the written test to fill out and gave me a funny look because I was pretty good at covering it and had been joking around with her earlier.

You should have seen her face after she saw my score. Heh.

But back on the original subject, I should probably let my doctor know. Just for knowin'.

[dsdrane]

'Course it helps that he's gay, too. :cool:

I actually prefer gay men or women (gay or straight), if at all possible. :agree:

[Nyshana]

A question here - why is it important?
There are, as far as I'm aware, no particular health risks involved in the various different varieties of sex. The only reason I can think of that sexuality might be important is either a doctor suggesting a pregnancy test to a lesbian, or in relation to mental health (a topic to which almost anything can be relevant).

iirc my doctor does know I'm bi, because at one point we had the conversation "Are you sexually active?" "Yes" "A steady boyfriend, or...?" "Not exactly..." :p

[BrianB]

My first impulse was to say that it's none of your business. My relationship with my doctor is confidential. However, I am out to my doctor. My ex was IMO promiscuous. That fact made me decide to ask the doctor for STD testing including HIV. The doctor was very professional. She asked if I had any symptoms. No, I didn't have any symptoms. The blood work came negative. It wasn't bad at all. My doctor does come to my home because of my limited mobility. It feels more comfortable to see the doc in your own home.

BrianB

[Daniel]

My first impulse was to say that it's none of your business. My relationship with my doctor is confidential. However, I am out to my doctor.

The thought behind the title of this thread is not one of purient interest about another person's sexual history. As the article notes in the first post, it's a matter of public health.

Are there health risks in not being out one's doctor? If one reads the article in the first post, I believe one can say, yes, there is. Full disclosure to one's doc means that one can receive- if one has a decent doc- full care. And that's the point.


A question here - why is it important?
There are, as far as I'm aware, no particular health risks involved in the various different varieties of sex.

I hope the point of this thread is not being missed. It's not about what one does with whom in bed. The concern here is what one can contract from one's partner. And if you ask any health care worker at a clinic, I think you will be told that any and all sex with another person brings with it a degree of risk. Which is why it is important to know how to protect yourself and your partner.

For instance: one can contract HPV and not even know it.

Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI). The virus infects the skin and mucous membranes. There are more than 40 HPV types that can infect the genital areas of men and women, including the skin of the penis, vulva (area outside the vagina), and anus, and the linings of the vagina, cervix, and rectum. You cannot see HPV. Most people who become infected with HPV do not even know they have it.

http://www.cdc.gov/std/HPV/STDFact-HPV.htm

Now. From another perspective, I understand a point you may be trying to make: women who sleep with women exlusively do not have the same level or risk for contracting HIV than gay men do. That said, it is my sense is that some important issues about women's health are important to remember here.

http://www.lesbianhealthinfo.org/your_health/breast_cancer_screening.html


Being a lesbian does not increase a woman’s risk of breast cancer but some life style differences between lesbians and heterosexual women might.

These differences may place them more at risk:

None or few full-term pregnancies

Increased body weight in comparison to hetero sexual women and bisexual women

Lower income and the resulting difficulty paying for health care

Lack of health insurance coverage

Fear of homophohic medical environments

[Nyshana]

It's not about what one does with whom in bed. The concern here is what one can contract from one's partner. And if you ask any health care worker at a clinic, I think you will be told that any and all sex with another person brings with it a degree of risk. Which is why it is important to know how to protect yourself and your partner.
Exactly - all sex carries risk. As such, I understand why it's important for your doctor to know that you're having sex - but not who you're having sex with, unless it comes up in conversation. Getting tested for all sorts of things is something that everyone should do - regardless of sexuality. As such, I don't understand why it's important for a doctor to know a patient's sexuality when all the same precautions should be taken regardless.

The statistics you quoted, however, do make interesting reading - I hadn't realised that sexuality had any real impact on health; with those in mind, and if they're more than just a scattering of mostly unrelated trends, the OP might start to make sense. :)

[wmanion]

I have not told my doctor of my sexual orientation. In the mid 80's when I was struggling with my same sex attraction (still married), I had a doctor who happened to ask me if I ever had sex with men. I told him "no, I am married but that before I married I had slept with other guys." Well...to make a long story short. I got the flu about two months after that visit and when I tried to make an appointment...low and behold...I was not a patient there...I insisted that I was and that I had just had a physical two months ago. The receptionist put me on hold and then a nurse came on the phone and proceeded to tell me that they have no medical records of me and that they were not accepting new patients. I knew then that I had been purged as a patient...I did not pursue the issue because I still had not come to terms with my sexuality and did not want the embarrassment. I have been with my present doctor for over 8 years and he also treats one of my sons and his family. The subject has never come up but I have the fear that I will lose my doctor and I think he is really a good doctor. My fears may be totally unfounded but because of that experience in the mid 80's, I just cannot bring myself to tell him.

Bill

[Zerbie]

I tried to make an appointment...low and behold...I was not a patient there...I insisted that I was and that I had just had a physical two months ago. The receptionist put me on hold and then a nurse came on the phone and proceeded to tell me that they have no medical records of me and that they were not accepting new patients. I knew then that I had been purged as a patient...I did not pursue the issue because I still had not come to terms with my sexuality and did not want the embarrassment. I have been with my present doctor for over 8 years and he also treats one of my sons and his family. The subject has never come up but I have the fear that I will lose my doctor and I think he is really a good doctor. My fears may be totally unfounded but because of that experience in the mid 80's, I just cannot bring myself to tell him.

Bill
:mad::mad:

That just makes me furious. I'm sorry, Bill. I can relate, too.

I had a chiropractor go bonkers on me ten years ago when I was a very scared little young adult away from home for the first time.

To this day, I cannot bring myself to tell my current (and very different) chiropractor about my advocacy projects. It's entirely possible that he might be a supporter, but after the way the last one reacted, I have this programming that says Do Not Be Open With Chiropractors. Which is silly. :p My current chiropractor even saw my campaign T shirt opposing the marriage amendment a few years ago and commented to say that he agreed with the tee shirt. But I still can't open my mouth to him about 7 Straight Nights. :rolleyes:

[wmanion]

Zerbie,
I can't help but believe it has happened to a lot of GLBT folk and that may be the reason for the hesitation in talking to their doctors. I know a lot has changed over the last few years, but not nearly enough.

Bill

[Zerbie]

Hmm.
Maybe I should just inform my current chiro about the 7SN event this year. He had to take care of me last year on the day after, since I was so worn down from it, and he didn't understand why I had worked the previous day for many hours outside in the heat without resting or stopping to eat. :p