Coming out to your doctor in rural America

From NPR online

Finding the perfect doctor can be a feat for anyone. And a poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health finds that 18 percent of all LGBTQ Americans refrain from seeing a physician for fear of discrimination.

One of those people is 20-year-old Alex Galvan. The moment right before he told his doctor earlier this year that he is gay and sexually active felt like a nightmare. Galvan lives in rural Tulare County in California’s Central Valley. He wanted to start a regimen of medication that helps prevent HIV infection, an approach called “pre-exposure prophylaxis,” or PrEP.

Alex Galvan

“Sitting in the waiting room was kind of like, ‘you got this, you’re just asking for a medication to help you,’ ” Galvan says, remembering what was going through his head before he came out to the doctor. “He’s not going to flip out. And then the moment before was, ‘Oh gosh, here it goes.’ ”

His doctor didn’t know about PrEP, and Galvan thought he was going to be rejected. Instead, his physician educated himself.

“I was kind of scared that he didn’t know what it was, but I was also relieved because I let him do most of the research,” Galvan says. “Yeah, and then I cried a little bit in the car, because I didn’t know what just had happened and it all kind of blurred together.”

Pediatrician Kathryn Hall knows about these concerns all too well. She has been practicing medicine in Tulare County for over a decade, and time and time again, her patients tell her they’re afraid to come out to their other doctors. A few years ago, she got so fed up that she surveyed more than 500 nearby doctors asking them basic questions about being welcoming. “I made the bar very, very low because we just didn’t get much education on LGBT health in medical school,” says Hall. “That is starting to change.”

Around 120 doctors responded to Hall’s survey, and most of them said they would be happy to serve this group. Hall says there are lots of ways that doctors can make it clear they’re accepting — a little rainbow flag on the door or taking out ad in a local magazine.

“Many of the physicians that I know are LGBT-friendly, but patients don’t know that and are very afraid that they’re being judged,” Hall says.

Read the full article on NPR.

 

‘Double discrimination,’ loneliness contribute to bisexual health disparities, study says

From NBC News online

“Double discrimination” and loneliness put bisexual individuals at “higher risk for poor mental health outcomes,” according to a recent study out of American University. The study compared the mental health of bisexual men and women to that of gay men, lesbians and heterosexuals.

“Bisexual people face double discrimination in multiple settings — bisexual people are often invisible, rejected, invalidated [and] stigmatized in the heterosexual community as well as the traditional LGBTQ communities,” Ethan Mereish, an assistant professor at American University and the study’s lead author, told NBC News. “Given that isolation and discrimination, bi people might be experiencing increase factors that might make them more lonely or isolated.”

Previous research has shown that lesbian, gay and bisexual individuals broadly face higher rates of mental health issues than their straight counterparts. Yet there are mental health disparities that the bisexual community faces at higher rates than even gays and lesbians. That said, the American University study surveyed 503 bisexual adults ranging in age from 18 to 64 to hone in on their unique minority stressors and the effects they have on mental health.

“This study adds to the growing body of research confirming that bisexual people face unique mental health disparities [that are] closely related to stigma and discrimination [they face] from straight, gay and lesbian communities,” Heron Greenesmith, a senior policy analyst at LGBTQ advocacy organization Movement Advancement Project, said. “Internal stigma adds another barrier to bisexual people.”

Greenesmith, whose organization has compiled a number of studies and reports that point to the relatively poor health of the bisexual community, said this latest study makes it “even more clear that the bisexual community needs tailored mental health services.”

Read the full article.

Panel creates health care standards for men who have sex with men

From the Washington Blade

The absence of a national standard of care for gay and bi men is partially to blame for higher rates of STDs and other health disparities a national panel of health professionals said this week according to the Clarion Ledger.

The panel, co-chaired by a University of Mississippi Medical Center professor, has created a standard of care for men who have sex with men to address STD prevention programs and other issues, the Ledger reports.

The panel’s sexual health standard of care for MSM includes:

  • A comprehensive sexual history; mental health assessments and referrals; counseling about condoms, lubrication, enemas and douches; and discussions about sexual satisfaction and pleasure.
  • A visual exam to check for signs of HPV, syphilis or other STDs.
  • Urethral swab or urine-based chlamydia and gonorrhea screening; rectal and pharyngeal chlamydia and gonorrheal screening.
  • Syphilis, HIV and hepatitis C screening every three to six months for sexually active MSM with multiple partners, and at least annually for other MSM.
  • Vaccines for human papillomavirus, or HPV, and Hepatitis A and B.
  • Pre- and post-exposure prophylaxis as indicated; expedited partner therapy for chlamydia or gonorrhea infection.

The panel’s recommendations go beyond federal guidelines and instead incorporate the collective experiences of the panel’s experts in sexual health. Their work took into consideration the social landscape for many MSM that can impact whether or not they walk into a clinic, the Ledger reports.

Smoking rampant in LGBTQ community, UIC researcher finds

From dnainfo.com

LGBTQ people smoke at twice the rate of straight people, a University of Illinois at Chicago researcher notes in a paper that offers five ideas to reduce the trend.

UIC clinical psychologist Phoenix Matthews

The paper, produced by a team led by UIC clinical psychologist Phoenix Matthews, said LGBTQ people are “at an elevated risk for tobacco related health disparities due to disproportionately high rates of tobacco use.”

Around 46 percent of gay men and 48 percent of adult lesbians smoke, according to the National Institutes for Health.

Many anti-smoking programs target specific ages, ethnicities and gender — but not sexual orientation, Matthews said in a press release about the paper, published in June by the Society of Behavioral Medicine. Cessation services, such as tobacco quit lines, “are underused by LGBT smokers,” Matthews added.

Matthews recommends that smoking surveys include gays and lesbians specifically and that anti-smoking media campaigns include messages that target them. In addition, the paper urges reducing menthol-flavored cigarettes, which are favored by young smokers, and creating a national clean air act aimed reducing second hand smoke.

Read the full article.

Gay guys: you’re douching wrong

From voice.com

…you don’t truly need to clean out before riding the baloney pony all night long. It all comes down to anatomy. As Dr. Goldstein told me, stool resides in the sigmoid colon, the part of the large intestine closest to the rectum and anus. There, you’ll find a muscle that keeps poo from going into the rectum and through the anus until you’re actually ready to, you know, poo. That means there shouldn’t be any stool where the top’s dick is going, unless your top is hung like Jon Hamm times Justin Theroux.

You’re probably about to say, “Yeah, but when I douche all kinds of poo comes out.” You’re not wrong. The thing about enemas and irrigation devices is that they were made for people with actual constipation issues, not bottoms. When we douche, the force of water propelled into the colon goes past the area that actually needs to be clean for sex, up into the sigmoid colon. That fills the feces up there with water, and then washes it all out, which is the point of the enema in the first place. An enema cleans out way more than you need to for sex, making your butthole even dirtier in the process. And many people do this repeatedly, until the water comes out clear. That’s like draining a whole pool just to get a few leaves out when you could be using a skimmer instead. (Though it’s possible for a dick to enter the sigmoid colon depending on one’s individual anatomy, it’s not common.)

Read the full article.

Do doctors need to know their patients’ sexual orientation and gender identity?

From the New York Times

A growing number of federal agencies has been pushing health care providers to ask. Federally funded community health centers, which treat millions of patients, have begun to collect the data. Electronic health software must be able to store it. And blueprints for national health goals recommend collecting the information from all patients.

By knowing whether a patient is lesbian, gay, bisexual, transgender or straight, say public health experts, clinicians can be more alert to a person’s medical needs and more thoughtful in interactions. If hospitals report statistics on all patients, health care disparities among L.G.B.T. patients can be identified and redressed more effectively.

Read the full article.