Dear Dr. Eva,

I’m a gay man in a long-term monogamous relationship. I have never had any sexually transmitted disease. Is there any real reason to come out to my doctor? I’m uncomfortable with him assuming I’m straight, but I don’t want to embarrass him.

Discreet

Dear Discreet,

First, if your suspicion that knowing you are gay would embarrass your doctor is correct, you may need a different doctor. I hope that he’ll respond in a friendly, comfortable way that shows he is not embarrassed.

It’s important for your doctor to have at least a basic understanding of who you are as a person. For example, knowing what kinds of work you have done and what part of the country you grew up in both are relevant to your health care. Knowing about your sexual orientation and about your current and past sexual behavior is at least as important. Although you are in a long-term relationship now, your past sexual history, as well as your partner’s past history, may put you at risk for health conditions that are much more common among men who have sex with men. Two of these conditions are chronic hepatitis B infection and genital/anal area human papilloma virus infection (also called HPV infection and “the wart virus.”) Both hepatitis B and HPV can cause cancer years after the initial infection. Early detection and successful treatment of these cancers is much more possible if the cancer is detected in an early stage. This can only occur if your health care provider knows you are at risk. In addition, both these viral infections can be prevented by vaccines if you have not already been exposed to the infection. A blood test will show whether or not you have been exposed to Hepatitis B. There is no such test for HPV, however the vaccine is recommended up till age 45, whether or not you have had warts. This is because there are many different strains of HPV, and the vaccine protects against 9 different strains. Finally, care of common conditions is affected by sexual practices. For example, anal problems such as hemorrhoids and fissures have different personal significance and need to be managed differently for a person who has anal sex.

The second part of your question also raises important issues. Your doctor should not assume that you are straight if he has not discussed it with you. Are you sure he makes that assumption? If he does, for example if he has asked you if you are married in a way that doesn’t leave you room to say you’re gay, you may want to find a doctor who is more aware. If you like your doctor otherwise, consider giving him the opportunity to care for you better by coming out to him and seeing how he reacts. If you don’t feel able to do that, it might be best to start by seeing a new doctor who you know will be friendly and coming out at the first visit. You can locate a gay-friendly doctor through the Gay and Lesbian Medical Association at GLMA.org.

Dr. Eva

Dear Dr. Eva,

I recently saw my doctor because of ear pain which started when I was getting over a cold. He diagnosed an ear infection then told me I didn’t need antibiotics! What do you think of that?

Expected A Prescription

Dear Expectant,

Your doctor should get extra credit not only for having current medical knowledge, but also for being willing to do the right thing even when it’s unpopular.

Most inner ear infections (the medical term is otitis media) in children, and almost all cases in adults, will heal just as soon and just as well without antibiotics as they will with them. Not only do antibiotics for ear infections cost money and give no benefit, they also cause harm by creating antibiotic-resistant bacteria, which have become a critical medical problem resulting in infections and deaths due to bacteria that do not respond to any antibiotics.

Dear Dr. Eva,

Will my pubic hair grow back thicker if I shave it?

Summer’s Coming

Dear Summer,

It won’t be any thicker, but it is likely to be itchy as it grows back in. Be sure to use a fresh blade if you shave your pubic hair, and a new blade each time, to reduce the chance of folliculitis (hair bumps.)

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