A Doctor's Perspective 

I am reminded of one Friday morning when two elderly gentlemen came into my office. One was a new patient and the other was introduced to me as his "friend." Usually, I do not see patients with their "friends" present, but the patient was clearly nervous. As we talked about his medical history, I asked my patient if he was single, married, or partnered. The patient told me he was "not married." He and his "friend" then exchanged knowing glances. I was suspicious but knew no additional information would be offered, so I continued, "Well, then, do you live alone?" Begrudgingly he replied, "I live with my friend." Eventually he confessed and told me that they had been living together for forty years and that their relationship was an intimate one. This information was produced after much interrogation, but it was not revealed until I was forced to press the issue. Afterward I queried, "Why didn't you just come right out and tell me?" They replied, "Because we weren't sure about you."

These two gay men had been in a forty- year relationship and, despite the fact that they were sitting in an HIV clinic opposite a male doctor, they still felt compelled to hide their sexuality until they felt more at ease with me. This encounter taught me two valuable lessons:

1. Never to assume that my patients know I'm gay

2. The power of the closet still exists

If anything, this experience reinforced my belief that finding a gay doctor or one who is gay friendly is paramount to your health as a gay man. I could not imagine life otherwise.

Another example comes courtesy of a friend, Greg, who went to see a doctor about a lump that developed under his nipple. He was worried that it might be cancer; however, after his initial consultation, Greg was more concerned with his new doctor's behavior than with whether or not he had cancer.

During the history portion of the visit, Greg told his doctor that he was gay, and he immediately noticed a change in his doctor's demeanor. The man became nervous and dismissive, and Greg clearly felt that the doctor was uncomfortable with his homosexuality. After the consultation, Greg followed his doctor's orders and returned in one week. They reviewed the results of Greg's tests, and interestingly, he found that his doctor had ordered a whole slew of tests for sexually transmitted diseases and HIV, despite the fact that Greg said he was in a long-term, monogamous relationship. Greg was quite embarrassed and wondered if his doctor ordered these tests routinely on all his patients or specifically for Greg because he had identified himself as gay? I gave the doctor the benefit of the doubt, but I was suspicious myself. Was Greg's new doctor acting in a way to suggest that gay men are more promiscuous than the general population, when Greg had explicitly told him that he was in a long- term relationship? Regardless of the answer, it was obvious that there was a breach in trust. Greg had not been made to feel like he was an active participant in his care plan. His doctor had acted without including Greg, and this, in turn, made him feel uncomfortable.

Final outcome: He had the lump removed by a good surgeon, but afterward he found himself a gay primary care doctor whom I recommended.