Get Ready for Frank Talk

In 2008, I wrote about the importance of coming out to your doctor and finding a gay or gay-friendly health care provider in The Advocate Guide to Gay Men's Health and Wellness. It is one of the most important things you can do for your health. The old adage that what goes on in your bedroom is no one's business but your own simply doesn't hold up. Is your relationship monogamous? Are you in an open relationship? Are you a single gay man who likes to attend sex parties? These are important aspects of your private life that you should divulge to your doctor. Offering your health care provider insight into your personal life will enable him to better understand you and allow him to incorporate preventative measures into your health care plan.

When you open up the lines of communication with your doctor, be ready for some frank discussion in return. Your doctor should be your confidant, but he should also be there to offer frank medical advice and dispel those health myths many of us carry around. If your doctor isn't comfortable discussing your gay personal life, get yourself another doctor. Your health is too important for you to go back into the closet. Homophobia often extends into the health care sector, and some medical professionals just aren't comfortable talking about sex, recreational drug use, anabolic steroids, or any number of issues relevant to gay men. Ideally, your doctor should create a welcoming environment so that you, as the patient, do not feel judged or insulted.

In 2006, an article titled "Optimizing Primary Care for Men Who Have Sex With Men" was published in the Journal of the American Medical Association. The authors concluded: "Primary care clinicians should never underestimate their importance in their patients' lives and they should promote healthful behavior by appearing open to discussing sexuality and making this as normal as reviewing smoking, diet, or exercise. With adequate education and training, clinicians not only will provide appropriate routine care for their sexual-minority patients but will also help patients avoid internalized stigma associated with homosexuality, access the optimum health care they need and deserve, and lead more satisfying and healthy lives."

Unfortunately, not all doctors agree. At a recent meeting of internists, I sat among hundreds of primary care doctors as we debated whether or not to offer HIV testing to all our patients. There was a fairly large group who said they didn't offer HIV testing because they didn't want to deal with the repercussions of a positive result.

Imagine a doctor not willing to offer a test because a negative outcome would complicate his day?