Dr. Lin: Gay men’s medical checklist

Fifteen key health items your doctor might not know to ask

So you haven’t seen a doctor in years and you finally have health insurance. You find a doctor and you’re done, right? Wrong.  Unfortunately, most physicians are still not attuned to gay men’s specific health needs. You need to be your own advocate. Print out this checklist and go over it with your doctor.

General

1. Homosexuality: I am comfortable being out to my doctor and my doctor is awesome about it.
— No?  Stop – find another provider. Do not continue. Check out the referral database at www.glma.org for suggestions.

Vaccinations

2. Hepatitis A vaccine: Recommended for all gay men.
–May cause long-term liver damage and is spread oral-fecally – read, if you rim or have oral sex you are at pretty high risk.

3. Hepatitis B: Recommended for all gay men.
–May cause long-term liver damage or cancer and is spread by contact exposure to bodily fluids. You can get this just sharing toe nail clippers.

4. HPV (human papilloma virus) vaccine: Recommended for all men (under the age of 26 but I say everyone should get it). No one wants anal/penile warts or anal cancer. Insurance companies often will pay for this. Refer to “What, what in the butt” for a full discussion.

STDs/HIV

5. HIV status: (within the last 6 months)
I don’t know: If not, ask your doctor to test you or if you live in Chicago go to TPAN, Howard Brown, or the Center on Halsted to get tested for free and anonymously. This way, you control who knows your status.
I am HIV-positive: you should be seeing an HIV specialist. Ask your doctor for a referral.
I am HIV-negative: Excellent, remember to keep getting tested every six months.

6. PEP (post-exposure prophylaxis): My doctor has heard of it and is comfortable prescribing it.
–I understand that if I have unprotected sex with an anonymous guy or if I find out he is HIV positive, if appropriate, my doctor can start me on anti-HIV medications within 48 hours of exposure to reduce my risk of infection. I am comfortable calling my doctor in the middle of the night if needed for this.

7. HIV prophylaxis: I know that if I am ever in a relationship where one of us is HIV positive and the other is not, there are anti-HIV medications that can be taken to reduce the risk of transmission.

8. Anal pap smears: My doctor has heard of this and is comfortable either performing them or referring me to someone who does them should I request it.
— Anal cancer (caused by the HPV) is 20 times more common in gay men. The only way to catch it is to get screened. Refer to “What, what in the butt” for a full discussion.

Substances

9. Recreational drug use: I am comfortable telling my doctor what drugs or substances I use recreationally: amyl nitrate (poppers), Viagra, Xanax, Percocet. These drugs often cause symptoms that I may not expect or have interactions with other drugs that are prescribed for me.

10. Supplements: I am comfortable telling my doctor what weight gain or weight loss drugs that I am taking such as Hydroxcut or if I use steroids. I understand that these supplements may interact with other drugs or cause abnormalities in my labwork.

11. Tobacco: I am honest with my doctor as to the extent that I smoke and I know he or she can provide me with resources to help quit.

12. Alcohol: I am honest with my doctor about the amount of alcohol I drink. I understand that gay culture has institutionalized alcoholic behavior in things like “Sunday Funday” that may be extremely harmful to my health.

Mental Health

13. Depression: I know gay men have a higher rate of depression, mood disorders and risk for suicide than straight men. My doctor routinely asks me and is comfortable discussing my mood/feelings and I feel safe enough to have this discussion.

14. Body image: “Manorexia” (a.k.a. anorexia or feeling like one is always fat) and its reverse “bigorexia” (a.k.a. muscle dysmorphia, feeling like one’s muscles are never big enough) is common in gay society. I can talk to my doctor about these compulsions or desires without judgment and receive assistance if needed.

Partner Rights

15. Partner Visitation Rights: If I am in a long-term relationship (married or domestic partnership), my doctor knows and has recorded who I would like to make decisions for me in the case that I cannot. My doctor will help advocate for my partner’s right to make decisions for me. Depending on my state, I may require a Health Care Proxy document that is signed.