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Let’s Talk About Sex…


Let's Talk About Sex...

The Advocates: Expert advice on life -- as you live it.

The Advocates: Expert advice on life -- as you live it.

Dr. Frank Spinelli

Dr. Frank Spinelli is a board-certified internist in New York City. To ask medical questions for future, e-mail

Why it's vital to get personal with your doctor.

One particularly angry gay man once said to me, "What goes on in my bedroom is none of my doctor's @$ business." I couldn't disagree more. Sure, talking to a doctor about sex, particularly as a gay patient, can be embarrassing, but our sexuality is the primary basis for the differences in the health care needs of heterosexuals and gay people. Certainly, the ongoing AIDS crisis has taught us to be mindful of our health care concerns associated with sex, but doctors and researchers now know other ways in which our needs are unique; mental health -- as evidenced by the study from the Journal of Health and Social Behavior -- is of special concern as well.

The health care of gays and lesbians should be culturally sensitive to their needs. To that end, I'll be deciphering some of the more confusing medical jargon in the news -- and pharmaceutical advertising -- in the coming months. I also welcome the opportunity to answer your health-related questions. Knowledge is power, and it's my goal to help arm you with that power.

Positive Thinking
A study published in the December 2008 Journal of Health and Social Behavior found that gay men who feel sexually undesirable are more likely to engage in risky sexual practices, and their sexual partners are more apt to insist on not using condoms. Meanwhile, men who have a healthy body image are more likely to insist on safer sex. The study shows a clear link between mental states and sexual behavior. Given the emphasis many gay men place on physical appearance, this study demonstrates the vital importance of cultivating a strong sense of self-worth. If you feel you have knowingly put yourself at risk for HIV and other STDs because of low self-esteem, speak to a health care professional. The Gay and Lesbian Medical Association has a directory of gay-friendly medical providers and support groups.

Just for Girls?
Gardasil, the vaccine for the highly infectious human papillomavirus, has been in the news lately. The leading cause of cervical cancer in women and a cause of anal cancer in men, HPV can be spread through shared sex toys and direct skin-to-skin contact during vaginal, anal, and oral sex. Gardasil is currently FDA-approved only for females ages 9-26 -- but gay men and older women (even lesbians) should talk with their doctors about getting the vaccine. The $450 for the series of injections is unlikely to be covered by your insurance if you're not part of the FDA-approved group, but considering the growing number of cases of anal cancer in men and cervical cancer in women, Gardasil could be well worth the expense.

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