HEALTH LINE
The Country Gay & The City Gay
Health care for men having sex with men
“I lost my ‘virginity’ during my high school days,” said Ghing, our 30-year-old guest in our cable TV show entitled Pulso sang Banwa cable TV Show. “He was our star basketball player and he got me so drunk I couldn’t resist him.” Ghing was the city ‘girl’. The candid tell-all type. As he kept on boasting, Lando, the shy rural gay guest was green with envy. Lando, or ‘Landa’, just “came out from the closet” and has separated from his wife.
Ghing and Lando realized they were gays during elementary days. Ghing was open and his parents easily accepted his sexuality; while Lando kept his internal conflicts until lately at 47 when he was already married with four kids.
Anal, Oral and Carnal
Like Ghing, majority of MSMs (Men Having Sex with Men), practice anal intercourse. I pray that, unlike Ghing, they practice safe sex with condom protection. The anal and rectal linings, compared with that of the vagina’s, are so thin that minor irritations (anal intercourse is not minor) can cause bleeding and transmission of HIV, syphilis, Hepatitis B, and other sexually transmitted infections. Ghing not only practices receptive (receiver) anal sex but he also penetrates with the same STI risks.
Condom for Oral Sex?
Oral sex also transmits Hepatitis A, chlamydia, and even HIV. “I thought oral sex is safe, doc,” Ghing said.
The thought that oral sex cannot transfer germs is a misconception. They put a lot of MSMs at risk. Extra splatters can also cause havoc to structures nearby (gonorrhea of the eye). Ghing’s eyes widened in surprised as I explained to him the reason why there are condoms with banana and strawberry flavors.
Sexual Risk Takers
More MSMs now become sexual risk takers. Society’s apathy (or antipathy) coupled with lack of exposure to persons living with HIV or persons who have died of AIDS, and belief that STDs won’t happen to them, lead to aggressive risk taking activities. MSMs must be tired of too much worries about AIDS plus the internal mental clash, low self worth, depression, lack of peer support, and no access to preventive services. These could be the reasons why use of condoms had declined by twenty percent.
Sex Everywhere
While Landa could not practice gay sex because of watchful eyes, Ghing enjoys his nightly escapades at the city plaza. From the romantic ambiance of the grasses and bushes to the dark lonely corners of the paseo, Ghing releases his male or female bravado.
Glenn Beup, our show’s main anchor reported that one MSM had been apprehended by the police for “pushing in the bush.” These events, as reported, could only collect a so-so, if not entertaining, public reaction.
And Whomever
The issue on sexual promiscuity is important for healthy gay sex lives. Of course, many an MSM has a happy monogamous life with his committed sexual partner. Many MSMs, however, enjoy their folly with a minimum of four different sex partners per month. John Diggs, MD quoted a 1978 study that gay males had at least 100 male partners in their lifetime. Same study showed that 28 % of them claimed that each had 1,000 lifetime sex partners. That was before the AIDS epidemic. It declined for a while but concerns now is: the numbers are approaching the pre-epidemic rate.
Ghing admitted he plays a lot and he even pays for a male partner. And by how much? Average of P100.00.
When ‘Gay’ means Sad and Lonely
Being gay could mean higher rates of psychological and behavioral problems. Rooting from early childhood teasings and adolescent mental turmoil, MSMs can only hide those deep emotional troubles. Depression, anxiety, suicidal plans, eating problems, alcohol or drugs use and smoking are common. Even in the corporate world, gays often hide their identity for fear of discrimination and privilege concerns. Netherlands, a country where gay, lesbian, and bisexual relationships are more socially accepted, reports the same psychological problems.
Death By Being Secretive
MSMs usually do not reveal their sexual orientation or practices for fear of being socially isolated, discriminated, and verbally or even physically abused (MMWR Morb Mortal Wkly Rep 2003). Ashamed and afraid that their physicians might turn unfriendly upon learning that they have sex with men, they miss the opportunity for important (read: life saving) screening procedures. Physicians’ lack of knowledge and awareness about the issue can be doubly deadly. If only doctors knew his patient is an MSM, then a simple sore throat could mean throat gonorrhea, a hemorrhoid could mean anal cancer, rectal gonorrhea or chlamydia, and a fever could mean a more serious infection or even an HIV (early symptoms) prodrome.
Early Death for Gays
Lando and Ghing felt upset when I told them of a study reporting about 20 years lost for being gay. One’s life span decreases because of medical complications discussed here. Despite the time constraints, we tried and hoped that we were able to deliver the messages and provide helpful insights about health risks for MSMs. My only regret was I was not able to elaborate further the danger of going down under.
Back to Anal Sex
To reiterate: “Gay Bowel Syndrome” exists. Dr. Diggs emphasized the danger of anal sex without protection. The anus is ‘for exit’ only and, unlike the vagina, is devoid of layers of muscles and natural lubrication. Repeated trauma and stretching can cause damage to the control of its opening that may cause leakage of waste. The male ejaculate/ semen (commonly mistaken for the unseen ‘sperm’) contain immunosuppressive materials purposedly to counter the female reproductive area for easy insemination. Used by males for males, this immunosuppression causes easy damage. Even Human Papilloma virus can easily enter causing anal and rectal cancer. The importance of protected anal sex can never be overemphasized.
Blissful Ignorance Is Hazardous
The episode with Ghing and Lando earned a lot of viewers’ reactions (fortunately all positive ones). Many still hunger for more views about homosexuality and we could only offer some civility. Many are still challenged about the topic yet still needing to be picked. Like my male college classmate, from a Catholic school in Bacolod, when asked by our UP Professor in Social and Political Thoughts: “What is Anal Intercourse?”, my classmate stammered. The good professor put his hand with the blackboard eraser into his butt screaming, “Sa Buli!”
Last message: The American Academy of Family Physicians Guidelines advise that MSMs practicing receptive anal sex with or without protection should receive a yearly Pap Smear for Cancer. You may wonder Pap Smear is only for women. Where is the Pap Smear area for men then? Answer: “Sa Buli!”
(Our writer is a member of the American Association of Sexual, Educators, Counselors and Therapists, and The Kapisanan ng Mga Brodkasters sa Pilipinas. You can catch Dr. Yap every Sunday morning at Bombo Good Morning Philippines 900 MHz, and Fridays at “Health Line” Wesfardell Budyong Kapihan TV Show with Rexam Laguda. Saturdays at Pulso sang Banwa with Glenn Beup channel 5 Alto Cable 8 am. Dr. Yap’s book “Joyful Life…& Sex? GO TO HEALTH!” is now available at all National Book Stores outlets nationwide)
