Dear Dr. Eva,
How about a special GLBT
health column for Gay Pride?
Here you go. My sources
for this column are from the website of GLMA, the Gay and Lesbian Medical
It is difficult to
address the health concerns of GLBT people as a group because the
"GLBT" umbrella covers six distinct groups of people: gay men,
lesbians, bisexual women, bisexual men, transwomen and transmen. Still,
there are some issues that are important for all six groups. This column will
address seven of those issues. Future columns will cover issues specific to
transwomen and transmen, issues specific to lesbians, and issues specific to
men who have sex with men.
Communicate with your
People's health risks
vary according to sexual behavior. Cross-gender hormones also cause specific
health risks. To provide you with the best care, your clinician needs to know
your sexual orientation and gender identity. Once you inform your provider, he
or she should ask you specific questions relating to your orientation or gender
identity. A complete sexual history is essential for comprehensive health care.
Be honest about your behaviors. If there are some things you are unwilling to
disclose, ask yourself why - if you are embarrassed by your behavior, there's a
good chance it's dangerous. If your provider does not seem comfortable with
your sexual orientation or gender identity, look for another provider.
GLBT people use tobacco
at much higher rates. Smoking is guaranteed to damage your health and shorten
your life. Long-term tobacco-related health problems include emphysema, lung
cancer, throat cancer, bladder cancer, heart disease, strokes, high blood
pressure, and many other serious problems. Short term consequences of smoking
include bad breath, stained teeth, smoker's cough, and the expense of smoking.
Free resources for smoking cessation are available by calling 1-800-quitnow or
searching 1-800-quitnow online.
Fitness (Diet and
GLBT people, like all
Americans, are prone to obesity. Obesity causes high blood pressure, diabetes,
and arthritis of the hips and knees. Obesity is also associated with increased
rates of heart disease, breast cancer and other cancers, and with premature
death. Regular exercise and a low-fat, low calorie diet are the way to
prevent obesity and also the way to cure it. We all find it hard to make time
for exercise, but just 20 minutes of brisk exercise three times a week will
significantly decrease your risk of heart disease and move you towards a
healthier lifestyle. Brisk exercise means your heart rate increases and you are
a little out of breath, and not able to carry on a conversation while
GLBT people use illegal
drugs and alcohol more than the general population. Some GLBT people's social
lives are largely limited to a small, tightly knit group of friends. When
everyone in the group is drinking or drugging, it normalizes the behavior and
can serve as an excuse not to change. Regular use of drugs or alcohol
eventually leads to problems at work and in relationships. In time, alcohol use
leads to nerve damage, brain damage, liver failure and death. Alcohol also
increases the risk of heart disease and cancer. Alcohol and drugs cause many
deaths through driving while intoxicated and violence against oneself and
others. Cocaine can cause abnormal heart rhythms and heart attacks.
Amphetamines cause premature aging and gum disease resulting in tooth loss.
Twelve-step programs are free and have been effective for many people in
stopping and staying off alcohol and drugs. Thee are specific GLBT groups in
both Alcoholics Anonymous and Narcotics Anonymous.
Depression and anxiety
affect GLBT people at a higher rate than the general population. This is at
least in part due to effects of homophobia and transphobia, and the rejections
many GLBT people experience from their families and religions. GLBT people in
their teens and twenties have a much higher risk of attempting suicide than
straight people of the same age and sex. Young GLBT people with signs of
depression need close monitoring; suicide threats should always be taken
seriously. When accessing mental health care, it's important to make sure that
the counselor or therapist is affirming (not just neutral) towards GLBT people.
Depression is easily treatable with effective medications: seek help sooner,
All sexually active
people are at risk for sexually transmitted diseases. STD's occur at a very
high rate in gay and bisexual men. A person can be infected with most STD's
without any symptoms. People who are infected without symptoms can still infect
their partners. STD's caused by bacteria and lice are curable with
medication. These include syphilis, gonorrhea, Chlamydia, trichomonas, and
pubic lice ("crabs").. STD's caused by viruses are not
curable. These include HIV, Hepatitis A, B, and C, Human Papilloma Virus (HPV),
and herpes. Vaccines are available to prevent Hepatitis A, Hepatitis B, and
HPV. It has been repeatedly shown that the use of condoms (male and female
types) and dental dams reduces the risk of sexually transmitted diseases. The
more partners a person has in a year, the more often they should be tested for
STD's. People are much more likely to become infected with STD's when
they are intoxicated with alcohol or drugs, when they do not know their
partner, and when they meet a partner through the internet.
GLBT people suffer from
violence in intimate relationships at least as often as the general population.
Medical providers, emergency room staff and police are less likely to suspect
or ask about intimate partner violence when the partners are the same sex. It
is especially difficult for GLBT people to get help if they do not acknowledge
being in a relationship.
Ask Dr. Eva is distributed by Healthy Living News. Email comments and questions to