noizemagazine - Index

noizemagazine - Spring 2008 Issue # 55 - Index

as you were young and beautiful, life was fabulous. I felt such a strong desire to
be part of this world, however after I came out, it was clear to me how foolish a
notion this was. When I realized this, it marked the first time in my life that I had
taken up my own personal authority. I was no longer my parents‘ son or what they
wanted me to be. I was my own person. I was gay.
My private practice is located in Chelsea, which is an area of Manhattan that has a
high concentration of gay men. I am openly gay, and although my patients know
this, there is still a certain degree of shyness when I try to get them to discuss their
sexual history. Obviously, not everyone is comfortable with talking about sex, but
I feel that a man’s sexual history is just as an important part of a patient’s history
as any other. I try my best to approach the matter as someone who is non-judgmental.
My feeling is that I would rather know the truth so that I am better able to
serve my patients. The majority of my patients appreciate this approach, although
it takes a period of adjustment. A certain level of trust has to be established.
For example, I had a patient named John who was fifty years old. On his initial
visit, I asked if he was sexually active. He confirmed that he was. I followed up
this question with, do you engage in sexual activity with women or men? I feel it
is more appropriate not to label patients as gay or straight. Labeling patients can
be perceived as judging them. John was hesitant to answer, although he eventually
did confirm that he engaged in sexual activity with men. I sensed his timidity
and concluded his sexual history by making sure he practiced safe sex by using
condoms.
On John’s follow-up visit two weeks later, he appeared guarded. As we sat down
to discuss his labs, he interrupted me by saying he had something urgent to discuss.
John informed me that he was very angry when I asked him about his sexual
history. His sexual practices were a private matter, he said, and he did not want
this information in his chart. I reassured John that under New York State law, his
chart was confidential and any information in it could not be divulged without his
written consent. John seemed more at ease after our discussion, but I later found
myself thinking that, clearly, John was not comfortable with his sexuality, and harbored
a certain amount of internalized homophobia.
Internalized homophobia is a source of conflict that can translate into shame for
many gay men: shame about loving the same sex and shame over wanting sexual
pleasures that are regarded as unnatural. Shame is one of the reasons why gay
men find it difficult to talk about sex. It is so important that all gay men understand
the fundamental facts about gay sex because, by and large, many of the
daily problems for which I treat gay men are predicated upon the fact that they
are ignorant about sexual issues. This is completely understandable because gay
men do not learn about the birds and the bees from their fathers – they learn on
their own, talking with their gay friends, or from watching porno.
All gay men should be empowered with enough knowledge about their health,
sexuality, and lifestyle in order to enable them to make informed decisions about
their own well being. Gay health encompasses following a plan that will allow you
to live your life to the fullest without the constraints of homophobia. Since the
average life expectancy for all men has increased, contemporary gay men need to
educate themselves in order to maintain the same healthy lifestyle that they had in
their twenties and to disprove the tired myth that life ends at forty. There is a journey
to be traveled and lived with as much vitality to last well into your seventies,
eighties, and beyond.
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