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Presumptions —When counselling gay people about sex, it is important not to have preconceived ideas about their sexual repertoire. Be honest with yourself; if you are uncomfortable with gay people refer the patient to someone else. If an adolescent is confused about his or her sexuality try to help the patient to adjust. Disapproval —The days when physicians would try to impose their own moral standards on their patients should be long past.

If individual clinicians are aware that they are uncomfortable with the issues of gay sex and relationships then they should refer the patient on to somebody else. It is difficult to focus on the relevant clinical issues if you are having to concentrate on your own discomfort and trying not to express it. Inaccurate advice —It is unwise to advise patients on subjects that they may know more about than you do, and if anal sex is not something that you know much about it is better to admit this rather than offer inaccurate or misleading advice.

Gay men face practical problems, such as a future application for life insurance, which mean that some patients will not wish to disclose their sexual orientation to their general practitioner, no matter how sympathetic and confidential. It is unclear what proportion of men and women have same sex experiences in their lives.

Studies have been fraught with methodological errors and with researchers trying to confirm their own preconceptions. Gay men and lesbians have as wide a range of sexual lifestyles as does the general community. Some homosexuals live in a stable partnership and never have sex elsewhere. Others have a strong, committed relationship but with an open acknowledgment that one or both partners also have sexual liaisons elsewhere. Infidelity in a supposedly closed relationship is probably just as common as among heterosexuals.

Single gay men have a reputation for having many sexual partners, and in urban communities the opportunities for this are widespread. Casual or anonymous sex can provide sexual gratification without the complications of a relationship. Sexual dysfunctions should be assessed objectively without a moral stance being taken on the manner in which sexual expression is likely occur.


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There can also be considerable distress for those who find it difficult to establish same sex relationships that could progress to become sexual and committed. Gay men —Anal sex remains a taboo subject even for many professional sexual discussions; however, it is widely practised in most communities. Sexual activity is protean in all groups, and gay men are no different in this.

Mutual masturbation, oral sex, and anal sex can be considered core activities, although many gay men do not practise anal sex at all.

Sexually Transmitted Diseases Among Gay and Bisexual Men | CDC

Lesbians —Mutual masturbation, oral sex, caressing, and penetration with fingers or sex toys can be considered as core activities. Once they have sought help, gay men and women are often less reticent in discussing at length and in detail specific sexual acts. It is therefore useful for a doctor to be forearmed with a basic vocabulary of gay sex, although many men and women who perform these activities will lack the words to describe them, and few people of any orientation are likely to have all the activities in their personal behavioural repertoire.

Most gay men will not fit exclusively into either of the roles implied by the old fashioned heterosexual model, and if the words are applied to oral sex great confusion may result. Gay male oral sex includes two sexual acts, fellatio and irrumation—cock sucking and face fucking respectively—depending on whether it is the mouth sucking or the penis thrusting that is the main act. When it is necessary to determine who did what, it is easier to talk about insertive and receptive partners to avoid confusion. Erectile dysfunction is being seen increasingly, usually of an organic type, in those with late stage HIV infection, although whether this is an effect of the virus or of the antiviral drugs is not yet clear.

Piles caused by dilation of an anal venous plexus are no more common in those having receptive anal sex, and are usually caused by straining at stool. Anal fissures usually arise from constipation rather than receptive anal sex. However, if they are a sexual problem they generally respond to the use of an anal dilator. A topical anaesthetic such as EMLA cream may be used on the first few occasions, until healing is under way. Female sexual problems —Like heterosexual women, lesbians can suffer from vaginismus, primary or secondary, and from anorgasmia and low sexual drive see earlier article by Butcher.

Sexually transmitted diseases are common in people with many sexual partners, which includes some homosexual men. The ease of transmission of most sexual infections is similar for vaginal and anal sex, with the exception of HIV, which is much more easily spread by anal sex. Strong condoms greatly reduce this risk. Oral sex, while a recognised route of transmission, is considered to be relatively safe for HIV, but it is a common means of acquiring gonorrhoea and non-specific urethritis.

Avoiding prejudice

Lesbians are considered a low risk group for HIV infection. Sexually transmitted diseases are common in all gay people with a high number of different partners. The transmission of infection through vaginal and anal intercourse is no different, apart from HIV.

List of LGBT slang terms

The greater incidence of hepatitis B is an indicator of a large number of partners, not of specific sexual practices. Faeco-oral spread of pathogens such as Giardia and hepatitis A are well recorded from oro-anal sexual contact. Minor episodes of diarrhoea may be related to faecal exposure, and are often self limiting. If they persist, stool culture will usually pick up any bacterial cause, and if the culture is negative it is better to treat for presumed giardiasis than do extensive investigations to attempt to prove the diagnosis.

Hepatitis B, though commoner in gay men, has not been shown to be spread by specific sexual practices and may simply be a marker of exposure to a greater number of sexual partners. Immunisation against hepatitis A and B is recommended by the Department of Health for all men with male sexual contacts. This means that, in absolute numbers, there are more heterosexuals having anal sex than there are gay men. There are little published data on how many heterosexual men would like their anus to be sexually stimulated in a heterosexual relationship.

Anecdotally, it is a substantial number. What data we do have almost all relate to penetrative sexual acts, and the superficial contact of the anal ring with fingers or the tongue is even less well documented but may be assumed to be a common sexual activity for men of all sexual orientations. The organization is named after one of the earliest physicians to work with transsexuals, Dr.

Harry Benjamin. The most widespread set of standards and guidelines used by professionals for the medical and mental health treatment of transsexuals. The HBSOC are periodically updated and revised as new scientific and medical information becomes available.

Homosexual men and women

General term used to refer to over-the-counter herbal hormones that claim to simulate natural or prescription female or male hormones. An outdated term, usually considered offensive, for intersex persons. The assumption, in individuals or in institutions, that everyone is heterosexual, and that heterosexuality is superior to homosexuality and bisexuality. Prejudice against individuals and groups who display nonheterosexual behaviors or identities, combined with the majority power to impose such prejudice.

Usually used to the advantage of the group in power. Any attitude, action, or practice — backed by institutional power — that subordinates people because of their sexual orientation. Those benefits derived automatically by being heterosexual that are denied to homosexuals and bisexuals. Also, the benefits homosexuals and bisexuals receive as a result of claiming heterosexual identity or denying homosexual or bisexual identity. The irrational fear or hatred of homosexuals, homosexuality, or any behavior or belief that does not conform to rigid sex role stereotypes.

It is this fear that enforces sexism as well as heterosexism. Administration of hormones to affect the development of masculine or feminine secondary sex characteristics. Hormone therapy is usually continued for life. This surgery is often pursued by FTMs as part of the transition process, as well as for health reasons. The idea that gender identities and expressions do not fit on a linear scale, but rather on a sphere that allows room for all expression without weighting any one expression as better than another.

Refers to a homosexual, bisexual, transperson or intersex person who will not or cannot disclose their sex, sexuality, sexual orientation or gender identity to their friends, family, co-workers, or society. Arrangements of a society used to benefit one group at the expense of another through the use of language, media, education, religion, economics, etc.

Sexual activities

The process by which a member of an oppressed group comes to accept and live out the inaccurate stereotypes applied to the oppressed group. Some intersex people are also transgender, but intersex is not typically considered a subset of transgender, nor transgender a subset of intersex. A type of FTM chest surgery procedure that is effective for individuals with small amounts of breast tissue. In the keyhole method, a small incision is made along the border of the areola usually along the bottom , and the breast tissue is removed via a liposuction needle through the incision.

The nipple is left attached to the body via a pedicle a stalk of tissue in order to maintain sensation. Once the breast tissue has been removed, the incision is closed. The nipple is usually not resized or repositioned. The term lesbian is derived from the name of the Greek island of Lesbos and as such is sometimes considered a Eurocentric category that does not necessarily represent the identities of African-Americans and other non-European ethnic groups. The heterosexist notion that any woman who prefers the company of woman, or who does not have a male partner, is a lesbian.

Usually refers to a lesbian with a feminine gender expression. Can be used in a positive or a derogatory way, depending on who is using it. Is sometimes also used to refer to a lesbian who is seen as automatically passing for heterosexual. A male-bodied person who identifies as a lesbian. This differs from a heterosexual male in that a male lesbian is primarily attracted to other lesbian, bisexual or queer identified people.

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A person who was born in a male body but whose gender identity is female. Also can refer to those assigned male at birth, in the case of intersex people, whose gender identity is female. Scrotal implants may or may not be added. First used in by British journalist Mark Simpson, who coined the term to refer to an urban, heterosexual male with a strong aesthetic sense who spends a great deal of time and money on his appearance and lifestyle.

This term can be perceived as derogatory because it reinforces stereotypes that all gay men are fashion-conscious and materialistic. Short for Male-To-Female. Individuals who have not attained and may not desire to attain gender reassignment surgery, and may or may not take hormone therapy. The surgical removal of one or both ovaries. This surgery is often pursued by FTMs, usually in combination with a hysterectomy, as part of the transition process, as well as for health reasons.

The systematic subjugation of a group of people by another group with access to social power, the result of which benefits one group over the other and is maintained by social beliefs and practices. This causes sterilization and greatly reduces the production of testosterone.

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