LGBTQ Health

Gay Men and MSM Health

Welcome to the gay men and men who have sex with men (msm) health page of the Health Education web site. The web site is designed to be sensitive to gay students on every page and to address the health information needs of gay students throughout the site, not just on this page. For example, we use gender neutral language in the Sexual Health section (unless we're talking about things like pregnancy), and our dating violence pages include information on same-sex dating violence and resources for LGBTQ students. This page was designed as an introduction to some health issues for gay men and men who have sex with men and as an easy way to find information, links, student groups, and campus resources. 

What do the terms "gay"and "msm" mean?

Men who identify as gay are a diverse group, but are generally men who are sexually and romantically attracted to other men. Men who have sex with men (MSM) refers to men who engage in sexual activity with other men, regardless of how they identify themselves; many choose not to accept social identities of gay or bisexual. The term MSM is often used in medical literature and social research to describe a group for clinical study without considering issues of sexual self-identity. 

Addressing homophobia

Homophobia is a term used to describe the fear of or aversion to homosexuality, or discrimination against LGBTQ people who are homosexual or perceived to be homosexual. It can also mean hatred, hostility, disapproval of, or prejudice towards LGBTQ people, sexual behavior, or cultures.
It's a shame that we have to deal with this sort of thing, but sometimes we do. Homophobic words, threats, or even violence can be very damaging to our sense of safety. It's good to be prepared with a response before it happens.
Each person's response will be unique and may be different from situation to situation. Addressing homophobia without escalating the situation is the best option, but that's not always possible if you feel intimidated, threatened, or if you're not out of the closet. Fortunately at Brown you have allies in students and student groups, in the administration, and in the faculty. Here are some ideas for ways to handle these situations:

  1. Assess your situation. Are you alone? Are you in any physical danger? Do you feel comfortable addressing the homophobia/biphobia or do you have a more immediate need to see to your safety?

  2. If you feel that you're in any danger, try to leave the situation and get to a blue phone to call Public Safety (401.863-4111). If that's not possible look around and see if there's anyone else's help you can enlist. Don't be afraid to be loud and draw attention to yourself.

  3. If you feel you can respond safely, try to respond in a way that does not escalate the situation. Insulting your harasser or casting aspersions on his/her own humanity or sexuality typically isn't a good method either.

  4. You can also report homophobic and biphobic harassment to Brown through the Office of Student Life (401.863-3800 Dean Carla Hansen) or the Special Victims Unit of the Department of Public Safety (863-2542).

  5. Get support from the LGBTQ Resource Center (863-3062, Faunce House, Room 321) or the student group Queer Alliance.

 

Remember that if you've been harassed it's normal to feel upset, angry, or sad. Talk to someone you trust to help you work through your feelings and decide if there's something more you want to do. There is help on campus for getting through this including Counseling and Psychological Services, and the Office of Student Life.

How do I prepare for a visit to Health Services as an LGBTQ student?

Sometimes you might feel uncomfortable seeking health care because of a fear of homophobia. This can make it harder to seek health care when you need it. This problem may be compounded if you are a person of color and fear racial prejudice. Health Services works hard to be a safe space for LGBTQ students to seek appropriate, sensitive, non-discriminatory health care.

What you can expect
On a visit to Health Services you can expect to receive comprehensive care that is sensitive to you as an LGBTQ person and knowledgeable about health care concerns you might have. This includes, but is not limited to, concerns you might have about sexual health and sexuality. Questions about sexual activity are not intended to stereotype you and are not based on assumptions about how you behave. Rather, they're a standard part of care at Health Services. A good medical provider will ask questions about your health behavior in a sensitive way, not making any assumptions, but assessing your level of risk. However, if you ever don't feel comfortable answering a question, just say so. Remember that your visits to Health Services are covered by medical confidentiality laws.

Patient-provider communication
You play an integral part in the health care you receive. Communicating openly and honestly with your medical provider is an important way to receive comprehensive and sensitive medical care. This includes talking about issues like sex and gender identity. It's also important that you feel like you can ask questions of your provider. We suggest that you find a provider at Health Services that you feel comfortable with to take the lead on your medical care. While all providers are available to you, this provider can come to know your history well, and, by building a relationship with this provider, you will optimize your health care and feel safer discussing your concerns and issues. You can ask around about which providers your friends use or make a point of meeting different providers when you schedule appointments. You can always request a specific Health Services provider by name or request a provider by gender.

Prepare for your visit
One way to approach a trip to Health Services if you're nervous is to do some research before you come in. Check out our pages on health issues and concerns for women who have sex with women, men who have sex with men, bisexuals, and trans* students. If you have questions for your provider, write them down and bring them in -- sometimes it's hard to remember all of your questions once you're in the exam room. Remember that you can tell your provider that you are nervous and they can help you through the questions.

Give us feedback
Finally, patient comments are very important to us. If you have any feedback about our services, good or bad, please fill out a patient comment form and put it in the boxes that are in the waiting rooms. We address all complaints, and the more specific you are, the better we will be able to fix the problem. If you choose to leave your name, we will follow up with you.

Health Services is located at 13 Brown Street on the corner of Brown and Charlesfield Streets. Call 401.863-3953 to make an appointment. 

What health concerns are specific to gay men and men who have sex with men?

Gay men and men who have sex with men are a diverse group with diverse health concerns. Your own specific circumstances and behaviors determine which health issues it makes sense to research further. Generalizations about gay male/msm health necessarily rely on generalizations about identity and behavior. The list of health concerns below, therefore, is not prescriptive, but for your information. It may be that some or even many of the health issues do not apply to you simply because you identify as gay. It is most important to find a medical provider that you trust to respond to your questions and concerns.

The Journal of the Gay and Lesbian Medical Association has identified the following top 10 health issues. Click on the heading for a discussion of these issues.

  1. Substance use

  2. Alcohol use

  3. Sexual health

  4. Tobacco use

  5. Cancer

  6. Nutrition, fitness and weight

  7. Heart health

  8. Depression and anxiety

  9. Social support and emotional well being

  10. Self harm 

Health concerns for gay men and men who have sex with men

1. HIV/AIDS and Safer Sex

That men who have sex with men are at an increased risk of HIV infection is well known, but the effectiveness of safer sex in reducing the rate of HIV infection is one of the gay community's great success stories. However, the last few years have seen the return of many unsafe sex practices. While HIV treatments have dramatically increased life expectancies, there is no substitute for preventing infection. Safer sex is proven to reduce the risk of receiving or transmitting HIV. All health care professionals should be aware of how to counsel and support maintenance of safer sex practices.

2. Substance Use

Gay men use substances at a higher rate than the general population, and not just in larger communities such as New York, San Francisco, and Los Angeles. These include a number of substances ranging from amyl nitrate ("poppers"), to marijuana, Ecstasy, and amphetamines. The long-term effects of many of these substances are unknown; however current wisdom suggests potentially serious consequences as we age.

3. Depression/Anxiety

Depression and anxiety appear to affect gay men at a higher rate than in the general population. The likelihood of depression or anxiety may be greater, and the problem may be more severe for those men who remain in the closet or who do not have adequate social supports. Adolescents and young adults may be at particularly high risk of suicide because of these concerns. Culturally sensitive mental health services targeted specifically at gay men may be more effective in the prevention, early detection, and treatment of these conditions. At Brown, Counseling and Psychological Services can help with these problems.

4. Hepatitis Immunization

Men who have sex with men are at an increased risk of sexually transmitted infection with the viruses that cause the serious condition of the liver known as hepatitis. These infections can be potentially fatal, and can lead to very serious long-term issues such as cirrhosis and liver cancer. Fortunately, immunizations are available to prevent two of the three most serious viruses. Universal immunization for Hepatitis A virus and Hepatitis B virus is recommended for all men who have sex with men. Safer sex is effective at reducing the risk of viral hepatitis, and is currently the only means of prevention for the very serious Hepatitis C Virus.

5. STIs

Sexually transmitted infections (STIs) occur in sexually active gay men at a high rate. This includes STIs for which effective treatment is available (syphilis, gonorrhea, chlamydia, pubic lice and others), and for which no cure is available (HIV, Hepatitis A, B, or C virus, Human Papilloma Virus and others). There is absolutely no doubt that safer sex reduces the risk of sexually transmitted diseases, and prevention of these infections through safer sex is key.

6. Prostate, Testicular, and Colon Cancer

Gay men may be at risk for death by prostate, testicular, or colon cancer. Screening for these cancers occurs at different times across the life cycle, and access to screening services may be negatively impacted because of issues and challenges in receiving culturally sensitive care for gay men. All gay men should undergo these screenings routinely as recommended for the general population. All college-age men should conduct regular testicular self-exams and be screened by a medical provider for testicular cancer.

7. Alcohol

Although more recent studies have improved our understanding of alcohol use in the gay community, it is still thought that gay men have higher rates of alcohol dependence and abuse than straight men. One drink daily may not adversely affect health; however, alcohol-related problems can occur with low levels of consumption. Culturally sensitive services targeted to gay men are important in successful prevention and treatment programs.

8. Tobacco

Recent studies seem to support the notion that gay men use tobacco at much higher rates than straight men, reaching nearly 50% in several studies. Tobacco-related health problems include lung disease and lung cancer, heart disease, high blood pressure, and a whole host of other serious problems. All gay men should be screened for and offered culturally sensitive prevention and cessation programs for tobacco use.

9. Fitness (Diet and Exercise)

Problems with body image are more common among gay men than their straight counterparts, and gay men are much more likely to experience an eating disorder such as bulimia or anorexia nervosa. While regular exercise is very good for cardiovascular health and in other areas, too much of a good thing can be harmful. The use of substances such as anabolic steroids and certain supplements can adversely affect health. At the opposite end of the spectrum, overweight and obesity are problems that also affect a large subset of the gay community. This can cause a number of health problems, including diabetes, high blood pressure, and heart disease. Our Nutrition section includes information on healthy eating, sports nutrition, eating concerns and campus resources.

10. Anal Papilloma

Of all the sexually transmitted infections gay men are at risk for, human papilloma virus --which cause anal and genital warts -- is often thought to be little more than an unsightly inconvenience. However, these infections may play a role in the increased rates of anal cancers in gay men. Some health professionals now recommend routine screening with anal Pap Smears, similar to the test done for women to detect early cancers. Safer sex should be emphasized. Treatments for HPV do exist, but recurrences of the warts are very common, and the rate at which the infection can be spread between partners is very high.

Adapted from Vincent M. B. Silenzio, MD, MPH, Board of Directors, GLMA
Co-Editor, Journal of the Gay and Lesbian Medical Association 

On-Campus Resources

Brown LGBTQ Resource Center   401.863-6062          
The LGBTQ Resource Center is a safe space for all students, staff, and faculty dealing with questions of sexual orientation and gender identity. The Center offers confidential support, information, and referrals for LGBTQ individuals and the people in their lives. Additionally, it offers fellowship advising and assistance with academic projects, as well as educational workshops.

BWell Health Promotion 401.863-2794
Health Promotion is available for individual appointments and group education on a variety of health issues, including LGBT health, alcohol, other drugs, nutrition and safer sex. We have condoms, lube, and dental dams available at rock-bottom prices. Come visit us, we are located on the 3rd floor of Health Services.

Health Services 401.863-3593  
Health Services provides a range of services including general health care, STI testing, inpatient services and emergency medical care. You can request a specific medical provider by gender or by name. We are located at 13 Brown Street on the corner of Brown and Charlesfield Streets. Call 401.863-3953 to make an appointment.

Counseling and Psychological Services 401.863-3476
Counseling and Psychological Services provides individual appointments, referrals, and groups on a variety of issues, including SORT (Sexual Orientation Reflection Time).

Chaplain's Office 401.863-2344 
The Chaplains are available for personal counseling about religious and social issues, parental and peer difficulties, career choices, interpersonal relationships and sexuality. A number of programs are offered during the year that include ecumenical discussion groups, innovative worship experience, ecumenical services, and dramatic and artistic events.

Queer Alliance 
The Queer Alliance serves as an umbrella organization for a number of groups on campus. Its mission is to be a multifaceted service to the LGBT community by offering resources through subgroups, community discussions, and events. The LGBTQ Resource Center (Faunce House, Room 321) has a wide array of queer-related books, movies, literature and resources. You can e-mail queer@brown.edu for more information or to get involved.

Off-Campus Resources

Options (Gay and Lesbian Newspaper) 401.781-1193 
Rhode Island's gay and lesbian newspaper provides local news, health information, arts information and lists local resources and support groups. You can request free copies online or view recent issues online.

RI Pride 401.467-2130          
RI Pride promotes and celebrates the diversity and successes of the LGBT community. The web site includes a calendar of events and volunteer opportunities.

Youth Pride, Inc. 401.421-5626   
Youth Pride, Inc. has a drop-in center, support group and outreach activities for LGBT youth ages 13-23.

Related Links

Gayhealth.com  
This health and wellness site is dedicated to the health of lesbian, gay, bisexual, and transgender men and women. It provides access to accurate, current, and vital health information through health professionals within the community. The site has a "Ask the Doctors" question-and-answer forum that has responded to a range of questions such as "Is it possible to get HPV without having anal sex?" and "Are water sports safe?" You can look at the question-and-answer index or you can post your own questions. This site also has information on current news, drugs, emotional health, general health, health insurance, and LGBTQ-friendly medical providers.

Gay and Lesbian Medical Association  
This site provides LGBTQ-friendly health care referrals, medical information, publications, news and links.

PFLAG Parents and Friends of Lesbian and Gays 
National group helping parents understand their children's sexuality and advocating for LGBT civil rights.

Advocates for Youth 
Advocates for Youth has developed programs to help decrease the isolation felt by many LGBTQ youth. It offers a variety of research based approaches, designed to decrease health disparities in LGBTQ communities, which can be used by both LGBTQ community members and allies.

The GLBT Health Access Project 
The GLBT Health Access Project works with GLBT populations, and those who serve them, to respond to needs in a timely and targeted manner. They provide training, technical assistance and materials to help service providers learn more about the health care needs of GLBT populations and create welcoming environments for staff and clients.

Fenway Community Health  
Fenway Community Health is a Boston based clinic that serves LGBTQ patients. Their webpage offers a variety of health information needs, as well as research and resources outside of FCH. 
 
Go Ask Alice  
This is an LGBTQ-friendly question-and-answer web site where you can anonymously email any health questions you have. Alice not only answers your questions in a fully detailed and comprehensive way, but she offers a bit of wit and humor along with her advice. This site has a huge archive that you can read through or search before posing your own question. Alice has answered a range of questions from "Is shoe size a predictor of penis length?" to "Does masturbation inhibit my growth?" Check out this in-depth web site for information about relationships, sexuality, emotional health, alcohol and other drugs, and nutrition. This site is provided by Columbia University's Health Education Program.

The National Coalition for Lesbian, Gay, Bisexual, and Transgender Health 
The National Coalition for Lesbian, Gay, Bisexual, and Transgender Health is committed to improving the health and well-being of lesbian, gay, bisexual and transgender individuals and communities through public education, coalition building and advocacy that focuses on research, policy, education and training.

CDC Lesbian, Gay, Bisexual and Transgender Health Pages
A variety of information on important health issues, including safer sex and STI information

PHONE NUMBERS
  • 401.863-2794
    Health Promotion
  • 401.863-3953
    Health Services
  • 401.863-6000
    Sexual Assault Response Line
  • 401.863-4111
    EMS
  • 401.863-3476
    Counseling & Psychological Services
  • 401.863-4111
    DPS