Surprise Pap


I just had a consultation with a doctor.  I have had a few this year; I am almost used to the awkward silences and fluorescent lighting. Some involved nudity, one left me a bit angry and confused. Today’s was awkward (but not silent) and definitely flourescently lit. As we all know from encounters in clothing shop fitting rooms, there can only be truth under flourescent lights.

The first thing I did when I arrived in my new doctor’s office is to take a furtive picture of a book on his desk (the book shown above). It set the scene for our consultation (which, by the way, had nothing to do with the topic of the book… or so I thought when I made the appointment).

I don’t want to go into details about our encounter (maybe I will later, when I have processed).  Right now, I just want to tell you that if you are a homo man you should probably get the HPV vaccine. What I will share about my consultation is this unexpected pamphlet I got at the end.

You Have Just Had an Anal Pap Smear

Introduction – Over the last decade, medical providers have become more aware of the risk of infection with the human papillomavirus (HPV) in the anus. Doctors have long known how HPV affects the cervix in women and we now know that it can affect the anus in a very similar fashion.  The surface of the anus is made up of the same tissue as the cervix. When HPV infects a cell it can occasionally cause the cell to develop changes in its DNA called mutations. As more and more mutations occur there is a chance that a normal cell will become a cancer cell.  In the cervix we perform Pap smear to check for abnormal cells which can then be easily treated to prevent cancer. In fact, forty years of cervical Pap smears have reduced cervical cancer rates in this country [U.S.] by 500%. In recent years rates of anal cancer in gay and bisexual men have been rising dramatically.  In an effort to combat this problem we recommend the same kinds of preventative screening in the anus to prevent cancer as we do in the cervix.  And that is why you’ve just had an anal Pap smear.

Stephen E. Goldstone, M.D.

Brazen and lewd as I am, I don’t know whether I would have been able to talk about my last sex, bottoming and topping, condom use and sexual partners in the clinic if it all frightened or disgusted my doctor. I can only imagine how much more unpleasant a pap smear could have been. When I have energy, I will write about the time a doctor tried to ask me all of those things without making eye contact and without speaking in full sentences… Or the time a nurse asked me with deer-in-headlights-eyes if I was ok with her looking “down there”. I would have been ok if I knew that she knew her way around “down there”. Anger, confusion, flourescent lighting and awkwardness.

What I am thankful for, this thankstaking holiday, is medical providers that recognize my life as a gay boy, and are well prepared to take care of all of my health needs, not only the polite ones.

*Read this New York Times article about the neglect of LGBT health by the medical profession. The comments are especially entertaining (but in a distressing way).

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