A new tool makes it even easier to let your sex partners know—anonymously—that they may have been exposed to a treatable sexually transmitted infection (STI) and that they might want to get tested.
The free service, Tell Your Partner, is a fast, secure, easy-to-use notification system that doesn’t require you to share any of your personal information. Simply add phone numbers or email addresses for partners you’d like to notify and enter the infection(s) your partner(s) should get tested for. After you preview a sample message and confirm you’re not a robot, hit send.
“Notifying sex partners about a recent infection makes it more likely that those partners will get tested, treated and not pass the infection along to anyone else,” said Jen Hecht, MPH, senior director of program strategy & evaluation at San Francisco AIDS Foundation and director and co-founder of Building Healthy Online Communities. “In that way, you’re also improving your own future health, by reducing the overall infection rate in the community.”
As trauma psychologists, we’re leading a team to help alleviate psychiatric distress in gay, bi and trans males who have been sexually abused or assaulted.
In collaboration with two nonprofit organisations, MaleSurvivor and Men Healing, we recruited and trained 20 men who have experienced sexual abuse to deliver evidence-based online mental health interventions for sexual and gender minority males – an umbrella term for individuals whose sexual identity, orientation or practices differ from the majority of society.
This study should help men in this group who have been sexually assaulted know that they are not alone, that they are not to blame for their abuse, and that healing is possible.
But, there are some things that trauma psychologists already know about these men, such as how prevalent sexual abuse of men is and ways to help men recover.
All too common, all too traumatic.
At least 1 in 6 boys are sexually abused before their 18th birthday. This number rises to 1 in 4 men across their lifespan.
Sexual violation in gay, bisexual, transgender and intersex individuals often complicates their sense of self, and how they fit, or don’t fit, into LGBTQ+ culture and communities. Such abuse may even impact their reaching out for help or reporting traumatic events as they fear stigmatisation or victim-blaming.
Men and women who have experienced sexual abuse and assault are at risk for a wide range of medical, behavioural and sexual disorders. They have high rates of several psychiatric disorders, including post-traumatic stress disorder, substance abuse and dependence, depression and anxiety, as well as greater risk for suicide. They also have more educational, occupational and interpersonal difficulties than non-abused men. Further, sexual trauma is linked to medical illnesses, increased health care utilisation and poor quality of life.
But, sexual minority males who have experienced sexual trauma face even greater health disparities. Gay and bisexual men with histories of childhood and adult sexual victimisation are more likely to report greater numbers of sexually transmitted infections, increased sexual risk for human immunodeficiency virus, and higher sexual compulsivity than men with no history of sexual assault. In addition, sexual minority male survivors exhibit more negative psychological outcomes related to their sexual identities, such as lower self-esteem, distorted sense of self and difficulties forming healthy adult intimate relationships.
The cumulative impact of sexual abuse, in conjunction with individuals’ sexual minority status, also can result in higher rates of sexual re-victimisation, as well as anti-gay violence and discrimination.
Gay and bisexual men are also exposed to significant minority stress, a term used to describe the sociopolitical stressors placed on individuals as a result of their minority status. Sexual orientation disparities start relatively early in development. LGBTQ+ individuals are disproportionately exposed to day-to-day discrimination, peer and parental rejection, unsupportive or hostile work or social environments, and unequal access to opportunities afforded to heterosexuals, including marriage, adoption and employment nondiscrimination.
Chronic expectations of rejection, internalised homophobia, alienation and lack of integration with the community can understandably lead to problems with self-acceptance. As a result, a sexual minority male who has experienced sexual abuse may feel deficient, inferior or impaired. Further, they may view themselves as shameful, undesirable, undeserving, or incapable of forming a loving relationship.
Many sexual minority males who have experienced sexual abuse internalise harmful beliefs that make it harder for them to heal. These myths include the false belief that men cannot be forced to have sex against their will; that men who become sexually aroused or have an erection when assaulted must have wanted or enjoyed it; and that real men should welcome any opportunity to have sex.
These men often bottle up additional detrimental myths, such as men become gay or bisexual because they were sexually abused, and sexual minority men are obsessed with sex, and that they molest children at higher rates than straight men. Sexual minority males who have been abused are not born with these beliefs. They learn them from their families, religion, society and the media. But, the more men hold these beliefs to be true, the harder it is for them to move forward in their psychological recovery.
There are many hurdles to male sexual abuse survivors receiving needed mental health care. When encountering perceived authority figures, such as health care providers, these men sometimes experience harsh judgment and distrust. In addition, when initiating psychological services, they may have difficulty finding knowledgeable and experienced health care providers who understand the nuances specific to male sexual abuse and, consequently, won’t disclose their sexual trauma.
Nondisclosure of sexual abuse may also be due to a male’s own lack of understanding of what abuse is. This is in line with research that found that the majority of men who endorsed survey items or behaviours indicating sexual abuse did not actually label themselves as sexual abuse survivors. Not disclosing one’s sexual trauma history is associated with increased emotional distress, while self-disclosure and seeking mental health services are related to psychological well-being.
Nearly 2 million LGBTQ youths ages 13 to 24 in the United States consider suicide each year, according to research released Thursday by the Trevor Project.
Using data from a variety of sources, including the U.S. Census Bureau, the Centers for Disease Control and Prevention and its own National Survey on LGBTQ Youth Mental Health, Trevor Project researchers determined that LGBTQ teens were particularly at risk. Those 13 to 18 were approximately twice as likely to contemplate suicide as those 19 to 24.
Amy E. Green, the nonprofit’s director of research, told NBC News that although these numbers are harrowing, they are “conservative estimates.”
“These numbers are the bare minimum they could be because we used a conservative method to conclude our estimates,” Green said. “The fact that we still arrived at these huge astonishing numbers shows that this is a serious health problem.”
According to the mental health survey, released this month, there are multiple factors that can negatively affect the well-being of queer adolescents — the foremost being lack of acceptance.
More than 70 percent of respondents reported experiencing discrimination because of their sexual orientation or gender identity, and two-thirds of respondents stated that someone has tried to convince them to change those identities.
Though previous research has revealed that LGBTQ youth are more likely to experience thoughts of suicide, Green said these latest figures “provide additional context to just how widespread this problem is.”
A separate research released by the Trevor Project on Thursday offered some positive news, however. LGBTQ youth who report having at least one accepting adult in their lives were 40 percent less likely to report a suicide attempt in the past year.
“I hope this research will inspire the country to come together to change policies on the state and federal levels that affect LGBTQ youth’s lives, like ending the harmful practice of conversion therapy, as well as inspire other researchers who are looking into this area to study the factors and find solutions,” Green said. “We also need to support organizations that are doing the work to launch anti-bullying and suicide prevention efforts.”
Alkyl nitrites, commonly known as poppers, pose very little chance of addiction, risky consumption habits or other psychosocial problems.
Many LGBTI people, but especially gay and bisexual men use poppers for recreational purposes or to enhance sex.
A new study found little evidence of typical dependency characteristics, including health, social, legal and financial problems. It also found no correlation between popper use and mental health or psychological stress.
Researchers at the University of Technology Sydney (UTS) surveyed more than 800 men aged 18 to 35. Lead researcher Dr Daniel Demant, welcomed the decision by the Therapeutic Goods Administration (TGA) to not ban poppers.
In 2018, the TGA issued a temporary ban on poppers. It put them onto Schedule 9 of the Poisons Standard – the same schedule as heroin.
But thanks to a vocal campaign from the LGBTI community and passionate submissions to the TGA, it backtracked on the ban. The TGA instead elected to classify them as a Schedule 3 drug. From February 2020, poppers will be available over the counter in pharmacies.
Poppers users will be made ‘overnight criminals’
Demant described the ban as creating ‘overnight criminals’ of the estimated more than 100,000 Australian users.
‘What we see with this research is that poppers are a very commonly used drug in the LGBT community, both recently and over their lifetime,’ Demant said.
‘Most of the users are already oppressed or marginalized based on their social identity as gay or bisexual men. This creates a question as to whether there would have been a discriminatory element in banning a substance with such a low risk profile.
Currently, poppers are available on prescription from pharmacies. But many people buy them illicitly at sex-on-premises venues or LGBTI bars. A vial for up to AU$50,(US$34.60/€30.63) despite costing a couple of cents to manufacture.
The new TGA decision to regulate poppers rather than banning them hopefully paves the way for some measure of quality control as well as the removal of the ‘extreme profit margin’ that exists now Demant said.
‘We could stop pretending that poppers are sold for anything other than getting people high,’ he said.
‘And once we do offer it in pharmacies, we would have something made to the highest standards for people to use.’
Doctors should ditch the requirement for a mental health assessment of transgender teens and adults before prescribing them hormone treatment, argues an activist and bioethicist, drawing on their own personal experience in the Journal of Medical Ethics, MedicalXPress reports.
The practice is dehumanizing, unjustified and turns the process of transformation into the treatment of a mental illness, says Florence Ashley of McGill University, Montreal, Canada.
It should instead be replaced with informed consent, which respects a patient’s lived experience and autonomy, they insist, MedicalXPress reports.
The informed consent approach is becoming more common, they acknowledge. But many doctors still require an assessment and referral letter from a mental health professional in compliance with the World Professional Association of Transgender Health (WPATH) Standards of Care, MedicalXPress reports.
The author says that their decision to take hormones was not made in haste, and they had socially transitioned months before opting for hormone treatment. Their university health clinic had adopted informed consent for transgender care, which allowed them to get a prescription for hormones without a referral letter, MedicalXPress reports.
But “many others are not so lucky,” they point out, adding that their own luck ran out when they had to get two referral letters for genital surgery.
The assessment of gender dysphoria — discomfort or distress caused by the mismatch between a person’s gender identity and his/her sex assigned at birth — left them “feeling exposed, naked and dehumanized,” because it was viewed as a mental flaw that needed fixing, MedicalXPress reports.
“Referral requirements for [hormone treatment] treat self-reports of gender dysphoria not as one would treat reports of normal mental experiences, but as one would treat reports of mental illnesses,” they write.
By requiring a mental health assessment instead of taking the transgender person’s word, doctors “deny the authority trans people have over their own mental health experiences,” they say.
“As being transgender is not a mental illness, treating gender dysphoria in this way is pathologizing and, because it pathologizes normal human variance, dehumanizing.”
Gay and bisexual men experience erectile dysfunction at a higher rate than their heterosexual counterparts.
New UK research found that 56% of gay or bi men experience erectile dysfunction, whereas only 46% of straight men do.
For one in four gay or bi men, it’s an issue most or every time they’re with a partner. Of those men, 21% have given up on sex altogether.
The research conducted by Intrinsic Insight also found that psychological factors often cause erectile dysfunction. The study surveyed 2,000 men in the UK, 150 of whom identified as gay or bisexual.
Gay and bi men feel that pressure to perform is the leading cause of it. So much so, they ranked it higher as a cause than drinking too much or side effects from medication.
Some men said ‘insecurities about my body’, work stress and mental health issues as other reasons causing erectile dysfunction.
The study also found that erectile dysfunction lead to the relationship breakdown of 14% of gay or bi men. That could be because those men are keeping their problems to themselves. Only 20% of men with erectile dysfunction told their partners, instead giving other excuses to avoid having sex such as, being tired from work.
A third of men don’t tell anyone about it because they “don’t think there’s a solution”. Only one in five men actually seek help from a healthcare professional.
Dr Kathryn Basford a General Practitioner at Zava who commissioned the study, encouraged men to speak to a medical professional about their problems.
‘ED is traditionally seen as an older man’s condition but in reality men of any age can be affected and our recent study proves this,’ she said.
‘Men today are under rising pressure to “perform”.
‘Worry about living up to male stereotypes, insecurity about their bodies, and wider stresses can all play a part when it comes to sex. Whatever the potential causes, it’s always worth having a conversation with a healthcare professional, be that online or in person.’
“I recently had a change in insurance and it no longer covers my top surgery at all, so I’m needing to raise the full amount.”
– Transgender man Oliver Jordan
The bill shows that he was charged over $10,000 to stay in a room in the medical centre for eight nights.
Meanwhile, another cost—simply put as “Pharmacy-General”—came to more than $6,000 for eight days.
Transgender man Oliver Jordan is also fundraising for top surgery
Jordan is also fundraising at the moment so he can have top surgery. He has raised $1,311 of $6,000 so far.
Writing on his GoFundMe page, Jordan said: “I’ve been out as transgender for over four years now, I’ve been on testosterone (hormone replacement therapy) for nearly three years, and I’m hoping to have top surgery as soon as possible.
“The largest point of my dysphoria is my chest. Binding helps, but it’s caused me to break ribs and miss out on so many things I enjoy due to the pain, the decreased lung capacity, and shortness of breath.
“To be able to not wear a binder would be my greatest dream. I recently had a change in insurance and it no longer covers my top surgery at all, so I’m needing to raise the full amount. Any donations are highly appreciated, anything will help!”
The US spends more on health care per capita than most other developed countries, with the main reason for the prohibitively high cost being higher prices, according to a recent study from John Hopkins Bloomberg School of Public Health.
The study’s lead author, Gerard F. Anderson said: “In spite of all the efforts in the US to control health spending over the past 25 years, the story remains the same—the US remains the most expensive because of the prices the US pays for health services.”
Transgender adults may be more likely to have unhealthy habits and medical issues that negatively impact their quality of life than people whose gender identity matches what it says on their birth certificates, a U.S. study suggests.
Researchers examined survey data from 3,075 transgender adults as well as 719,567 adults who are cisgender, meaning their gender identity matches the sex they were assigned at birth.
Compared to cisgender Americans, transgender individuals were more likely to be sedentary, current smokers, and uninsured, researchers report in JAMA Internal Medicine.
Transgender people were also 30 percent more likely to report being in “fair” or “poor” health over the past month than cisgender adults, as well as 66 percent more likely to report experiencing severe mental distress.
“The U.S. has made a lot of progress over the last several years toward acceptance and celebration of natural human diversity in gender identity and expression,” study author Kellan Baker said by email. But between 2014 and 2017 – the period when the survey was done – attitudes shifted and treatment of transgender often got worse, said Baker, a researcher at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
“This study shows that being a transgender person in the U.S. today – being transgender in a society that you know doesn’t fully accept you – is hard,” Baker added. “It affects your health in negative ways, and that’s why issues such as nondiscrimination protections for transgender people are public health issues.”
An estimated 0.55 percent of the people in the survey identified as transgender, which suggests there may be about 1.27 million transgender adults in the U.S.
Survey participants were asked if they considered themselves transgender and were given four options to categorize their identities: trans male (people who identify as male but were assigned female at birth); trans female (individuals who identify as female but were assigned male at birth); gender non-conforming; or not transgender.
Overall, about 19 percent of transgender respondents were current smokers, compared with roughly 16 percent of cisgender people.
About 35 percent of transgender individuals were inactive, compared with nearly 26 percent of cisgender adults.
And, almost 80 percent of transgender participants had health insurance, compared with 85 percent of other people in the study.
Transgender adults also reported more days in the previous month when they felt physically and mentally unhealthy or felt unable to do all of their usual daily activities.
The study wasn’t a controlled experiment designed to prove whether or how gender identity might directly impact health. Another limitation is that researchers lacked data on how differences within the transgender population such as gender, race and sexual orientation might influence the results.
“I think the take-home message for transgender adults here is clear, which is that transgender adults face additional mental and physical health disparities when compared to cisgender individuals,” said Xiang Cai, a researcher at the Columbia University Mailman School of Public Health in New York City who wasn’t involved in the study.
Cai attributes the higher risks for poor health in trans people to “multiple levels of transgender-specific stigmas.”
“However, I think it is important to note that adults in the transgender community are capable and resilient,” Cai said by email.
The study also didn’t look at whether transgender individuals had gender-affirming surgery or were able to make their outward appearance match their gender identity, Cai said.
“Gender-affirmation treatments may be associated with higher levels of quality of life among those who desire them regardless of age,” Cai noted.
The study included 2,981 mainly gay and bisexual men. Researchers published their results in the Journal of the American Medical Association.
They found there was an increased risk of acquiring an STI while on PrEP compared to before starting PrEP. But they also found there was no link between that increase and the rate of condom use.
Researchers found it ‘surprising’ that ‘condom use was not a significant predictor of acquiring an STI when using PrEP’.
So, why more STIs?
The study found that an increase in casual sex partners and group sex lead to the STI diagnoses. But also like previous studies found that more regular testing explained the increase in STI diagnoses. But results of the study also showed that about 25% of participants accounted for a majority of the diagnoses and that group experienced high rates of STIs.
‘It’s important to understand that when people start taking PrEP, they also get tested more frequently, so STIs are more likely to be detected anyway,’ said lead author, Burnet PhD student Michael Traeger.
He argued the study results should help better guide STI prevention campaigns for people who take PrEP. Those campaigns should not just focus on condom use, but also reducing the time to STI diagnosis through frequent testing.
‘But as PrEP uptake increases, identifying individuals most at risk of STIs will become increasingly important for informing effective and focused STI prevention,’ Traeger said.
End the PrEP backlash
PrEP sceptics often cite the increase risk of STIs while to criticize the medical treatment.
Associate Professor Edwina Wright argued the findings ‘are a rebuttal to the backlash against PrEP users for reducing condom use’.
Wright is the principal investigator of the PrEPX Study, an infectious diseases physician and clinical researcher. She is also the co-head of the HIV Elimination Program at Burnet Institute.
‘The findings are also important because they highlight the need to target our sexual health messaging about STI risks to a relatively small proportion of PrEP users to help reduce their STI rates,’ she said.
‘We need to address these findings by engaging in more research to prevent STIs including STI vaccines and antibiotics that may prevent STIs.’
Ahead of Pride Day 2019, ForLikeMinds.com (www.forlikeminds.com) is pleased to announce that it has launched the first online peer-based support community dedicated to mental illness and substance use conditions in the LGBTQ+ community. ForLikeMinds empowers members to connect and communicate one-on-one and in groups to support, inform, and inspire each other’s recovery from mental illness and substance use. Recovery is not a cure, but living a full and meaningful life with mental illness.
ForLikeMinds was inspired by the recovery journey of its founder Katherine Ponte, who was diagnosed with bipolar I disorder over 15 years ago. It also reflects the experiences of her spouse and main supporter. ForLikeMinds uses peer-based support, an evidence-based approach, to help people affected by mental illness and substance use overcome stigma and pursue recovery. ForLikeMinds is the only dedicated mental health platform tailored to the needs of both members living with a condition and their supporters. It allows people to anonymously connect one-on-one and in groups and create groups. ForLikeMinds offers this service for free to users who sign-up at its website.
Greater awareness of mental health and substance use issues in the LGBTQ community is of critical importance. According to the National Alliance on Mental Illness, in the general population, one in five adults have a condition, but LGBTQ individuals are almost 3 times more likely to experience a mental health condition, particularly depression or generalized anxiety disorder. The LGBTQ also reports higher rates of drug and alcohol abuse. An estimated 20-30% of LGBTQ people abuse substances, compared to about 9% of the general population, and 25% of LGBTQ people abuse alcohol, compared to 5-10% of the general population.
Disparities in the LGBTQ community stem from a variety of factors including social stigma, discrimination, prejudice, denial of civil and human rights, abuse, harassment, victimization, social exclusion, and family rejection.
Thoughtful examination of these circumstances and issues especially given the severity of the situation requires more than just an “LGBTQ+ umbrella” approach. According to The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding Report, “Lesbian, gay, bisexual, and transgender (LGBT) individuals experience unique health disparities. Although the acronym LGBT is used as an umbrella term, and the health needs of this community are often grouped together, each of these letters represents a distinct population with its own health concerns. Furthermore, among lesbians, gay men, bisexual men and women, and transgender people, there are subpopulations based on race, ethnicity, socioeconomic status, geographic location, age, and other factors.”
ForLikeMinds is the only mental health and substance use peer support community to thoughtfully consider this reality. While ForLikeMinds allows the broader LGBTQ+ community to connect, we also allow people to connect based on specific gender identities and sexual orientations. For example, a bisexual person can connect with a bisexual person, a trans man can connect with a trans man, etc. This allows for highly relatable exchanges.