Post Traumatic Stress from my Doctor

Friday, July 08, 2011

Question

I went in for an exam after a male sex partner told me he had gonorrhea. My gynecologist did a vaginal swab. When it became clear that this was the only test he was going to do, I explained we had oral and anal sex, not vaginal. The doctor seemed taken aback and said he couldn't test me for “those sorts of things.” He sent me home with no further testing and no treatment. What now? I thought I was being a good citizen to go get tested.

Answer

You were being a good citizen of the Sex Radical Nation. It is very important for us to get tested for a sexually-transmitted infection (STI) as soon as possible after we hear that we may have been exposed. It's also important to get a complete battery of tests for STIs done once every six months to a year, depending on how many sex partners you have. I recommend this even for people who believe they are in monogamous relationships. There are far too many women coming down with chlamydia, hepatitis, HIV, and other STIs because their “monogamous” husbands weren't. My last gay male friend who seroconverted thought his partner was monogamous as well.

You obviously need a new physician. But unless you have the name of a better-educated one on tap, make an appointment or drop in at your county or city VD (venereal disease—an old-school term) clinic. Virtually every area has a clinic set up specifically to test people for STIs. They sometimes will also help you with the process of notifying your partners, if you have contact information for them. These clinics have to keep updated on the latest testing methods and treatment procedures. They usually aren't very glamorous-looking places, but the staff are often kind and well-informed public health people who just want to make sure you get better.

Your doctor gave you incorrect information. Of course there are tests for oral and rectal gonorrhea! Swabs are applied to the vulnerable area, then taken to the lab for culturing, to see if the bacteria that causes gonorrhea will proliferate and then do a little dance under the microscope. A swab might miss infected tissue, however, so these tests are not 100% reliable. But the severe consequences of an untreated STI like gonorrhea are well-known. Policy is often to simply give you a massive dose of the appropriate antibiotics if you know you had contact with an infected partner. Women with gonorrhea sometimes don't have any troublesome symptoms. If they go untreated, the disease harms their reproductive organs and can cause Pelvic Inflammatory Disease (PID) or infertility. This is why you may warrant treatment even if a doctor can't guarantee you have the clap. Men who get fucked have a similar problem. Rectal gonorrhea may not cause any discomfort. An infection in the urethra/penis is traditionally supposed to burn like fuck-all when you try to piss, but even that key marker is sometimes missing.

Use of a condom can prevent exposure to semen that carries gonococcal bacteria or other pernicious microorganisms. Even if you are taking the pill or using some other hormonal birth control method, an IUD, or a cervical cap, use a condom to guarantee that you stay healthy. While it's important to inspect your partner to make sure he or she doesn't have any abnormal rashes, bumps, tiny traveling cooties, or other symptoms of an STI, many infected people seem healthy. Even “nice” people get sexually-transmitted infections. A handy-dandy condom that takes only a minute to put on greatly reduces exposure to herpes, syphilis, and the virus that causes genital warts or cervical cancer. I could list all of the STIs we currently know about, but you get the idea.

If your partner objects to the condom, tell him you don't have sex without them. If a little white lie will ease the tension, joke that you need it just in case you forgot to take one of your pills. Some other convenient excuses include: you like the way they look, they help the man to last longer, or you are afraid your period might come early this month, or you have fewer inhibitions if you know you won't have to worry about anything the next day. If he digs his heels in, intercourse is off the table, and so is oral sex. Does he want mutual masturbation? Let him go home where you don't have to see him pout and stamp his little feet, and take out your vibrator instead. There are worse things than getting yourself off! A partner who won't take safer-sex precautions may try to control you in other harmful ways or be unrealistic about how the world operates. In other words, he may be clueless about cause and effect.

Smart guys are masturbating with condoms, experimenting to find out which brands fit them the best, and eroticizing sex with latex. If you are lucky enough to live in the industrialized west, where condoms are available and affordable, it's ridiculous to think you should have sex without them. Sadly, the guys who object the loudest to condoms are the ones most likely to put you at risk if you don't insist they wear one.

 

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