See the Doctor!

Friday, December 05, 2014

Question

About 14 years ago, something happened that frightened the life out of me. I thought my I had necrotizing fasciitis on my uncircumcised penis! Despite being supremely conscientious about my hygiene, I got a reddish, dry looking patch on my foreskin. When I got an erection and the foreskin retracted, it caused a split in the skin which was almost half an inch long. It was very painful, and would not clear up with antibiotic cream. I tried other home remedies, but nothing made it clear up. I was confident that it wasn't a sexually-transmitted disease, and continued to have sex with my wife, albeit sporadically because it was painful. The pain endured and finally outweighed any pleasure gained. Being a typical man, I was deathly afraid that my penis would inevitably fall off. Even so, I wouldn't see a doctor. The thought of showing my equipment to a disapproving physician who would ask me personal questions just embarrassed the hell out of me. Then each time I got an erection, the skin would split again, and it was incredibly painful. Even flaccid it became very uncomfortable.

Eventually, I did visit a doctor because my wife made me. It turned out to be thrush, which I guess is like a yeast infection on your skin? I had no idea men could get thrush. Some hydrocortisone cream cleared it up in a couple of days. I'm sure a lot of uncut guys have had this and have no idea what it is. I thought I would write this in to you, hoping somebody would see this and get spared a lot of worry and aggravation.

Answer

Thanks for this little window into a personal world of hurt. I am always concerned when I get a letter from somebody saying, “Why do I have a rash/bump/sore on my penis/vagina/clitoris/cervix?” I assume that the symptom was present for a while before they wrote to me, and I am always worried that this was a sexually-transmitted infection (STI) that could have been passed to somebody else before I could possibly answer the letter. These are the only e-mails that I answer personally, ASAP, with exactly the advice that you give: Go see a doctor, quick as spit, right fuckin’ now!

The fact that we are all reluctant to get a medical opinion when something is hurting our family jewels is one of the most dangerous results of sexual shame and repression. I know y’all are probably sick of me banging that particular drum. Goddess knows I have been harping on this point since 1978. But since there still seems to be enough sexual shame and repression to go around like one of those disgustingly huge American Thanksgiving dinners, I have to keep on saying: Don’t let it control your life.

Here are some of the reasons I have been given for why people left genital lesions untreated. “I was afraid my doctor would be able to tell I had been masturbating.” “I was afraid the doctor would know I had tied my dick up.” “I was afraid it had happened because I had lesbian sex.” “I knew it was the result of going to a bathhouse, and I probably had AIDS.” “I didn’t want a doctor to give me a pelvic exam because then I wouldn’t be a virgin any more.” “I knew they would give me a drug test if I went to a doctor’s office.” “My parents would find out I had been having sex.” “I thought I might be pregnant.” “They would call the police and force me to report that I had been raped.” “A doctor might examine me and find out I had been sexually molested, and I don’t want that in my medical records.” “If I have an STD, they will make me tell them who my sexual partners are.” “I can’t talk to the same pediatrician I had since I was a little kid about my sex life.” “It just makes me too anxious.”

Sad, right? And mostly not true. A doctor can’t tell, by looking at your genitals, whether you have been masturbating, having kinky sex, what gender your partners are, or whether you have a history of drug use. If you have been exposed to HIV, you need to know, because there are prophylactic treatments that can keep you from seroconverting if you get them soon enough. Being a virgin is about not having sex yet, not about whether you have a hymen (a thin membrane at the vaginal entrance). In fact, many women who are virgins don’t even have a hymen. In many states, minors can receive medical treatment without their parents being notified: know your rights. Call Planned Parenthood. You do not have to take a drug test just to get general medical treatment. If you think you might be pregnant, you need to know, because the longer you wait to find out, the fewer options you have. Even if you want to keep your baby, that child needs you to receive prenatal care.

Do you want to keep your capacity for pleasure and reproduction? Go see the doctor. If you are worried about legal fallout, call your attorney on the way to the office, but get medical help first. Privacy is a precious commodity these days. I often remind people that if they absolutely cannot risk having someone turn up in their medical records, they can always show up and pay cash for treatment. Some doctors will not allow this; they will insist on seeing identification and proof of insurance. But some will still just accept the cash and let an assumed name go, understanding they are not likely to see you again. Of course, then you have to ask yourself what level of care you are going to get, because there is no accountability. Don’t let paranoia or sexual shame get you into a situation where you are getting less decent care than you deserve.

Some states do ask that public health services trace contacts for some sexually-transmitted diseases. But their ability to get information from private doctors who have diagnosed STDs varies a great deal. Some doctors report; others don’t. Be informed about what the laws in your area might be. Nobody is going to torture you to reveal names. But also think about your partners. Even if it might be embarrassing, if somebody might have syphilis or some other STI that can be treated, they ought to know. They need to be treated to avoid spreading this illness to others. I say, tell and be damned. In the long run, you will do them and your self a favor.

Finally, if you are still seeing the same doctor you had since you were six, I have to ask: Why? If you can’t talk to your current doctor about your sexual concerns, find another one. You are the consumer. You have hired your doctor to work for you. The doctor is your employee. You can fire them. You can find a replacement. Don’t let yourself get mistreated by a physician who is poorly informed or has a disapproving attitude. There are doctors out there who are warm, humane, and up-to-date about sexual issues. So let your doctor know this is important to you, and be sure to insist that you will be at ease when you need to come in for care. This will do much to prevent anxiety later. But even if you have the worst doctor in the world, and no time to seek out a better one, get help! That is the important thing to do, for the sake of your precious and cute little sex-bits. They have done so much to keep you healthy and bring you joy. Don’t let them down, provide them with what they need to keep being a part of your life and your body for years to come.

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