Gay bowel syndrome

Last updated

"Gay bowel syndrome" is an obsolete classification of various sexually transmitted rectal infections observed in men who have sex with men. It was first used by Dr. Henry L. Kazal in 1976 to describe conditions he observed in his proctology practice, which had many gay patients. [1] The term has fallen into disuse, as both clinically imprecise and prejudicial: the issues it describes are not specific to gay and bisexual men, limited to the bowel, nor a medical syndrome.

Contents

Early history

The term was first used in the pre-HIV era, by Kazal et al. in 1976. [2] After Kazal, the term was used sporadically in medical literature from the 1970s to refer to a complex of gastrointestinal symptoms affecting gay men. [3] The term was not specific to any particular disease or infection, and was used clinically to describe proctitis, diarrhea, [4] and a variety of other complaints caused by a wide range of infectious organisms. Reported causes include herpes viruses, syphilis, gonorrhea, chlamydia, campylobacter, and shigellosis, as well as a variety of protozoal infections. [3] The concept of "gay bowel syndrome" was later expanded to include various opportunistic cancers. Transmission was considered to take place by anal sex, a fecal-oral route, or both. [3] Following the onset of the AIDS epidemic, the reported incidence of these complaints has declined, likely as a result of safer sexual practices. [5]

Criticism and decline in use

In 1985, an article in the peer-reviewed journal Gut said that "gay bowel syndrome" was not a syndrome, and had limitations in medical use:

The "gay bowel syndrome" was first used to describe not a syndrome, but a list of conditions. The term hides the problems facing the gastroenterologist. Firstly, the sexual orientation of a patient may not be easily ascertainable in the setting of a general outpatient clinic. Secondly, many infections of the gay bowel are asymptomatic and are missed without full microbiological screening. Thirdly, coinfection is common and the organism isolated may not be causing the symptoms and signs. Finally, the bowel has limited and non-specific clinical and histopathological responses to many infections. [6]

A 1997 article in the Journal of Homosexuality argued that use of the term should be abandoned:

It is apparent that Gay Bowel Syndrome is an essentialized category of difference that is neither gay-specific, confined to the bowel, nor a syndrome. The use and diagnosis of Gay Bowel Syndrome must be abandoned. [7]

The term was withdrawn as "outdated" by the Canadian Association of Gastroenterologists in 2004. [8] Activist Michael Petrelis said "it is very much a defamation to say ‘gay bowel syndrome', when what they’re really talking about is parasites", and Marty Algaze of the Gay Men's Health Crisis argued: "Sickle cell anemia is primarily seen in African Americans, but would you call it African American anemia? People would never accept that." [8]

The U.S. Centers for Disease Control confirmed the term was already informal and no longer in use by 2005. [9]

The 2009 McGraw-Hill Manual of Colorectal Surgery states that "gay bowel syndrome" is considered obsolete and derogatory:

Coined in the pre-HIV era, the term "gay bowel syndrome" comprised a rather unselective potpourri of unusual anorectal and GI symptoms experienced by homosexual males... with better understanding of the underlying causes, this term is outdated: the derogatory terminology should be abandoned and more specific entities and terms recognized and used. [10]

Gay activist and author Michael Scarce criticized the concept of "gay bowel syndrome" in his book Smearing the Queer: Medical Bias in the Health Care of Gay Men (1999), saying that "gay bowel syndrome has been, and remains today, a powerful tool for the specific surveillance, regulation, definition, medicalization, identification, and fragmentation of gay men's bodies." [11] Scarce's work has been cited in the Journal of the American Medical Association with a positive review. [12]

See also

Related Research Articles

<span class="mw-page-title-main">Pelvic inflammatory disease</span> Infection of uterus, fallopian tubes, ovaries or the inner surface of pelvis

Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is an infection of the upper part of the female reproductive system, namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Often, there may be no symptoms. Signs and symptoms, when present, may include lower abdominal pain, vaginal discharge, fever, burning with urination, pain with sex, bleeding after sex, or irregular menstruation. Untreated PID can result in long-term complications including infertility, ectopic pregnancy, chronic pelvic pain, and cancer.

<span class="mw-page-title-main">Safe sex</span> Ways to reduce the risk of acquiring STIs

Safe sex is sexual activity using methods or contraceptive devices to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer sex or protected sex to indicate that some safe sex practices do not eliminate STI risks. It is also sometimes used colloquially to describe methods aimed at preventing pregnancy that may or may not also lower STI risks.

Urethritis is the inflammation of the urethra. The most common symptoms include painful or difficult urination and urethral discharge. It is a commonly treatable condition usually caused by infection with bacteria. This bacterial infection is often sexually transmitted, but not in every instance; it can be idiopathic, for example. Some incidence of urethritis can appear asymptomatic as well.

<span class="mw-page-title-main">Lymphogranuloma venereum</span> Sexually transmitted infection

Lymphogranuloma venereum is a sexually transmitted infection caused by the invasive serovars L1, L2, L2a, L2b, or L3 of Chlamydia trachomatis.

<span class="mw-page-title-main">Chancroid</span> Sexually transmitted bacterial infection in humans

Chancroid is a bacterial sexually transmitted infection characterized by painful sores on the genitalia. Chancroid is known to spread from one individual to another solely through sexual contact. However, there have been reports of accidental infection through the hand.

<span class="mw-page-title-main">Frot</span> Penis-to-penis sexual contact

Frot or frotting is a gay sexual practice that usually involves direct penis-to-penis contact. The term was popularized by gay male activists who disparaged the practice of anal sex, but has since evolved to encompass a variety of preferences for the act, which may or may not imply particular attitudes towards other sexual activities. This can also be used as some type of foreplay.

Men who have sex with men (MSM) are men who engage in sexual activity with other men, regardless of their sexual orientation or sexual identity. The term was created by epidemiologists in the 1990s, to better study and communicate the spread of sexually transmitted infections such as HIV/AIDS between all sexually active males, not strictly those identifying as gay, bisexual, pansexual or various other sexualities, but also for example male prostitutes. The term is often used in medical literature and social research to describe such men as a group. It does not describe any specific kind of sexual activity, and which activities are covered by the term depends on context. The alternative term "males who have sex with males" is sometimes considered more accurate in cases where those described may not be legal adults.

Proctitis or anusitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum.

<span class="mw-page-title-main">Genital herpes</span> Infection by herpes simplex viruses of the genitals

Genital herpes is a herpes infection of the genitals caused by the herpes simplex virus (HSV). Most people either have no or mild symptoms and thus do not know they are infected. When symptoms do occur, they typically include small blisters that break open to form painful ulcers. Flu-like symptoms, such as fever, aching, or swollen lymph nodes, may also occur. Onset is typically around 4 days after exposure with symptoms lasting up to 4 weeks. Once infected further outbreaks may occur but are generally milder.

<span class="mw-page-title-main">HIV/AIDS</span> Spectrum of conditions caused by HIV infection

The human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. It can be managed with treatment. Without treatment it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). Effective treatment for HIV-positive people involves a life-long regimen of medicine to suppress the virus, making the viral load undetectable. There is no vaccine or cure for HIV. An HIV-positive person on treatment can expect to live a normal life, and die with the virus, not of it.

<span class="mw-page-title-main">Women who have sex with women</span> Sexual identity-neutral term

Women who have sex with women (WSW) are women who engage in sexual activities with women, whether they identify as straight, lesbian, bisexual, pansexual, have other sexualities, or dispense with sexual identification altogether. The term WSW is often used in medical literature to describe such women as a group for clinical study, without needing to consider sexual self-identity.

Radiation enteropathy is a syndrome that may develop following abdominal or pelvic radiation therapy for cancer. Many affected people are cancer survivors who had treatment for cervical cancer or prostate cancer; it has also been termed pelvic radiation disease with radiation proctitis being one of the principal features.

<span class="mw-page-title-main">Gonorrhea</span> Sexually transmitted infection

Gonorrhoea or gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with urination, discharge from the penis, or testicular pain. Infected women may experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain. Complications in women include pelvic inflammatory disease and in men include inflammation of the epididymis. Many of those infected, however, have no symptoms. If untreated, gonorrhea can spread to joints or heart valves.

<span class="mw-page-title-main">Sexually transmitted infection</span> Infection transmitted through human sexual behavior

A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, oral sex, or sometimes manual sex. STIs often do not initially cause symptoms, which results in a risk of transmitting them on to others. The term sexually transmitted infection is generally preferred over sexually transmitted disease or venereal disease, as it includes cases with no symptomatic disease. Symptoms and signs of STIs may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. Some STIs can cause infertility.

Rectal discharge is intermittent or continuous expression of liquid from the anus. Normal rectal mucus is needed for proper excretion of waste. Otherwise, this is closely related to types of fecal incontinence but the term rectal discharge does not necessarily imply degrees of incontinence. Types of fecal incontinence that produce a liquid leakage could be thought of as a type of rectal discharge.

Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981, and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.

<span class="mw-page-title-main">Sexual practices between men</span> Sexual activity between men

Sexual activities involving men who have sex with men (MSM), regardless of their sexual orientation or sexual identity, can include anal sex, non-penetrative sex, and oral sex. Evidence shows that sex between men is significantly underreported in surveys.

<span class="mw-page-title-main">Rectal douching</span> Act of rinsing the rectum with liquid

Rectal douching is the act of rinsing the rectum with intent to clean it. An instance of this rinsing or a tool used to perform the rinse may be called a rectal douche.

<span class="mw-page-title-main">Tim Read</span> Australian politician

Tim Read is an Australian politician. He has been a Greens member of the Victorian Legislative Assembly since November 2018, representing the seat of Brunswick. A former general practitioner, and medical researcher with a PhD on the epidemiology of sexually transmitted infections, he is the current Victorian Greens Spokesperson for Health, Justice, Integrity and Science.

References

  1. ↑ Kazal HL, Sohn N, Carrasco JI, Robilotti JG, Delaney WE (1976). "The gay bowel syndrome: clinico-pathologic correlation in 260 cases". Ann. Clin. Lab. Sci. 6 (2): 184–92. PMID   946385.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  2. ↑ Kazal HL, Sohn N, Carrasco JI, Robilotti JG, Delaney WE (1976). "The gay bowel syndrome: clinico-pathologic correlation in 260 cases" (PDF). Ann. Clin. Lab. Sci. 6 (2): 184–92. PMID   946385.
  3. 1 2 3 Kenneth A. Borchardt; Michael A. Noble (1997). Sexually Transmitted Diseases: Epidemiology, Pathology, Diagnosis and Treatment. CRC Press. pp. 296–305. ISBN   978-0-8493-9476-8.
  4. ↑ "Textbook of medicine", Robert L. Souhami, John Moxham. Elsevier Health Sciences, 2002. ISBN   0-443-06464-4, ISBN   978-0-443-06464-7. p. 817
  5. ↑ Bartlett, John (March 15, 2004). "New Look at "Gay Bowel Syndrome", Etiology of Clinical Proctitis Among Men Who Have Sex With Men". Medscape.
  6. ↑ Weller, I. V. (1985). "The gay bowel". Gut. 26 (9): 869–875. doi:10.1136/gut.26.9.869. PMC   1432868 . PMID   3896960.
  7. ↑ M, Scarce (1997). "Harbinger of Plague: A Bad Case of Gay Bowel Syndrome". Journal of Homosexuality. 34 (2): 1–35. doi:10.1300/j082v34n02_01. PMID   9328857.
  8. 1 2 Garbo, Jon (December 21, 2004). ""Gay Bowel Syndrome" struck from textbook". Gmax.co.za. Archived from the original on 2005-01-04. Retrieved June 24, 2009.
  9. ↑ Lee, Ryan (April 8, 2005). "Activist fights 'outdated' medical phrase: Effort to debunk 'gay bowel syndrome' may face new challenge". Washington Blade . Archived from the original on May 7, 2009. Retrieved June 24, 2009.
  10. ↑ Kaiser, Andreas (2009). McGraw-Hill Manual of Colorectal Surgery. McGraw-Hill Education. p. 205. ISBN   978-0-07-159070-9.
  11. ↑ Scarce, Michael (1999). Smearing the Queer: Medical Bias in the Health Care of Gay Men. Routledge. p. 13. ISBN   978-1-56023-926-0.
  12. ↑ "Gay Men's Health". JAMA. 284 (15): 1986. 18 October 2000. doi:10.1001/jama.284.15.1986-JBK1018-2-1.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.