Homosexuality in a Changing World: Are We Being Misinformed?

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Homosexuality in a Changing World: Are We Being Misinformed?

By Dr. Nadia El-Awady


Diseases Related To Homosexuality

1. Mental Illness

In October 1999, the Archives of General Psychiatry published two studies related to homosexuality and mental health. The first, “Sexual Orientation and Suicidality: A Co-twin Control Study in Adult Men” by Richard Herrel et al, reported that same-gender sexual orientation is significantly associated with each of the suicidality measures. The study found that men with same-sex partners were 2.4 times as likely as their co-twins to have thoughts about death, 4.4 times as likely to want to die, 4.1 times as likely to have suicidal ideation, 6.5 times as likely to have attempted suicide, and 5.1 times as likely to have any of the suicidal symptoms. After adjustment for substance abuse and depressive symptoms (other than suicidality), all of the suicidality measures remained significantly associated with same-gender sexual orientation except for wanting to die.

The second study, “Homosexuality and Mental Illness” by J. Michael Bailey, reported on a New Zealand study which followed 1007 individuals since birth. At the age of 21, the 28 subjects classified as gay, lesbian or bisexuals were significantly more likely to have had mental-health problems than the 979 classed as heterosexual.

The Archives of General Psychiatry also published in its January 2001 issue a study titled, “Same-Sex Sexual Behavior and Psychiatric Disorders: Findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)” by Sandfort et al., which found that psychiatric disorders were more prevalent among homosexually active people compared with heterosexually active people. Homosexual men were 2.94 times as likely to have a 12-month prevalence of mood disorder and 2.61 times as likely to have a 12-month prevalence of anxiety disorder than heterosexual men. Homosexual women were 4.05 times as likely to have a 12-month prevalence of substance use disorders than heterosexual women. More homosexual than heterosexual persons had 2 or more disorders during their lifetimes.

It should be noted that Dutch society is a very gay-affirming and gay-friendly society, which may suggest that “society’s oppression” of homosexual people is not necessarily the cause of increased rates of mental illnesses among homosexuals as some people might suggest.

2. Kaposi Sarcoma

In an indirect fashion, anal intercourse is implicated in the development of Kaposi’s sarcoma, one of the diseases on the AIDS-indicator list of the U.S. Centers for Disease Control (CDC). This is because nitrite inhalant recreational drugs, known commonly as “poppers”, have been popular in the gay community and are used to facilitate this practice through relaxation of the anal sphincter. Researchers at the National Institute on Drug Abuse have recognized that nitrite inhalant abuse is associated with Kaposi’s sarcoma, and HIV-negative gay men with a history of using poppers have developed this disease.

The International Journal of Dermatology explains why homosexuals’ behaviors place them at high risk for this disease, which affects the mucous membranes and the skin of its victims:

In this high risk group [the gay male population], the predominant portal of entry of free and cell-bound HIV as well as the brunt of associated cofactors and opportunistic infections can be traced to both ends of the gastrointestinal tract (mouth and anus) and also the genitalia, which happen to be common sites for KS lesions in addition to their lymphatic watersheds.

Kaposi’s sarcoma has taken a particularly tragic toll on HIV-infected homosexual men, sending them to an earlier grave than their IV-drug user counterparts. AIDS reports:

According to our data, homosexual men had a significantly higher risk of progression to AIDS and shorter survival compared with IDU [IV drug users] and other categories. In a multivariate analysis the increased risk was found to be independent of demographic and clinical characteristics but was accounted for by the higher probability of developing Kaposi's sarcoma.

3. Hodgkin’s Disease

Homosexual men suffering from HIV/AIDS also suffer from other cancers and lymphomas. One study published in the Annuls of Medicine noted the connection between homosexual AIDS patients and Hodgkin’s disease. The study concluded, “An excess incidence of Hodgkin’s disease was found in HIV-infected homosexual men.” The Journal of Clinical Oncology published a study that further supports a connection between homosexual male AIDS patients and Hodgkin’s disease.

4. Anal Cancer

Homosexual males are also at elevated risk for anal cancer. A likely possibility is that chemicals in the lubricants used to facilitate anal intercourse are a factor associated with this disease. Researchers R.J. Ablin and R. Stein-Werblowsky describe sperm and seminal plasma as capable of promoting cancer, and suggest that this accounts for the increase in cancer among people practicing anal sex.

One article in the New England Journal of Medicine commented, "Our study lends strong support to the hypothesis that homosexual behavior in men increases the risk of anal cancer: 21 of the 57 men with anal cancer (37 percent) reported that they were homosexual or bisexual, in contrast to only one of 64 controls." The Journal of the American Medical Association also published similar findings: "Epidemiological studies have shown that risk factors for anal cancer include homosexuality, history of receptive anal intercourse, presence of anal condylomata, and smoking." And the International Journal of Cancer stated, "Being single and having practiced anal intercourse appears to be associated with anal cancer and case reports have suggested a recent increase in the number of cases of anal cancer."

Another article published in the Journal of the American Medical Association stated that, “…studies indicate that immunosuppressed male homosexuals have a high prevalence of anal human papilomavirus infection and anal intra-epithelial neoplasia, and this population may be at significant risk for the development of anal cancer.”

Along the same lines, an article in the New England Journal of Medicine concluded: “Anal intercourse may predispose to anal cancer through the transmission of an infection, most probably infection with human papillomavirus.”

5. Impairment of Immune Response

Several researchers have concerned themselves with the immune dysfunction consequent to the direct entry of semen into the bloodstream by means of anal intercourse. Joseph Sonnabend has argued that repeated exposures to semen combined with various sexually transmitted disease pathogens result in impairment of immune response. Robert Root-Bernstein concluded that exposure to semen through anal intercourse can initiate lymphocytotoxic autoimmunity. Another researcher who recognizes the pathogenic effects of semen is Eleni Papadopulos-Eleopulos (Department of Medical Physics, Royal Perth Hospital, Perth, Western Australia), author of “Looking Back on the Oxidative Stress Theory of AIDS” published in Continuum volume 5, number 5 - mid-winter 1999.
 

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6. AIDS

The CDC reports in its June 2000 HIV/AIDS Surveillance Report that men who have sex with men (MSM) account for the majority of AIDS cases in the United States.

AIDS CASES BY EXPOSURE CATEGORY
[parsehtml]
<table border="1" cellpadding="0" cellspacing="1" width="100%">
<tbody>
<tr>
<td valign="middle" width="74%"><div align="center"><strong>EXPOSURE CATEGORY</strong></div></td>
<td align="center" width="9%"><div align="center"><strong>MALE</strong></div></td>
<td align="center" width="8%"><div align="center"><strong>FEMALE</strong></div></td>
<td align="center" width="9%"><div align="center"><strong>TOTAL*</strong></div></td>
</tr>
<tr>
<td width="74%"><div align="left">Men who have sex with men</div></td>
<td width="9%"><div align="center">348,657</div></td>
<td width="8%"><div align="center">-</div></td>
<td width="9%"><div align="center">348,657</div></td>
</tr>
<tr>
<td width="74%"><div align="left">Injecting Drug Use</div></td>
<td width="9%"><div align="center">137,650</div></td>
<td width="8%"><div align="center">51,592</div></td>
<td width="9%">189,242<br></td>
</tr>
<tr>
<td width="74%"><div align="left">Men who have sex with men and inject drugs</div></td>
<td width="9%"><div align="center">47,820</div></td>
<td width="8%"><div align="center">-</div></td>
<td width="9%"><div align="center">47,820</div></td>
</tr>
<tr>
<td width="74%"><div align="left">Hemophilia/coagulation disorder</div></td>
<td width="9%"><div align="center">4,847</div></td>
<td width="8%"><div align="center">274</div></td>
<td width="9%"><div align="center">5,121</div></td>
</tr>
<tr>
<td width="74%"><div align="left">Heterosexual contact</div></td>
<td width="9%"><div align="center">27,952</div></td>
<td width="8%"><div align="center">50,257</div></td>
<td width="9%"><div align="center">78,210</div></td>
</tr>
<tr>
<td width="74%"><div align="left">Recipient of blood transfusion, blood components, or tissue</div></td>
<td width="9%"><div align="center">4,920</div></td>
<td width="8%"><div align="center">3,746</div></td>
<td width="9%"><div align="center">8,666</div></td>
</tr>
<tr>
<td width="74%"><div align="left">Risk not reported or identified</div></td>
<td width="9%"><div align="center">48,343</div></td>
<td width="8%"><div align="center">19,042</div></td>
<td width="9%"><div align="center">67,387</div></td>
</tr>
</tbody>
</table>
* Includes 3 persons whose sex is unknown.</div>
</center>
[/parsehtml]
CDC semiannual HIV/AIDS Surveillance Report. Numbers are based on AIDS cases reported to CDC through June 2000.

The CDC reports:

In the United States, HIV-related illness and death historically have had a tremendous impact on men who have sex with men (MSM). Even though the toll of the epidemic among injection drug users (IDUs) and heterosexuals has increased during the last decade, MSM continue to account for the largest number of people reported with AIDS each year. In 1999 alone, 15,464 AIDS cases were reported among MSM, compared with 10,138 among IDUs and 7,139 among men and women who acquired HIV heterosexually.

Overall, the number of MSM of all races and ethnicities who are living with AIDS has increased steadily, partly as a result of the 1993 expanded AIDS case definition and, more recently, improved survival. (See chart)

The World Health Organization in its Global HIV/AIDS and STD Surveillance reports on the epidemiology of AIDS in different countries. Giving the Netherlands as a first example due to its large acceptance of gay practices comparative to other countries worldwide, homosexuals form 68.6% of AIDS cases, whereas heterosexuals form only 15.2%. Intra-venous drug users (IDU) form 11.6% and blood donations 2.3%. In the UK, MSM form 65.8% of AIDS cases followed by 18.1% heterosexuals. IDU form 8.1% of the cases. Those two countries are given as typical examples of what is found in other European countries in general where homosexuality is more commonly practiced.

7. Sexually transmitted diseases

Dr. Steven Wexner of the Cleveland Clinic in Ft. Lauderdale, Florida, stated in a 1990 study published in Diseases of the Colon and Rectum that “up to 55% of homosexual men with anorectal complaints have gonorrhea; 80% of the patients with syphilis are homosexuals. Chlamydia is found in 15% of asymptomatic homosexual men, and up to one third of homosexuals have active anorectal herpes simplex virus.”

The Canadian Medical Association Journal in 1991 stated that “gonorrhea was associated with urethral discharge…and homosexuality (3.7 times higher than the rate among heterosexuals).”

This is especially true of gonorrhea of the pharynx. A study published in the Journal of Clinical Pathology found, “In homosexual men a much higher prevalence of pharyngeal gonorrhea (15.2%) was observed in comparison with heterosexual men (4.1%).”

Unlike its effect on the genitals, when gonorrhea infects the pharynx and rectal regions, it often emerges without symptoms. And even if it does emerge with symptoms, those symptoms can be easily misinterpreted as simply a sore throat or misdiagnosed as part of a simultaneous ailment such as hemorrhoids. The Journal of the American Medical Association stressed the importance of properly diagnosing these infections: “Detection and treatment of these occult infections are essential, because gonococcal ‘carriers’ represent reservoirs of potential infection in the community.”

8. Surgical problems and medical problems

Dr. Selma Dritz wrote in the New England Journal of Medicine, “Oral and anal intercourse present physicians with surgical as well as medical problems, ranging from anal fissures and impaction of foreign bodies in the rectum to major diagnostic dilemmas.” Dr. Marlys Witte et al. noted in The International Journal of Dermatology that homosexual male practices such as “receptive anal and oral intercourse and oral-anal contact, recurrent rectal trauma associated with ‘fisting’, and venereal and parasitic infections, lead to many medical problems including tissue inflammation...intense angiogenesis, and progressive fibrosis.” Finally, Dr. Christina M. Surawicz et al. noted that “homosexually active men have frequent intestinal and rectal symptoms resulting from sexually acquired gastrointestinal infections.”
 
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