Impotence

By Gallagher, John | The Advocate (The national gay & lesbian newsmagazine), September 30, 1997 | Go to article overview

Impotence


Gallagher, John, The Advocate (The national gay & lesbian newsmagazine)


Gay men have always been open about discussing sex--with other gay men, at least. When it comes to chatting about impotence, however, they maintain an uncharacteristic silence--especially in front of a straight doctor.

"There are not many gay urologists," says Mark Litwin, an assistant professor of urology and public health at the University of California, Los Angeles. "A gay man may be uncomfortable talking about gay sexual issues to a doctor he perceives is not open to his sexuality."

Regardless, some gay men, like some straight men, suffer from impotence. "I'm not sure how many gay men deal with this openly," says Phil (not his real name), a gay man in his 40s who has suffered from impotence for two decades. "I come across a lot of men who clearly have issues, who aren't getting erections or have difficulty with it. I want to say, I know what you're going through."

When Phil goes out on a date, he takes along a needle filled with a vasodilator, a new drug that in ten to 15 minutes produces an erection that can last up to several hours. Usually he injects the drug in private, out of sight of his partner. "It's awkward filling up these insulin needles, carrying that with you, and being prepared to inject yourself," he says. "But I still prefer that over being flaccid."

Phil sought help, but it didn't come easy. At the university hospital where he went for treatment, he was counseled before being given the drug. "They clearly had been dealing with married couples," he says. "I lied and told them I had an ongoing partner, because to them the whole issue of sex with anonymous people was not something they could deal with. I'm not sure they would have let me have the injections if I had told the truth."

Phil's fears are not unfounded. Litwin says that patients suffering from HIV-related impotence are all too often turned down for testosterone therapy. "I can tell you plenty of horror stories of urologists telling patients, `You have HIV, so you shouldn't be having sex anyway,'" Litwin says. "That's sad, not the least because your relationship with your partner is a source of solace for people with HIV. It's far beyond our purview as physicians to decide who is worthy of getting erections. …

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