The year was 2016 — young Kanye fans thought he had just discovered new, raw talent in Paul McCartney; the How Old Am I? App was giving us all body dysmorphic disorder; and Taylor Swift was too busy insuring her legs for $40 million to vocally condemn Trump or the conservative base that she shared with him. At 24-years-old, gay, and recently single (read: dumped), I was liberally using my Grindr account. No stranger to the one night stand, I became curious about joining the growing legion of queer men I knew who were on PrEP.
At the time of my initial research, the Centers for Disease Control and Prevention had just released a report stating that one in six men who have sex with men (also known as MSM) will acquire HIV in his lifetime — and the number was even higher for MSM of color. According to the CDC, the demographics most at risk of acquiring HIV are youth and young adults aged 13-24. This is in part due to younger men engaging in riskier sexual behavior. But that’s not the whole picture, because in addition to being blinded by our horniness, my generation also did not grow up in the time of the AIDS epidemic: We were too young to experience what it was like during the ’80s and ’90s.
The information available online about PrEP at the time was pretty all over the place, but after compiling the data, and looking at my options I decided that I wanted to do it. Hakuna Truvada!
So, I made an appointment with my GP and imagined myself a la Carrie Bradshaw — popping the daily pill at the behest of my phone alarm, echoing in sync with that of all the women in my office, as all the straight men continue to be as confused as ever.I felt like the liberated sex object that I was. But, life doesn’t always go as we planned.
Here is how the conversation went over with my very straight, very male doctor:
GP: So, what brings you in today?
Me: I have decided that I want to go on PrEP, and I would like to get the process started.
GP: (long pause)…You don’t actually need PrEP. Condoms do the same job.
Me: I don’t see the two being mutually exclusive. I want to use PrEP in addition to the other safer sex strategies I’m currently using.
GP: Well, we also don’t know enough about the long-term effects of PrEP.
Me: Multiple studies have shown PrEP to be safe and highly effective against contracting HIV. I appreciate your concern, but for me, the benefits of PrEP far outweigh the risks.
GP: (another long pause)… You know that PrEP is quite expensive?
Me: Thank you for your concern, but my financial situation is my business.
Me: You’re not even going to pretend to consider prescribing or testing me for it, are you?
GP: I think you should seek a second opinion.
F*ck my drag, right?
Unfortunately, what I experienced with my now-former healthcare provider isn’t particularly unusual. Many medical providers are uncomfortable with issues that adversely affect LGBT+ identifying individuals. As Dr. Meera Shah, the Associate Medical Director of Planned Parenthood, explains in Jezebel that “many medical providers are uncomfortable asking for a thorough sexual history, leaving patients uncomfortable, and not wanting to come back. It makes it incredibly hard for them to access care and leads to a lack of information about many things, including HIV.” She adds, “I wish every patient walked away from their healthcare provider feeling understood and equipped with knowledge about how best to protect themselves.”
So, what did I do next? I went to a new doctor. I made my case, and this time I added an additional request: An anal Pap smear.
The anal Pap smear is a test similar to the vaginal Pap. A small sample of cells is collected from the anus and rectum using a Dacron swab. They are then examined under the microscope to identify any structural changes in the cells. These changes are often identified as precursors to anal cancer, a type of cancer which disproportionately affects gay and bisexual men. The procedure is quick, painless, and simple.
My latest Doc’s response? A resounding “No” to both. Her reason? She didn’t actually give one. Strike two.
Following these two run-ins with healthcare providers who didn’t care enough about my specific situation to even do the research before refusing to provide me with adequate medical care, I was left feeling exactly how Dr. Shah had described: Despondent and unprepared.
Enter Howard Brown Health, whose mission (similar to the DC Health and Wellness Center) is to eliminate the disparities in healthcare experienced by lesbian, gay, bisexual and transgender people through research, education and the provision of services that promote health and wellness.
As a Chicagoan, I was able to find solace in going to a healthcare provider who would understand my needs as a queer person who had been let down by the system thus far. Unfortunately, by this point I was now 25-years-old, and no longer qualified for free testing services. Oh, well! I had insurance, no biggie. Wrong again, Bro! While my insurance at the time, PHCS, did list Howard Brown Health as being in their network on their website, it turns out, it’s not really. Like, huh? Essentially, I now had to foot the bill for all of my tests, which I didn’t find out till after.
But, despite all of the problems and holes in the healthcare system that I ran into, I did eventually (after nearly a year) get the medical care that I needed to feel safe and secure in my health.
So, if you find yourself in the same boat as me, being denied healthcare services by providers who don’t understand your situation: take a deep breath, relax, and remember, the doctor is working for you. A good doctor wants to give patients the best care possible, and your attitude should be that you deserve no less. If you aren’t satisfied, seek out a different doctor. Do your research; call ahead and make sure that the doctor is open to prescribing PrEP and offering services unique to LGBT+ individuals; and seek providers who are uniquely qualified to help those in our community.
Nick Moutvic is a Chicago-based writer blissfully preoccupied with trying to make a career out of creating GIFs from the Lizzie McGuire Movie. He is interested in the intersection of feminism, race, and LGBTQ+ life as it is represented in popular culture. His work has been published on The Daily Dot, Bustle, INTO, and Thought Catalog, among others. Witness his public meltdowns on Twitter @nickmoutvic.