Talking with gay male patients about cardiovascular health
What is a Bear?
Bears are a sub-group of gay men generally identified by their larger body size, and facial and body hair which connects them to community and with sexual partners. In the medical clinic, they are frequently seen as obese men at increased risk for cardiovascular disease and diabetes.
These men have likely heard plenty of societal messages and health providers saying they are fat. While weight loss may be a goal for some patients, consider instead addressing the sequelae of large body habitus as a strategy to build trust as a non-judgemental provider.
Medical education about gay men is commonly limited to risk of HIV, STIs and substance use. These men need all the same age-related screening as non-queer patients.
Case Study: Mac goes to the doctor
Recommended health screening for Bears
Unique screening for Bears*
- Joint and back pain
- Erectile dysfunction
- Obstructive sleep apnea
- Kidney stones
- Skin and soft tissue infections
Screening for gay & bisexual men
- Sexually transmitted infections
- HIV & Syphilis
- Gonorrhea & Chlamydia urine/swabs
- Hepatitis A/B immunity
- Hepatitis C infection
- Depression & anxiety
- Substance use
- Tobacco + Cannabis
- Crystal meth/GHB/other substance
- Anal pap for HIV+ (evolving evidence for HIV-)
Screening by age and risk factor
- Colorectal & Lung cancers
- Pap of cervix and ultrasound chest for trans men