From The GAPHR Advocate

May 2001

Co-Presidential Communications:


There’s no doubt that we in GAPHR have achieved a number of milestones over the years. Our presence at Pride celebrations, the Doctor Is Out column in Southern Voice, and – as James described last month – our Health Fair all represent significant achievements we can be proud of. But let’s not rest on our laurels. While we’ve made many inroads, I think all of us would agree that more remains to be done. Expanding our outreach and inclusiveness may be one such goal.

I think we in the collective gay community can easily become insulated – and isolated. After all, we have our own neighborhoods, newspapers, bookstores, community centers, and houses of worship. While there are many reasons underlying the need for all of the above, I wonder if we, at times, may inadvertently distance ourselves from others.

One of the things that struck me when I first entered the gay community was how self-contained it seemed. Everyone seemed to somehow already know each other and I soon learned the other meaning of the word "family". (Yes, I’m a bit slow. I originally thought all those rainbow bumper stickers belonged to supporters of Jesse Jackson’s rainbow coalition...). But more seriously, it got me thinking. Does our sense of community sometimes lead us to exclude outsiders?

"I hate straight people. I find ‘breeders’ so annoying ... I wish everybody was gay," disdainfully pronounced one young man at a community event. Granted, an extreme example. But while I can appreciate that there is often comfort in numbers, attitudes such as his are just as offensive as the reverse. And they deprive us all of opportunities to get to know and value others.

Building bridges is a laudable goal and one which GAPHR has made some investment in.  I hope that the expanding inclusiveness of GAPHR sends a signal that we are here to serve diverse communities. Our booths at medical conferences represent another example of bridge building. While our "outness"as a medical organization may involve some risk, the potential rewards are great. And, in my experience, our anxieties are usually unfounded.

I remember the first time GAPHR had a booth at the Medical Association of Georgia (MAG) convention. The decision to exhibit at MAG elicited some strong reactions within our organization. This was a first for GAPHR and many of us wondered how we’d be received. But the opportunity to translate our mission of educating our physician colleagues about the unique medical care concerns of L/G/B/T patients into action was too important to pass up. So, with rainbow banner in tow, we assumed our place among a smattering of drug company booths at the SwissHotel.

As it turns out, we were very well-received. Many of our physician colleagues were unaware of medical concerns other than HIV in our community and were very appreciative of our presence. Some of our heterosexual colleagues – supportive of the mission of GAPHR -- expressed interest in joining us. Sounds like a true "win-win" situation to me! And they all left armed with new knowledge to improve their care of their L/G/B/T patients. We achieved our mission with flying colors.

And we built a bridge.



Pride Booth Needs Volunteers

Pride is fast approaching, so "now is the time for all good GAPHR members to come to the aid of their favorite medical organization." No, not the AMA ... us! We need volunteers to help with setup, to staff the booth, to march with us, and to help with takedown. This is one of GAPHR’s most important outreach activities to our community and we need YOU to make it a success! Dan  and Tom are serving as co-chairs. Please contact Dan @ (404) 607-0817 to offer to help. Don’t delay – call today!

Save Your Sunscreen Samples

We’re sending out an SOS (or is it an SYS?) to please save your sunscreen samples.  These seem to be in short supply in recent years, so we all need to stock up now if our GAPHR Pride booth is to be a success. Giving out sunscreen has become our "hook" at Pride and we want to continue this tradition of promoting skin health. If need be, we would be happy to pick up your sunscreen samples at your convenience. Please call Dan Chapman @ (404) 607-0817 to help with this important outreach activity.

GAPHR Pride Health Fair

Plans for the upcoming GAPHR Pride Health Fair are well underway, but we still need your help. Please contact us to help make this important event a success!

GLMA Board at May GAPHR Meeting

We are especially honored to have members of the GAPHR Board of Directors as our special guests at our May 19th meeting. GLMA is something of our parent organization and the May meeting will give us all a chance to network with many leaders of national efforts to advance the medical care of L/G/B/T patients. Many thanks to GAPHR Resident Liaison and GLMA Board Member Jason Schneider for making this happens! Who knows, we may well have some future GLMA Board Members (or GLMA Presidents!) among our GAPHR members.

Circle May 19th on your calendar now – you won’t want to miss this important networking opportunity!

This is the Last Issue of the GAPHR Advocate

... if you haven’t paid your 2001 dues yet. Due to rising postage and production costs we are unable to mail our newsletter to those with unpaid 2001 dues. As the newsletter features the meeting announcement, this means you won’t be getting the meeting invitations either.

We don’t want to lose you, so please mail in your dues today ($75 for postgraduate physicians, $20 for residents/fellows, $10 for medical students) to our P.O. box, or – better yet – bring your check with you to the May meeting!

No June Meeting

Because the GAPHR Pride Booth and the GAPHR Pride Health Fair both fall in June, GAPHR will not have a general membership meeting in June. However, we look forward to seeing you at one or both of these events! Our regular membership meetings will resume in July.

Literary Pearls

Pope HG, Phillips KA, Olivardia R. The Adonis Complex: The Secret Crisis of Male Body Obsession New York: Free Press, 2000.

This book addresses the fascinating – but hidden – topic of body dysmorphia. Previously believed to be found primarily in women, the prevalence and implications of body dysmorphia among men are grippingly documented in The Adonis Complex. By combining both scientific data with clinical vignettes, the authors have succeeded in compiling a book which is both authoritative and readable.

While the specific focal points of body dissatisfaction characteristically vary between men and women, the underlying phenomenology appears to be very similar. Among those suffering from body dissatisfaction, sensible efforts at losing weight or improving muscle tone grow obsessive. The book describes the plight of those in the heights of body dysmorphia who did little else other than work and exercise, often losing both jobs and relationships along the way. Like those suffering from anorexia nervosa, individuals with body dysmorphia often present with physical appearances which strongly belie their self-perception. Particularly striking were the numerous accounts of massive bodybuilders with "muscle dysmorphia" (also known as "bigorexia") who wore only baggy sweats because they were certain they didn’t "look big enough."

As the book is devoted to body dissatisfaction among men, the authors briefly highlight distinctions between men and women suffering from this disorder. While women primarily seek to lose weight or add to their bust size, men with body dissatisfaction frequently wish to be more muscular, to have a full head of hair, or to increase their penis size. The Adonis Complex describes the pratfalls involved in all of these undertakings and the lengths to which some men have gone to improve their appearance.

The Adonis Complex describes body dysmorphia among gay men and speculates about its etiology. For some, body dissatisfaction may reflect deficits in self-esteem, which the sufferer believes will be bolstered as his body bulks up. Attaining a body ideal may also provide an assurance of desirability to some, as illustrated by the following passage:

"In the gay world, your body is the only currency you’ve got to negotiate with," said Kyle, a thirty-year-old gay man. "With a woman, it’s going to matter whether you show up in a 2000 Porsche or an ‘87 Ford. But to a gay man that’s not going to make much difference in comparison to what you look like" (p.217).

For others, the time and energy invested in their appearance may be a means of avoiding underlying concerns about sexual orientation and identity.

The authors note that while many conjecture that the prevalence of body dysmorphia is greater among gay than heterosexual men, this difference may not be as pronounced as believed. Cognizant of the effects of popular culture, the authors draw on Playgirl centerfolds, Muscle and Fitness covers, and GI Joes to document changing body ideals among men. They assert that increasing "objectification" of men by both women and Madison Avenue may render heterosexual as well as homosexual men vulnerable to body dysmorphia. As such, The Adonis Complex extends its scope beyond the confines of an academic text and provides a thought-provoking read to those concerned with the health of men of all sexual orientations.


L/G/B/T Medical Watch

Thurlow C. Naming the "outsider within": Homophobic pejorative and the verbal abuse of lesbian, gay, and bisexual high-school pupils. J Adolesc 2001;24:25-38 (special issue of J Adolesc on L/G/B youth).

377 14- and 15-year-olds listed the pejoratives they heard at school and identified the ones they considered the most taboo. Homophobic pejoratives accounted for 10% of the 6000 items generated. Significantly, however, the impact of homophobic abuse was rated as much less serious than racist abuse or other taboo slang. Boys reported more homophobic pejorative than girls, but rated instances more seriously. Conclude that this study provides further evidence of the daily assault on the psychological health of L/G/B youth fostered by verbal abuse and the disregard with which it is used.

Bradford J, White J, Honnold J, Ryan C, Rothblum E. Improving the accuracy of identifying lesbians for telephone surveys about health. Womens Health Issues 2001;11:126-137.

Conducted focus groups with 46 lesbians in five cities to discuss methods for enhancing participation of lesbians in telephone health surveys. Noted that closeted lesbians are a difficult to reach population and suggested methods to enhance their participation in research. Appealing to participants’ altruism and sponsorship of the survey by an impartial organization may improve participation, as could allowing respondents to verify the legitimacy of the contact before participating. Assessing other aspects of life than sexual behavior and gradually leading up to sensitive questions were also suggested. Respondents indicated that providing multiple response options and avoiding stereotypic assumptions about lesbians would also enhance participation.

Burke BP, White JC. The well-being of gay, lesbian, and bisexual physicians. West J Med 2001;174:59-62.

Noted that while previous research has examined the attitudes and experiences of L/G/B patients, relatively little attention has been paid to L/G/B physicians. Conducted a MEDLINE search from 1966 to June 2000 using search terms gay or lesbian or bisexual or homosexual, physician or doctor or health professional, and professional practice. Noted anti-homosexual attitudes and behaviors are evident in physicians and affect medical education and training. Cited previous research indicating one quarter of responding family practice residency directors would rank an openly L/G/B candidate lower and one third had experienced verbal harassment or insult from medical colleagues. However, found support services for L/G/B medical students and residents are growing in number and that fewer physicians would deny medical school admission to a highly qualified L/G/B medical student in 1996 (4.3%) than in 1982 (29.7%). Suggested that L/G/B physicians come out when possible, join an L/G/B organization, sponsor a Pride booth, and advocate that sexual orientation be added to their hospital or practice-related nondiscrimination statement.