Guys, Go to the Doctor
What’s the best place for young men’s health care? Planned Parenthood.
Many of Mazzoni’s male patients who have sex with men get regular sexual health screenings and, Latimer says, LGBT-oriented health care providers tend to be much better at being frank with their patients about sex than other practitioners are. “I talk to almost every patient I see about sex,” Latimer says. “If they come in with an ear infection, we’ll focus on that. But for most general follow-ups, we’re going to talk about sex.”
I can attest to that. My previous primary care physicians discussed sex only if I initiated the conversation. I had to specifically ask for an STD test, and once my request was met with a surprised, “Again?” One doctor seemed utterly clueless about HPV (“I don’t see any genital warts, so you don’t have it”), and the office did not even offer the HPV vaccine to men. When I switched to Mazzoni for my primary care, I was quizzed on my sexual history, got my HPV shots, and received an STD test, without a fuss.
The question is how to get such care for the vast majority of American men. Among the Affordable Care Act’s virtues is a wonderfully comprehensive list of free preventive services for women: contraceptives, mammograms, pap smears, and screenings for all the major STDs. “Well-woman visits” are also included: general annual preventive care checkups “for adult women to obtain the recommended preventative services that are age and developmentally appropriate.”
Similarly sweeping services are not provided for men. The ACA does offer screenings for HIV and syphilis and STD-prevention counseling, regardless of gender, if a patient is deemed a “higher risk.” Immunizations against HPV and hepatitis B should also be freely available. But these are not particularly thorough or comprehensive standards.
What would an annual “well-man visit,” as the Men’s Health Network terms it, look like? Williams’ organization recommends HPV vaccinations, annual screenings for gonorrhea and chlamydia, along with prostate exams for those at higher risk: black men, anyone exposed to Agent Orange, and those with a family history of prostate cancer.
But there is only one organization I know of that has a comprehensive list of men’s sexual health services akin to the ACA’s preventive package for women: Planned Parenthood.
On Planned Parenthood’s web page devoted to men’s sexual health, the list of services (which vary by location) includes everything from colon, testicular, and prostate cancer screenings, erectile dysfunction and premature ejaculation services, male infertility screenings, “jock itch exam and treatment,” vasectomies, and the whole battery of sexual and routine physical examinations and testing. Many Planned Parenthood locations also offer the HPV vaccine for men. An affiliate in Denver treats obesity in young men, and centers in Texas screen for diabetes and teach men how to perform a testicular exam.
How many men go to Planned Parenthood for these treatments? Leslie Kantor, vice president of education for Planned Parenthood Federation of America, says the number of male patients has doubled in the past 10 years. The organization is popularly associated with women’s sexual health, and I have never known a man, even in my progressive and relatively sexual-health-conscious circles, to utilize their services. Men should support Planned Parenthood not just for the sake of the women in their lives but because it’s an excellent place to get their own sexual and reproductive health needs met.
Planned Parenthood probably can’t be expected to go to bat politically for “well-man” visits, as the organization is still battling a frontal assault from the Republican Party. The Men’s Health Network has issued a position statement about the preventive care they would like to see included as the Affordable Care Act moves forward. Back in the early 2000s, there was a bipartisan bill pushed by Sen. Mike Crapo, R-Idaho, and Rep. Vito Fossella, R-N.Y., to establish a federal office of men’s health, under the auspices of HHS. It never went anywhere, and in our current hyper-polarized and austerity-obsessed political environment, it seems unlikely to be resurrected.
Policymakers and health care stakeholders should take a keener interest in men’s sexual and reproductive health. If close to half the population is going without regular, standardized checkups, often for years, public health will be, and is being, harmed. Without such norms, American men will continue to be woefully uninformed, unprotected, and unexamined. And that’s not good for anyone.