Showing posts with label Men’s Health. Show all posts
Showing posts with label Men’s Health. Show all posts

April 5, 2018

I’m a Gay Psychiatrist and Here’s Why I Went on Grindr to Survey Men {What is Grind'r Doing to Our Gay Men?}


 

This story originated at VOX and it has the adamfoxie🦊blog taste


When I open the Grindr app on my smartphone, I see there’s a 26-year-old man with tanned abs just 200 feet away. He’s called “looking4now,” and his profile explains that he wants sex at his place as soon as possible.
Scrolling down, I find 100 similar profiles within a one-mile radius of my apartment in Boston. I can filter them by body type, sexual position (top, bottom, or versatile), and HIV status.
As a gay psychiatrist who studies gender and sexuality, I’m thrilled with the huge strides we’ve made over the past decade to bring gay relationships into the mainstream. The Supreme Court ruled that same-sex marriage is a constitutional right. Today in Boston, two men can walk down the street holding hands without consequence.
But I’m worried by the rise of the underground digital bathhouse. Apps like Grindr, with 3 million daily active users, and others like Scruff and Jack’d, are designed to help gay men solicit sex, often anonymously, online. I am all for sexual liberation, but I can’t stop wondering if these apps also have a negative effect on gay men’s mental health.
Since there’s little published research on the men using Grindr, I decided to conduct an informal survey and ask men why they’re on the app so much and how it’s affecting their relationships and mental health. I created a profile identifying myself as a medical writer looking to talk to men about their experiences. I received about 50 responses (including propositions). 
It’s a small sample size, but enough to give us some clues about how Grindr is affecting gay men. And it doesn’t look good.

Apps like Grindr are designed to make finding sex easy. And that can make them hard to stop using.

The most common reason users gave for going on the app is that sex feels great and Grindr makes it accessible, right at your fingertips. The screen full of half-naked men excites users. With a few clicks, there’s a possibility of meeting a sexual partner within the hour.
Neuroscientists have shown that orgasm causes activation of pleasure areas of the brain like the ventral tegmental area while deactivating areas involved with self-control. And these patterns of activation in men are strikingly similar to what researchers see in the brain of individuals using heroin or cocaine. So when a neutral action (clicking on Grindr) is paired with a pleasurable response in the brain (orgasm), humans learn to do that action over and over again.
This can be a normal pleasure response or it could be a setup for addiction, depending on the situation and individual.
Grindr, intentionally or not, also leverages a psychological concept called variable ratio reinforcement, in which rewards for clicking come at unpredictable intervals. You may find a hookup immediately, or you may be on your phone for hours before you find one.
Variable ratio reinforcement is one of the most effective ways to reinforce behavior, and it makes stopping that behavior extremely difficult. Slot machines are a classic example. Because gamblers never know when the next payout will come, they can’t stop pulling the handle. They hold out hope that the next pull will give them the pleasurable sound of coins clanking against a metal bin, and they end up pulling for hours.
Now imagine a slot machine that rewards you with an orgasm at unpredictable intervals. This is potentially a powerful recipe for addiction and may explain why one user I spoke with stays on Grindr for up to 10 hours at a time, hoping to find the perfect partner for casual sex.
The phrase “addiction” continues to be controversial when it comes to sex and technology, But as John Pachankis, an LGBTQ mental health expert at the Yale School of Public Health, described the impact of Grindr to me: “I don’t know if it’s an ‘addiction,’ but I know it causes a lot of distress.”
For now, it’s hard to know just how many Grindr users feel their use of the app is problematic. Early research on app use and health has focused only on sexually transmitted infections, for instance, rates of HIV among Grindr users, using Grindr to get people tested for STIs, etc. 
Just last week, Grindr announced that it will start sending users HIV testing reminders and the addresses of local testing sites (on an opt-in basis). In less pleasant news, BuzzFeed revealed on Monday that Grindr has also been sharing the HIV status of its users with third-party companies. (The company later said it would stop sharing the information.)
Though there is this new attention to sexual health, both Grindr and the research community have been silent on mental health. Yet since 2007, more gay men have died from suicidethan from HIV. 
This suggests it’s time we start thinking about Grindr’s health effects more broadly. Other dating apps, like Tinder, for example, are now the subject of early research looking at mental health implications. It’s time to do the same for gay hookup apps. 

Grindr may provide men with some relief from their anxiety and depression. But it’s temporary.

For some users I talked to, the allure of Grindr was not just the rush to feel good. It was to stop feeling bad. Users told me they log on when they feel sad, anxious, or lonely. Grindr can make those feelings go away. The attention and potential for sex distract from painful emotions.
A staggering number of gay men suffer from depression, with some estimates as high as 50 percent. Because gay men’s anxiety and depression often stem from childhood rejection for being gay, messages of affirmation from other gay men are particularly appealing. Unfortunately, these messages are typically only skin-deep: “Hey man, cute pic. Looking to ****?”
A recent survey of 200,000 iPhone users by Time Well Spent, a nonprofit focused on the digital attention crisis, showed that 77 percent of Grindr users felt regret after using the app.












 The users I interviewed told me that when they closed their phones and reflected on the shallow conversations and sexually explicit pictures they sent, they felt more depressed, more anxious, and even more isolated. Some experience overwhelming guilt following a sexual encounter in which no words are spoken. After the orgasm, the partner may walk out the door with little more than a “thanks.” 
And yet they keep coming back for that temporary emotional relief. One user told me that he feels so bad after a hookup that he jumps right back on the app, continuing the cycle until he is so tired he falls asleep. Every once in a while, he deletes the app, but he finds himself downloading it the next time he feels rejected or alone.
“We see patients like this almost every day,” Pachankis told me. “Apps like Grindr are often both a cause and a consequence of gay and bisexual men’s disproportionally poorer mental health. It’s a truly vicious cycle.”
Not all Grindr users are addicted and depressed, of course. Some users I interacted with seem to use Grindr in a healthy, positive way. One man I interviewed met his fiancĂ© there; they are excitedly planning their wedding. Some I spoke with said they use the app for sex but haven’t suffered any negative consequences and have control over their use.

Using Grindr may keep men from finding lasting relationships

Why do so many of these men turn to Grindr to begin with? Perhaps Grindr’s popularity is a sign we haven’t made as much social progress as we think for same-sex relationships. The general population seems comfortable with the idea of gay marriage, but it’s still difficult for a gay man to find a partner.
One 23-year-old user told me that the only places he can find gay men are clubs and Grindr, and both are hypersexualized. The cultures of both intimidate him. According to Pachankis, gay culture is often “status-focused, competitive, hierarchical, and exclusionary.” He explains that these traits are common among men generally, but in the gay community, they become amplified in a group that “both socializes and sexualizes together.” 
The 23-year-old is afraid of rejection, and Grindr shields him from the pain of in-person turndowns. “My framework now is sex first. I don’t know how to date people in person.” 
His relationships, he says, start with casual sex on Grindr. They first meet at 2 am for a hookup. He’ll try to schedule the next sex date a little earlier, maybe 11 pm. Then the next step may be drinks.  
But this sex-first approach hasn’t led to lasting relationships for the men I interviewed and is affecting their self-worth and identity. “My self-esteem now is all about my sexual ability,” the 23-year-old said. “I don’t feel confident about myself as a partner in any other way.” 
Another user told me he downloaded the app hoping to find a husband. Now he says that when he and a boyfriend (he’s gone through several) fight, his natural response is to open Grindr to “find an alternative” instead of working through problems. He can’t maintain a monogamous relationship because he is constantly cheating.

There may be ways to treat men with problematic Grindr use

The mental health professionals I spoke to are seeing problematic Grindr use in their clinics. And there is little published guidance on how to help those who are struggling.
Doctors I spoke to say the best available tools for treating problematic Grindr use are the ones they use in general sex addiction treatment. Citalopram, a common antidepressant, was shown in one small study to be helpful with sex addiction in gay men. Naltrexone, a drug commonly used for other compulsive behaviors, may work as well. 
For more extreme cases, patients could request hormonal implants that turn off testosterone signaling, making sexual cravings less intense. However, even these treatments have modest empirical support at best, and none have been studied for hookup app use specifically.
Dr. Shane Kraus, the director of the behavioral addictions clinic at Bedford Veterans Hospital and an assistant professor of psychiatry at the University of Massachusetts Medical School, says the most promising treatment for problematic Grindr use is likely talk therapy techniques like cognitive behavioral therapy (CBT). CBT can teach patients to engage in other behaviors that are more productive (though often more difficult and time-consuming than Grindr) to help them feel loved or supported. 
Another psychotherapeutic technique known as acceptance and commitment therapy (ACT) can help teach patients how to better tolerate the feeling of being alone without logging on to Grindr.
The dynamics of Grindr, though, are complicated, and it can take time to work through all the angles. Are you self-soothing anxiety? Are you addicted to sex? Have you lost interest in your monogamous relationship? Do you think you can’t attain love, so you’re settling for hookups? Did your parents tell you being gay is wrong and you’re searching for acceptance? Ultimately, Kraus explains that therapy can help clarify these kinds of thoughts and feelings, and lead to insights that bring about a healthy change.
He also believes it’s only a matter of time before states and the federal government sponsor research exploring Grindr use and mental health. Grindr did not respond to our request for comment on this piece. But if future data supports what I suspect about the link between Grindr and mental health problems, even small interventions like advertising mental health resources on the app may help to address these users’ suffering.
As we continue to fight to bring gay relationships into the mainstream, we need to keep an eye on Grindr and how it both reflects and affects gay culture. The bathhouse is still around. It’s now open 24/7, accessible from your living room.
By Jack Turban a physician and medical writer at Harvard Medical School, where he researches gender and sexuality. His writing has appeared in the New York Times, Scientific American, and Psychology Today, among other publications. Find him on Twitter at @jack_turban.



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September 28, 2017

See What is Being Done To Save HIV Gay and BI Men from a Cancer Epidemic


The medical and scientific language is just as it appeared at the Medical Press study page. If you have a question about anything on this posting please don't hesitate to ask by using the comment section. You can also email the publisher at his email page included on the main page (left and down)of the blog.






Almost 620,000 gay and bisexual men in the United States were living with HIV in 2014, and 100,000 of these men were not even aware of their infection. These men are 100 times more likely to have anal cancer than HIV-negative men who exclusively have sex with women. Yet, no national screening guidelines exist for anal cancer prevention in any population.

Anal cancer is predominantly caused by chronic or persistent human papillomavirus (HPV) infection. HPV infection can lead to the development of anal precancer which, if remains undetected or not adequately treated, may lead to anal cancer. Likewise, HPV infection is also responsible for causing cervical, vaginal, vulvar, oropharyngeal, penile and rectal cancers.

The objective of screening is to identify and treat these precancers to prevent occurrence of anal cancer. However, one of the reasons for the lack of screening guidelines is that anal precancer treatment has not yet been shown to prevent invasive cancer. Our study, published today in the journal Cancer, attempts to find a possible solution to prevent anal cancer in HIV-positive gay and bisexual men, using the best available data. We found that age-specific anal precancer management, including post-treatment HPV vaccination, can potentially lead to an 80 percent decrease in lifetime risk of anal cancer and anal cancer mortality among gay and bisexual men.
Anal cancer: the next big crisis

Some in the medical community have identified anal cancer as the next big crisis among HIV-infected gay and bisexual men. Initiation of anti-retroviral therapy in the 1990s greatly reduced the AIDS-related death rate and improved survival. However, this improvement in survival led to an increase in the lifetime risk of developing anal cancer, especially among HIV-positive gay and bisexual men.
Anal cancer is typically preceded by persistent HPV infection that often leads to precancer. HPV is common among U.S. men; about one out of two men in the general population has HPV infection. HPV typically clears naturally; however, under certain circumstances, it might persist longer and might progress to anal precancer. If it remains undetected, untreated or inadequately treated, this precancer can progress to anal cancer.

The American Cancer Society estimates there will be 8,200 new anal cancer cases in 2017. In the absence of national screening recommendations, more than 50 percent of these individuals will be diagnosed at stage III or IV, when five-year survival is less than 40 percent. This creates a major public health concern.

We do not yet know how best to manage anal precancer (also known as high-grade squamous intraepithelial lesions) so that anal cancer could be prevented. A national randomized clinical trial study – Anal Cancer HSIL Outcomes Research (ANCHOR) – is currently determining optimal anal precancer management by comparing treatment and active monitoring.

How the anal cancer epidemic in gay and bi HIV-positive men can be prevented

The question then arises: How do we start managing our patients using the best available evidence? Likewise, it is imperative that these individuals have as much information as possible about anal cancer prevention.

How our study brings insight

Using a mathematical model, we simulated the life course of 100,000 hypothetical HIV-positive men who have sex with men (MSM) who were 27 years or older and were diagnosed with high-grade squamous intraepithelial lesions. In our model, we compared four different management strategies:
(1) individuals were not provided any form of treatment, which is the current practice; 

(2) individuals were actively monitored (followed biannually) and those who developed early cancer were treated;

(3) individuals were immediately treated using surgery (current most popular strategy among clinicians who treat precancer); and 

(4) individuals in addition to surgical treatment received HPV vaccination (potential strategy).

We followed these hypothetical patients over their lifetime in our computer model to estimate harms and benefits of the management strategies. We tracked the number of individuals who developed anal cancer and then estimated their risk of death from anal cancer. We then estimated above outcomes by patient age. For each strategy, we estimated age-specific lifetime outcomes considering cost, quality of life and life expectancy.

We found that HIV-infected gay and bisexual men who are 38 years or older should be treated using surgical treatment of ablation (either infrared coagulation or electrocautery), and that HPV vaccination should be administered at the time of surgery. This strategy is cost-effective and has the potential to decrease the lifetime risk of anal cancer by up to 80 percent in those men.

The model also found that because younger men are more likely to be cured of their precancer without intervention, patients younger than 29 should not be treated and those between 29 and 38 years old should be actively monitored (watch-and-wait approach) in order to prevent treatment-related inconvenience and morbidity that might affect their quality of life.
How the HPV vaccine could help

Currently, HPV vaccination is not recommended for administration among individuals 27 years or older. However, multiple observational studies have shown, and our findings have confirmed, that a practice of vaccinating individuals who have already been diagnosed with precancer may decrease the risk of the precancer coming back after treatment.

Given that the HPV vaccine has minimal side effects, we believe that clinicians can consider adopting this practice. Such practice may have many advantages, such as decreasing the number of treatments a patient needs for precancer recurrence thus decreasing the adverse outcomes of surgical treatment (possibility of scarring, anal stenosis and incontinence). 

In the long run, post-treatment HPVvaccination also has the potential to decrease the lifetime risk of anal cancer, save health care costs for treating patients for recurrence and cancer, and improve their life expectancy and quality of life.






August 5, 2017

In NY Insurance Has Denied HIV Med To a Gay Man Because His 'High Risk of Homosexual Behavior'






A patient applied for Truvada, FDA's only approved drug to prevent HIV infection, in July

The New York man received a denial letter citing his 'high risk homosexual behavior' as the reason
However, Truvada criteria state the drug should be covered for adults 'at high risk of sexually acquiring HIV-1'

HIV activism groups claim this is hardly the first case of a baseless denial
They also slam the language of the letter and 'down right discrimination'

United Healthcare has overturned the decision amid uproar over the letter
Dr Anthony Fauci, head of HIV at the NIH, told Daily Mail Online 'it seems like an inherent contradiction: PrEP was approved to prevent HIV for people at risk' 

An insurance company refused to cover a gay man's HIV-prevention drug because he 'engages in High risk homosexual behavior'.

The man, who lives in New York, applied for Truvada's PrEP in July to protect himself from the life-threatening disease. The drug is the only FDA-approved antiretroviral treatment to block HIV from infecting cells. 

But days later he received a denial letter from United Healthcare, which stated: 'The information sent in shows you are using this medicine for High risk homosexual behavior'.

The company claimed health plans only cover Truvada for patients who have HIV or have been exposed to the virus, adding that his request for coverage 'is not medically necessary under New York State Law'.

However, the letter also includes a list of United Healthcare Truvada criteria, which state that the drug - which costs $1,450 a month wholesale - should be covered for adults 'at high risk of sexually acquiring HIV-1'.

HIV activism groups have slammed the denial as illegal, and the phrasing of the letter as 'homophobic and discriminatory'.

Dr Anthony Fauci, director of the HIV/AIDS department at the National Institutes of Health, told Daily Mail Online: 'It seems like an inherent contradiction.

'PrEP is made for people who are actually at risk for HIV infection, not for people who are not at risk. 
'It has been proven that PrEP is a highly effective way of preventing HIV infection. That is the reason Truvada was approved.'

After receiving the letter on July 11, the patient, who remains anonymous, went to HIV activism groups for support to appeal the decision.

He sent the document to Jeremiah Johnson, of Treatment Action Group (TAG), who has led calls against the insurance company and the state health department to acknowledge the denial as a violation of guidelines.

'At best, it's gross incompetence of the insurer to carry out their own policy,' Johnson told Daily Mail Online. 'At worst, it's down right discrimination and it's illegal. 
'The patient was shocked by the language, as we all are.

'The words they use were stigmatizing terms on their own, but when you send that on UHC letterhead, saying "you're being denied this essential medication because you're homosexual"... We were just horrified.

'It's a clear violation of policy, it's unethical and it's malicious to deny people who are vulnerable.' 
The patient appealed to overturn the decision through his doctor, and has now been issued PrEP.
However, activism collectives have launched a petition to New York State Health Department to condemn United Healthcare's denial letter.

James Krellenstein, of ACT UP NYC which is behind the letter and petition, said this is hardly the first case of a baseless denial.

'We are hearing story after story of patients being denied Truvada coverage despite being fully in compliance with CDC, federal and state guidelines,' he told Daily Mail Online. 
'Often you can appeal the decision and get approved, but studies show these kinds of denials deter people and led to lower overall coverage.

'The language in this letter shows that this case is a black and white case of discrimination based on the patient's sexual orientation.'
Krellenstein pointed out that last year the New York City Health Department issued guidelines to doctors, highlighting gay men as candidates for PrEP.

And federal guidelines from the National Institutes of Health say the LGBT community is one of the most vulnerable populations to HIV infection, and therefore should receive PrEP. 
'United Healthcare endangered a patient's health because of his sexual orientation,' Krellenstein said.
'Every time this happens, insurance companies are endangering the health and well-being of the entire LGBT community.'

United Healthcare has not responded to Daily Mail Online's request for a comment.
The CDC last year said that 1.5 million Americans could benefit from taking PrEP to lower their risk of contracting HIV sexually or through intravenous drug use.

Contradiction: The letter included Truvada's criteria, which states that the drug is meant for adults at high risk of sexually acquiring HIV. It is the only FDA-approved drug for that purpose
Currently, figures suggest just over 100,000 people take the drug.
Krellenstein urged insurance companies to make contact with HIV activism groups to discuss coverage, criteria, and costs.

'We are interested in solving this problem, we're willing to sit down with UHC or any insurance company to work this out,' he said.

'But we are not going to remain silent while they endanger the health and well-being of our community.'

Johnson urges people who have been denied PrEP to visit the National Coalition for LGBT Health, which allows patients to anonymously share their stories and get support to appeal the decision if necessary.

'Don't shame yourself if you were denied,' Johnson adds.

'This is a stigmatized medication, like the contraception pill was years ago. Anyone taking a stigmatized medication needs to be very persistent.

'Work with your doctor to keep appealing the decision, and do what you can to make HIV activists aware if you were denied.'


By Mia De Graaf For Dailymail.com 

March 24, 2017

White Americans Are Dying Faster: What’s Killing Them?




In rich countries, death rates are supposed to decline. But in the past decade and a half, middle-aged white Americans have actually been dying faster. Princeton economists Anne Case and Angus Deaton first pointed out this disturbing trend in a 2015 study that highlighted three “diseases of despair”: drugs, drinking and suicide. 
On Thursday, the pair released a deeper analysis that clears up one of the biggest misconceptions about their earlier research.
The problem of dying whites can’t only be blamed on rising rates of drug overdoses, suicides and chronic alcoholism, they say. More and more, middle-aged white Americans are dying for all kinds of reasons — and the underlying issue may have less to do with opioids and more to do with how society has left behind the working class.
“Ultimately, we see our story as about the collapse of the white, high school educated, working class after its heyday in the 1970s, and the pathologies that accompany that decline,” they write.

On the streets of Chillicothe, Ohio: 'Shooting heroin is like drinking beer'

Play Video5:07
Chillicothe, Ohio is grappling with an addiction epidemic driven by opioids like heroin. But some here aren’t letting overdoses rule. (Lee Powell/The Washington Post)
This is slightly different than what they said in their first paper, where they emphasized that the trend of rising white mortality was “largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis.” That's technically correct — but by focusing only on the increase in death rates, Case and Deaton distracted from the larger picture.
The alarming fact isn't just that middle-aged whites are dying faster, but also that mortality rates have been dramatically declining in nearly every other rich country. The United States is getting left behind.
In the last 15 years, a chasm opened up between middle aged whites in America and citizens of European countries like France, Germany and the United Kingdom. While white death rates in America rose slightly, death rates in those other countries continued to plummet. In comparison to what happened in Europe, the situation for American whites starts looks much more dire — and it's a bigger problem than opioids or suicides can explain. It’s not just about what went wrong in America, but what stopped going right. 
Fifteen years ago, middle-aged whites in the United States were neck and neck with their German counterparts. Now, middle-aged white Americans are 45 percent more likely to die than middle-aged Germans.
As Case and Deaton show, the gap in mortality between white middle-aged Americans and middle-aged Germans is about 125 deaths per 100,000 people now. Every year, of 100,000 Germans between the ages of 45 and 54, about 285 die. In the United States, it's more than 410.
Out of those 125 additional American deaths, only about 40 might be explained by the spike in deadly drug use, drinking and suicides. And the rest? It’s hard to say. In their latest paper, Case and Deaton say that heart disease is part of the problem. While other countries have cut down heart disease deaths by over 40 percent in the past 15 years, heart disease remains a significant killer for white middle-aged Americans.
There’s still much left unexplained, but the latest data tell a larger — and more troubling — story. Most of the increase in white deaths is concentrated among those who never finished college. These are the same people who have been pummeled by the economy in recent decades. It’s gotten more difficult for them to find jobs, and what jobs they do come across nowadays don’t pay as well.
Yet, it's not entirely a matter of income either. Some of these same economic trends — driven by globalization and automation — afflicted countries like the U.K. and Germany, where the death rate has been dropping. Besides, according to a Washington Post analysis of recent Census Bureau data, white American men without a college degree still earn 36 percent more than their black counterparts. But the death rate among less-educated black Americans has actually been decreasing. In recent years, the two groups have converged — they are dying at about the same rate — even though white Americans still earn more.
So the theory comes back to despair. Case and Deaton believe that white Americans may be suffering from a lack of hope. The pain in their bodies might reflect a “spiritual” pain caused by “cumulative distress, and the failure of life to turn out as expected.” If they're right, then the problem will be much harder to solve. Politicians can pass laws to keep opioids out of people’s hands or require insurers to cover mental health costs, but they can’t turn back the clock to 1955.

By Jeff Guo
washingtonpost.com

July 8, 2016

In a Caribbean Village Many Boys are Born Without a Penis”Guevedoce”


Scientists and BBC presenter travelled to the Dominican Republic to meet the ‘Guevedoce' males who do not grow a penis until puberty

This little girl is a boy born without a penis but will develop one at 12








I hated going through puberty; voice cracking, swinging moods, older brother laughing at me. But compared to Johnny, who lives in a small town in the Dominican Republic, I had it easy. 
We came across Johnny when we were filming for a new BBC2 series, “Countdown to Life”, which looks at the consequences of normal, and abnormal, developments in the womb. 
Johnny is known as a “Guevedoce”, which literally means, “penis at twelve”. And the reason he’s called that is because, like 1 in 90 of the boys in the area, he first started to grow a penis when he was going through puberty. 
Guevedoces are also sometimes called “machihembras” meaning “first a woman, then a man”. When they’re born they look like girls with no testes and what appears to be a vagina. It is only when they near puberty that the penis grows and testicles descend. 
Johnny, who is now in his 20s, was once known as Felicita. He was brought up as a girl and remembers going to school in a little red dress. 
When he was young he would happily play with other little girls, but after the age of seven he started to change 
“I did not feel good, I no longer liked to wear a skirt, and I was no longer drawn to play with girls. All I wanted to do is play with toy guns and boys” 
When he turned obviously male he was teased at school because”, as he put it, “it is hard to imagine a girl that is now is a boy”.  
One of the first people to study this unusual condition was Dr Julianne Imperato, a Cornell endocrinologist. She travelled to this remote part of the Dominican Republic in the 1970s because of strange rumours about girls turning into boys 
She eventually unraveled the mystery of what is going on and by doing so helped make a surprising medical breakthrough. 
At conception we all inherit a set of genes from our parents that will, in time instruct our bodies to make us male or female. But for the first few weeks of our lives human embryos are neither. Instead we have a protrusion called a tubercle. If you’re genetically male the Y chromosome instructs the gonads to become testicles. They also send testosterone to the tubercle, where it is converted into a potent hormone called dihydro-testosterone This transforms the tubercle into a penis. If you’re female and don’t make dihydro-testosterone then your tubercle becomes a clitoris. 
When Dr Imperato investigated the Guavadoces she discovered the reason they don’t have male genitalia at birth is because they are deficient in an enzyme called 5-α-reductase, which normally converts testosterone into dihydro-testosterone. So they appear female when they are born, but around puberty, when they get another surge of testosterone, they sprout muscles, testes and a penis. 
Apart from being slightly undersized everything works and the Guavadoces normally live out their lives as men, albeit with wispy beards and small prostates. 
By a quirk of chance Dr Imperato’s research was picked up by the American pharmaceutical giant, Merck. They used her discovery to create a drug called finasteride, which blocks the action of 5-α-reductase. IT is now widely used to treat benign enlargement of the prostate and male pattern baldness. For which, I’m sure, many men are truly grateful 
Since he’s become male Johnny has had a number of short term girlfriends, but he is still looking for the love of his life. “I’d like to get married and have children, a partner who will stand by me through good and bad”, he sighs wistfully.

By 

May 18, 2016

Sexual Roulettes with HIV Men in Barcelona



Image result for gay roulette barcelona
                                                                         
                                                                       
                                                                         

















Sexual roulettes with an unknown HIV person are going on in Barcelona as a fun orgy in which one person could win the Prize. Jesus Vazquez, Boris Izaguirre and Fernando Grande-Marlaska, are Doctors that have been in a campaign fighting the spread of AIDS since 2007.

Hospital and clinic Doctors of infectious diseases and AIDS have warned that in Barcelona men are holding parties called sexual roulette (ruletas sexuales). Gay Men are invited to this gatherings with someone who is HIV, the virus that causes AIDS, to make a more stimulating sexual experience. Specialists, which include Dr. Josep Mallolas, deputy in that service, warn that “they have lost respect” for a disease that, well treated, is not deadly because it can be managed just like any chronic illness but its also incurable and life threatening.

These parties, reports Cadena Ser, consisting of gay men —habitually these groups meet in a place to have an orgy or engage in group sex, including the guest HIV individual but without disclosing to participants which one is the one. "Who gets him, gets him," they explain.

Sexual roulettes have different formats. Some are unique to HIV carriers, and others that can also access healthy people. “There is smorgasbord of everything: parties that are authentic sexual roulettes, or events they cannot go if you're not already infected with HIV," said Mallolas.

The disease is still fatal in countries where the population does not have publicly funded health care system, but clearly added Mallolas, here they don’t fear it. A Doctor specialist in HIV has related the story of a gay young man of 22 years.  The young man explains:  “My sexuality is very important to me and I do not want to give it up, at age 22, to live the rest of my life with a condom on?  Living every day with the fear of getting infected for the rest of my life, so the sooner I get infected, the sooner I can try to get an undetectable viral load, before suffering and always thinking ‘what if I get infected’.” Dr.Mallolas added, “When he said that, I froze.”

Antiretroviral therapy for HIV costs the Ministry of Health about 7,000 euros per year per person, plus other drugs that the patient needs to eliminate other occasional, frequent infections in HIV people.

The Health dept. says in Catalonia you have 30,000 people receiving anti-AIDS treatment.  The gay community is the only one experiencing a steady increase in the numbers of new infections, says Health.

Translated by adamfoxie blog International

Original Spanish Newspaper story:


EL PERIĂ“DICO / BARCELONA

 Ruletas sexuales en Barcelona con un enfermo de sida como invitado de incĂłgnito en la orgĂ­a
Jesús Vázquez, Boris Izaguirre y Fernando Grande-Marlaska, en una campaña contra el contagio de sida entre hombres del 2007.
Médicos del servicio de enfermedades infecciosas y sida del Hospital Clínic han alertado de que en Barcelona se están celebrando encuentros denominados ruletas sexuales, a los que se invita a un infectado por el VIH, el virus que causa el sida, con el fin de hacer más estimulante la experiencia. Los especialistas, entre los que figura el doctor Josep Mallolas, adjunto en el citado servicio, advierten de que "se ha perdido el respeto" a una enfermedad que, bien tratada, no resulta mortal ya que se puede sobrellevar de forma crónica, pero que es incurable y potencialmente mortal.

Estos encuentros, informa la Cadena Ser, consisten en grupos --habitualmente hombres homosexuales- que se citan en un local con el objetivo de celebrar una orgía o mantener relaciones sexuales colectivas, incluyendo al invitado que sufre el sida pero sin revelar a los participantes cuál de ellos es el individuo enfermo. "A quien le toca, le toca", explican.

 Ruletas sexuales en Barcelona con un enfermo de sida como invitado de incĂłgnito en la orgĂ­a
www.dinostock.com 
Las ruletas sexuales tienen diversos formatos. Unas son exclusivas para portadores del VIH, y otras a las que pueden acceder también personas sanas. "Hay de todo: fiestas que son auténticas ruletas sexuales, o encuentros a los que no puedes acudir si no estás ya infectado por el VIH", ha explicado Mallolas.

La enfermedad sigue siendo mortal en los paĂ­ses donde la poblaciĂłn no dispone de sistema sanitario financiado pĂşblicamente, pero es evidente, añadiĂł Mallolas, que aquĂ­ no se la teme. El especialista ha relatado a la emisora el comentario que le hizo un homosexual de 22 años: "Me dijo, mi sexualidad es importantĂ­sima y no me quiero resignar, a los 22 años, a vivir el resto de mi vida con un preservativo puesto. ¿Que alternativa tengo?: Infectarme. Y cuanto antes me infecte y antes me trate y mantenga una carga viral indetectable, antes dejarĂ© de sufrir por si me infecto", ha explicado Mallolas. "Cuando me lo dijo, me quedĂ© helado", ha añadido el mĂ©dico.

La terapia antirretroviral que debe seguir un infectado por el VIH cuesta a la Conselleria de Salut unos 7.000 euros al año, más los fármacos que el paciente necesita para eliminar otras infecciones ocasionales, frecuentes en estas personas.

En Catalunya reciben tratamiento antisida unas 30.000 personas. El colectivo homosexual es el Ăşnico que experimenta un constante incremento en las cifras de nuevos infectados, indica Salut. 

May 17, 2016

A Cancer Survivor Receives the First Penis Transplant in the US




Thomas Manning gives a thumbs up after being asked how he was feeling following the first penis transplant in the United States, in Boston. Sam Riley / Mass General Hospital via AP




Surgeons said Monday they have done the first penis transplant in the U.S., helping a 64-year-old man who lost his organ to cancer. 
Massachusetts General Hospital planned a news conference later Monday to give details about the transplant, which is only the third recorded penis transplant ever done globally. 


"Earlier this month during a 15-hour procedure, surgeons connected the intricate vascular and nerve structures of a donor penis with those of the 64-year-old transplant recipient. The patient continues to recover well," the hospital said in a statement. 

The New York Times interviewed the patient, who it identified as Thomas Manning, a bank courier from Halifax, Massachusetts. 


"I want to go back to being who I was," the newspaper quoted Manning as saying. 
Last year, a South African university said it had performed a successful penis transplant. Later, the patient went on to father a child
China reported an unsuccessful transplant in 2006, saying it was reversed deliberately because the man and his wife did not like the result. 
Penis transplants are complicated. The organ has many blood vessels and nerve endings, and also must connect the urethra to the bladder and to the prostate inside the body. 
Plastic surgeons can perform penile reconstruction using a patient's own skin but a transplant of an entire organ is more complicated. 
 Lab-Grown Penises Lets Bunnies do What Bunnies do Best
Researchers funded by the U.S. military are also working on ways to regenerate penises in the lab for transplant using a patient's own cells. The hope is to help soldiers whose genitals have been damaged by mines and other explosive devices. 
The United Network for organ Sharing says there is one patient on the waiting list for a penile transplant in the United States. The University of Maryland Medical System, Wake Forest Baptist Medical Center, Massachusetts General Hospital, Brigham and Women’s Hospital and Johns Hopkins Hospital all have approval to perform them. 

nbcnews.com
MAGGIE FOX

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