The foundation of medicine is the prevention of disease, disability, and death so that everyone has the best quality of life they can. Treating illness once it’s happened is all well and good, but it’s far better to prevent that illness from happening wherever possible. But stigma, discrimination, and ignorance prevent many gender and sexual minority people from getting the preventive medicine they need!
This is a living document collecting together information on daily health maintenance, immunizations, health screening, and cancer screenings specifically for gender and sexual minority people. Content will change over time as new guidelines come out and as I receive feedback.
This document was last updated on February 19, 2016.
Table of Contents
Health maintenance for…
- Gay and bisexual cisgender men (men who have sex with men) — in progress
- Lesbian and bisexual women (women who have sex with women) — in progress
- Transgender women, individuals assigned as male at birth — in progress
- Transgender men, individuals assigned as female at birth — in progress
- People in non-monogamous relationships — in progress
- Kinkers, people who practice non-vanilla sex — in progress
Health Maintenance for Everyone
What is health promotion/preventive health? Why should I care?
At its core, health promotion gives you the tools to take care of yourself. Your actions and choices are the core of your health. Doctors, surgeons, and nurses can provide services that help, but the ultimate decision is almost always yours.
Taking care of your health every day won’t stop all bad things from happening. It can’t stop a bad car accident, for example. But it can increase the chances of you surviving the accident and thriving afterwards.
Choosing healthier options can also add years to your lifespan. For example, non-smokers live roughly 10 years longer than smokers. And smokers who quit add years onto their lifespan, no matter when they quit (though earlier is better!)
What can I do on a daily or weekly basis to promote my own health?
This is the nuts and bolts of living well. Little choices every day add to up to a lot! In general, it’s best to make small choices you think you can succeed at rather than huge life changes all at once.
Diet: Consider eating more vegetables, less meat, and less sugar. Too much red meat and too little vegetables is associated with heart disease. Too much sugar can lead to obesity and diabetes. So consider replacing beef with chicken, and chicken with lentils or beans. And consider drinking water, seltzer, or diet soda instead of sugared soda. You don’t have to eat kale and quinoa all day to make better choices. The mediterranean diet is another heart-healthy option. MyPlate and the American Heart Association have more details if you’re interested.
- Exercise: Consider moving more and spending less time sitting down. Park a little further away from work and walk in. Take the stairs. Walk the long way to the bathroom. Go for a walk for part of your lunch break. It all adds up. Consider asking a friend or partner to walk/exercise with you. If your mobility is limited, do what you can. Swimming can be gentle on painful joints, and arm exercises are useful for people who need wheelchairs. Some people find a fitness tracker or pedometer helpful, others don’t. Do what works for you.
- Tobacco: Avoid tobacco and nicotine products. If you currently use tobacco, make a plan to quit and quit as soon as you can. Many people find a support group, nicotine replacement therapy, and some medications helpful but they’re not necessary for quitting. And remember: relapsing doesn’t mean you’re a failure — you’ve quit before, you can quit again. You have the tools. Also keep in mind that e-cigarettes may not be healthier than regular cigarettes. Early reports show they’re high in formaldehyde, a carcinogen. So it’s best to avoid all tobacco and nicotine. The CDC has resources for those looking to quit.
- Alcohol: If you drink, drink in moderation. Current recommendations are around 1-2 drinks per day. 1 “drink” is 1 shot worth of alcohol. Limit the times you drink heavily (“binge” drinking). If you do drink heavily occasionally, don’t drink to the point of passing out or vomiting. As always, don’t drink and then drive and avoid drinking when you’re on certain medications. The CDC has more information.
- Addiction: If you feel that you may have a problem with your use of drugs or other habits, it’s probably worth taking a break from those drugs/habits for a while. If that’s intolerable, it may be time to quit outright. Help for addiction does exist. The best help comes from trained mental health professionals. But if those aren’t available for you, you can consider support groups (online or in person), seeking help from a physician, or working through workbooks on your own. Here’s more information on addiction treatment.
- Illegal drugs: Most sources say you should always avoid using illegal drugs. And avoiding illegal drugs is best for your health. But that’s simply not reality for everyone. If you choose to use illegal drugs, it’s important to reduce your risks. First — be careful with your sources. As I’m sure you know, contamination isn’t a made up problem. Second — use those drugs as little as possible. This helps avoid addiction and tolerance. Third — use the drugs in the safest way possible. Vaporize, don’t smoke. Avoid injecting drugs, but if you do inject then don’t share needles. Here’s more information.
- Brush your teeth: No, really. I mean it. It’s not just about having good breath! The bacteria in your mouth can cause serious health problems if they go unchecked. To find out more, talk with your dentist or dental hygienist, or visit the NIH webpage.
- Mental health: Your emotions and thinking are just as important as your bodily health. Your own mental health is going to be different and need different kinds of care than another person’s. Cultivate stress reduction techniques, from the Mayo Clinic’s 4 A’s to activities like running, knitting, or massage. Try different things. But if the common suggestions aren’t enough or you are thinking of suicide, professional help can and does help.
- Sexuality: Play fun and play safe. Use barriers (condoms, dental dams, gloves) to prevent the spread of sexually transmitted infections. If you do not desire pregnancy and are having sex that could lead to pregnancy, use contraception. If you prefer kinky sex, consider playing under the “Safe, Sane and Consensual” or “Risk Aware Consensual Kink” principles. For more information on (vanilla) sex, the CDC has good information.
- Sleep: Sleep is absolutely crucial to good health. If only it was easy to consistently get good quality sleep. If you have trouble, consider trying sleep hygiene tips like keeping your bedroom dark and cool, avoiding looking at screens before bed, and avoiding tobacco/caffeine/alcohol before bed. If you’ve tried a lot of different things and you still can’t sleep well or you don’t feel rested, talk with your doctor. There could be a medical reason for your sleep difficulties. As always, the CDC has more information.
- Vitamin/mineral supplements: Put down that multivitamin! Unless your doctor has told you otherwise, most people don’t need supplements. You might need them if you don’t eat a balanced or varied diet, are vegan (B12), are looking to get pregnant (folic acid/folate), or are concerned about your bone health (calcium). For everyone else, they don’t help and they may even do harm. Recent studies have found that antioxidants (like vitamin E) may actually raise the cancer risks.
- Alternative medicines: There are little to no benefits from alternative medicine and there’s definitely evidence of harm. Ayurvedic supplements have been found to have heavy metals in them. Traditional Chinese medicine is a significant contributor to the loss of important species like the tiger and rhino. Acupuncture is a placebo effect that has spread blood borne illnesses. Chiropractic manipulations are associated with stroke. And homeopathy? It’s just very expensive water. If you have a medical condition or concern, please visit your physician.
What do I need that doctor for?
First — it’s best to see your physician every year or so for a “wellness” visit. During this visit the physician ask you about changes to you and your family’s health. They’ll do a physical examination. They’ll also order blood work. The blood work looks for common, invisible changes like anemia and high cholesterol (which can then be treated!). They’ll check to see if you need vaccines or screenings too, and refill any medications you may be on. This visit is also a great time to ask the physician any questions or concerns you may have. If you can’t see them every year, it won’t be the end of the world. But it’s definitely recommended.
What about those screenings? Some are a series of questions, others involve a blood test or a procedure. Let’s break them down!
All adults should be screened for:
- HIV. All adults should receive at least one HIV test. Those who are at higher risk for HIV infection should be getting tested regularly.
- High blood pressure
- Those born between 1946-1965 in should receive one test for Hepatitis C.
- Those over the age of 45 should have their blood cholesterol checked
- Those aged 50-75 should receive colon cancer screening. Options include colonoscopy, sigmoidoscopy, and fecal occult blood test — talk with your physician to decide which is best for you.
- Those over the age of 55 should speak with their physician about wehther a daily aspirin would help reduce their risk for heart disease
All other screenings really depend on your risk factors and your sex/gender. We’ll dive into those more specific recommendations in later sections. These recommendations are also based on the USPSTF guidelines, and specific physician organizations have their own recommendations.
What about immunizations? All adults (who are medically able to) should receive…
- Influenza/flu vaccine every year.
- Tetanus/diphtheria (sometimes including pertussis) booster shot every 10 years.
- Adults under the age of 26 should receive the human papilloma virus (HPV) vaccine
- Adults over the age of 60 should receive a shingles vaccine
- Adults over the age of 65 should receive two different pneumonia (pneumococcus) vaccines (PCV13 and PPSV23)
- Catch-up vaccines if you were not vaccinated fully as a child or if you did not get the disease as a child. These include measles, mumps, rubella, and varicella (chicken pox).
If you have a weak immune system, are pregnant, have kidney or heart problems, or are going to travel or become a health care professional then you likely need different vaccines.
You can also check out the CDC’s webpage which has a tool that will give you a list of topics to talk with your doctor about.
That’s where we’re up to for now. Subscribe to Open Minded Health or follow us on Facebook to get new additions to the series as they’re published. Please let me know if you have questions!