(…and what you can do about it—plus a sneak-peek at our upcoming book!)
The Training Gap Is Real
Most U.S. medical schools devote fewer than five hours of formal instruction to LGBTQ+ health across the entire four-year curriculum—far short of what’s needed for comprehensive care. A recent systematic review found that lack of LGBTQ+‐specific training remains “a major barrier” for clinicians, limiting both knowledge and confidence when treating gay and bisexual men. PMC
A July 2025 study echoed the problem: even non-clinical staff (think front desk, billing) rarely receive cultural-competency training, increasing the odds of awkward—or outright harmful—encounters before you even see the doctor. ScienceDirect
How Under-Prepared Providers Slip Up
| Common Miss | What It Looks Like in Real Life | Why It Matters |
|---|---|---|
| Skipping sexual-behavior history | “You’re in a monogamous relationship, right?” (asked without actually asking) | Missed opportunities for PrEP, STI screening, or harm-reduction counseling |
| No extragenital STI swabs | Only urine tests, no throat or rectal screening | Up to 75 % of gonorrhea/chlamydia in MSM is extragenital and would be missed |
| Assumptions about fertility & family planning | “Let me know when you and your wife want kids.” | Gay men and their partners need tailored fertility discussions and HPV counseling |
| Kink & fetish blindness | Zero questions about BDSM, pup play, or sex-toy hygiene | Misses injury prevention, infection risk education, and consent counseling |
| Non-inclusive language | “You chose this lifestyle…” or using the wrong pronouns for partners | Erodes trust, discouraging future disclosure |
Arm Your Provider (or Find a New One)
If your clinician is willing but under-educated, share these free, evidence-based resources:
National LGBTQIA+ Health Education Center – Free CME webinars and clinical briefs from Fenway Health. Fenway Health
OutCare Health’s OutList® – Directory of affirming providers nationwide; handy if you need a second opinion. OutCare
GLMA Clinical Toolkits & Webinars – Quick-reference guides on everything from anal cancer screening to mental-health best practices. glma.org
CDC HIV Nexus – The latest (March 2025) PrEP/PEP clinical guidance and pocket cards. CDC
Coming in September: Primary Care of Men Who Have Sex with Men
After two years of writing (and plenty of Provincetown caffeine), our full-length textbook drops this September. Designed for busy primary-care and urgent-care clinicians, it delivers:
Step-by-step protocols for PrEP, PEP, and long-acting injectables
Fetish-aware care (pup play, impact, electro)—how to talk risk without kink-shaming
STI screening algorithms that include extragenital testing and self-collection
Mental-health chapters on body image, chemsex, and minority stress
350+ real-world references—no fluff, no fake citations
Have a provider who’s unsure about prescribing injectable PrEP or discussing sling-safety? Point them to the book (pre-orders open now on our website and at major retailers). It’s the fastest way to level-up their competency—and keep you healthier in the process.
Takeaway for Patients
Expect better care. Culturally competent, kink-aware, evidence-based primary care exists—and you deserve it.
Bring receipts. Walk into appointments with the resources above (or our book, come September) and hand them over.
Vote with your feet. If a provider stays stuck in the 1990s, use directories like OutList to find one who isn’t.
Your health is too important to be somebody’s “first time” at talking about anal sex or FetLife profiles. Demand more, share the tools, and let’s close the gap—together.
—Team Tom of P-Town Health
Comments
Post a Comment