Book Review: Gender Issues: Caring for Lesbian and Gay People: A Clinical Guide (2005)

Gender Issues Caring for Lesbian and Gay People: A Clinical Guide Allan D Peterkin, Cathy Risdon. Toronto (ON): University of Toronto Press; 2003. 378 p. CAN$40.00. Reviewer rating: Excellent Here is a long overdue and very necessary book. Dr Peterkin and Dr Risdin present, with admirable care, a practical and evidence-based text covering topics as various as the doctor-patient relationship; lesbians' and gay men's physical and sexual health; the management of disease, mental health, and substance abuse; and the pressing needs of gay and lesbian adolescents. Engaging vignettes introduce each chapter, and from the first, when we read of a gynecologist who hasn't learned his patient is lesbian and reproaches her for not using some form of birth control or the ophthalmologist, consulted for glaucoma, who turns his inquiry to AIDS and sexually transmitted diseases (STDs) when he learns his male patient lives with a man, we catch a glimpse of why a clinical guide for lesbian and gay health is needed. Whether they know it or not, all health care providers deal with plenty of lesbians, bisexuals, and gay men. However, homophobia is one of the main barriers to their care, and all of us are tarnished by it. Since heterosexuality is seen as the social norm, many health care workers assume that their patients fit this norm. Further, reluctance to raise sexual topics often keeps health care providers unaware of salient realities of their patients' lives. In Chapter 2, the authors challenge readers to examine their attitudes and offer suggestions for learning appropriate details of their patients' sex lives-starting, for example, with the question, Is your partner a man or a woman? Lesbians have a lower profile than gay men and are frequently shortchanged by the medical system. Compared with heterosexual women, they have higher rates of smoking and drinking and a higher body mass index, but despite these risk factors, they are failed by providers who neglect to investigate for STDs, cancers, and coronary disease, as well as for reproductive health concerns. As in the following chapter, which deals with gay men's physical and sexual health, we find extensive tables detailing sexual practices, risks, and risk reduction. Risks, indeed, are blithely taken by many gay men; in these pages, doctors will find critical information about appropriate screening and treatment for, among others, STDs, HIV, cardiovascular disease, and cancers, together with suggestions about preventive counselling, especially for sexual health. For gays and lesbians, adolescence is filled with challenges. Family rejection, social hostility, and antigay violence are only a few of the hurts and insults they face, and consequent low self-esteem, even self-hate, can lead them not only to lasting self-fakery but also to drug abuse and suicide. The chapter on adolescent physical and mental health will prepare readers to offer compassionate help, ranging from sexual identity counselling to physical, sexual, and mental health interventions, always emphasizing the message that these young persons have the right to respect and that you [the provider] are there to give facts and not to judge. …