Florida Agenda

By DR. ARLEN LEIGHT

I unexpectedly lost my partner-in-life on Memorial Day. We met in 1980 and, as relationships always do, ours evolved and changed over the passing years. Charles was the love of my life, and I miss him dearly. It’s hard to imagine my life without him. My professional career and my book, coming out later this year, grew out of the successes and the challenges of our 32-year connection. The following is the eulogy I gave at his funeral service held in the small town where he grew up in Tennessee. Being gay is not something folks in this community openly talk about. I chose my words and message in a way that would honor Charles, and respect the sensitivities of the attendees. I realized that what I learned from Charles and our relationship were universal in scope, and could in no way offend my fellow mourners.

So, I thought I might take this column to bring them to you. I hope I can always live up to these ideals, and I hope they have meaning for you:

“Charles was not a man of many words, but he was my greatest teacher. I’d like to share with you the 10 most important lessons he taught me by the grace and dignity of his life.

1. Being honest with yourself is absolutely necessary to being honest with others.

2. Trust is the most important aspect of all relationships.

3. True love is unconditional, comes from the heart—not from the head—and is given freely without any expectation about receiving anything in return.

4. Silence is golden.

5. Peace of mind is happiness.

6. The more we judge, the less we love.

7. We learn when we are listening, not when we are talking.

8. Forgiving ourselves and forgiving others are among the greatest gifts we can give to ourselves.

9. Life, like relationships, is not about how long it lasts, but, rather, about the love you leave behind.

10. There’s no place like home, because home is where the heart is.”

After Charles was laid to rest, family and friends from this Bible Belt town came up to me one-by-one to offer their condolences.

By far the single most frequent comment to me was, “I am so grateful Charles had you to love.” I was especially touched by Charles’ great nephew. A tall, good looking guy— about 20 years old, extensively tattooed, and dressed in the casual attire of his generation—he reminded me of the young Charles I had met 32 years ago. There is definitely a family resemblance, and on three separate occasions he came up to me to shake my hand and say, “I’m really sorry for your loss, man.” Through the rough exterior, I could see the gentle man inside, which is so much about who Charles was.

I really appreciate all the expressions of sympathy from friends, family, and loved ones. Everyone described Charles as a warm, gentle soul with a big heart. I am so grateful to have had this wonderful man to love. And I appreciate you giving me the opportunity to share with you the lessons and love of Charles, my Forever Babycakes.

By Arlen Leight , Ph.D.

A diagnosis of prostate cancer is a frightening prospect for both men and their partners. Unfortunately, most physicians treating for prostate cancer never inform their gay patients that the implications will impact gay male sex differently than for straight male sex.

The result can be uninformed, under-informed, or misinformed treatment selection. Prostate cancer is the second leading cause of cancer deaths in men. One out of every six men will develop prostate cancer, as compared to one out of every eight women who will develop breast cancer.

If you live to age 80, your chances are greater than 50 percent that you will develop prostate cancer. For a gay male couple, there is a 28 percent chance that one partner or the other will be diagnosed with prostate cancer during their lives together. If you have a father or brother who has had prostate cancer or if you are African American, your risk doubles. Diagnosis is always confirmed by biopsy, but PSA blood tests and digital rectal examinations are used for initial screening.

These are generally recommended for men over 50 (or over 40 if in a high risk group). If you take Propecia for hair loss or Proscar for prostate enlargement, your PSA may be falsely low. You want to double the number for accuracy. And gay-receptive partners should wait three days after anal penetration, as prostate massage can elevate the PSA. Your physician should perform a digital exam AFTER he or she takes your blood.

The most commonly prescribed treatment after a diagnosis of prostate cancer is prostatectomy, or removal of the prostate. This is major surgery with the potential for major residual, life altering implications. While considered the “gold standard” for curing prostate cancer, five to 10 percent of men remain incontinent, and for men under 60, 25 to 30 percent remain impotent. For men over 70, 70 to 80 percent remain impotent.

And sexual function tends to improve with time. Erectile rigidity post-treatment may be sufficient for vaginal penetration, but often isn’t sufficient for anal penetration. There are erectile treatments available that can help or even restore function, so consult your urologist for assistance in this regard. The other major change in sexual function is that ejaculation will now be retrograde (so the ejaculate will back up the urethra rather than forge out the penis). This can be disturbing, but men are still able to ejaculate even if they cannot attain a significant erection.

The other curative option that is generally recommended is radiation therapy. With radiation, less than two percent remain incontinent. Recurrence of cancer is three to 40 percent higher than with prostatectomy (depending upon the stage of the cancer). There is a risk of frequent urination, burning, and chronic bowel complications. Rectal bleeding is a problem in around five percent of brachytherapy (radiation) patients. Because radiation has long term effects, sexual function may not be impaired at first, but may decrease over time.

The rates of impotence are approximately the same as for surgery. There may likewise be penile shrinkage, and a decreased amount of ejaculate. Radiation can be problematic for men who enjoy being penetrated. Anal bleeding, diarrhea, and tightening and/ or spasm of the sphincter may make anal penetration uncomfortable or impossible. Psychologically, an overall sense of helplessness, anger, loss/grief, depression, and anxiety are very common.

Communication with partners about fears, embarrassment, and frustrations are critical. Patience is vital for the man with prostate cancer—and his partner—as recovery is often slow and uncertain.

By CLIFF DUNN

I received a text message last week from a friend with whom I haven’t spoken in years. It was an ultrasound image showing an unborn baby girl. The message that accompanied it conveyed all the joy and happiness that I imagine must have been registered on the sender’s face. “Cliff,” it said, “this is my daughter. I’m excited that I’m going to be a dad and starting a family of my own.” The sender—let’s call him Jim—and I haven’t spoken in several years: the last time was when he was moving out of the one-bedroom apartment we shared upon my return to South Florida about six years ago.

What I doubt Jim’s baby’s mother will ever know is that Jim and I once enjoyed a brief intimate relationship before both he and I came to the conclusion that our “deal” was “just one of those things,” and that Jim was really straight. (Please hold the rolling of your eyes until the end of this piece.)

Fast forward to sometime last summer, and a conversation I had with an otherwise forward-thinking and progressive heterosexual male with whom I am happy to be acquainted.

Walking in during the tail-end of a chat about human sexuality, I heard my friend say “I don’t care: a guy who takes it up the *** is gay.” I am not mentioning his name so as not to embarrass this normally open-minded and thoughtful guy, because I know what many “straight” men, and not a few “gay” men, already know: The words “gay” and “bisexual”—and now, heaven help us, “Questioning”—have lost all meaning.

The April 5 issue of the Agenda featured a thought-provoking LEIGHT REFLECTIONS column in which Dr. Arlen Leight discussed a person’s Sexual Template. Like many gay men “of a certain age” who spent their formative years growing up among the straights, a large number of my early post-adolescent “relationships” were with (generally) straight guys.

For the most part, these were short-lived, but there were a couple of instances where something akin to feelings developed. This worked best when I was in a single frame of mind, since realistically there was an expiration date on these “relationships” from the get-go. Too, years ago, I realized the futility of pursuing the emotionally unavailable, and have been fortunate in my loving relationships with involved partners over the intervening years.

My point here is that despite the occasional brief gay “episode” (or what an earlier era might refer to as a “fling”), there was no question in my mind—and clearly not in their minds—that these guys were straight. I say that with the confidence and assuredness of a gay man who has—like many gay men since the time of Alexander the Great—on several occasions enjoyed the intimate company of a member of the opposite sex.

I want to be clear that these were all of them crimes of opportunity (often, I am half-embarrassed to admit) accomplished through the agency of the right wine and the right music. I know this seems like a story about how cool I am, however, I only make reference to it to illustrate this point: I am not bisexual and I am certainly not straight. I am a gay man just as sure as is my boyfriend, and just as sure as Jim is straight.

Regardless of whether or not there is a genetic basis for homosexuality—even though science seems pretty cut and dry on this—there is a difference between what it means to be a “homosexual” (whatever that is) and what it means to be “gay.” The designation MSM (“men who have sex with men”) is a clinical one, which reflects nothing of the lifestyle choices we make as gay men.

I say “choice” because some of us are able to choose to live openly as gay men, in a community that enables and supports our individual identities. My friend Jim was homosexual (for all of three months), but I can’t envision him being “gay:” that simply isn’t how he identifies. Someone once told me “you are what you fantasize about.” I would offer that while all gays are homosexual, not all homosexuals are gay. Said differently (and with regrets to Sen. Santorum): “Gay” is to “homosexual” as “man” is to “monkey.”