Care for Gay, Bi and Queer Men
Integrated General Practice, Sexual and Mental Health Care
Finding a doctor you can trust, as a gay, bi or queer man
Perhaps you’re having difficulty finding a doctor who understands you, who you feel comfortable talking with and who you trust.
Perhaps you’ve just moved to London and you’re trying to navigate both the NHS and private systems and don’t know where to begin.
Perhaps you’ve had a consultation with a GP that left you feeling angry, dismissed or ashamed.
Perhaps you want your healthcare to include being able to talk about your sex life freely, without worrying about judgement or how your doctor might react.
Perhaps you’ve been given a prescription — or even sold a long-term subscription for medication — and you’re not sure whether that really reflects what’s best for your long-term health.
Or perhaps you have symptoms no one has yet been able to make sense of, and you’re left wondering where to turn next.
There are many reasons why gay, bi and queer men seek out a doctor with lived experience as a gay man. Many of these are things I have encountered myself in my own interactions with healthcare. I offer integrated care and a single, trusted point of contact for gay, bi and queer men seeking safe, tailored and clinically excellent medical care in London.
Understanding the health needs of gay, bi and queer men
What impact does minority stress have on gay men’s health?
Gay, bi and queer men often grow up in environments where they have had to hide parts of themselves — from family, friends and sometimes from healthcare providers. For many men this includes experiences of concealment, rejection, discrimination, internalised shame and the ongoing effort of monitoring how they are perceived by others.
These experiences can create what is known as minority stress.[1] This form of chronic stress affects not only emotional wellbeing, but also the body — influencing inflammation and chronic disease — and it can shape behaviour, relationships and the ways in which people try to manage or soothe distress.[2,3]
Many gay men are highly successful and reach the top of their industries, yet these pressures can still quietly shape patterns of anxiety, low mood, burnout, substance use and physical health, even in men who appear outwardly well and thriving.
Informed, sensitive care with someone you can be genuinely open with can make a profound difference to both diagnosis and treatment.[4] This includes sexual health and HIV prevention, but also cardiometabolic risk, weight and metabolic health, hormones, ageing, colorectal health, cancer screening, mental health and the impact of relationships, work and life context on wellbeing.
Encouragingly, research shows that finding a healthcare provider who is affirming and trusted is associated with improved health outcomes[4,5] and even a lower risk of death.[6]
What are the key health considerations for gay, bi and queer men?
Gay, bi and queer men share a lot health risks with heterosexual men.
However, there are some areas where patterns of illness are more common, as well as areas where there may be particular protective factors.[7,8]
Sexual health and HIV prevention
Sexual health remains an important part of care, including HIV prevention, regular screening for sexually transmitted infections, HPV-related disease and vaccination. Sexually transmitted gastrointestinal infections such as shigella and giardia are also more frequent.
Historically, clinics serving gay men have focused mainly on STI prevention and treatment. While this remains important, gay men’s health is much broader than this.
Mental health
Mental health difficulties such as anxiety, depression, OCD, drug-induced psychosis and burnout are more common in gay men.[9]
Cardiovascular and metabolic health
Cardiovascular and metabolic health are increasingly important and often under-recognised. Higher lifetime exposure to stress, alcohol, smoking, anabolic steroid use, stimulant and polysubstance use can contribute to elevated risk of hypertension, hypercholesterolaemia, insulin resistance and vascular disease, particularly in men living with HIV.[10,11]
Sexual difficulties and intimacy
Sexual difficulties — including erectile problems, changes in desire and performance anxiety — are common and often reflect an interaction between psychological, relational, hormonal and cardiometabolic factors.
Body image and performance-enhancing drugs
Body image concerns, disordered eating and the use of performance-enhancing drugs are more prevalent in some gay and bisexual men and can affect hormones, fertility, mood and long-term health.[12]
Cancer risk and screening
Cancer risks differ slightly, with higher rates of anal HPV-related disease and the need for appropriate screening and vaccination. Decisions about treatment for cancers such as prostate cancer are ideally informed by an understanding of sexuality and what gives a person pleasure — something still rarely discussed in routine cancer care.[8,13]
Bowel health
Bowel conditions such as inflammatory bowel disease are more common in men who have sex with men, and these conditions can have a significant impact on sexual wellbeing and quality of life.[14] Irritable bowel syndrome is also more common in gay men and sexual minorities and is often more severe.[15,16]
An integrated approach: general practice, sexual medicine and therapy
Seeing a GP and physician who is familiar with the issues gay, bi and queer men face often means that patterns are recognised earlier and the right questions are asked in a comfortable, respectful way.
Getting to the right diagnosis allows us to choose the right treatment. Sometimes this involves medication, vaccination, procedures or surgery. At other times it means avoiding unnecessary intervention and focusing instead on lifestyle factors, emotional health and relationships.
Common reasons gay, bi and queer men come to see me
General health - building a relationship with a GP they can turn to for any health concerns over time
Cardiovascular health - family history of heart disease, blood pressure, cholesterol and lipid management
Weight and metabolic health - obesity, diabetes risk and diabetes management
Body image and eating concerns - body dissatisfaction, disordered eating and overtraining
Anabolic steroids and performance-enhancing drugs - thinking about use, recovering from past use, harm reduction and long-term effects
Mental and emotional health - anxiety, depression, OCD, stress, burnout
Sleep and fatigue - insomnia, early waking, non-restorative sleep and persistent tiredness
Alcohol, smoking and drug use - cutting back alcohol, harm reduction for recreational drug use, smoking cessation, concerns about past exposure
Gastrointestinal and bowel symptoms - diarrhoea, abdominal pain, bloating, reflux, anal pain and persistent gut symptoms
Sexual difficulties and intimacy - erectile difficulties, premature or delayed ejaculation, low or high desire, performance anxiety, compulsive sexual behaviour and relationship concerns
Skin problems - eczema, persistent rashes, fungal or bacterial infections, acne and chronic itch
Hormonal health - testosterone concerns, fertility and thyroid health
Prostate and urinary health - nocturia, daytime urinary symptoms and concerns about prostate cancer
Cancer screening and prevention - prostate, bowel, lung, liver and skin cancer, HPV-related disease
Preventative health screening - thorough, evidence-based health checks without unnecessary or anxiety-provoking tests
Sexual health and HIV prevention - STI screening and treatment, PrEP, PEP and long-term HIV care
Vaccination - HPV, hepatitis, shingles and travel vaccines
Breathing and chest symptoms - asthma, unexplained breathlessness and chest pain assessment
Unexplained physical symptoms - abdominal discomfort, fatigue, "not feeling right", complex or persistent symptoms
Ageing and long-term health planning - healthy ageing, frailty prevention, cognitive health and planning for later life
End-of-life and advance care planning - discussing preferences, future care wishes and supporting patients and partners through serious illness
Confidential, discreet and non-judgemental care
Everything you tell me is confidential.
Confidentiality would only be broken if I believed you were at serious risk of harming yourself or others, if you disclosed ongoing child abuse, if you were planning an act of terrorism, or if required by a court.
Updating your NHS GP is recommended but always your choice. Where helpful, I can write to request shared prescribing to reduce costs, with your consent.
A team supporting the healthcare needs of gay, bi and queer men
I work closely with Dr James Arkell, consultant psychiatrist and Dr Henry Clements, Clinical Psychologist.
I also refer to a trusted network of clinicians including:
Clinical psychologists
Psychotherapists
Sex therapists
Psychiatrists
Gastroenterologists
Cardiologists
Respiratory physicians
Pelvic health physiotherapists
General surgeons
Dermatologists
Welcome to the clinic at 23 Devonshire Place
When booking, you can choose how much time you would like to spend with me. For most new patients I recommend a 30-minute appointment. If you have a more complex history or multiple concerns, a 60-minute consultation usually works best.
When you arrive you’ll be welcomed by my reception team and shown to our comfortable, quiet waiting area at Devonshire Place. Feel free to make yourself a cup of tea or coffee and enjoy the space.
Time to talk
In the consultation, you’ll have time to talk through what has been going on, including things you may not have felt able to discuss elsewhere. We’ll review your medical history and wider life context so I can understand you as a person as well as your health.
Examination
Examination is always optional and only done if helpful. I will explain each step, check in throughout, and you may pause or stop at any point. You are welcome to have someone with you if that feels supportive.
Investigations
Where useful, we may arrange blood tests, urine tests or imaging through trusted partner clinics. For sexual or hormonal concerns, recent blood tests are often helpful and can be arranged before or during your appointment.
Referral
I work closely with psychiatrists, psychologists, psychotherapists, pelvic health physiotherapists and sex therapists who are experienced and safe working with gay, bi and queer men.