Maybe you have never felt able to be fully open with a doctor about your sex life, your relationships, or the things that actually worry you. Maybe you were given a prescription when what you needed was a conversation. You do not have to explain yourself here.
You don't need to educate me about gay, bi or queer experience, translate it into language a straight doctor would follow, or manage my reaction while you are trying to describe a problem. I'm a gay man myself, and the practice is built around gay, bi and queer men rather than adapted for them. Your relationship structure, the kind of sex you are having, where you are having it: all of it is fine here. You just get to be honest, which is usually the difference between a consultation that helps and one you leave having left something out.
You don't need a label, either. Plenty of the men I see are still working out what their desires mean: men married to women, men who have never said any of it out loud, men whose sexuality shifted in their forties. Nothing you say here commits you to anything.
If you are bi, some of it is different, and the health data is blunt about it. Bi men in the UK come out worse than gay men on several measures, and one likely reason is that fewer are out to their GP, so the questions never get asked. There is also the tiredness of being read as straight in one room and gay in another, and doubted in both. I won't assume your partner's gender, or that your history is a phase you are passing through.
Several things stack up, and they are worth separating. Minority stress first: the chronic load of growing up expecting rejection, managing who knows, and absorbing a fair amount of hostility along the way. That does not stay emotional. It shows up in inflammation, in cardiovascular risk, in smoking and drinking and drug use, and in how distress gets managed.
Then the sex. Anal health, HIV, HPV and anal cancer risk all sit differently for men who have sex with men, and the national screening programmes do not cover some of it.
A lot of gay and bi men have never had a conversation with a doctor about their heart or about bowel cancer. Not because it doesn't apply to us. Because nobody asks.
Then avoidance, which compounds the other two. A bad experience in a clinic means you go less often, and things get found later than they should. A lot of the men I see are outwardly thriving, and all of this still quietly shapes what turns up in their forties and fifties. The research is consistent that finding a trusted, affirming doctor improves health outcomes, and may even reduce mortality risk. That sounds soft and is not.
So if you have had a bad experience, it is worth saying out loud. Maybe they made assumptions about you, your relationships or your sex life. Maybe they asked something invasive. Maybe you found yourself lying about what had been happening because it was easier than being shamed for it, then left angry and wondering why you hadn't said anything. I have been there myself, as a patient in sexual health clinics in central London. Even working in the field I found a raised eyebrow hard to challenge, and it was easier to head for the door and not come back. If you are wary of trying again, that makes complete sense to me.
Finding a GP who genuinely understands gay, bi and queer men's health, rather than being tolerant about it, is harder than it should be. My practice is built around it, at 23 Devonshire Place in Marylebone, a quiet building a short walk from Regent's Park, and you can book directly without a referral.
Some of it is specific to us. Most of it is not, and gets missed anyway.
Erections, performance anxiety, premature and delayed ejaculation, assessed across the vascular, hormonal, psychological and relational rather than treated with a prescription.
Loss of interest, mismatched desire, compulsive sexual behaviour, and sex that quietly stopped without either of you naming it.
Pain during receptive sex, fissures, proctitis, and a pelvic floor that has learned to grip.
Insertive and receptive function are affected differently, and the cancer clinic rarely asks about either.
Non-monogamy, mismatched desire, and one partner's difficulty becoming both partners' problem.
Harm reduction or stopping, whichever you actually want, and the sex itself rather than only the drugs.
Monitoring, recovery, and the inner critic that is usually somewhere underneath it.
More common in gay, bi and queer men, and the reason is not mysterious.
It rarely arrives announcing itself. It shows up as a difficulty that will not shift.
Blood pressure, cholesterol, weight, insulin resistance and diabetes risk, where HIV, stimulants and steroids push the numbers up.
IBS, inflammatory bowel disease, reflux, and the infections passed on sexually such as shigella and giardia.
Testosterone, thyroid and the rest, assessed properly rather than from a single number.
Prostate, bowel, lung and skin, and preventative checks generally. The right test at the right time rather than a package.
Complex or unexplained symptoms, investigated somewhere else and left without an answer. A large part of what I see.
As a COSRT-registered sex and relationship therapist as well as a doctor, I can work on the physical and the psychological sides of a sexual difficulty in one clinical relationship, without sending you elsewhere for the therapy. There is a fuller page on sex therapy for men.
Anal health is one of the things men most often cannot find anyone to ask about. Pain during receptive sex, anodyspareunia, is common and rarely discussed, and the physical and psychological causes usually run together: a hypertonic pelvic floor, fissures, proctitis, anxiety, and patterns that behave a lot like vaginismus. I assess both sides, and where muscle tension is doing most of the work I bring in a pelvic health physiotherapist. There is a fuller page on pelvic and genital pain.
After prostate cancer treatment there is usually a conversation nobody has had. Urology and oncology clinics are mostly built around a heteronormative picture of sex, and the rehabilitation conversation tends to assume penetrative sex with a female partner, which leaves a lot unasked. Insertive and receptive function are affected differently and both matter. Receptive sex after radiotherapy raises its own questions about pain and what is comfortable. A busy cancer clinic is rarely a room where that feels possible to raise, so most of the men I see haven't been asked and haven't asked. You can ask here.
Couples are welcome. Open relationships and non-monogamy, mismatched desire, sex that has quietly stopped, one partner's difficulty becoming both partners' problem. These come up the same way they do for anyone, and I won't treat the shape of your relationship as the thing that needs fixing. Do mention it when you book so I can allow enough time.
You can talk about chemsex here, and it doesn't have to become the only thing we talk about. It sits right where a lot of my work meets: what the drugs do to erections and to being able to come, sex that starts to feel impossible without them, the days lost afterwards, and the shame that builds around all of it. I won't make stopping the price of being helped. Harm reduction is a legitimate goal, so is stopping, and working out which one you actually want is often where we start.
What is harder to find is somewhere to talk about the sex itself. London has decent drug and mental health support, and the link between chemsex and mental health is well recognised. What goes unspoken is sex that has started to feel flat or impossible without them, or an erection that only really works chemically. That is the part I can pick up alongside the rest.
Body dissatisfaction, disordered eating and steroid use are far more common in gay and bi men's spaces than they are talked about, and they are rarely separate from everything else, because the same inner critic is usually somewhere in it. I do monitoring and harm reduction for men who are using, recovery for men coming off, and the psychological side alongside either. There is a fuller page on steroid use.
And do mention poppers. You can just say it, no preamble needed. They come up constantly and I would far rather know, because poppers and the erection medications both drop blood pressure and together that can be a problem. It isn't a flat prohibition: plenty of men are fine on a low dose of tadalafil. It depends on what you use, how much, and what else is going on with your heart. That is a conversation, and it can only happen if poppers feel mentionable.
Shame is often right at the centre of it. Most of us carry some around sex, individual, familial, cultural or religious, and it rarely arrives announcing itself as shame. It shows up as a difficulty that won't shift, as sex that needs chemical help, as a body that never feels like enough. As a gay man I struggled with sexual shame for years myself, and the way out of it was not short. I believe in the positive power of human sexuality, and whatever your erotic life looks like, open or monogamous, vanilla or kinky, at home or on the Heath, it is fine to bring here.
Anxiety, depression, OCD, burnout, stress and the mental health difficulties that come with drug use all come up constantly. They are more common in gay, bi and queer men, and the reason isn't mysterious, because chronic concealment and minority stress do real damage over time. I can assess and treat most of this myself, and where more is needed I work alongside consultant psychiatrist Dr Jamie Arkell, so you are not starting again from scratch with someone new.
Sometimes. EMDR is Eye Movement Desensitisation and Reprocessing, a therapy developed for trauma that I use in my psychosexual work. It isn't right for everyone. It helps most where a current difficulty is anchored to something specific: a humiliating experience, an assault, an HIV diagnosis, or a stretch of your life you have never quite put down. There is more on the sex therapy page.
Prescribed and monitored here as ordinary care. Tablet for now, injectable as soon as it exists privately in the UK.
Time critical, within 72 hours. A&E and NHS clinics do this faster than I can, and I will say so.
Same day results, and a screen built around what you actually do rather than a fixed list.
Hepatitis A and B, HPV, and gonorrhoea using the meningococcal B vaccine.
Risk-stratified screening for dysplasia and referral for anoscopy. No national programme covers this.
Yes, as part of ordinary care rather than a separate service. PrEP is medication taken regularly to prevent HIV. Tablet PrEP for now, since injectable isn't yet available privately anywhere in the UK, and I will offer it as soon as it is. I also look after people living with HIV, though I am not an HIV physician and would want you to stay under a specialist team for that.
I offer HPV vaccination, risk-stratified screening for anal dysplasia, and referral for high-resolution anoscopy where it is needed. Particularly worth thinking about if you are living with HIV or have a history of HPV. There is no national programme for this in the UK, so it will not happen unless someone raises it.
Same day testing, so usually you have results that evening, occasionally within 24 hours. There is a fuller page on STI testing, treatment and prevention covering what gets screened for, how soon after sex you can test, and what it costs.
Go today, and don't wait for an appointment with me. PEP is a month of medication that greatly reduces the chance of an HIV exposure becoming an infection, but it has to start within 72 hours and sooner is better. A&E and NHS sexual health clinics both hold it and can start you the same day. The main drug, raltegravir, is expensive and hard to get privately, and this is genuinely one thing the NHS does faster than I can.
Everything a GP sees, and some of it more often. The point is that it can be one doctor who knows all of it rather than four who each know a piece.
Getting older gets far less attention than it should. Men who have sex with men are considerably more likely to live alone, and that shows up medically: later presentation, less support around illness and recovery, and the practical question of who is actually around if something happens. Worth talking about before it becomes urgent, and a reasonable thing to bring even when nothing is obviously wrong.
There is a generation of men now in their sixties and seventies who learnt about sex alongside the AIDS years. Sex and fear arriving together, shame that came with it and never entirely left, friends lost, freedoms won and then carefully guarded. That doesn't stay in the past. It shapes how a man talks about his sex life decades later and how easily he asks for help at all. I would rather it was part of the conversation than something we talk around.
Fertility is the one thing I would not take on directly. For gay and bi men it usually means donor conception, surrogacy or co-parenting, which is specialist territory, and I would refer you to a fertility clinic. What I can do is the groundwork: a semen analysis, a look at anything hormonal, and an honest conversation about what is involved before you start.
Possibly, and most men find it easier than they expected. The first few minutes are about making it feel safe, and having spoken with a great many men about their sexual and emotional lives there is very little I haven't heard. You won't be judged or rushed. The appointment is 60 minutes, which is enough time to go at a manageable pace. You control what you share and when, and you can come back to something in a later appointment.
Examination is always optional and fully explained. I check in throughout, and you can pause or stop at any point. You are welcome to bring someone with you.
Yes, for general medical care and for sexual difficulties. What I can't do is start or change gender-affirming treatment. That needs a clinician working specifically in that field and I'll refer you to colleagues who do. Everything else, including the psychosexual side, is welcome here.
Then it will be to someone safe. I work closely with consultant psychiatrist Dr Jamie Arkell here at Central Health London, and with pelvic health physiotherapist Lucy Allen. Beyond that I refer to psychotherapists, sex therapists, gastroenterologists, cardiologists, dermatologists and surgeons, all of them experienced working with gay, bi and queer men. You shouldn't have to vet that yourself.
Yes. Confidentiality would only be broken in very limited circumstances: if I believed you or someone else was at serious risk of harm, if child abuse was disclosed, if you disclosed a planned act of terrorism, or if required by a court. Other than that, everything stays in the clinic.
No referral needed, and most patients self-refer. First appointments are 60 minutes, with a 30-minute option if you have one focused question, and I only charge for the time we use. Appointment types and fees are on the booking page. I see patients from across the UK and internationally, in person in Marylebone or by video.
If you are based outside the UK I can't take you on as a new patient for general medical care online, but I do offer a sexual difficulties consultation remotely. Get in touch and we can work out what is possible.
Only with your consent. It is good practice to keep your NHS GP informed, though many patients prefer to keep private care separate, and some come here precisely because they have no established relationship with an NHS GP. Either is fine. Where it helps, for example for shared prescribing, I can write to them with your permission.
The clinic is at Central Health London, 23 Devonshire Place, Marylebone, a quiet and discreet address a short walk from Regent’s Park. Most men arrive anxious and leave relieved. You will be welcomed by reception, offered tea or coffee, and given time to settle before we start.
A first consultation is usually an hour. We go through your symptoms, your medical and family history, and your sexual experience, relationships and lifestyle: the medical, psychological and relational picture together rather than one at a time.
I will ask you a lot of questions. You do not have to answer any of them: saying "I would rather not answer that" is a complete answer and nothing follows from it. A physical examination is sometimes useful, particularly for erection problems, and it is always optional. You stay in control of the appointment throughout.
If you have had recent blood tests, send them ahead. If not I will arrange them, and I will tell you which ones need taking before 11am.
If you are in your fifties or sixties, have no GP you know well, do not much like going to the doctor, but recognise it is time to take your health seriously, this is a reasonable place to start. I often find things that matter and have been missed.
If you want help but are wary of seeing someone who is not comfortable talking about gay or queer sex, you can come to someone who does not need it explained, and who will not judge or shame you.
Men who have tried quick fixes, or had a purely medical or purely therapeutic approach that did not help. I see a lot of men for second opinions. And men of any age and in any kind of relationship who want to understand what is going on rather than be handed a prescription.
I am a GP, a sexual medicine specialist and a COSRT-registered psychosexual therapist, working at 23 Devonshire Place, Marylebone, central London, alongside NHS general practice in Hackney.
Most men reading a page like this arrived from a search rather than my homepage, so this is probably the first you have heard of me. The short version: I hold the medical, the psychological and the relational picture together in one appointment, rather than sending you to three people who each see a third of it.
More about how I workThese rarely arrive on their own. If one of these sounds closer to what you’re dealing with, start there instead.
If something doesn’t feel right, it’s worth understanding why, before deciding what, if anything, to treat.
Booking and availability