Tuesday, July 14, 2009

Gay rights is ok, but what about health risks?

Gay rights is ok, but what about health risks?

Dr Rajan B Bhonsle

Tuesday, July 14, 2009 1:52 IST





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All human beings have equal worth and therefore straight or gay, everyone has the right to live with dignity. I am all for "equal human rights" for gays and to not treat them like some inferior species or second-class citizens. They are as much human as anyone and thus deserve to be treated humanely.

Being a medical practitioner in the field of sexual medicine for over two decades, I have seen severe medical complications arising out of "consensual sodomy" or "anal sex", whether between two homosexuals, or even when it has been compelled on a woman by a man.

The physical and emotional trauma of these victims stirs my heart and cannot go unmentioned in the midst of all this debate of "de-criminalising consensual sexual behavior in privacy between two same-sex individuals". I fully agree with every scripture that separates the person from the action. Therefore, I reiterate that while all human beings should be viewed and treated "equally" with the same human dignity by law and society, all sexual acts done by anyone gay or straight, if causing physical or emotional trauma to another, (whether minor or major), should also be punishable.

Kiran was a 20-year-old frail boy from a poor family. His father was dead and his mother was old and ill with two younger sisters at home to support. He got a job of a peon in a private office after a lot of struggle. His boss, a 46-year-old rich married man, fancied anal sex. He pressurised Kiran to have anal sex with him after office hours in his cabin. Kiran felt helpless as this job was vital for him. He consented to the demands of his boss.

A few months later, when he approached a doctor, he had developed infected painful fissures at his anus and had partially lost control on the mechanism of the anal opening which was not functioning due to the injuries during anal sex. He had lost his job and had no courage to approach the police as he felt he had neither the moral right nor the legal standing as he was major and had "consented" to this act.

Deepak, a 32-year-old married government employee was a bisexual. He would indulge in anal sex with some of his male office colleagues 'consensually' for mutual pleasure. His wife was completely oblivious to this side of her husband. Deepak also never felt that his secret parallel life would ever affect his marriage.

During the second pregnancy of his wife, the obstetrician detected that she was not only HIV positive, but her tests for Syphilis, Hepatitis-B and Genital Herpes were also found positive. Deepak too was tested positive for these four STDs. It was obvious that Deepak had contracted all these STDs from his multiple homosexual contacts and now his wife and unborn child were also victims of these life threatening infections.

In all the cases, the involved individuals were 'adults' and were engaging into anal sex with 'mutual consent' in 'privacy'. Doctors get to see several such cases. I wish all those who are critical of section 377 of the Indian Penal Code (1860) need to give serious consideration to their demands. The legal experts, social activists, gay organisations and the media cannot afford to be ignorant about possibilities such as these.

It also needs to be noted that as per Section 377 of the Indian Penal Code, 'anal sex' is a punishable offence, even when it is happening between husband and wife with mutual consent. Any sexual activity is a matter of personal choice, but should be with genuine mutual consent. As a medical expert, I would like to talk about some medical facts related to anal sex. Medical science regards anal sex as "high-risk behavior".

Physiologically, the anus is not designed for penetration by any hard object. The anal sphincter tightens ordinarily if stimulated, as a protective reflex action, and any attempt at penile insertion may be distressing even if done slowly and gradually. If the penis is forced into the anus, injury is possible. The lining (mucus membrane) of the rectum is very thin, tears easily, does not heal fast and therefore is vulnerable to infections.

Also, the tears can enlarge to a fissure or a crack leading to the outside of your body. There is also a possibility that a fistula could open up, allowing faeces to re-route into the abdominal cavity or into the vagina. This can cause serious surgical complications. One may lose control over the anal sphincter causing continuous involuntary leakage of faecal matter.

Some of the micro-organisms that are normally present in the anus of even a healthy individual are known for causing severe urinary infection if they enter the urethra and urinary tract. During anal sex the urethra actually enters the rectum, inviting infective bacteria into the urethra and thus the urinary tract. Repeated urinary infection can cause serious problems such as renal damage and even kidney failure.

Masters & Johnson in their book on 'Sex and Human Loving' warn, that because bacteria are naturally present in the anus, anything that has been inserted into the anus if subsequently put into the vagina, can cause severe vaginal infections. Therefore moving from anal intercourse to vaginal intercourse is extremely hazardous.

The rate of transmission of HIV (and other STDs) through anal sex is much higher compared to other penetrative sexual acts. It will be enlightening to know that the condom, which is thought to be a means of "so-called safe sex", is not designed for anal sex by the manufacturers. Anal sex involves a totally different kind of pressure dynamics, and the latex or polyurethane condoms are not manufactured keeping these pressure dynamics in mind. The condom is far more likely to get torn during anal sex (thus paving the way for the transmission of HIV/AIDS and other STDs). Therefore I reiterate that anal sex even with the use of a condom is definitely a "high risk behavior".

Finally, I would like to conclude by saying that as a society, we need to learn to accept all "persons" with equal human rights irrespective of their choices, but we do reserve the right to reject certain "behaviors" that are injurious to the health of those persons or others connected to them. Those choosing to be in loving same-sex relationships are no less human and do not deserve any less respect than anyone else. Therefore, an equal human approach must be adopted by the moral keepers of our society and by the law of our land in this regard.

(Dr. Rajan Bhonsle, MD is a senior sex therapist in Mumbai. He is an Hon. professor and head of the department of sexual medicine at Seth GS Medical College and KEM Hospital, Mumbai)



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