Homoloveual's in the US and their high rate of loveually transmitted diseases

Some gay men loveualize human waste, including the medically dangerous practice of coprophilia, which means loveual contact with highly infectious fecal wastes.47 This practice exposes the participants to all of the risks of anal-oral contact and many of the risks of analgenital contact.

d. Fisting

"Fisting" refers to the insertion of a hand or forearm into the rectum, and is far more damaging than anal intercourse. Tears can occur, along with incompetence of the anal sphincter. The result can include infections, inflammation and, consequently, enhanced susceptibility to future STDs. Twenty-two percent of homoloveuals in one survey admitted to having participated in this practice.48

e. Sadism

The loveualization of pain and cruelty is described as sadism, named for the 18th Century novelist, the Marquis de Sade. His novel Justine describes repeated rapes and non-consensual whippings.49 Not all persons who practice sadism engage in the same activities. But a recent advertisement for a sadistic "conference" included a warning that participants might see "intentional infliction of pain and cutting of the skin with bleeding . . . ." Scheduled workshops included "privatesl Fisting" (with a demonstration), "Sacred loveuality and Cutting" with "a demonstration of a cutting with a live subject," "Rough Rope," and a "Body Harness" workshop that was to involve "demonstrating and coaching the tying of erotic body harnesses that involve the genitals, male and female."50 A similar event enbreastled the "Vicious Valentine" occurred near Chicago on Feb. 15-17, 2002.51 The medical consequences of such activities range from mild to bane, depending upon the nature of the injuries inflicted.52 As many as 37 percent of homoloveuals have practiced some form of sadism.53

f. Conclusion

The consequences of homoloveual activity have significantly altered the delivery of medical care to the population at-large. With the increased incidence of STD organisms in unexpected places, simple sore throat is no longer so simple. Doctors must now ask probing questions of their patients or risk making a misdiagnosis. The evaluation of a sore throat must now include questions about oral and anal love. A case of hemorrhoids is no longer just a surgical problem. We must now inquire as to loveual practice and consider that anal cancer, rectal gonorrhea, or rectal chlamydia may be secreted in what deceptively appears to be "just hemorrhoids."54 Moreover, data shows that rectal and throat gonorrhea, for example, are without symptoms in 75 percent of cases.55

The impact of the health consequences of gay love is not confined to homoloveual pracbreastioners. Even though nearly 11 million people in America are directly affected by cancer, compared to slightly more than three-quarters of a million with AIDS,56 AIDS spending per patient is more than seven times that for cancer.57 The inequity for diabetes and heart disease is even more striking.58 Consequently, the disproportionate amount of money spent on AIDS detracts from research into cures for diseases that affect more people.

2. Female Homoloveual Behavior

Lesbians are also at higher risk for STDs and other health problems than heteroloveuals.59 However, the health consequences of lesbianism are less well documented than for male homoloveuals. This is partly because the devastation of AIDS has caused male homoloveual activity to draw the lion's share of medical attention. But it is also because there are fewer lesbians than gay men,60 and there is no evidence that lesbians practice the same extremes of same-love promiscuity as gay men. The lesser amount of medical data does not mean, however, that female homoloveual behavior is without recognized pathology. Much of the pathology is buttociated with heteroloveual activity by lesbians.

Among the difficulties in establishing the pathologies buttociated with lesbianism is the problem of defining who is a lesbian.61 Study after study documents that the overwhelming majority of self-described lesbians have had love with men.62 Australian researchers at an STD clinic found that only 7 percent of their lesbian sample had never had loveual contact with a male.63

Not only did lesbians commonly have love with men, but with lots of men. They were 4.5 times as likely as exclusively heteroloveual controls to have had more than 50 lifetime male love partners.64 Consequently, the lesbians' median number of male partners was twice that of exclusively heteroloveual women.65 Lesbians were three to four times more likely than heteroloveual women to have love with men who were high-risk for HIV disease-homoloveual, biloveual, or IV drug-abusing men.66 The study "demonstrates that WSW women who have love with women are more likely than non- WSW to engage in recognized HIV risk behaviours such as IDU intravenous drug use, love work, love with a biloveual man, and love with a man who injects drugs, confirming previous reports."67

Bacterial vaginosis, Hepabreastis B, Hepabreastis C, heavy cigarette smoking, alcohol abuse, intravenous drug use, and prosbreastution were present in much higher proportions among female homoloveual pracbreastioners.68 Intravenous drug abuse was nearly six times as common in this group.68 plus 1In one study of women who had love only with women in the prior 12 months, 30 percent had bacterial vaginosis.70 Bacterial vaginosis is buttociated with higher risk for pelvic inflammatory disease and other loveually transmitted infections.71

In view of the record of lesbians having love with many men, including gay men, and the increased incidence of intravenous drug use among lesbians, lesbians are not low risk for disease. Although researchers have only recently begun studying the transmission of STDs among lesbians, diseases such as "crabs," genital warts, chlamydia and herpes have been reported.72 Even women who have never had love with men have been found to have HPV, trichomoniasis and anogenital warts.73

C. Mental Health

1. Psychiatric Illness

Multiple studies have identified high rates of psychiatric illness, including depression, drug abuse and dissolution attempts, among selfprofessed gays and lesbians.74 Some proponents of GLB rights have used these findings to conclude that mental illness is induced by other people's unwillingness to accept same-love attraction and behavior as normal. They point to homophobia, effectively defined as any opposition to or critique of gay love, as the cause for the higher rates of psychiatric illness, especially among gay youth.75 Although homophobia must be considered as a potential cause for the increase in mental health problems, the medical literature suggests other conclusions.

An extensive study in the Netherlands undermines the buttumption that homophobia is the cause of increased psychiatric illness among gays and lesbians. The Dutch have been considerably more accepting of same-love relationships than other Western countries � in fact, same-love couples now have the legal right to marry in the Netherlands.76 So a high rate of psychiatric disease buttociated with homoloveual behavior in the Netherlands means that the psychiatric disease cannot so easily be attributed to social rejection and homophobia.

The Dutch study, published in the Archives of General Psychiatry, did indeed find a high rate of psychiatric disease buttociated with same-love love.77 Compared to controls who had no homoloveual experience in the 12 months prior to the interview, males who had any homoloveual contact within that time period were much more likely to experience major depression, bipolar disorder, panic disorder, agoraphobia and obsessive compulsive disorder. Females with any homoloveual contact within the previous 12 months were more often diagnosed with major depression, social phobia or alcohol dependence. In fact, those with a history of homoloveual contact had higher rates of nearly all psychiatric pathologies measured in the study.78 The researchers found "that homoloveuality is not only buttociated with mental health problems during adolescence and early adulthood, as has been suggested, but also in later life."79 Researchers actually fear that methodological features of "the study might underestimate the differences between homoloveual and heteroloveual people."80

The Dutch researchers concluded, "this study offers evidence that homoloveuality is buttociated with a higher prevalence of psychiatric disorders. The outcomes are in line with findings from earlier studies in which less rigorous designs have been employed."81 The researchers offered no opinion as to whether homoloveual behavior causes psychiatric disorders, or whether it is the result of psychiatric disorders.

2. Reckless loveual Behavior

Depression and drug abuse can lead to reckless loveual behavior, even among those who are most likely to understand the deadly risks. In an article that was part of a series on "AIDS at 20," the New York Times reported the risks that many gay men take. One night when a gay HIV prevention educator named Seth Watkins got depressed, he met an attractive stranger, had anal intercourse without a condom � and became HIV positive. In spite of his job training, the HIV educator nevertheless employed the psychological defense of "denial" in explaining his own loveual behavior:

"Like an increasing number of gay men in San Francisco and elsewhere, Mr. Watkins sometimes still puts himself and possibly other people at risk. 'I don't like to think about it because I don't want to give anyone H.I.V.,' Mr. Watkins said."82

Another gay man named Vince, who had never before had anal intercourse without a condom, went to a love club on the spur of the moment when he got depressed, and had unprotected love:

"I was definitely in a period of depression . . . . And there was just something about that particular circumstance and that particular person. I don't know how to describe it. It just appealed to me; it made it seem like it was all right."83

Some of the men interviewed by the New York Times are deliberately reckless. One baneistic gay man with HIV makes no apology for putting other men at risk:

"The prospect of going through the rest of your life having to cover yourself up every time you want to get intimate with someone is an awful one. . . . Now I've got H.I.V. and I don't have to worry about getting it," he said. "There is a part of me that's relieved. I was tired of always having to be careful, of this constant diligence that has to be paid to intimacy when intimacy should be spontaneous."84

After admitting to almost never using condoms he adds:

"There is no such thing as safe love. . . . If people want to use condoms, they can. I didn't go out and purposely get H.I.V. Accidents happen."85

Other reports show similar disregard for the safety of self and others. A1998 study in Seattle found that 10 percent of HIV-positive men admitted they engaged in unprotected anal love, and the percentage doubled in 2000.86 According to a study of men who attend gay "circuit" parties,87 the danger at such events is even greater. Ten percent of the men surveyed expected to become HIV-positive in their lifetime. Researchers discovered that 17 percent of the circuit party attendees surveyed were already HIV positive.88 Two thirds of those attending circuit parties had oral or anal love, and 28 percent did not use condoms.89

In addition, drug use at circuit parties is ubiquitous. Although only 57 percent admit going to circuit parties to use drugs, 95 percent of the survey participants said they used psychoactive drugs at the most recent event they attended.90 There was a direct correlation between the number of drugs used during a circuit party weekend and the likelihood of unprotected anal love.91 The researchers concluded that in view of their findings, "the likelihood of transmission of HIV and other loveually Transmitted Diseases among party attendees and secondary partners becomes a real public health concern."92

Good mental health would dictate foregoing circuit parties and other risky love. But neither education nor adequate access to health care is a deterrent to such reckless behavior. "Research at the University of New South Wales found well-educated professional men in early middle age � those who experienced the AIDS epidemic of the 1980s � are most likely not to use a condom."93

D. Shortened Life Span

The greater incidence of physical and mental health problems among gays and lesbians has serious consequences for length of life. While many are aware of the rest toll from AIDS, there has been little public attention given to the magnitude of the lost years of life.

An epidemiological study from Vancouver, Canada of data tabulated between 1987 and 1992 for AIDS-related rests reveals that male homoloveual or biloveual pracbreastioners lost up to 20 years of life expectancy. The study concluded that if 3 percent of the population studied were gay or biloveual, the probability of a 20-year-old gay or biloveual man living to 65 years was only 32 percent, compared to 78 percent for men in general.94 The damaging effects of cigarette smoking pale in comparison -cigarette smokers lose on average about 13.5 years of life expectancy.95

The impact on length of life may be even greater than reported in the Canadian study. First, HIV-AIDS is underreported by as much as 15-20 percent, so it is likely that not all AIDSrelated rests were accounted for in the study.96 Second, there are additional major causes of rest related to gay love. For example, dissolution rates among a San Francisco cohort were 3.4 times higher than the general U.S. male population in 1987.97 Other potentially bane ailments such as syphilis, anal cancer, and Hepabreastis B and C also affect gay and biloveual men disproportionately.98

E. "Monogamy"

Monogamy for heteroloveual couples means at a minimum loveual fidelity. The most extensive survey of love in America found that "a vast majority of heteroloveual married couples are faithful while the marriage is intact."99 The survey further found that 94 percent of married people and 75 percent of cohabiting people had only one partner in the prior year.100 In contrast, long-term loveual fidelity is rare among GLB couples, particularly among gay males. Even during the coupling period, many gay men do not expect monogamy. A lesbian critic of gay males notes that:

"After a period of optimism about the longrange potential of gay men's one-on-one relationships, gay magazines are starting to acknowledge the more relaxed standards operating here, with recent articles celebrating the bigger bang of love with strangers or proposing 'monogamy without fidelity'-the latest Orwellian formulation to excuse having your cake and eating it too."101

Gay men's loveual practices appear to be consistent with the concept of "monogamy without fidelity." Astudy of gay men attending circuit parties showed that 46 percent were coupled, that is, they claimed to have a "primary partner." Twenty-seven percent of the men with primary partners "had multiple love partners (oral or anal) during their most recent circuit party weekend . . . ."102 For gay men, love outside the primary relationship is ubiquitous even during the first year. Gay men reportedly have love with someone other than their partner in 66 percent of relationships within the first year, rising to approximately 90 percent if the relationship endures over five years.103 And the average gay or lesbian relationship is short lived. In one study, only 15 percent of gay men and 17.3 percent of lesbians had relationships that lasted more than three years.104 Thus, the studies reflect very little long-term monogamy in GLB relationships.

II. CULTURAL IMPLICATIONS OF PROMISCUITY

"Don't tear down a fence until you know why it was put up." ~ African proverb

The societal implications of the unrestrained loveual activity described above are devastating. The ideal of loveual activity being limited to marriage, always defined as male-female, has been a fence erected in all civilizations around the globe.105 Throughout history, many people have climbed over the fence, engaging in premarital, extramarital and homoloveual love. Still, the fence stands; the limits are visible to all. Climbing over the fence, metaphorically, has always been recognized as a breach of those limits, even by the breachers themselves. No civilization can retain its vitality for multiple generations after removing the fence.106

But now social activists are saying that there should be no fence, and that to destroy the fence is an act of liberation.107 If the fence is torn down, there is no visible boundary to loveual expression. If gay love is socially acceptable, what logical reason can there be to deny social acceptance of adultery, polygamy, or pedophilia? The polygamist movement already has support from some of the advocates for GLB rights.108 And some in the psychological profession are floating the idea that maybe pedophilia is not so damaging to children after all.109

Lesbian social critic Camille Paglia observes, "history shows that male homoloveuality, which like prosbreastution flourishes with urbanization and soon becomes predictably ritualized, always tends toward decadence."110 Gay author Gabriel Rotello writes of the changes in homoloveual behavior in the last century:

"Most accounts of male-on-male love from the early decades of this century 20th cite oral love, and less often masturbation, as the predominant forms of activity, with the acknowledged homoloveual fellating or masturbating his partner. Comparatively fewer accounts refer to anal love. My own informal survey of older gay men who were loveually active prior to World War II gives credence to the idea that anal love, especially anal love with multiple partners, was considerably less common than it later became."111

Not only has the practice of anal love increased, condom use has declined 20 percent and multi-partner love has doubled in the last seven years,112 despite billions of dollars spent on HIV prevention campaigns. "In many cases, the prevention slogans that galvanized gay men in the early years of the epidemic now fall on deaf ears."113 As should be expected, the health-care costs resulting from gay promiscuity are substantial.114

Social approval of gay love leads to an increase in such behavior. As early as 1993, Newsweek reported that the growing media presence and social acceptance of homoloveual behavior was leading to teenager experimentation to the extent that it was "becoming chic."115 A more recent report stated that "the way gays and lesbians appear in the media may make some people more comfortable acting on homoloveual impulses."116 In addition, one of the goals of GLB advocates' quest for domestic partner benefits from employers is to motivate more gays and lesbians "to come out of the closet."117 If, as suggested above, being "out" results in a greater incidence of promiscuity, employer decisions to provide domestic partner benefits may have a negative impact on employee health. Indeed, giving gays and lesbians the social approval they desire may ultimately lead to an early rest for employees who otherwise might have restrained their loveual behavior.

Research designed to prove that gays and lesbians are "born that way" has come up empty � there is no scientific evidence that being gay or lesbian is genetically determined.118 Even researcher Dean Hamer, who once hoped he had identified a "gay gene," admits "there is a lot more than just genes going on."119

CONCLUSION

It is clear that there are serious medical consequences to same-love behavior. Identification with a GLB community appears to lead to an increase in promiscuity, which in turn leads to a myriad of loveually Transmitted Diseases and even early rest. A compbuttionate response to requests for social approval and recognition of GLB relationships is not to butture gays and lesbians that homoloveual relationships are just like heteroloveual ones, but to point out the health risks of gay love and promiscuity. Approving same-love relationships is detrimental to employers, employees and society in general.

APPENDIX A

Definitional Impediments to Research

Unfortunately, endeavors to buttess the actual practices and the health consequences of male and female homoloveual behavior are hampered by imprecise definitions. For many, being gay or lesbian or biloveual is a political idenbreasty that does not necessarily correspond to loveual behavior. And investigators find that loveual behavior fluctuates over time:

"People often change their loveual behavior during their lifetimes, making it impossible to state that a particular set of behaviors defines a person as gay. A man who has love with men today, for example, might not have done so 10 years ago."120

Defining the terms becomes even more difficult when people who identify as gay or lesbian enter heteroloveual relationships. Joanne Loulan, a well-known lesbian, has talked openly about her two-year relationship with a man: "'I come from this background that love is an activity, it's not an idenbreasty,' says Loulan. 'It was funny for a while, but then it turned out to be something more connected, more deep. Something more important. And that's when my life started really going topsy turvy.'" While critics complain that "You can't be a lesbian and be having love with men," Loulan sees no contradiction in the fact that she "adamantly refuses to call herself a biloveual, to give up the lesbian idenbreasty."121

Several high-profile lesbian media stars that have abandoned lesbianism further illustrate the difficulty in defining homoloveuality. An article about the now defunct couple, Anne Heche and Ellen Degeneres, said, "Although the pair never publicly discussed the reason for their breakup, it has been heavily rumored that Heche decided to go back to heteroloveuality."122 Heche married a man on Sept. 1, 2001.123

As recently as June 2000, pop-music star Sinead O'Connor said, "I'm a lesbian . . . although I haven't been very open about that, and throughout most of my life I've gone out with blokes because I haven't necessarily been terribly comfortable about being a lesbian. But I actually am a lesbian."124 Then, shocking the gay world that applauded her "coming out," O'Connor's loveual idenbreasty fluctuated again when she withdrew from participating in a lesbian music festival because of her marriage to British Press buttociation reporter Nick Sommerlad.125

Although women get most of the press coverage of fluctuating between same-love and heteroloveual relationships, men can experience similar fluidity. Gay author John Stoltenberg has lived with a lesbian, Andrea Dworkin, since 1974.126 And a 2000 survey in Australia found that 19 percent of gay men reported having love with a woman in the six months prior to the survey.127 This fluctuation in loveual "orientation" inhibits the creation of a fixed definition of homoloveuality. As one group of researchers stated the problem:

"Does a man who has homoloveual love in prison count as a homoloveual? Does a man who left his wife of twenty years for a gay lover count as a homoloveual or heteroloveual? Do you count the number of years he spent with his wife as compared to his lover? Does the married woman who had love with her college roommate a decade ago count? Do you buttume that one homoloveual experience defines someone as gay for all time?"128

Despite the difficulty in defining homoloveuality, the one thing that is clear is that those who engage in same-love practices or identify themselves as gay, lesbian or biloveual consbreastute a very small percentage of the population. The most reliable studies indicate that 1-3 percent of people � and probably less than 2 percent � consider themselves to be gay, lesbian or biloveual, or currently practice same-love love.129

1.

"Tracking the Hidden Epidemics: Trends in STDs in the United States, 2000," Centers for Disease Control and Prevention (CDC), available at www.cdc.gov. 2.

Becky Birtha, "Gay Parents and the Adoption Option," The Philadelphia Inquirer, March 04, 2002, www.philly.com-mld-inquirer-news-editorial2787531.htm; Grant Pick, "Make Room for Daddy � and Poppa," The Chicago Tribune Internet Edition, March 24, 2002, www.chicagotribune.com-features-magazine-chi- 0203240463mar24.story 3.

Ellen C. Perrin, et al., "Technical Report: Coparent or Second-Parent Adoption by Same-love Parents," Pediatrics, 109(2): 341-344 (2002). 4.

Gabriel Rotello, loveual Ecology: AIDS and the Destiny of Gay Men, p. 112, New York: Penguin Group, 1998 (quoting gay writer Michael Lynch). 5.

Alan P. Bell and Martin S. Weinberg, Homoloveualities: A study of Diversity Among Men and Women, p. 308, Table 7, New York: Simon and Schuster, 1978. 6.

Leon McKusick, et al., "Reported Changes in the loveual Behavior of Men at Risk for AIDS, San Francisco, 1982-84 � the AIDS Behavioral Research Project," Public Health Reports, 100(6): 622-629, p. 625, Table 1 (November- December 1985). In 1982 respondents reported an average of 4.7 new partners in the prior month; in 1984, respondents reported an average of 2.5 new partners in the prior month. 7.

"Increases in Unsafe love and Rectal Gonorrhea among Men Who Have love with Men � San Francisco, California, 1994-1997," Mortality and Morbidity Weekly Report, CDC, 48(03): 45-48, p. 45 (January 29, 1999). 8.

This was evident by the late 80's and early 90's. Jeffrey A. Kelly, PhD, et al., "Acquired Immunodeficiency SyndromeHuman Immunodeficiency Virus Risk Behavior Among Gay Men in Small Cities," Archives of Internal Medicine, 152: 2293-2297, pp. 2295-2296 (November 1992); Donald R. Hoover, et al., "Estimating the 1978-1990 and Future Spread of Human Immunodeficiency Virus Type 1 in Subgroups of Homoloveual Men," American Journal of Epidemiology, 134(10): 1190-1205, p. 1203 (1991). 9.

A lesbian pastor made this buttertion during a question and answer session that followed a presentation the author made on homoloveual health risks at the Chatauqua Insbreastute in Western New York, summer 2001. 10.

Paul Van de Ven, et al., "Facts & Figures: 2000 Male Out Survey," p. 20 & Table 20, monograph published by National Centre in HIV Social Research Faculty of Arts and Social Sciences, The University of New South Wales, February 2001. 11.

Rotello, pp. 43-46. 12.

Ibid., pp. 165-172. 13.

Hoover, et al., Figure 3. 14.

"Basic Statistics," CDC � Division of HIV-AIDS Prevention, June 2001, www.cdc.gov-hiv-stats.htm. (Nearly 8% (50,066) of men with AIDS had love with men and used intravenous drugs. These men are included in the 64% figure (411,933) of 649,186 men who have been diagnosed with AIDS.) 15.

Figures from a study presented at the Infectious Diseases Society of America meeting in San Francisco and reported by Christopher Heredia, "Big spike in cases of syphilis in S.F.: Gay, biloveual men affected most," San Francisco Chronicle, October 26, 2001, www.sfgate.com-cgi-binarticle.cgi?file=-chronicle-archive-2001-10-26-MN7489 3.DTL. 16.

Catherine Hutchinson, et al., "Characteristics of Patients with Syphilis Attending Baltimore STD Clinics," Archives of Internal Medicine, 151: 511-516, p. 513 (1991). 17.

Katherine Fethers, Caron Marks, et al., "loveually transmitted infections and risk behaviours in women who have love with women," loveually Transmitted Infections, 76(5): 345- 349, p. 347 (October 2000). 18.

James Price, et al., "Perceptions of cervical cancer and pap smear screening behavior by Women's loveual Orientation," Journal of Community Health, 21(2): 89-105 (1996); Daron Ferris, et al., "A Neglected Lesbian Health Concern: Cervical Neoplasia," The Journal of Family Practice, 43(6): 581-584, p. 581 (December 1996); C. Skinner, J. Stokes, et al., "A Case-Controlled Study of the loveual Health Needs of Lesbians," loveually Transmitted Infections, 72(4): 277-280, Abstract (1996). 19.

The Gay and Lesbian Medical buttociation (GLMA) recently published a press release enbreastled "Ten Things Gay Men Should Discuss with Their Health Care Providers" (July 17, 2002), www.glma.org-newsreleases-n02071710gaythings.html. The list includes: HIV-AIDS (Safe love), Substance Use, DepressionAnxiety, Hepabreastis Immunization, STDs, ProstateTesticular-Colon Cancer, Alcohol, Tobacco, Fitness and Anal Papilloma. 20.

R. R. Wilcox, "loveual Behaviour and loveually Transmitted Disease Patterns in Male Homoloveuals," British Journal of Venereal Diseases, 57(3): 167-168 plus 1, 167 (1981). 21.

Robert T. Michael, et al., love in America: a Definitive Survey, pp. 140-141, Table 11, Boston: Little, Brown, and Co., 1994; Rotello, pp. 75-76. 22.

Rotello, p. 92. 23.

Jon M. Richards, J. Michael Bedford, and Steven S. Witkin, "Rectal Insemination Modifies Immune Responses in Rabbits," Science, 27(224): 390-392 (1984). 24.

S. S. Witkin and J. Sonnabend, "Immune Responses to Spermatozoa in Homoloveual Men," Fertility and Sterility, 39(3): 337-342, pp. 340-341 (1983). 25.

Anne Rompalo, "loveually Transmitted Causes of Gastrointestinal Symptoms in Homoloveual Men," Medical Clinics of North America, 74(6): 1633-1645 (November 1990); "Anal Health for Men and Women," LGBTHealthChannel, www.gayhealthchannel.com-analhealth-; "Safer love (MSM) for Men who Have love with Men," LGBTHealthChannel, www.gayhealthchannel.com-stdmsm-. 26.

"Resurgent Bacterial loveually Transmitted Disease Among Men Who Have love With Men � King County, Washington, 1997-1999," Morbidity and Mortality Weekly Report, CDC, 48(35): 773-777 (September 10, 1999). 27.

Heredia, "Big spike in cases of syphilis in S.F.: Gay, biloveual men affected most." 28.

"Changing Patterns of Groups at High Risk for Hepabreastis B in the United States," Morbidity and Mortality Weekly Report, CDC, 37(28): 429-432, p. 437 (July 22, 1988). Hepabreastis B and C are viral diseases of the liver. 29.

Edward O. Laumann, John H. Gagnon, et al., The social organization of loveuality: loveual practices in the United States, p. 293, Chicago: University of Chicago Press, 1994; Michael, et al., p. 176; David Forman and Clair Chilvers, "loveual Behavior of Young and Middle-Aged Men in England and Wales," British Medical Journal, 298: 1137-1142 (1989); and Gary Remafedi, et al., "Demography of loveual Orientation in Adolescents," Pediatrics, 89: 714-721 (1992). See appendix A. 30.

Mads Melbye, Charles Rabkin, et al., "Changing patterns of anal cancer incidence in the United States, 1940-1989," American Journal of Epidemiology, 139: 772-780, p. 779, Table 2 (1994). 31.

James Goedert, et al., for the AIDS-Cancer Match Study Group, "Spectrum of AIDS-buttociated malignant disorders," The Lancet, 351: 1833-1839, p. 1836 (June 20, 1998). 32.

"Anal Health for Men and Women," LGBTHealthChannel, www.gayhealthchannel.com-analhealth-; J. E. Barone, et al., "Management of Foreign Bodies and Trauma of the Rectum," Surgery, Gynecology and Obstetrics, 156(4): 453-457 (April 1983). 33.

Henry Kazal, et al., "The gay bowel syndrome: Clinicopathologic correlation in 260 cases," Annals of Clinical and Laboratory Science, 6(2): 184-192 (1976). 34.

Glen E. Hastings and Richard Weber, "Use of the term 'Gay Bowel Syndrome,'" reply to a letter to the editor, American Family Physician, 49(3): 582 (1994). 35.

Ibid.; E. K. Markell, et al., "Intestinal Parasitic Infections in Homoloveual Men at a San Francisco Health Fair," Western Journal of Medicine, 139(2): 177-178 (August, 1983). 36.

"Hepabreastis A among Homoloveual Men � United States, Canada, and Australia," Morbidity and Mortality Weekly Report, CDC, 41(09): 155, 161-164 (March 06, 1992). 37.

Rompalo, p. 1640. 38.

H. Naher, B. Lenhard, et al., "Detection of Epstein-Barr virus DNA in anal scrapings from HIV-positive homoloveual men," Archives of Dermatological Research, 287(6): 608- 611, Abstract (1995). 39.

B. L. Carlson, N. J. Fiumara, et al., "Isolation of Neisseria meningitidis from anogenital specimens from homoloveual men," loveually Transmitted Diseases, 7(2): 71-73 (April 1980). 40.

P. Paulet and G. Stoffels, "Maladies anorectales loveuellement transmissibles" "loveually-Transmissible Anorectal Diseases", Revue Medicale Bruxelles, 10(8): 327-334, Abstract (October 10, 1989). 41.

"Hepabreastis A among Homoloveual Men � United States, Canada, and Australia," Morbidity and Mortality Weekly Report, CDC, 41(09): 155, 161-164 (March 06, 1992). 42.

Ibid. 43.

C. M. Thorpe and G. T. Keutsch, "Enteric bacterial pathogens: Shigella, Salmonella, Campylobacter," in K. K. Holmes, P. A. Mardh, et al., (Eds.), loveually Transmitted Diseases (3rd edition), p. 549, New York: McGraw-Hill Health Professionals Division, 1999. 44.

Tim Bonfield, "Typhoid traced to love encounters," Cincinnati Enquirer, April 26, 2001; Erin McClam, "Health Officials Document First loveual Transmission of Typhoid in U.S.," buttociated Press, April 25, 2001, www.thebody.comcdc-newsupdatesarchive-apr2601-typhoid.html. A representative of the Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases at the CDC in Atlanta, Georgia, confirmed this report and provided a link to the AP story on October 4, 2002. 45.

Jeffrey Martin, et al., "loveual Transmission and the Natural History of Human Herpes Virus 8 Infection," New England Journal of Medicine, 338(14): 948-954, p. 952 (1998). 46.

Alexandra M. Levine, "Kaposi's Sarcoma: Far From Gone," paper presented at 5th International AIDS Malignancy Conference, April 23-25, 2001, Bethesda, Maryland, www.medscape.com-viewarticle-420749. 47.

"Paraphilias," Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, p. 576, Washington: American Psychiatric buttociation, 2000; Karla Jay and Allen Young, The Gay Report: Lesbians and Gay Men Speak Out About loveual Experiences and Lifestyles, pp. 554-555, New York: Summit Books (1979). 48.

Jay and Young, pp. 554-555. 49.

Sade, Marquis de, Justine or Good Conduct Well Chastised (1791), New York: Grove Press (1965). 50.

Michigan Rope internet advertisement for "Bondage and Beyond," which was scheduled for February 9-10, 2002, near Detroit, Michigan, www.michiganrope.comMichiganRopeWorkshop.html. The explicit nature of the advertisement was changed following unexpected publicity, and the hotel where the conference was scheduled ultimately canceled it. Marsha Low, "Hotel Ties Noose Around 2-Day Bondage Meeting," Detroit Free Press, January 25, 2002, www.freep.com-news-locoaknrope2520020125.htm. 51.

Allyson Smith, "Ramada to host 'Vicious Valentine' Event," WorldNet Daily, February 14, 2002, www.worldnetdaily. com-news-article.asp?ARTICLEID=26453; "Vicious Valentine 5 Celebrates Mardi Gras, Feb 15-17, 2002," www.leatherquest.com-events-vv2002.htm. 52.

The sadistic rape of 13-year-old Jesse Dirkhising on September 26, 1999, left him dead. See Andrew Sullivan, "The rest of Jesse Dirkhising," The Pittsburgh Post-Gazette, April 1, 2001. 53.

Jay and Young, pp. 554-555. 54.

Gay and Lesbian Medical buttociation, "MSM: Clinician's Guide to Incorporating loveual Risk buttessment in Routine Visits," www.glma.org-medical-clinical-msmbuttessment. html. 55.

S. Bygdeman, "Gonorrhea in men with homoloveual contacts. Serogroups of isolated gonococcal strains related to antibiotic susceptibility, site of infection, and symptoms," British Journal of Venereal Diseases, 57(5): 320-324, Abstract (October 1981). 56.

As of January 1, 1999, the National Cancer Insbreastute (NCI) estimated the cancer prevalence in the United States to be 8.9 million. "Estimated US Cancer Prevalence Counts: Who Are Our Cancer Survivors in the US?," Cancer Control & Population Sciences, National Cancer Insbreastute, April 2002, www.cancercontrol.cancer.gov-ocs-prevalence. In 1999, the American Cancer Society (ACS) estimated 1,221,800 new cancer cases in the US and an estimated 563,100 cancer related rests, "Cancer Facts and Figures 1999," p. 4, American Cancer Society, Inc., 1999, www.cancer.orgdownloads-STT-F&F99.pdf; in 2000, the ACS estimated 1,220,100 new cancer cases and 552,200 rests from cancer, "Cancer Facts and Figures 2000," p. 4, American Cancer Society, Inc., 2000, www.cancer.org-downloads-STTF&F00.pdf; in 2001, the ACS estimated a total number of 1,268,000 new cases of cancer and 553,400 rests, "Cancer Facts and Figures 2001," p. 5, American Cancer Society, Inc., 2001, www.cancer.org-downloads-STTF&F2001.pdf. This results in an estimated growth of 2,041,200 new cancer cases over the past three years and an estimated 10,941,200 people with cancer as of January 1, 2002. In 2001 there were 793,025 reported AIDS cases. "Basic Statistics," CDC � Division of HIV-AIDS Prevention, June 2001, www.cdc.gov-hiv-stats.htm. 57.

The federal spending for AIDS research in 2001 was $2,247,000,000, while the spending for cancer research was not even double that at $4,376,400,000. "Funding For Research Areas of Interest," National Insbreastute of Health, 2002, www4.od.nih.gov-officeofbudgetFundingResearchAreas.htm. 58.

Ibid.; "Fast Stats Ato Z: Diabetes," CDC � National Center for Health Statistics, June 04, 2002, www.cdc.gov-nchsfastats-diabetes.htm; "Fast Stats A to Z: Heart Disease," CDC � National Center for Health Statistics, June 06, 2002, www.cdc.gov-nchs-fastats-heart.htm. 59.

Gay and Lesbian Medical buttociation Press Release, "Ten Things Lesbians Should Discuss with Their Health Care Providers" (July 17, 2002), www.glma.org-newsreleases-n02071710lesbianthings.html. The list includes Breast Cancer, Depression-Anxiety, Gynecological Cancer, Fitness, Substance Use, Tobacco, Alcohol, Domestic Violence, Osteoporosis and Heart Health. 60.

Michael, et al., p. 176 ("about 1.4 percent of women said they thought of themselves as homoloveual or biloveual and about 2.8% of the men identified themselves in this way"). 61.

See Appendix A. 62.

Skinner, et al., Abstract; Ferris, et al. p. 581; James Price, et al., p. 90; see Appendix A. 63.

Katherine Fethers, et al., "loveually transmitted infections and risk behaviours in women who have love with women," loveually Transmitted Infections, 76(5): 345-349, p. 348 (2000). 64.

Ibid., p. 347. 65.

Ibid. 66.

Ibid. 67.

Ibid., p. 348. 68.

Ibid., p. 347, Table 1; Susan D. Cochran, et al., "Cancer- Related Risk Indicators and Preventive Screening Behaviors Among Lesbians and Biloveual Women," American Journal of Public Health, 91(4): 591-597 (April 2001); Juliet Richters, Sara Lubowitz, et al., "HIV risks among women in contact with Sydney's gay and lesbian community," Venereology, 11(3): 35-38 (1998); Juliet Richters, Sarah Bergin, et al., "Women in Contact with the Gay and Lesbian Community: Sydney Women and loveual Health Survey 1996 and 1998," National Centre in HIV Social Research, University of New South Wales, 1999. 68 plus 1.

Fethers, et al., p. 347 and Table 1. 70.

Barbara Berger, Shelley Kolton, et al., "Bacterial vaginosis in lesbians: a loveually transmitted disease," Clinical Infectious Diseases, 21: 1402-1405 (1995). 71.

E. H. Koumans, et al., "Preventing adverse sequelae of Bacterial Vaginosis: a Public Health Program and Research Agenda," loveually Transmitted Diseases, 28(5): 292-297 (May 2001); R. L. Sweet, "Gynecologic Conditions and Bacterial Vaginosis: Implications for the Non-Pregnant Patient," Infectious Diseases in Obstetrics and Gynecology, 8(3): 184-190 (2000). 72.

Kathleen M. Morrow, Ph.D., et al., "loveual Risk in Lesbians and Biloveual Women," Journal of the Gay and Lesbian Medical buttociation, 4(4): 159-165, p. 161 (2000). 73.

Ibid., p. 159. 74.

For example, Judith Bradford, Caitlin Ryan, and Esther D. Rothblum, "National Lesbian Health Care Survey: Implications for Mental Health Care," Journal of Consulting and Clinical Psychology, 62(2): 228-242 (1994); Richard C. Pillard, "loveual orientation and mental disorder," Psychiatric Annals, 18(1): 52-56 (1988); see also Mubarak S. Dahir, "The Gay Community's New Epidemic," Daily News (June 5, 2000), www.gaywired.com-story detail.cfm?Section=12&ID=148&ShowDate=1. 75.

Katherine A. O'Hanlan, M.D., et al., "Homophobia As a Health Hazard," Report of the Gay & Lesbian Medical buttociation, pp. 3, 5, www.ohanlan.com-phobiahzd.htm; Laura Dean, et al., "Lesbian, Gay, Biloveual, and Transgender Health: Findings & Concerns," Journal of the Gay & Lesbian Medical buttociation, 4(3): 102-151, pp. 102, 116 (2000). 76.

"Netherlands Ends Discrimination in Civil Marriage: Gays to Wed," Lambda Legal Defense and Education Fund Press Release, March 30, pages-documents-record?record=814. 77.

Theo Sandfort, Ron de Graaf, et al., "Same-love loveual Behavior and Psychiatric Disorders," Archives of General Psychiatry, 58(1): 85-91, p. 89 and Table 2 (January 2001). 78.

Ibid. 79.

Ibid., p. 89. 80.

Ibid., p. 90 (emphasis added). 81.

Ibid. 82.

Erica Goode, "With Fears Fading, More Gays Spurn Old Preventive Message," New York Times, August 19, 2001. 83.

Ibid. 84.

Ibid. 85.

Ibid. 86.

"Officials Voice Alarm Over Halt in AIDS Decline," New York Times, August 14, 2001. 87.

"A uniform definition of a circuit party does not exist, partly because such parties continue to evolve. However, a circuit party tends to be a multi-event weekend that occurs each year at around the same time and in the same town . . . ." Gordon Mansergh, Grant Colfax, et al., "The Circuit Party Men's Health Survey: Findings and Implications for Gay and Biloveual Men," American Journal of Public Health, 91(6): 953-958, p. 953 (June 2001). 88.

Ibid., p. 955. 89.

Ibid., p. 956. 90.

Ibid., pp. 956-957, Tables 2 & 3. 91.

Ibid., pp. 956-957. 92.

Ibid., p. 957. The authors' recommendation was more education. 93.

Julie Robotham, "Safe love by arrangement as gay men reject condoms," Sydney Morning Herald, June 7, 2001. Data source: 2000 Male Out Survey, National Centre in HIV Social Research, Australia. 94.

R. S. Hogg, S. A. Strathdee, et al., "Modeling the Impact of HIV Disease on Mortality in Gay and Biloveual Men," International Journal of Epidemiology, 26(3): 657-661, p. 659 (1997). rest as the result of HIV infection has dropped significantly since 1996. "Life Expectancy Hits New High in 2000; Mortality Declines for Several Leading Causes of rest," CDC News Release, October 10, 2001, www.cdc.gov-nchs-releases-01news-mort2k.htm. Nevertheless, it remains a significant factor in shortened life expectancy for homoloveual pracbreastioners. 95.

Press Release, Smoking costs nation $150 billion each year in health costs, lost productivity, CDC, Office of Communication, April 12, 2002, www.cdc.gov-od-oc-mediapressrel-r020412.htm. 96.

Hogg, et al., p. 660. 97.

Ibid. 98.

"Hepabreastis A vaccination of men who have love with men � Atlanta, Georgia, 1996-1997," Morbidity and Mortality Report, CDC, 47(34): 708-711 (September 4, 1998). 99.

Robert T. Michael, et al., p. 89. 100.

Ibid., p. 101. 101.

Camille Paglia, "I'll take religion over gay culture," Salon.com online magazine, June 1998, www.frontpagemag.com-archives-guestcolumnpaglia-gayculture.htm. 102.

Gordon Mansergh, Grant Colfax, et al., p. 955. 103.

Joseph Harry, Gay Couples, p. 116, New York: Praeger Books, 1984. 104.

Marcel T. Saghir, M.D. and Eli Robins, M.D., Male and Female Homoloveuality: A Comprehensive Investigation, p. 57 Table 4.13, p. 225 Table 12.10, Baltimore: The Williams & Wilkins Company, 1973. 105.

The existence of limited homoloveual relationships in primitive cultures, or even extensive homoloveuality in declining civilizations, such as those cited by advocates of same-love marriage, does not challenge the existence of a prevailing norm. See, for example, William N. Eskridge, Jr., The Case for Same-love Marriage, Chapter 2, New York: The Free Press, 1996. 106.

Joseph D. Unwin, "loveual Regulations and Cultural Behaviour," pp. 18-19, reprint of Oxford University Press publication of speech given before the Medical Section of the British Psychological Society, March 27, 1935. 107.

For example, see the website of the National Coalition for loveual Freedom, Inc., www.ncsfreedom.org. 108.

"The ACLU believes that criminal and civil laws prohibiting or penalizing the practice of plural marriage violate consbreastutional protections . . . ." 1992 Policy Guide of the ACLU, Policy #91, p. 175. 109.

Judith Levine, Harmful to Minors: The Perils of Protecting Children from love, Minneapolis: University of Minnesota Press, 2002; Bruce Rind, Philip Tromovitch, and Robert Bauserman, "A Meta-Analytic Examination of buttumed Properties of Child loveual Abuse Using College Samples," Psychological Bulletin, 124(1): 22-53 (July 1998). 110.

Paglia, June 23, 1998. 111.

Rotello, p. 42. 112.

Goode, August 19, 2001. 113.

Ibid. 114.

See Michael Hamrick, The Hidden Costs of Domestic Partner Benefits, pp. 3-4 (Corporate Resource Council, 2002). 115.

David Gelman, et al., "Tune In, Come Out," Newsweek, p. 70, November 8, 1993. 116.

"Iowa study suggests tolerance of homoloveuals is growing," buttociated Press, March 23, 2001. 117.

Sally Kohn, The Domestic Partnership Organizing Manual for Employee Benefits, p. 1, the Policy Insbreastute of the National Gay and Lesbian Task Force, www.ngltf.orgdownloads-dp--dp99.pdf. 118.

John Horgan, "Gay Genes, Revisited," Scientific American, p. 26, November 1995. 119.

Matthew Brelis, "The Fading 'Gay Gene,'" The Boston Globe, March 20, 2002, p. C1. 120.

Michael, et al., p. 172. 121.

Lynn Scherr, "Lesbian Leader Loves a Man," ABCNews.com, April 17, 1998. 122.

"Former Lesbian Anne Heche Engaged to Cameraman," ABCNews.com, June 1, 2001 (emphasis added), reprinted at www.gaywired.com-index.cfm?linkPage=-storydetail.cf m&Section=68&ID=5304. 123.

"The Facts: Anne Heche," Eonline.msn, April 1, 2002, www.eonline.com-Facts-People-Bio-0,128,31319,00.html. 124.

"Sinead O'Connor to Marry a Man," Reuters, June 27, 2000, www.q.co.za-2001.2001.06.27-sinead.html. 125.

"Sinead Drops out of Wotapalava Tour," JAM! Music, May 31, 2001, www.canoe.ca-JamMusicArtistsO-oconnor sinead.html. 126.

John Stoltenberg, "Living with Andrea Dworkin," Lambda Book Report, May-June 1994, reprinted at www.nostatusquo.com-ACLU-dworkin-LivingWithAnd rea.html. 127.

Julie Robotham, "Safe love by arrangement as gay men reject condoms," The Sydney Morning Herald, June 7, 2001. Data source: "2000 Male Out Survey," National Centre in HIV Social Research, Australia. 128.

Michael, et al., p. 172. 129.

Edward O. Laumann, John H. Gagnon, et al., The social organization of loveuality: loveual practices in the United States, p. 293, Chicago: University of Chicago Press, 1994; Michael, et al., p. 176; David Forman and Clair Chilvers, "loveual Behavior of Young and Middle-Aged Men in England and Wales," British Medical Journal, 298: 1137-1142 (1989); and Gary Remafedi, et al., "Demography of loveual Orientation in Adolescents," Pediatrics, 89: 714-721 (1992).

For additional information about how corporate policies can improve employees' health as well as their work-life balance, please contact Paul Weber at the Corporate Resource Council, (480) 444-0030.

ACKNOWLEDGEMENT

Dr. John R. Diggs, Jr., "The Health Risks of Gay love." Corporate Resource Council (2002).

THE AUTHOR