A physician with experience caring for armed forces personnel says the US military's "don't ask, don't tell" policy puts both service members and the general public at risk by encouraging secrecy about sexual health issues.
"Infections go undiagnosed. Service members and their partners go untreated," Dr Kenneth Katz, a physician at San Diego State University and the University of California at San Diego, wrote in a commentary published 1 December in the New England Journal of Medicine.
And civilians "pay a price" because they have sex with service members who miss out on programs aimed at preventing the spread of the HIV, the virus that causes AIDS, as well as other sexually transmitted diseases, Katz wrote.
The military is currently pondering the end of the "don't ask, don't tell" policy, which does not allow gay service members to serve openly. No one knows how many gays are in the armed forces. However, one 2002 study found that active-duty Navy sailors made up 9% of the patients who visited one gay men's health clinic in San Diego.
Sexually transmitted disease
Katz writes that he treated one active-duty gay member of the military who visited a sexually transmitted disease clinic in San Diego and was diagnosed with gonorrhoea. Even though the military covered the man's medical expenses, he feared his career would be jeopardised if he went to a military doctor over issues of sexual health.
The US military has said it will no longer use confidential medical information in its efforts to ferret out gay service members. But Katz writes that service members have told him that they haven't heard about such a change.
In an interview, a psychologist who studies sexual orientation issues said that Katz "may be underselling the risks" posed to service members who must keep their personal lives private in order to avoid losing their jobs.
Research has shown that the act of inhibiting oneself is unhealthy, according to David Huebner, an assistant professor of psychology at the University of Utah.
On the other hand, he said, "if you disclose things that are personally difficult to you in a constructive way, your physical health can improve."
Physicians often deal with mental health issues, Heubner added, and they'll be hobbled if service members aren't open about themselves. (HealthDay/ November 2010)
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