Abstract

Gay bowel syndrome was a medical term first used by Henry L Kazal and colleagues in 1976 to describe the various sexually transmitted perianal and rectal diseases and sexual traumas seen in Kazal's proctology practice, which had many gay patients.

History

After Kazal, the term was used sporadically in medical literature from the 1970s to refer to a complex of gastrointestinal symptoms affecting gay men. The term was first used in the pre-HIV era, by Kazal et al. in 1976. The term was not specific to any particular disease or infection, and was used clinically to describe proctitis and a variety of other complaints caused by a wide range of infectious organisms. Reported causes include herpes viruses, syphilis, gonorrhea, chlamydia, campylobacter, and shigellosis, as well as a variety of protozoal infections. The concept of "gay bowel syndrome" was later expanded to include various opportunistic cancers. Transmission of disease was considered to take place by two routes: anal sex, and fecal-oral route. Sometimes, difficulty in specifying the method may be a result of transmission by both methods. Following the onset of the AIDS epidemic, the reported incidence of these complaints has declined, likely as a result of safer sexual practices. Those with the ano-rectal disorder experience increased incidents of diarrhea.

Usage

The term "gay bowel syndrome" is considered obsolete and derogatory by some. The "McGraw-Hill Manual of Colorectal Surgery" says:

A 1997 article in the "Journal of Homosexuality" concluded:

"Gut", a well-respected, peer-reviewed journal of gastroenterology published by the BMJ, said in 1985 that:

The term "gay bowel syndrome" was withdrawn as "outdated" by the Canadian Association of Gastroenterologists in 2004, and the U.S. Centers for Disease Control described the term as informal and no longer in use in 2005. The gay activist and author Michael Scarce criticized the concept of "gay bowel syndrome" in his book "Smearing the Queer: Medical Bias in the Health Care of Gay Men" (1999), saying that "gay bowel syndrome has been, and remains today, a powerful tool for the specific surveillance, regulation, definition, medicalization, identification, and fragmentation of gay men's bodies." Scarce's work has been cited in the "Journal of the American Medical Association" with a positive review.