More than 25 years ago, I followed Dr David Goldmeier as research senior registrar at the Royal London Hospital in the genito-urinary medical clinic and saw all the homosexual patients.
Dr Goldmeier became the psycho-sexual consultant at St Mary’s Hospital and also, incidentally, was the principal medical editor of Sex Book, by my colleague Suzi Godson. Being consulted by numbers of gay patients daily, and in this way becoming their friend as well as their medical adviser, was a privilege and a revelation.
Initially, when taking the clinic’s standard medical history the answers they gave to such routine questions as when did you last have sex? was it with a regular or casual partner? etc, were answered almost as if the patient had been heterosexual. Gay people, not unreasonably, dislike being stereotyped, but although they tried to hide it there are differences in behaviour patterns between homosexual and heterosexual people beyond the gender of the choice of partner. This was summed up to me by one patient, who was a student at one of the London colleges of music. Initially, we accepted the history that he had given me. One day he said: “Now, doctor, that we know each other better, would you like to hear the truth?” I told him that it almost always made life easier.
In the edited history he had given me before, he had been honest about sex with his regular partner, but had concealed his more colourful adventures. He lived in Essex. One of his first needs of the day was to seek a casual contact at the mainline station’s lavatories. He repeated this at lunchtime near his college and again on returning to the flat he shared with his regular partner. He never knew his casual contacts and exchanged only a few words. This may have been an extreme case, but as I came to know the other regulars in the clinic I realised that it was not exceptional. Usually casual partners are met in clubs, gay pubs and less often in parks, stations or other communal spots.
A sense of guilt may cause you anxiety about this lifestyle, although you always have safe sex, but, if it is any consolation, many other gay people have a similar sex life. We, the heterosexual majority, should neither condemn nor praise this lifestyle. Although it is undesirable to interpret sex lives or other aspects in terms of a stereotype, there is no doubt that different cultural groups have different habits.
You don’t mention how many partners you have a week, or whether you have a regular partner and, if so, whether he, too, has multiple partners and, if he does, if they are shared. What you must do is to be meticulously strict about following all the guidelines concerning safer sex. Oral sex can transmit sexually transmitted diseases just like other forms of intercourse. Research two or three years ago showed that a remarkably high proportion of HIV in some countries could have been transmitted only by oral sex. There is also the suggestion that the increase in oral sex in both heterosexual and homosexual people may be one of the factors in the recent increase in oral cancer.
Are you obsessed with sex? Only those people who know you well can answer that. If you are, is there any underlying cause? Are you insecure and does sexual activity, however transitory, relieve this? If this continues, choose those methods of sexual relief that are unlikely to lead to infection.
There is no specific threshold to define when someone crosses the line from enthusiast to addict but, when a person expends a large amount of time and energy indulging in something that could incur distressing life consequences, and they feel unable to stop that behaviour, they certainly need help.
Robert Weiss, a psychotherapist and the author of Cruise Control: Understanding Sex Addiction in Gay Men, describes gay sex addicts as “risk-takers”, and in this context you certainly fit the bill. You say you have “safe” sex, but there is actually no such thing. All barrier methods have a failure rate so you are kidding yourself if you think that you are completely protected from STIs, HIV and Aids. And you are not safe from the law either. Sex in public toilets, parks or places where other passers-by may be offended is illegal, so if you are caught you could be prosecuted.
Though there is greater social emphasis on drug and alcohol dependencies, for some the chemicals that the body generates during sex (adrenalin, phenylethylamine and dopamine) become as addictive as any drug. When the temporary euphoria experienced after orgasm becomes so determinedly associated with anonymous sexual encounters, the addict is compelled to “act out” increasingly risky behaviour to trigger that release, and as Weiss also points out, “the law of probability dictates that the more frequently you take risks, the more likely it is that you will reap severe consequences”.
Research into addictions shows that addictive disorders tend to coexist — fags and booze, sex and drugs — so it’s highly likely that if you are taking sexual risks, you are taking risks in other aspects of your life as well. An anonymous survey of 75 self-identified sex addicts (Schneider & Schneider, 1991) found that 39 per cent were also recovering from chemical dependency and 32 per cent had an eating disorder. In another study (Washton, 1987), 70 per cent of cocaine addicts entering an outpatient treatment programme were found also to be engaging in compulsive sex.
Weiss argues that increased sexual openness has made the urban gay man a “prisoner of his own freedoms”. You can, so you do, so to speak. Anonymous sex is easy and accepted in the gay community; any gay man can pitch up on Hampstead Heath at sundown knowing that he won’t be short of offers.
That’s a powerful buzz in itself. Straight or gay, being wanted is intoxicating, even if the rush lasts only as long as a blow job. In fact, anonymous sex pushes so many erotic buttons that many gay men, who are unwilling to accept their behaviour as dysfunctional, attempt to justify it on the basis that it is considered a problem only by straight people because it deviates from expected courtship rituals and sticks two fingers up at love and romance.
But it is dysfunctional. Male sex addicts choose compulsive behaviours that require little emotional involvement — voyeuristic sex, paying for sex, anonymous sex or exploitative sex (Carnes et al, 1991) — because they are not capable of sustaining a normal relationship. After the singer George Michael was arrested for propositioning an undercover police officer in a public toilet in Los Angeles, he said: “I can never be that turned on again. Guilt is a massive turn-on.” It’s difficult not to feel sorry for any man who feels that is all he deserves from life and love.
OVER TO YOU
Do you have a sexual dilemma for Suzi Godson and Dr Thomas Stuttaford?Send your e-mails to body&soul@thetimes.co.uk or write to Body&Soul, The Times, 1 Pennington Street, London E98 1TT. The authors regret that, although your letters are much appreciated, they cannot respond personally.
