Gay bowel syndrome is a term that was first used by Henry L. Kazal and colleagues in 1976 to describe various sexually transmitted rectal infections seen in Kazal's proctology practice, which had many gay patients. The term is considered obsolete as the issues it describes are not gay-specific, confined to the bowel, nor a syndrome. In 2005, the U.S. Centers for Disease Control described the term as informal and no longer in use.
Early history
The term was first used in the pre-HIV era, by Kazal et al. in 1976. 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 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.
Criticism and decline in use
In 1985, an article in the peer-reviewed journalGut said that gay bowel syndrome was not a syndrome, and had limitations in medical use: A 1997 article in the Journal of Homosexuality argued that use of the term should be abandoned: The term "gay bowel syndrome" was withdrawn as "outdated" by the Canadian Association of Gastroenterologists in 2004. The activist Michael Petrelis said "it is very much a defamation to say ‘gay bowel syndrome', when what they’re really talking about is parasites", and Marty Algaze of the Gay Men’s Health Crisis argued: "Sickle cell anemia is primarily seen in African Americans, but would you call it African American anemia? People would never accept that." The U.S. Centers for Disease Control confirmed the term was already informal and no longer in use by 2005. The 2009 McGraw-Hill Manual of Colorectal Surgery states that gay bowel syndrome is considered obsolete and derogatory: 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 ofGay Men, 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.
