Heterocopulative Syndrome: Clinico-Pathologic Correlation in 260 Cases

Michael Scarce

Abstract

The hazards of heterosexual behaviour have been well documented. They include, but are not limited to, unplanned pregnancies, penile and cervical cancer, vaginitis, a host of sexually transmitted diseases (some of them incurable or deadly), a disproportionate propensity to engage in child molestation, global overpopulation, socially oppressive gender roles, and more. A recurring pattern of these health disorders resulting from the union of the penis and vagina has been named heterocopulative syndrome. These people could pose a serious public health threat if such practices continue unchecked and may be especially dangerous if employed as food handlers.(2)

Problem and Literature Review

Heterosexuals represent approximately 90 per cent of the United States population, yet they account for well over 99 per cent of the burdens faced by our health care system. Frequency, number, and dishonesty of sexual contacts among heterosexual men and women, which are facilitated at single's bars, church socials, and fraternity parties are cited by Stiffen and Stare as reasons for the emergence of new heterosexual diseases, as is their perception of heterosexuals as a ‘highly stagnant, immobile population’ and ‘"unnatural" sexual practices such as copulation, which allows transmission of a variety of organisms’.(3) High rates of infidelity and a rising divorce rate in excess of 50 per cent compound these risk factors.

For the sake of brevity, the term heterosexual practices will be used hereafter to denote penis-to-vagina copulation.(4) The fact that the patient has had or is now having homosexual relationships is irrelevant to the topic of discussion. Previous heterosexual activity, even if represented by a single experience, exposes the patient to the conditions under consideration.(5)

Method

The subjects for this study were 260 heterosexual patients who visited a private family practice in a suburb of Salt Lake City, Utah, over a span of three years.(6) All of the patients were treated for some form of genitourinary affliction. Investigators reviewed the records of these patients, tabulating data on lab results, diagnoses, course of treatment, and demographic information. In addition, a survey instrument was designed to gain a sexual history from these heterosexuals. The form of the instrument was developed by modifying questions from our previous studies on homosexual health and cancer, and on the advice of one male heterosexual.(7) These forms of data collection were used to measure the multiple disorders and afflictions found with unusual frequency in male and female heterosexuals.

Results

Clinical diagnoses of these patients included twenty conditions: vaginitis, yeast infections, impotence, delayed ejaculation, nongonococcal urethritis, abdominal cramping, unplanned or unwanted pregnancy, syphilis, urethral discharge, hepatitis B, irregular menstruation, delayed ejaculation, impotence, epididymitis, crab lice, chlamydia, human papillomavirus (HPV), HPV-related cancer, sterility, and physical trauma resulting from sexual assault.

Discussion

There are certain physical findings which, while not absolutely diagnostic, should alert the examiner to the possibility of heterosexuality—pregnancy in women, diminished vaginal muscle tone, penile abrasions, expressed anxiety during prostate exams, female inability to achieve orgasm with her sexual partner, vasectomy, and more. An additional sign can be termed the Negative ‘O’ Sign in which the male patient is incapable of voluntarily maintaining the anus in a dilated position. This sign was present in approximately 40 per cent of the patients.(8)

Impotence was a common problem associated with heterocopulative syndrome in male heterosexuals. For the purposes of this study, impotence was defined as the lack of penile erection sufficient to engage in anal penetration.(9)

The typical patient has a history of multiple disease accompanied by social dysfunction, which may tend to recur. When alert to this clinical pattern, the physician may recognize the heterocopulative syndrome even before a history of heterosexuality has been elicited.

Conclusion

Physicians should broaden the scope of their medical examinations and diagnoses to encompass more than unplanned pregnancy, prostate cancer and Pap smear screening when treating heterosexual patients. There is no doubt that our traditional conceptions of sexually transmitted diseases were too narrow; it is only slightly less certain that our current understanding of heterocopulative syndrome will expand and develop as new etiologies are implicated and new clinical syndromes are described.(10) The public health implications of heterosexual behaviour are very important. These patients may be employed as food handlers or in other roles where they could come into contact with others and spread a host of infectious and other conditions.

Notes

Extract from ‘Smearing the Queer’a by Michael Scarce (see Essay Review on pp.501–503)

This parody purports to be reprinted from the Annals of Nuclear Family Clinical and Laboratory Science 1998;6.1:1–6.(1)

a Smearing the Queer: Medical Bias in the Health Care of Gay Men. Michael Scarce. Binghampton, NY: Harrington Park Press, 1999, p.183, US$19.95. ISBN: 1560239263. (Reprinted with permission of the author and publishers.) Back

(1) The purpose of this parody is to articulate an oppositional narrative that reveals the laughable biases and social prejudice embedded in many medical science studies, often published as objective and unquestionable fact. Although this is an elementary strategy of turning the tables, it is nonetheless effective in demonstrating the continued prevalence of medical science's baseless assumptions, unfamiliarity with gay male cultures, and heterosexist methodology. Back

(2) The spectre of the infectious food handler is frequently used as a medical basis for employment discrimination against gay, lesbian, bisexual, and transgendered people in the formulation of public policy and law. This form of discrimination against gay men is bolstered by the stereotype of the gay male employed as waiter or hospitality servant, representing a fear that gay men have infiltrated and now control every corner of the food service industry. Such fears also justify prominence in medical journal publication, for it purports to serve a larger social good. Back

(3) Several medical publications attempt to use gay stereotypes to create epidemiological traffic patterns, citing the ‘well-known facts’ that gay men travel and relocate residency more frequently, as well as their engagement in ‘bizarre’ sexual practices such as fisting, rimming, and sadomasochism. Examples of this can be found in the work of Eric Z Silfen and Thomas Stari, ‘Gay Bowel Syndrome: A Constellation of GI Disorders Peculiar to Homosexual Males', Consultant July 1982;85–94. Back

(4) Many medical science publications use the term ‘homosexual practices’ or ‘homosexuality’ synonymously with penis-to-anus intercourse, as if this is the only (or even most popular) expression of same-sex sexual behaviour. In addition, ‘homosexual’ is often used in reference only to men, rendering lesbian women invisible or asexual. Back

(5) This is a parody of the classification provided by Norman Sohn and James Robilotti in ‘The Gay Bowel Syndrome: A Review of Colonic and Rectal Conditions in 200 Male Homosexuals', American Journal of Gastroenterology 1997;67(5):478–84. The fact that someone is currently engaging in heterosexual sex is deemed irrelevant by many researchers; a single same-sex experience in the patient's past is enough to taint the individual and permanently classify them as homosexual. Back

(6) Many studies conducted on gay men and infectious diseases use inner city, public, sexually transmitted disease clinics for their sample population. Too often these results are then generalized as a representation of all gay men regardless of socio-economic status and geographic residence. Back

(7) This is a parody of Janet Daling's study on homosexual practices and anal cancer, in which she attempts to establish the validity of her interview instrument by stating that it was developed by ‘modifying questions from our previous studies on reproductive health and cancer, from the questionnaire used by the San Francisco Sexually Transmitted Diseases Clinic and on the advice of a male homosexual’ (italics mine). It would be unthinkable for a peer-reviewed, medical science article to be published in a prestigious journal if the instrument used to measure heterosexual sex practices had been adapted from previous studies of nonreproductive health and based on the advice of a single heterosexual individual who is presumed to speak for all heterosexual people. See Janet Daling, Noel S Weiss, T Gregory Hislop, Christopher Maden, Ralph J Coates, Karen J Sherman, Rhoda L Ashley, Marjorie Beagrie, John A Ryan, and Lawrence Corey, ‘Sexual Practices, Sexually Transmitted Diseases, and the Incidence of Anal Cancer', New England Journal of Medicine 1987;317(16):973. Back

(8) Again, see Sohn and Robiloti. They define the ‘O’ sign as the ability to voluntarily maintain the anus in a dilated position, which in their research is a good indicator of the male patient's homosexuality. Back

(9) Most clinical research on male erectile dysfunction defines potency as one study claims, ‘It is generally agreed ... that vaginal penetration can be considered a suitable criterion of sexual potency’, in Gunilla Ojdeby, Anders Claezon, Elinar Brekkan, Michael Haggman, and Bo Johan Norlen ‘Urinary Impotence and Sexual Impotence After Radical Prostatectomy’, Scandinavian Journal of Urology and Nephrology 1966; 30:473–77. This narrow scope of analysis devoted to the phallic insertive role mirrors much of the sexism in clinical trials involving heterosexual vaginal intercourse, where success is measured in terms of penile erection, vaginal penetration, and sometimes male ejaculation, but not clitoral stimulation or female orgasm.

In a study conducted by E Sterwart Geary, Theresa E Dendinger, Fuad S Freiha, and Thomas Stamey, ‘Nerve Sparing Radical Prostatectomy: A Different View’, Journal of Neurology July 1995;154(1): 145–49, ‘Patients were questioned preoperatively regarding the frequency of sexual intercourse with vaginal penetration. Even if a patient reported normal penile erections he was not considered to be sexually active if he was not engaging in vaginal intercourse’. By this disturbing definition, men who masturbate, have oral or anal sex, or engage in sex with men are not sexually active. Back

(10) In the case of gay bowel syndrome, statements such as these reserve medial science's right to continuously update and revise the definitions of gay health and illness, while maintaining a space in which gay men can be perpetually objectified, fragmented, and scapegoated as responsible for any medical, and therefore social, problems which may arise. See Michael Heller, ‘The Gay Bowel Syndrome: A Common Problem of Homosexual Patients in the Emergency Department’, Annals of Emergency Medicine 1980;9(9):492. Back





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