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Wednesday, 8th December 2010

Health Hazards of “Don't Ask, Don't Tell”

Health Hazards of “Don't Ask, Don't Tell”
Source: New England Journal of Medicine

Recognizing that “don't ask, don't tell” compromises the medical care of gay, lesbian, and bisexual service members by stymieing normal lines of questioning in clinical encounters, the American Medical Association rightly came out against the policy in 2009.4 On those same grounds, in November the Executive Committee of the California STD Controllers Association, on which I serve as secretary–treasurer, took a position in favor of repealing “don't ask, don't tell.” The ethical dilemmas that physicians face when attempting to provide appropriate clinical care in the context of “don't ask, don't tell” have also been detailed in the medical literature.5

Moreover, the policy leads to wild-goose chases that squander public health resources. After being diagnosed with an STD at a military treatment facility, one active-duty gay service member told me, he was compelled to provide the names of and contact information for his sex partners, who were to be contacted by the treatment facility and informed that they had been exposed to an STD. Rather than identify the man with whom he had actually had sex, the service member provided the name of a female friend. He then called his friend to make sure she was prepped for a call from the military about an STD exposure. Sure enough, she was contacted by the facility. Meanwhile, the service member, on his own, told his male partner to go to the municipal STD clinic.

The consequences of “don't ask, don't tell” are clear. Infections go undiagnosed. Service members and their partners go untreated. Appropriate STD- and HIV-prevention messages, tailored to the types of sex gay, lesbian, and bisexual service members are having, go undisseminated.

In addition to gay troops themselves, the military as a whole also loses. STDs cause illness that can compromise troop readiness and increase the likelihood of HIV acquisition. Once infected with HIV, service members cannot, except in rare circumstances, be deployed on combat missions. Meanwhile, their health care costs, borne by the military, are substantial.


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