Drink 20 oz. of Water

Yesterday, I was on the go early. I arrived at the imaging center, ready for a sonogram promptly at 8:50 a.m. The person who had made my appointment told me to be there, and that I was to drink 20 ounces of water (1-1/4 lbs!) one hour before I arrived.

You can imagine my fragile state of mind upon entering the center. The front door told me that this was the right place for ma'amograms and pre-natal sonograms. Nuclear imaging was down the hall. I walked into a room of elderly woman, pregnant women, and day laborers with work injuries.

I signed in, and after a spell, the woman at the desk asked me for my Dr's orders and for my insurance card. She then informed me that my appointment had been cancelled. (Meanwhile, I was doing my little dance.)

I was stunned! I inquired why my appointment had been cancelled, and she replied she didn't know. After some clicks of a mouse and a few keystrokes, it appears that my appointment had been scheduled for the previous day, and that I had not shown up. This was news to me, since I had been very careful to schedule this appointment for yesterday, and had confirmed it at the time of making my appointment. After some to-ing and fro-ing, she rescheduled my appointment for noon.

So at eleven o'clock, I drank another 20 ounces, and headed off for the imaging center at 11:30. This time, they got me in promptly at noon, and got to work immediately.

This was the third sonogram I'd had in my life, but the second I'd had this week. You sprawl out on an examination table, the technician smears some goo (it's glacial mint blue) on a probe that looks something like a rubber spatula, then runs the probe over the skin above the body parts being imaged. The doctors want to see my kidneys and bladder - this in preparation for next Tuesday's biopsy.

The technician asked me to lower my pants, and yes, I wore underwear this time. She then had me hold up my shirt, and she draped my groin with paper toweling and went to work, first my right kidney, then my left kidney, and then my bladder. It's a weird feeling to have someone pushing down on your bladder with a medical device when your bladder has 20+ oz. of liquid inside. I was summoning thoughts of the Kalahari.

Finally, she directed me to the men's room, I came back, and she imaged the bladder again. She told me this was to determine how effectively I emptied my bladder (pretty damn good, I think!).

Medicare

Well, almost. I went to the doctor again, today. It's becoming a habit, except it's always a different doctor. Today was a pre-op physical for my prostate biopsy a week from now. In contrast to the Dr.'s visit on Friday, today was quick, efficient, friendly, and professional. What more could a guy want while worrying about his prostate? I'm grateful for my health insurance coverage.

My doc asked me if my cholesterol was normal. Hello. Isn't that his job? But it's okay. He was having a bad bout of hay fever and was feeling pretty miserable. He looked like warmed over death, too. It's perversely comforting that doctors have maladies just like the rest of us. The white coat only goes so far for disease prevention.

Movie Reviews

Into the Wild is the story of a driven, emotionally immature college graduate who is seeking to expiate the sins of his parents in an ill-fated Alaskan adventure. Emile Hirsch plays the character, Chris McCandless, a lost soul on the road looking for something, creating a myth.

I liked this movie. It's a raw film that captures the arrogance, innocence, and tragic inexperience of youth. Chris's hubris is not letting go of a poisonous past, while fleeing the people who really love him. Chris has a dream, a quest that seduces him. Part of growing older is gaining the experience to know that we don't have to live our dreams. We can be less than our dreams - a discovery Chris makes too late.

Hal Holbrook plays the character, Ron Franz, an old retired army guy who is living a reclusive, fearful life. Chris happens into Ron's life and changes it. Holbrook's performance is masterful and poignant, and is the humane, loving heart of the movie.

Orgazmo (1997) is a sophomoric farce starring Trey Parker as Joe Young, a Mormon missionary cum inconvenient porn star, and Dian Bachar as Ben Chapleski. Through various plot twists, Joe ends up starring in a porn flick as Orgazmo, a sexual superhero with Ben playing Choda Boy, his heroic sidekick.

The plot is contrived, the performances are over the top, this is a good film to watch with beer and popcorn. I really liked this film. It manages to skewer the Mormons, Hollywood, and pornography in one convenient DVD.

Its portrayals should not be mistaken as literary truths. The film takes a lot of license with the facts (e.g. conflating Catholic iconography with Mormon practice), but gets at some deeper truths about the nature of belief, desire, and fame. I want Choda Boy's helmet. I loved the costumes, and I'd really like to try out for the part of "Stunt Cock." P.S. This film is rated NC-17 and is offensive to just about any audience.

The Doctor Is In

Well, maybe not. He did apologize for being late, though. Today I went to see the cardiologist. He isn't nearly as much fun as the urologist, but a lot more demanding.

In February during my annual checkup, my physician noticed some irregularities on my EKG. He said he didn't think that it was serious, but in light of my family history, he wanted my heart checked out by a cardiologist. I had an initial visit with the cardiologist two weeks ago. After my checkup, he said he didn't think anything was amiss, but he wanted to do a stress test, which was scheduled for today.

Before the stress test, a medical technologist performed an echocardiogram. I had to strip from the waist up, which was okay, even though I had forgotten to wear my tightie whities. (I really need a medical visit checklist.) I enjoyed the echocardiogram, because I was able to sleep through most of it. It consists of smearing goo on your chest and abdomen, then the technician holds a scanning device next to the skin. The only collateral damage is a lot of minty-blue goo smeared over your chest.

Then came the stress test. The technician wired me up to an EKG, took my blood pressure, then sat me shirtless (I wish I had six pack abs at this point) in the room for the next 20 minutes or so. I played a video game on my cell phone, but then thought that maybe this would be stress inducing.

Finally, the Doctor ambles in and gives me the shameless apology, "Sorry I'm late." He tells me that I'm going to be audited by the IRS just as he flips on the EKG. And that was the stress test.... Just kidding.

He put me on a treadmill, and started me off at 2.5 miles per hour. The test ran for about 12 minutes, and at the end I was walking at 4.2 miles per hour up a rather steep slope. I was sweating like a mad dog, and trying to act nonchalant. I was worried that my pants were slipping. I was thinking, "I should have worn my gym shorts."

The upshot: my cardiologist has eaten at The Inn at Little Washington, and highly recommends it, although his wife thinks the cost is "obscene." My echocardiogram and EKG appear to be normal, although he's going to look at the results more closely and give me a call next week.

I'm thinking I'm going to check out the Inn at Little Washington. It comes highly recommended.

We Don't Get No Respect

I was riding the train this evening back from square dancing. The husband of one of my former work colleagues was also on the train and struck up a conversation. He asked me, "Are you and Ron still together?" I'm sure he meant no offense (and I didn't take any), but it's a demeaning (and stupid) question. The fact that Ron and I are not married confuses some people. They assume that our relationship must be casual, or not quite as stable, or as real as marriage.

You read it here: Ron and I are still together, and will be for the forseeable future. Next week, we celebrate the 25th year of our casual, not quite stable, not quite real relationship. (No irony, please.)

Character in Fairfax County Schools

The Washington Post published an interesting article summarizing a study about character education in the Fairfax County public schools. The study seems to show that African American and Hispanic students receive lower marks for "sound moral character and ethical judgment." Needless to say, school board members and administration are scratching their heads about a staff study that tries to quantify character and moral behavior.

They should scratch our heads. Here's some examples of what the study considered to be moral behavior for third graders: '"respects school and personal property," "complies with established rules" and "follows through on assignments."' Other skills that were assessed included "contribute effectively within a group dynamic." The Board's goals for students included, '"Model honesty and integrity" and "Respect people, property and authority."' In earlier grades, character evaluation was done by teachers subjectively assessing students. In higher grades part of the moral assessment were based on student incidents that had to be reported to the state.

This quantification of character and moral behavior raises contentious issues. On the one hand, in spite of the "asterisks and footnotes" in the report, some people will maintain that African American and Hispanic students simply lack the character that other students display. That would probably be a false conclusion. Still, persistent educational issues lurk beneath the numbers and the subjective observations that need to be considered thoughtfully by the School Board.

I'm wondering if "complies with established rules" and "Respect... authority" are values that represent moral character. Do these goals and behaviors reflect the needs of the teachers and the education system, or do they promote respect for cultural differences, especially for children who are not part of the mainstream White American culture or who may not be part of the predominate socioeconomic status? Do the behaviors that are subjectively observed reflect the values of the observers or the values of the students? Motive-driven behavior arises from values, but unfortunately, when one observes behavior, one cannot necessarily deduce motive or the underlying values.

I believe that public schools should encourage some core values: participation in the classroom, respect for other's opinions, hard work, cooperation. I think the Fairfax School Board is right in trying to emphasize and assess character education. The puzzle about this study is whether it is really measuring character, or instead, is measuring observer and cultural bias.

Religious Persecution

I was watching CNN last night, and the breaking news about the Texas sheriff's raid on the Fundamentalist Latter-Day Saints' compound, then the busing away of 401 children.

I'm disgusted by the media coverage. It's unbalanced and inflammatory. One commentator called the polygamists a cult. Another talked about statutory rape and abuse, but no one was defining those terms, or telling the public what is really going on.

Admittedly, polygamy, especially from the outside, looks like an ugly, difficult life. But these people are practicing their religion, and they fervently believe it. Furthermore, it's been their way of life for at least a hundred years. This didn't just start happening yesterday! Most apalling to me is that the Texas authorities are seriously thinking about taking children from their parents and placing them in foster care, because of "imminent danger."

Religious freedom doesn't count for much, if you can't practice your religion, no matter how odd that religion seems to the rest of us. Certainly, some of the girls did enter into early marriages, but by the standards of their religion and culture, it certainly isn't rape. What's going on in Texas amounts to state-sanctioned religious persecution.

Media Skank?

Dr. Bonecrusher's office provides many print media opportunities. Today, while waiting for my scheduled pummeling, I picked up Cosmopolitan. Girls, do you actually buy this mag in the supermarket checkout? What kind of boyfriends do you have?

Reading Cosmo makes me happy I'm gay. This magazine walks a fine line between "Fearless Female" and skank. What demographic is this Hearst Communications, Inc. targeting? I thought sexy was different from skanky.

I'm not surprised to see a mag in which women are displayed as sex kittens with claws, and their guys are basically dicks with brains. I just expected more from the 21st Century. And ya, my brain has a dick, but I don't write about it in Cosmopolitan.

Perry Has a New Man in His Life

We went out to dinner last night with Perry, and had a chance to meet the new man in his life: Charley. Charley is eight years old and weighs 16 pounds, a big ol' middle-aged cat. He's very friendly, and didn't mind the introductions at all.

Over dinner, we mused some about Mookie, Perry's recently departed cat. She was very different in temperament and stature than Charley. She was much smaller, and very regal, not a good ol' boy at all. She ruled with an iron-but-velvet paw. So I'm looking forward to getting better acquainted with the new guy in the neighborhood.

We ate at the Austin Grill in downtown Silver Spring. The atmosphere is young family-friendly. The wait staff's average age appears to be something between 10 and 14. We had a very solicitous waiter who always disappeared about the time we wanted to order something or had a question, not that there's anything wrong with that. I do not recommend the pecan pie, although the Joe Ely combo, while perhaps too much food, tasted swell.

So this is what gay men do on Saturday nights in Silver Spring, Maryland.

Exploring Drupal

I'm tired of creating handcrafted websites that require custom functionality. If I could just find a package that had nearly everything, so that I wouldn't have to invent the wheel, I'd be grateful. So, I'm now in the middle of installing Drupal, a website platform package, on one of my websites, then I'm going to play with it. So far, though, installing it has not been straighttforward. I'll eventually get it figured out, though. I even bought the book....

Under the 'Scope

This is another blog entry about my plumbing. In fact, it now appears, that I'll probably have a whole reality TV series about my plumbing! Today, I had a cystoscopy, a camera session with the doc. Those urologists - what great equipment they have!

I had problems finding the office. It's just off a main road. The GPS guidance in the car got me close by, but also got me confused, and it took me a few extra minutes. Have you noticed how doctors' offices tend to be full of unhappy looking people? I feel bad about that. It's like going to the doctor is going to be an unpleasant experience, or something.

Nurse Number One escorts me to the dressing room, which is about the size of a broom closet. She spreads out a plastic sheet-like covering on the bench and says, "Take off all your clothes below your waist, but you can leave your socks on. Put on a gown, open in the back." She is a very cheerful, upbeat nurse. I'm thinking, I trust these people. I'm happy that I'm here.

I remove my shoes and jeans, stuff them, my jacket, and umbrella in the locker and read The Economist. Reading world news calms me, and I think the Economist's style is kind of classy. Nothing like sitting in a closet, half naked, reading about Heathrow Airport. The nurse knocks on the door, then leads me down the hall to the surgical suite.

Aw, very interesting. The suite has what looks like a nice Barcalounger-like chair, which I believe is properly called a "table." It's very comfy. Nurse Number Two begins her briefing. Her voice is calm and well-practiced. She, too, is exceedingly upbeat and is acting almost like I'm doing her a favor by being there. "I'm going to clean the area with a Betadine (iodine) solution. It will feel cold." Boy, did she get that right! "We aren't using any needles." I'm cool with that.

"I'm going to drape you. Please leave your hands on your chest. It is very important that you relax completely." I'm beginning to twitch. "I'm going to take this syringe, no needle, put an applicator on it, and SHOOT THIS NUMBING JELLY UP YOUR PENIS." I'm quite sure she didn't shout, that's just what my ears heard. "You may feel some stinging, and it might be unpleasant."

She's saying this with a very calm, happy voice. Then I remember, I'm the one who's getting jelly shot up his penis, not her. I do feel some stinging, and it's distinctly unpleasant. "Dr., you can come in."

My urologist greets me with a happy smile. He explains that he'll be threading a tube through my urethra so that he and insert a camera into my bladder. We're talking about serious photography here. In the process, he'll be irrigating my urethra with a serious amount of water. "You'll feel like it's wet, and it will feel strange." Well, he certainly got that sensation correctly. I felt like I was peeing on myself, but it's really the flow of water up my urethra into my bladder. Nature is sadly backwards.

The nurse told me how important it is to relax, but it's difficult not to tense up when you feel like you're peeing backwards. I feel small tremors in my thigh and groin, and I have to explicitly remind myself to relax. It stings, it's unpleasant, I feel wet where I don't like to feel wet. The doc backs away from the scope and says, "I'll talk with you in my office as soon as you're dressed."

Betadine solution is all over my crotch, making it look worse than it feels. Nurse Number One comes in and fetches me back to the broom closet. I change into my clothes then go see my urologist. It turns out that this is just the second act. I'll be back in a few weeks for a biopsy. It appears that I have some kind of growth in my prostate that needs to be checked out. The doctor told me that the burning during urination after a biopsy lasts about three weeks. I can hardly wait.

Tea, Enemas, and Men on Film

Okay, we've had sex, we're sitting on his couch drinking tea, and having this random conversation about the prep work involved in getting ready for sex. The tea was very good - I had green and he had peppermint to take care of some subtle congestion, of which he was aware, and I was not. The tea brought a warmth and shine to the moment. I had this flash, that this conversation should be recorded and put up on YouTube, and a lot of perplexed straight people would be wondering exactly how we were sticking what up where to do this before that in order to be... prepared.

He laughed, and we started our bad impressions of In Living Color's Men on Film, which lead to an illuminating discussion about gay stereotyping and self-inflicted victimization. I am so happy I am a gay man!

KhushDC Fundraiser

Ron and I went to the KhushDC fundraiser last night. KhushDC is a South Asian group that fosters support for LGBTQ people in DC Metro's South Asian community. For its fundraiser, the group presented a night of entertainment, food, panel discussion, and dancing around the theme, "Dancing at the Intersections: Understanding Gender Variances in S. Asian LGBTQ Communities."

First off, the food was very good. It's difficult to pull off a really great buffet in a DC bar, but this group did it. We shared our dinner with a Sinhalese Sri Lankan. The South Asian community is very diverse covering many important cultures, languages, and religions.

The performers were Indian, Pakistani, and Tamil. Of course, I know what drag is, but this was something different. Two of the performers, Sudarshan Belsare and Bijli, did some knockout dances based on Pakistani, and Indian traditional dances. The other performer, D'Lo did a stand-up monologue of a Sri-Lankan mother talking about her gay son. It was disturbingly funny.

The panel touched on trans identity and its challenges in the South Asian cultures, but more than that were the deeply moving personal stories of moving from a traditional society's oppression to a personal liberation of self.

Three of the panelists had the vocabulary and philosophical underpinnings to place themselves in the context of a larger social movement. Two of the panelists did not use that lens, but instead, described their personal acts that moved them outside their traditions to a new place where they discovered their own personal freedom.

I liked the title of the evening. The panelists and performers are at the intersections of lots of communities, and maybe fit in none of them. I am not sure why gender is the panic button that it is for so many people. I don't feel threatened by a transgender person's conception of self, and respect for others demands that I honor others as who they truly are.

We all want respect. It's a tough cord to cut. That longing for respect can prevent us from living as we want to be. It can cripple out own notions of self. Somehow, we have to learn to marry our desire to be ourselves with a healthy notion of respect. If respect is never going to come from our families or our societies, we have to find that respect in other places: from families that we make and choose, and we have to build a society that values all of us regardless of our sex, our gender, our orientation.

So thanks KhushDC for the great food, the wonderful entertainment, and the thought-provoking discussion. We need to keep reminding ourselves who we are.

Plumbing

Plumber's Helper
(a Dramatization)

I got my plumbing examined. The word, plumbing, derives from the Latin, plumbum or "lead" as in heavy metal, or "get the lead out." No dignity exists in a urologist's examination room.

The doctor was kind and gentle, but somehow with my pants down, my drawers dropped (yes, I did remember to wear my tighty-whities this time) and me holding my shirttails, I felt undignified as he sat before me and examined my penis and scrotum. I'm usually quite capable of sustaining conversations on almost nearly any subject, but I had an exceedingly difficult time at that moment telling the doctor about my penis's oral history. My plumbing had let me down.

Then he asked me to turn around, set my elbows on the table - well those men among you of a certain age know what happened next. He performed that exam in an efficient, experienced (and I might say, pleasurable) manner that bespoke of thousands of others who had rested their elbows in exactly the same place on that exam table. Maybe that's a (small) reward for wayward plumbing, and a visit to the urologist.

Ronald Haines

Bishop Ronald H. Haines died on Good Friday. I just read his obituary in the Washington Post. He was a good man who lived his convictions. He believed that the church was open to all. He confronted sexism and racism in the church. He supported the ministry of gay people. He paid a very personal price for his beliefs and his actions. His presence will be missed.

Caught in the Act!

Ron in Flagrante Delicto
Photo credit: ButterKup

Here's a picture of Ron eating ice cream at Baskin and Robbins! He's eating high dairy fat ice cream. You saw it here first! I mean, I offered the guy Daiquiri Ice, but he said he was tired of it, and he wanted to walk on the wild side! Well, he certainly outdid himself, didn't he? Look at that sly smile, as he sneaks a taste in front of the stealth camera. America's going to be shocked, that's all I can say. Move over Barack; get out of the way Hillary. This is the real breaking news story, and it happened, right here in Wheaton. Way to go!

Food So Good

Last night for dinner I was at Moby Dick, a small sushi restaurant in Wheaton. I was eating alone, contemplating life, and suddenly found myself thinking, "It's sinful how good this food tastes!" I was marveling at my Maryland crab roll. Maybe it was the moment, but it was, it was a awestruck moment for which I am grateful. I was caught up in the act of eating truly wonderful food. It was the crunchiness of the cucumbers against the backdrop of wasabi, perfectly cooked rice, and a slightly salty, sensuous crab filling finished off with sesame seeds. It was a perfect moment.

I love food, but it's rare that I get caught up in it so completely, and I'm very happy that I did. I was delighted.

Sunday Dinner

Jerry came over for dinner on Sunday. He's the guy who organized the sailing trip in the Caribbean. I was on for cooking. Jerry pointed out that my kitchen is somewhat more accommodating than the galley on the sailboat. Dinner consisted of greens (with tomato and avocado), eggplant and portabello mushrooms with mozzarella cheese, braised brussel sprouts, roasted yams and white potatoes, and butterscotch pudding. The pudding was Jello cooked, but talk about evoking childhood memories! And it tastes so good.

We had a nice evening, talking about retirement plans, sailing friends, and the peculiar social and sexual habits of some gay men. Jerry's planning a cycling trip across the U.S. next year. It's far more ambitious than anything I would undertake, but he's in better shape than I am, too. I think he will see America as it is meant to be seen. I'm excited for him.

More on Safer Sex

The only safe sex is complete abstinence. If you can't live with that, then you have to work with "safer sex." As a sexually active gay guy, I have my own notion of safer sex. I like the definition on one of Planned Parenthood's web sites:

Safer Sex is about getting maximum pleasure out of your sex life with minimum risk!

The article goes on to discuss some safer sex stories, and some safer sex guidelines. It's a good place to start.

So let's examine this definition a little more: The first part of the definition is, "getting maximum pleasure out of your sex life." You really have to know what kinds of sexual behaviors you want, or want to try out. What are your fantasies? What turns you on?

I believe that you don't have to give up what you want, although you may have to temper it with some prudence, which brings us to the second part of the definition: "with minimum risk." You need to know the risks associated with different sexual acts. You need to know your partners' sexual histories (as well as you own). You have to develop the communication skills to communicate with your partners.

Much information is available about risks associated with different sexual behaviors. Some behaviors, such as mutual masturbation, are much safer, say, than anal sex. That is, a range of risks can be associated with a range of behaviors. Using condoms and other barriers significantly and dramatically reduces risk of infections, if the barriers are used correctly. The important point, here, is to get educated about the risks associated with the different behaviors, and the risks that you are okay with.

You also need to know your own sexual history. What do you do in bed? How risky is your behavior? When was the last time you were tested for HIV, hepatitis B, and other STDs? What is your HIV and hepatitis B status? Have you been vaccinated for hepatitis A and B? How many sexual partners do you have? Do you know your partners?

Ask your partner about his history. When was he last tested? Does he know you? What kind of sex does he want with you (other than "hot"). What's his HIV and hepatitis B status? Do you trust him? Is he telling the truth?

So how do you have this conversation with your partner? The conversation can start in many ways. For example, if you have a profile on a sex site, you can include some of your sexual history in your profile, and you can look for profiles of potential partners that include similar sexual histories. Talk with your partner before you have sex! A phone call or an email is a good place to begin. It may be easier than face-to-face. Then again, before you take off your clothes, talk to him and ask him his expectations, review your sexual histories, and tell him what's acceptable to you, and what's not.

This safer sex conversation is a big deal, and it's probably the hardest part of safer sex. So how do you prepare for the conversation? Role play the conversation with yourself out loud with a friend, or in front of a mirror. Rehearse the talk, until you feel comfortable with it. Then use that talk with your sexual partners. Other than always using a condom or other barrier, this conversation is the single most important element in reducing your risk.

Finally, learn how to act on this conversation. If your partner wants to do things that you think are too risky, either say "No" or negotiate for a less risky behavior that matches your mutual desires.

If you and your partner want to play in ways that would ordinarily be considered risky (for example, bareback anal sex) you really have to evaluate your situation. Do you trust him to be telling you the truth about his sexual history? How long have you known him? How long has it been since you both were tested? Are you both disease free? Is this behavior worth the risk of contracting a life-threatening disease? Even in this situation, you have choices, just think through the choices before you take off your clothes.

Happy's Safer Sex Thoughts

As chronicled on Doodle Today, I recently contracted a sexually transmitted infection, which was easily treated. The experience has made me think about my sexual habits, and I wanted to invite a more public discussion among gay men about what constitutes safer sex.

I advocate the following approach:

• Decide what sexual behaviors you desire.
• Acquaint yourself with the risks associated with those sexual behaviors. Educate yourself about risk.
• Devise a behavioral strategy that lets you engage in the behavior you enjoy while mitigating the associated risk.
• Communicate openly with your sexual partners about what you will and won't do.
• Evaluate how well your behavioral strategy works.
• Be vigilant.

Safer sex is not about elminating risk; it's about weighing risk, deciding what's an acceptable level of risk, and adapting behavior to mitigate unacceptable risk. To do this, you need information. A lot of information is out there about specific behaviors, but very little of it actually quantifies risk, which means that you have to use your own judgment, and you may make wrong choices.

I have a couple of goals in my safer sex practices: (1) I want to, as far as possible, prevent getting infected with HIV, and (2) I want to prevent getting infected with hepatitis. Many other diseases can also transmitted sexually, but these two are the big ones for me. Others to be aware of include herpes, HPV, gonorrhea, syphilus, chlamydia, and amoebiasis. These other infections can be severe but appear to me to be associated with less health risk than either HIV or hepatitis. (I may be wrong about this.)

I've created the table, below, that lists common gay male sexual behaviors, some associated risks, and some risk mitigation. This table is by no means complete, and contains information that may not be medically proven or sound. Some of this may be highly controversial, but the objective of this is to get a discussion started, and to get gay men thinking again about how to have enjoyable sex while reducing their risk of sexually transmitted disease.

Sexual Behavior	Associated Risks	Mitigation Behaviors
Kissing	Herpes	Avoid kissing others if you are having an oral herpes outbreak or cold sores. Don't kiss other guys who have cold sores. Ask your partner if he has had herpes or cold sores.
Deep Kissing	Herpes, gonorrhea(?), chlamydia(?)	Flossing or brushing your teeth immediately before deep kissing can cause small cuts or abrasions in the mouth that could be a route for infection. [SFAF, 2007] Avoid deep kissing if you are having a herpes outbreak or cold sores. Ask your partner if he has had herpes or cold sores. Gonorrhea and chlamydia can occur in the throat. However, I have not read that they can spread through deep kissing.You should ask your partner whether he has been tested for gonorrhea and chlamydia.
Mutual Masturbation	Syphilus, herpes, gonorrhea(?)	You increase risk of an infection if you stroke another guy who has sores, ulcers or discharges caused by STDs then stroke yourself [S-CDC, 2008]. If you have syphilis or herpes and sores are present on your penis, do not mutually masturbate with another guy. Look at your partner's penis. If he has sores on it, or any discharge that looks abnormal, do not touch his penis! You can pretty much eliminate the risk by using latex gloves [SFAF, 2007].
Oral Sex	Syphilis, herpes, gonorrhea, HIV, hepatitis A and B, chlamydia	Without ejaculation, the risk of HIV infection is very low [USCF, 2003]. In unprotected oral sex, with ejaculation, the risk for the receptive partner is about 1/7 or less than the risk of HIV infection for a receptive partner in unprotected anal sex [ucsf, 2003].You greatly minimize chance of infection by using a condom during oral sex. Having said that, I know few gay men who do. The guy who is sucking is at greater risk than the guy who is getting sucked. Deep throating ("face fucking") is riskier for both guys than vanilla oral sex [SAP, n.d.]. Other precautions include waiting at least 15 minutes after flossing or brushing teeth before engaging in oral sex. Look at the other guy's penis before you stick it in your mouth. If he has discharges, sores, or ulcers (e.g., gonorrhea or syphilis) other than pre-cum, beware. If it looks skanky, it probably is.
Anal Sex	Syphilis, herpes, gonorrhea, HIV, hepatitis A and B, chlamydia	Having anal sex without a condom is a risky activity for all of the listed STDs. Being a bottom is much riskier for HIV infection than being a top in unprotected sex. The risk for a bottom is approximately a 3 percent chance of HIV infection. For a top, the risk is approximately .1 percent for HIV infection [AFOA/NAPWA, 2001]. This study also concluded about HIV transmission during anal sex that the higher a person's viral load the higher the chance of transmission; the higher the number of parters, the greater the risk; the longer and more vigorous activity, the greater the risk; pulling out before cumming is safer; having other untreated STDs increases the chance of transmission [AFOA/NAPWA, 2001]. Douching before anal sex may increase your risk of infection [SAP, n.d.]. You can greatly minimize your risk of infection by always using a condom.
Rimming	Herpes, Gonorrhea, syphilis, hepatitis B, amoebiasis	HIV is not transmitted through rimming. The big risk with rimming is hepatitis B. If you haven't been vaccinated, get it done now. Successful vaccination eliminates your risk of hepatitis B infection. If you are not vaccinated or cannot form hepatitis B antibodies, you can reduce your risk by giving up rimming, by using a barrier (plastic kitchen wrap works well), and/or having a conversation with your partner to determine whether he has been exposed to or had hepatis B or has been vaccinated. If the latter, and you trust that he is telling the truth, well stick your tongue where you will. The other really unpleasant and debilitating infection you can get from rimming is amoebiasis. It's extremely unpleasant, and the treatment is extremely unpleasant.
Fisting	HIV, hepatitis A and B, gonorrhea, syphilis	In fisting, the risk is spreading infection from the guy being fisted to the partner who is inserting his hand [SFAF, 2007]. The mode of infection is through any cuts or sores on the hand. You greatly reduce the risk of spreading infection if you use latex gloves.
S&M	--	The risk of infection during an S&M encounter depends on the sexual behavior you have during the encounter (see above behaviors). If you are going to be shaving, piercing, or doing anything that can cause bleeding, you can minimize risk of infection by using gloves, and keeping blood off of any cuts or sores. If you play watersports, it may create a mess in your dungeon, but the good news is that it's overall a low-risk activity.
Toys	Just about everything listed above	The easiest way to reduce risk of shared infection with toys is not to share them. If you do share, always wash the toy with an antibacterial soap. You can also use condoms on the toys. It helps with the cleanup, too.

If you always use condoms (and gloves for fisting), you greatly reduce your risk of infection. If you limit the number of partners that you have, you reduce your risk of infection. You don't eliminate it, though. Be careful how you play. Be open and honest about your sexual history with other guys. Finally, when you talk to your doctor, or to an STD clinic counselor, ask them to clarify, and where possible to quantify risk associated with sexual behaviors so that you can make informed judgments about the risks, and decide how you will avoid or lower them. And, of course, you can just decide not to have sex at all, but that's not an option for most of us.