Hailing from Australia, but recently seen educating us at CLAW this year, Dr George has amazing advice to keep ourselves healthy, in so many ways. This month, we are highlighting his first conversation with John Hernandez over at Bear World Mag – we will keep you posted with all his amazing advice.
Dr. George Forgan-Smith, The Healthy Bear doctor is here and ready to address all of your pressing medical and sexual health concerns!
As sexually active gay bears there are few things more vital to have than a dependable doctor you can trust. As bears we tend to be larger and heavier than average guys which may have an impact on our skeletal, muscular and circulatory systems. Notice I used the term ‘may have’ because as far as both myself and Dr. George are concerned, being heavy doesn’t necessarily translate to being unhealthy. As sexually active gay men, many of us will encounter issues related to our anal health and perhaps contract an STI (or two) at some point along our journey.
Having a doctor you can be open and honest with is the key to navigating these health concerns, unique to our population. I know not all of us have that luxury. A lot of doctors prejudge people of size the minute they walk through their door. Or conversely, if your doctor is open minded about weight and body size, then perhaps they fall short in understanding gay sexual health issues. That is why I sought out a doctor for the Bear World readership that could advise us in these matters, or at the very least point us in the right direction.
Dr. George is an amazing man; funny, humble and extremely dedicated to the bear, leather and kink communities which he serves faithfully in Melbourne, Australia. In addition to working at the Collins Street Medical Centre and creating tons of educational content for his social media accounts (links below), he is the creator of The Healthy Bear website which he uses to share vital health information pertaining to and about our community.
I am happy to announce that he will also now be joining us monthly here at BWM to discuss different health topics impacting our daily lives. But before we get to that, I thought it only proper that I introduce you to him, his work and his philosophy.
John Hernandez: Hey Dr. George, I cannot tell you how thrilled I am to be working with you! I love your work and I think the Bears in our readership will too. Let’s dive right in! What area of medicine do you practice or consider to be your area of expertise?
Dr. George Forgan-Smith: Definitely Gay Men’s Health. 90 to 95% of my work every day is in gay men’s health, whether that be sexual health or some of the medical issues that come as a result of being gay.
John: And where did you study? Can you share a bit of your history in practicing medicine?
Dr. George: I got my degree in medicine in Brisbane. Australia. I worked in emergency medicine, and then mainly psychiatry until one of my supervisors suggested I go and become a GP (General Practitioner), which sounded like a good idea based on my interests.
And so I went and I moved to Byron Bay, sort of like the Sedona of Australia, and I trained as a GP there. Then I decided that as lovely as it was to be at the beach, I needed to be in a bigger, gayer, more vibrant city, so I moved to Melbourne where I really became focused in on gay men’s health. And I’ve been doing it ever since and just loving it.
John: When did you launch The Healthy Bear and why?
Dr. George: Oh my gosh, it would have to be at least 10 or maybe even 15 years ago.
I created The Healthy Bear to provide resources for gay men and bears.
I was at a sauna one night and a person had overdosed on what I assume was GHB and his friend was looking after him by hanging his head over the toilet bowl. The guy was vomiting and choking at the same time and so I sort of slammed on the door and said “Can we just take him outside please?!” I took him outside, resuscitated him, got an ambulance and got him off to the hospital. But the thing that got me was that nobody knew what to do. So, I created an article that explained how to look after somebody and keep them alive if they’ve overdosed.
That was pretty much the first article that I ever wrote, and it got published in one of the local gay papers and I just sort of thought… “Well, I’ll just keep on doing this.” The Healthy Bear was a result of an understanding that good quality information needed to be out there. To this day I try to provide good, evidence-based health information with a gay or a bear spin on it.
I also started The Healthy Bear because I was a bigger bloke back then and I noticed that the Bears hated going to the doctor. And the reason for that was because doctors kept on telling them they were fat and they needed to lose weight. But body mass is only one parameter for health. There are lots of other things that we could look at, so, I just started concentrating on those things and was slowly able to pass on the message, through The Healthy Bear, that you can be heavy and be healthy at the same time.
From there, I gradually ended up doing a lot of sexual health stuff and a lot of education. I believe that I teach folks stuff that other doctors aren’t currently teaching their patients and because of that, instead of just passing it on to one person at a time, I’ll make a video and that way multiple people can receive that information quick, easy and at the same time.
Just recently, I was in one of Melbourne’s biggest, sex stores, where I was going through toys and lubes and just explaining some simple concepts that just aren’t explained to gay men. I talked about things like how to deal with a toy that’s fallen inside your body or, which lubes are best for sex and why water-based lube sucks for anal. I like to think that I’m that sex positive doctor.
John: I’d say you are! Where have you been all my life, doc?! (Laughs) But seriously a lot of big men, myself included, are written off by medical professionals because of our weight and if we’re lucky enough to avoid that kind of treatment than its really hard to find a sex positive/ queer doctor to talk about the unique health issues we as gay men and bears face. Speaking of which, do you identify as a bear? Do you hang out much in the scene?
Dr. George: When I was a big boy, I was definitely a bear but, I’ve got a fractured spine, so I had to lose weight to take the pressure off my back. But, yeah, absolutely! I’m connected with the bear scene as well as the leather scene and the kink scene.
But I’ve got to say that Covid’s really f***** with my head a little bit. So, I’m a little bit more homebound these days, but I’m in the process of slowly emerging out of this pandemic – which is still happening, by the way!
John: When you’re right you’re right doc. What would you say are the biggest health concerns for the bear community?
Dr. George: For the Bear community, I would say disengagement with health. We know that gay men, particularly marginalized gay men like Bears are already behind the eight ball because many of them don’t have regular medical care, for the reasons mentioned earlier. They don’t have a doctor that they see regularly, or they have fractured medical care. A lot of people come to me just for PrEP And I’m slowly training them up so that I’ll take their blood pressure when I do their PrEP follow ups or I’ll say “Hey are you aware that about this vaccine?” Like with monkey pox, I was at one of five clinics in Melbourne that was doing the monkey pox vaccine.
So, while I think sexual health is always going to be an important health issue for Bears, I think Improving quality of care for people and encouraging engagement with health providers is a bigger issue.
I’m always encouraging people to try and find doctors that they can feel safe with. And on the other side of the coin, I’m training doctors to provide safe care, or at least to provide same care to queer men that’s not based off prejudice, which unfortunately a lot of people do.
Beyond that. I think if we look at the data, the bigger problems within the LGBTI community are really based around depression, anxiety, mental health issues, substance abuse and body dysmorphia.
John: I like that you keep pulling us back to what the data says. I often feel that medical data and studies are lacking in relation to our community. What are your views on current medical data?
Dr. George: A lot of the information that is currently being used is biased against bigger people. It’s biased against homosexuals. It’s biased against people of color. We don’t acknowledge that gay people literally have different health needs than our straight counterparts. We also don’t acknowledge that people of color have different health needs either.
We have to talk about this so we can create awareness and through awareness, understanding and change, making it easier for everyone.
Say, for example, U=U. Within HIV circles, people knew that if they were taking their medicines, and they had an undetectable viral load that they weren’t infecting anybody. They knew that. And different scientific groups all knew this, but they didn’t talk to each other and make a universal policy to go to the public with. It was probably five, or maybe seven years ago that a group came together and brought all of those people to the table and said, “Hey, look, you realize that undetectable viral loads can’t be transmitted…right?” And then they all spoke about it and then finally a policy was made.
With situations like this I think first we have to get the information out there and then we actually have to push for systemic change. But first, there has to be people who are prepared to say “Well actually no, your data is wrong. This is the data and here’s how we move forward.” And I think education will always be the key to that.
John: Education is always the key. Absolutely. I was wondering, in Australia, are there any specific STIs on the rise? And how would you encourage Bears to better look after their sexual health?
Dr. George: Here in Melbourne, I have a little box of treatment for gonorrhea in my office and I empty it most weeks. Chlamydia is endemic, it’s everywhere, syphilis and gonorrhea, the big three, we see plenty of those and also, interestingly, microplasmic genitalium.
Microplasmic genitalium is a long-standing STI. We don’t routinely test for it because it’s near impossible to treat because of antibiotic resistance, but we have to be aware when it’s there. So when you have people who have symptoms, but test negative, for chlamydia, gonorrhea and syphilis, you have to test for microplasmic genitalium, and often you’ll find it.
With regards to encouraging people to take better care of their sexual health, PrEP has changed everything. People are required to come in for STI screenings every three months to get a new script and that’s made a big difference.
We need to get more people on board with this though because the only people I am currently seeing seroconvert into HIV positive are generally people in rural settings because they don’t have good engagement with health professionals. They live in places where that doctor may have looked after them from when there were a kid and so they don’t feel comfortable to admitting that they have sex with other men. We need to make it easier for people to access PrEP.
Essentially, we need to kind of “undoctify” a lot of health stuff, but the problem is, how do we manage that? And I don’t think we’ve mastered that yet. But we’ll get there…
John: I think you’re onto something there Dr. George. Do you have any health tips that you could give the readers to implement immediately in order to improve their overall health?
Dr. George: Sure! Love many, hate few, always paddle your own canoe!! (Laughs)
But seriously, YOU are in control. So, what I urge people primarily to do is to find a doctor that they feel comfortable with. You may have to audition several doctors in some places. If you are stuck with a doctor and they suck, or if they’re homophobic, or if you don’t feel comfortable with them, it’s not going to be a good outcome. So, you have to find a doctor that you can have an honest and open conversation with.
Check your testicles! Make sure there’s no lumps on them. If you are feeling down, if you’re feeling depressed, talk with somebody about that. The two main killers of young men are: suicide, that’s number one, but second are cancers like testicular and skin.
I’d also recommend walking. If you can get 20 to 30 minutes of walking in per day, you’d be amazed at the changes that will happen, your liver will work better, your testosterone will work better, your insulin will work better, your thyroid hormone will work better.
If you are living with a disability and you can’t use your legs, then hopefully you’re able to get into a pool or can talk with a physical therapist about ways that you can incorporate movement into your life.
But I suppose the real thing is that we just need to get to a point where we can actually have the conversation to start with.
John: That’s amazing advice Dr. George. Thank you so much for taking the time to talk with me. I am really looking forward to the knowledge you will impart to us in the coming months.
If you have any questions for Dr. George email them to firstname.lastname@example.org and we will try to have him answer the most popular and/or unique ones.
And be sure to check out his website The Healthy Bear.
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