Instability and promiscuity typically characterize homosexual relationships. These two factors increase the incidence of serious and incurable stds. In addition, some homosexual behaviors put practitioners at higher risk for a variety of ailments, as catalogued by the following research data:

Risky Sexual Behavior on the Rise Among Homosexuals. Despite two decades of intensive efforts to educate homosexuals against the dangers of acquired immunodeficiency syndrome (AIDS) and other stds, the incidence of unsafe sexual practices that often result in various diseases is on the rise.

· According to the Centers for Disease Control and Prevention (CDC), from 1994 to 1997 the proportion of homosexuals reporting having had anal sex increased from 57.6 percent to 61.2 percent, while the percentage of those reporting "always" using condoms declined from 69.6 percent to 60 percent.[2]

· The CDC reported that during the same period the proportion of men reporting having multiple sex partners and unprotected anal sex increased from 23.6 percent to 33.3 percent. The largest increase in this category (from 22 percent to 33.3 percent) was reported by homosexuals twenty-five years old or younger.[3] Homosexuals Failing to Disclose Their HIV Status to Sex Partners

· A study presented July 13, 2000 at the XIII International aids Conference in Durban, South Africa disclosed that a significant number of homosexual and bisexual men with hiv "continue to engage in unprotected sex with people who have no idea they could be contracting HIV."[4] Researchers from the University of California, San Francisco found that thirty-six percent of homosexuals engaging in unprotected oral, anal, or vaginal sex failed to disclose that they were HIV positive to casual sex partners.[5]

· A CDC report revealed that, in 1997, 45 percent of homosexuals reporting having had unprotected anal intercourse during the previous six months did not know the HIV serostatus of all their sex partners. Even more alarming, among those who reported having had unprotected anal intercourse and multiple partners, 68 percent did not know the HIV serostatus of their partners.[6]

Young Homosexuals are at Increased Risk. Following in the footsteps of the generation of homosexuals decimated by AIDS, younger homosexuals are engaging in dangerous sexual practices at an alarming rate.

· A Johns Hopkins University School of Public Health study of three-hundred-sixty-one young men who have sex with men (MSM) aged fifteen to twenty-two found that around 40 percent of participants reported having had anal-insertive sex, and around 30 percent said they had had anal-receptive sex. Thirty-seven percent said they had not used a condom for anal sex during their last same-sex encounter. Twenty-one percent of the respondents reported using drugs or alcohol during their last same-sex encounter.[7]

· A five-year CDC study of 3,492 homosexual males aged fifteen to twenty-two found that one-quarter had unprotected sex with both men and women. Another CDC study of 1,942 homosexual and bisexual men with HIV found that 19 percent had at least one episode of unprotected anal sex--the riskiest sexual behavior--in 1998 and 1997, a 50 percent increase from the previous two years.[8]

Homosexual Promiscuity. Studies indicate that the average male homosexual has hundreds of sex partners in his lifetime:

· A.P. Bell and M.S. Weinberg, in their classic study of male and female homosexuality, found that 43 percent of white male homosexuals had sex with 500 or more partners, with 28 percent having 1,000 or more sex partners.[9]

· In their study of the sexual profiles of 2,583 older homosexuals published in Journal of Sex Research, Paul Van de Ven et al., found that only 2.7 percent claimed to have had sex with one partner only. The most common response, given by 21.6 percent of the respondents, was of having a hundred-one to five hundred lifetime sex partners.[10]

· A survey conducted by the homosexual magazine Genre found that 24 percent of the respondents said they had had more than a hundred sexual partners in their lifetime. The magazine noted that several respondents suggested including a category of those who had more than a thousand sexual partners.[11]

· In his study of male homosexuality in Western Sexuality: Practice and Precept in Past and Present Times, M. Pollak found that "few homosexual relationships last longer than two years, with many men reporting hundreds of lifetime partners."[12]

Promiscuity among Homosexual Couples. Even in those homosexual relationships in which the partners consider themselves to be in a committed relationship, the meaning of "committed" typically means something radically different from marriage.

· In The Male Couple, authors David P. McWhirter and Andrew M. Mattison reported that in a study of a hundred-fifty-six males in homosexual relationships lasting from one to thirty-seven years, Only seven couples have a totally exclusive sexual relationship, and these men all have been together for less than five years. Stated another way, all couples with a relationship lasting more than five years have incorporated some provision for outside sexual activity in their relationships.[13]

· In Male and Female Homosexuality, M. Saghir and E. Robins found that the average male homosexual live-in relationship lasts between two and three years.[14]

Unhealthy Aspects of "Monogamous" Homosexual Relationships. Even those homosexual relationships that are loosely termed "monogamous" do not necessarily result in healthier behavior.

· The journal AIDS reported that men involved in relationships engaged in anal intercourse and oral-anal intercourse with greater frequency than those without a steady partner.[15] Anal intercourse has been linked to a host of bacterial and parasitical sexually transmitted diseases, including AIDS.

· The exclusivity of the relationship did not diminish the incidence of unhealthy sexual acts, which are commonplace among homosexuals. An English study published in the same issue of the journal AIDS concurred, finding that most "unsafe" sex acts among homosexuals occur in steady relationships.[16]

Human Papillomavirus (HPV). HPV is a collection of more than seventy types of viruses that can cause warts, or papillomas, on various parts of the body. More than twenty types of HPV are incurable STDs that can infect the genital tract of both men and women. Most HPV infections are subclinical or asymptomatic, with only one in a hundred people experiencing genital warts.

· HPV is "almost universal" among homosexuals. According to the homosexual newspaper The Washington Blade: "A San Francisco study of Gay and bisexual men revealed that HPV infection was almost universal among HIV-positive men, and that 60 percent of HIV-negative men carried HPV."[17]

· HPV can lead to anal cancer. At the recent Fourth International AIDS Malignancy Conference at the National Institutes of Health, Dr. Andrew Grulich announced that "most instances of anal cancer are caused by a cancer-causing strain of HPV through receptive anal intercourse. HPV infects over 90 percent of HIV-positive gay men and 65 percent of HIV-negative gay men, according to a number of recent studies."[18]

· The link between HPV and cervical cancer. Citing a presentation by Dr. Stephen Goldstone to the International Congress on Papillomavirus in Human Pathology in Paris, the Washington Blade reports that "HPV is believed to cause cervical cancer in women."[19]

Hepatitis: A potentially fatal liver disease that increases the risk of liver cancer.

· Hepatitis A: The Mortality and Morbidity Weekly Report published by the CDC reports: "Outbreaks of hepatitis A among men who have sex with men are a recurring problem in many large cities in the industrialized world."[20]

· Hepatitis B: This is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Each year in the United States, more than 200,000 people of all ages contract hepatitis B and close to 5,000 die of sickness caused by AIDS. The CDC reports that MSM are at increased risk for hepatitis B.[21]

· Hepatitis C is an inflammation of the liver that can cause cirrhosis, liver failure and liver cancer. The virus can lie dormant in the body for up to thirty years before flaring up. Although less so than with hepatitis A and B, MSM who engage in unsafe sexual practices remain at increased risk for contracting hepatitis C.[22]

Gonorrhea: An inflammatory disease of the genital tract. Gonorrhea traditionally occurs on the genitals, but has recently appeared in the rectal region and in the throat. Although easily treated by antibiotics, according to the cdc only "about 50 percent of men have some signs or symptoms, and "many women who are infected have no symptoms of infection."[23] Untreated gonorrhea can have serious and permanent health consequences, including infertility damage to the prostate and urethra.

· A CDC report documents "significant increases during 1994 to 1997 in rectal gonorrhea . . . among MSM," indicating that "safe sex" practices may not be taken as seriously as the aids epidemic begins to slow.[24] In 1999 the CDC released data showing that male rectal gonorrhea is increasing among homosexuals amidst an overall decline in national gonorrhea rates. The report attributed the increase to a larger percentage of homosexuals engaging in unsafe sexual behavior.[25]

· The incidence of throat Gonorrhea is strongly associated with homosexual behavior. The Canadian Medical Association Journal found that "gonorrhea was associated with urethral discharge . . . and homosexuality (3.7 times higher than the rate among heterosexuals)."[26] Similarly, a study in the Journal of Clinical Pathology found that homosexual men had a much higher prevalence of pharyngeal (throat) gonorrhea--15.2 percent compared with 4.1 percent for heterosexual men.[27]

Syphilis: A venereal disease that, if left untreated, can spread throughout the body over time, causing serious heart abnormalities, mental disorders, blindness, and death. The initial symptoms of syphilis are often mild and painless, leading some individuals to avoid seeking treatment. According to the National Institutes of Health, the disease may be mistaken for other common illnesses: "syphilis has sometimes been called 'the great imitator' because its early symptoms are similar to those of many other diseases." Early symptoms include rashes, moist warts in the groin area, slimy white patches in the mouth, or pus-filled bumps resembling chicken pox.[28]

· According to the CDC, "transmission of the organism occurs during vaginal, anal, or oral sex."[29] In addition, the Archives of Internal Medicine found that homosexuals acquired syphilis at a rate ten times that of heterosexuals.[30]

· The CDC reports that those who contract syphilis face potentially deadly health consequences: "It is now known that the genital sores caused by syphilis in adults also make it easier to transmit and acquire HIV infection sexually. There is a two to five fold increased risk of acquiring hiv infection when syphilis is present."[31]

Gay Bowel Syndrome (GBS):[32] The Journal of the American Medical Association refers to GBS problems such as proctitis, proctocolitis, and enteritis as "sexually transmitted gastrointestinal syndromes."[33] Many of the bacterial and protozoa pathogens that cause gbs are found in feces and transmitted to the digestive system: According to the pro-homosexual text Anal Pleasure and Health, "[s]exual activities provide many opportunities for tiny amounts of contaminated feces to find their way into the mouth of a sexual partner . . . The most direct route is oral-anal contact."[34]

· Proctitis and Proctocolitis are inflammations of the rectum and colon that cause pain, bloody rectal discharge and rectal spasms. Proctitis is associated with STDs such as gonorrhea, chlamydia, herpes, and syphilis that are widespread among homosexuals.[35] The Sexually Transmitted Disease Information Center of the Journal of the American Medical Association reports that "[p]roctitis occurs predominantly among persons who participate in anal intercourse."

· Enteritis is inflammation of the small intestine. According to the Sexually Transmitted Disease Information Center of the Journal of the American Medical Association, "enteritis occurs among those whose sexual practices include oral-fecal contact."[36] Enteritis can cause abdominal pain, severe cramping, intense diarrhea, fever, malabsorption of nutrients, weight loss.[37] According to a report in The Health Implications of Homosexuality by the Medical Institute for Sexual Health, some pathogens associated with enteritis and proctocolitis [see below] "appear only to be sexually transmitted among men who have sex with men."[38]

HIV/AIDS Among Homosexuals. The human immunodeficiency virus (HIV) is responsible for causing AIDS, for which there exists no cure.

· Homosexual men are the largest risk category. The CDC reports that homosexuals comprise the single largest exposure category of the more than 600,000 males with AIDS in the United States. As of December 1999, "men who have sex with men" and "men who have sex with men and inject drugs" together accounted for 64 percent of the cumulative total of male AIDS cases.[39]

· Women risk contracting HIV/AIDS through sexual relations with infected MSM. According to the CDC, "HIV infection among U.S. women has increased significantly over the last decade, especially in communities of color. cdc estimates that, in the United States, between 120,000 and 160,000 adult and adolescent females are living with HIV infection, including those with AIDS." In 1999, for example, most of the women (40 percent) reported with AIDS were infected through heterosexual exposure to HIV.[40] That number is actually higher, as "historically, more than two-thirds of AIDS cases among women initially reported without identified risk were later reclassified as heterosexual transmission."[41]

· Homosexuals with HIV are at increased risk for developing other life-threatening diseases. A paper delivered at the Fourth International AIDS Malignancy Conference at the National Institutes of Health reported that homosexual men with HIV have "a 37-fold increase in anal cancer, a 4-fold increase in Hodgkin's disease (cancer of the lymph nodes), a 2.7-fold increase in cancer of the testicles, and a 2.5 fold increase in lip cancer."[42] HIV/AIDS Among Young People

· AIDS incidence is on the rise among teens and young adults. The CDC reports that, "even though AIDS incidence (the number of new cases diagnosed during a given time period, usually a year) is declining, there has not been a comparable decline in the number of newly diagnosed HIV cases among youth.[43]

· Young homosexual men are at particular risk. The CDC estimates that "at least half of all new HIV infections in the United States are among people under twenty-five, and the majority of young people are infected sexually."[44] By the end of 1999, 29,629 young people aged thirteen to twenty-four were diagnosed with AIDS in the United States. MSM were the single largest risk category: in 1999, for example, 50 percent of all new AIDS cases were reported among young homosexuals.[45]

· Sexually active young women are also at risk. The CDC reports: "In 1999, among young women the same age, 47 percent of all AIDS cases reported were acquired heterosexually and 11 percent were acquired through injection drug use."

Homosexuals with STDs Are at an Increased Risk for HIV Infection. Studies of MSM treated in STD clinics show rates of infection as high as 36 percent in major cities.[46] A CDC study attributed the high infection rate to having high numbers of anonymous sex partners: "[S]yphilis, gonorrhea, and chlamydia apparently have been introduced into a population of MSM who have large numbers of anonymous partners, which can result in rapid and extensive transmission of STDs."[47] The CDC report concluded: "Persons with STDs, including genital ulcer disease and nonulcerative STD, have a twofold to fivefold increased risk for HIV infection."[48]

Anal Cancer: Homosexuals are at increased risk for this rare type of cancer, which is potentially fatal if the anal-rectal tumors metastasize to other bodily organs.

· Dr. Joel Palefsky, a leading expert in the field of anal cancer, reports that while the incidence of anal cancer in the United States is only 0.9/100,000, that number soars to 35/100,000 for homosexuals. That rate doubles again for those who are HIV positive, which, according to Dr. Palefsky, is "roughly ten times higher than the current rate of cervical cancer."[49]

· At the Fourth International AIDS Malignancy Conference at the National Institutes of Health in May, 2000, Dr. Andrew Grulich announced that the incidence of anal cancer among homosexuals with HIV "was raised 37-fold compared with the general population."[50] Lesbians are at Risk through Sex with MSM

· Many Lesbians also have had sex with men. The homosexual newspaper The Washington Blade, citing a 1998 study in the Journal of Infectious Diseases, reported that "the study's data confirmed previous scientific observations that most women who have sex with women also have had sex with men."[51] The study added that "sex with men in the prior year was common, as were sexual practices between female partners that possibly could transmit HPV."[52]

· Lesbians have more male sex partners that their heterosexual counterparts. A study of sexually transmitted disease among lesbians reviewed in The Washington Blade notes: "Behavioral research also demonstrates that a woman's sexual identity is not an accurate predictor of behavior, with a large proportion of 'lesbian' women reporting sex with (often high risk) men."[53] The study found that "the median number of lifetime male sexual partners was significantly greater for WSW (women who have sex with women) than controls (twelve partners versus six). WSW were significantly more likely to report more than fifty lifetime male sexual partners."[54]

· A study in the American Journal of Public Health concurs that bisexual women are at increased risk for contracting sexually transmitted diseases: "Our findings corroborate the finding that wsmw (women who have sex with men and women) are more likely than WSMO (women who have sex with men only) to engage in various high-risk behaviors" and also "to engage in a greater number of risk-related behaviors."[55] The study suggested that the willingness to engage in risky sexual practices "could be tied to a pattern of sensation-seeking behavior."[56]

· MSM spread HIV to women. A five-year study by the CDC of 3,492 homosexuals aged fifteen to twenty-two found that one in six also had sex with women. Of those having sex with women, one-quarter "said they recently had unprotected sex with both men and women." Nearly 7 percent of the men in the study were HIV positive."[57] "The study confirms that young bisexual men are a 'bridge' for HIV transmission to women," said the CDC.[58]

"Exclusive" Lesbian Relationships Also at Risk. The assumption that lesbians involved in exclusive sexual relationships are at reduced risk for sexual disease is false. The journal Sexually Transmitted Infections concludes: "The risk behavior profile of exclusive WSW was similar to all WSW."[59] One reason for this is because lesbians "were significantly more likely to report past sexual contact with a homosexual or bisexual man and sexual contact with an IDU (intravenous drug user)."[60]

Cancer Risk Factors for Lesbians. Citing a 1999 report released by the Institute of Medicine, an arm of the National Academy of Sciences, the homosexual newspaper The Washington Blade notes that "various studies on Lesbian health suggest that certain cancer risk factors occur with greater frequency in this population. These factors include higher rates of smoking, alcohol use, poor diet, and being overweight."[61] Elsewhere the Blade also reports: "Some experts believe Lesbians might be more likely than women in general to develop breast or cervical cancer because a disproportionate number of them fall into high-risk categories."[62] Sexually Transmitted Diseases Among Lesbians

· In a study of the medical records of 1,408 lesbians, the journal Sexually Transmitted Infections found that women who have sexual relations with womenare at significantly higher risk for certain sexually transmitted diseases: "We demonstrated a higher prevalence of bv (bacterial vaginosis), hepatitis C, and HIV risk behaviors in WSW as compared with controls."[63]

Compulsive Behavior among Lesbians. A study published in Nursing Research found that lesbians are three times more likely to abuse alcohol and to suffer from other compulsive behaviors: "Like most problem drinkers, 32 (91 percent) of the participants had abused other drugs as well as alcohol, and many reported compulsive difficulties with food (34 percent), codependency (29 percent), sex (11 percent), and money (6 percent)." In addition, "Forty-six percent had been heavy drinkers with frequent drunkenness."[64] Alcohol Abuse Among Homosexuals and Lesbians

· The Journal of Consulting and Clinical Psychologists reports that lesbian women consume alcohol more frequently, and in larger amounts, than heterosexual women.[65] Lesbians were at significantly greater risk than heterosexual women for both binge drinking (19.4 percent compared to 11.7 percent), and for heavy drinking (7 percent compared to 2.7 percent).[66]

· Although the Journal of Consulting and Clinical Psychologists article found no significant connection between male homosexuals and alcohol abuse, a study in Family Planning Perspective concluded that male homosexuals were at greatly increased risk for alcoholism: "Among men, by far the most important risk group consisted of homosexual and bisexual men, who were more than nine times as likely as heterosexual men to have a history of problem drinking."[67] The study noted that problem drinking may contribute to the "significantly higher STD rates among gay and bisexual men."[68]

Violence in Lesbian and Homosexual Relationships.

· A study in the Journal of Interpersonal Violence examined conflict and violence in lesbian relationships. The researchers found that 90 percent of the lesbians surveyed had been recipients of one or more acts of verbal aggression from their intimate partners during the year prior to this study, with 31 percent reporting one or more incidents of physical abuse.[69]

· In a survey of 1,099 lesbians, the Journal of Social Service Research found that "slightly more than half of the [lesbians] reported that they had been abused by a female lover/partner. The most frequently indicated forms of abuse were verbal/emotional/psychological abuse and combined physical-psychological abuse."[70]

· In their book Men Who Beat the Men Who Love Them: Battered Gay Men and Domestic Violence,D. Island and P. Letellier report that "the incidence of domestic violence among gay men is nearly double that in the heterosexual population."[71]

Compare the Low Rate of Intimate Partner Violence within Marriage. Homosexual and lesbian relationships are far more violent than are traditional married households:

· The Bureau of Justice Statistics (U.S. Department of Justice) reports that married women in traditional families experience the lowest rate of violence compared with women in other types of relationships.[72]

· A report by the Medical Institute for Sexual Health concurred,

It should be noted that most studies of family violence do not differentiate between married and unmarried partner status. Studies that do make these distinctions have found that marriage relationships tend to have the least intimate partner violence when compared to cohabiting or dating relationships.[73]

High Incidence of Mental Health Problems among Homosexuals and Lesbians. A national survey of lesbians published in the Journal of Consulting and Clinical Psychology found that 75 percent of the nearly 2,000 respondents had pursued psychological counseling of some kind, many for treatment of long-term depression or sadness: Among the sample as a whole, there was a distressingly high prevalence of life events and behaviors related to mental health problems. Thirty-seven percent had been physically abused and 32 percent had been raped or sexually attacked. Nineteen percent had been involved in incestuous relationships while growing up. Almost one-third used tobacco on a daily basis and about 30 percent drank alcohol more than once a week; 6 percent drank daily. One in five smoked marijuana more than once a month. Twenty-one percent of the sample had thoughts about suicide sometimes or often and 18 percent had actually tried to kill themselves. . . . More than half had felt too nervous to accomplish ordinary activities at some time during the past year and over one-third had been depressed.[74]

Greater Risk for Suicide.

· A study of twins that examined the relationship between homosexuality and suicide, published in the Archives of General Psychiatry,found that homosexuals with same-sex partners were at greater risk for overall mental health problems, and were 6.5 times more likely than their twins to have attempted suicide. The higher rate was not attributable to mental health or substance abuse disorders.[75]

· Another study published simultaneously in Archives of General Psychiatry followed 1,007 individuals from birth. Those classified as "gay," lesbian, or bisexual were significantly more likely to have had mental health problems.[76] Significantly, in his comments on the studies in the same issue of the journal, D. Bailey cautioned against various speculative explanations of the results, such as the view that "widespread prejudice against homosexual people causes them to be unhappy or worse, mentally ill."[77]

Reduced Life Span. A study published in the International Journal of Epidemiology on the mortality rates of homosexualsconcluded that they have a significantly reduced life expectancy: In a major Canadian centre, life expectancy at age twentyfor gay and bisexual men is eight to twenty years less than for all men. If the same pattern of mortality were to continue, we estimate that nearly half of gay and bisexual men currently aged twenty years will not reach their sixty-fifth birthday. Under even the most liberal assumptions, gay and bisexual men in this urban centre are now experiencing a life expectancy similar to that experienced by all men in Canada in the year 1871.[78]

In 1995, long after the deadly effects of AIDS and other stds became widely known, homosexual author Urvashi Vaid expressed one of the goals of her fellow activists: "We have an agenda to create a society in which homosexuality is regarded as healthy, natural, and normal. To me that is the most important agenda item."[79] Debilitating illness, chronic disease, psychological problems, and early death suffered by homosexuals is the legacy of this tragically misguided activism, which puts the furthering of an "agenda" above saving the lives of those whose interests they purport to represent.

Those who advocate full acceptance of homosexual behavior choose to downplay the growing and incontrovertible evidence regarding the serious, life-threatening health effects associated with the homosexual lifestyle. Homosexual advocacy groups have a moral duty to disseminate medical information that might dissuade individuals from entering or continuing in an inherently unhealthy and dangerous lifestyle. Education officials in particular have a duty to provide information regarding the negative health effects of homosexuality to students in their charge, whose very lives are put at risk by engaging in such behavior. Above all, civil society itself has an obligation to institute policies that promote the health and well-being of its citizens. --

END

NOTES

1. Bill Roundy, "STD Rates on the Rise," New York Blade News, December 15, 2000, p. 1.

2. "Increases in Unsafe Sex and Rectal Gonorrhea among Men Who Have Sex with Men--San Francisco, California, 1994-1997," Mortality and Morbidity Weekly Report (Centers for Disease Control and Prevention), January 29, 1999, p. 45.

3. Ibid. 4. Ulysses Torassa, "Some With HIV Aren't Disclosing Before Sex; UCSF Researcher's 1,397-person Study Presented During aids Conference," The San Francisco Examiner (July 15, 2000).

5. Jon Garbo, "Gay and Bi Men Less Likely to Disclose They Have HIV," GayHealth News (July 18, 2000). Available at: www.gayhealth.com/templates/0/news?record=136.

6. Ibid. 7. Jon Garbo, "Risky Sex Common Among Gay Club and Bar Goers," GayHealth News (January 3, 2001). Available at: www.gayhealth.com/templates/97863827496203.../ index.html?record=35.

8. "Bisexuals Serve as 'Bridge' Infecting Women With HIV," Reuters News Service (July 30, 2000). Available at: www.mb.com/ph/scty/2000%2D07/sc073004.asp. 9. A. P. Bell and M. S. Weinberg, Homosexualities: A Study of Diversity Among Men and Women (New York: Simon and Schuster, 1978), pp. 308,

9; see alsoBell, Weinberg and Hammersmith, Sexual Preference (Bloomington: Indiana University Press, 1981).

10. Paul Van de Ven et al., "A Comparative Demographic and Sexual Profile of Older Homosexually Active Men," Journal of Sex Research 34 (1997): 354. Dr. Paul Van de Ven reiterated these results in a private conversation with Dr. Robert Gagnon on September 7, 2000.

11. "Survey Finds 40 percent of Gay Men Have Had More Than 40 Sex Partners," Lambda Report, January/February 1998, p. 20.

12. M. Pollak, "Male Homosexuality," in Western Sexuality: Practice and Precept in Past and Present Times, edited by P. Aries and A. Bejin, pp. 40-61, cited by Joseph Nicolosi in Reparative Therapy of Male Homosexuality (Northvale, New Jersey: Jason Aronson Inc., 1991), pp. 124, 25.

13. David P. McWhirter and Andrew M. Mattison, The Male Couple: How Relationships Develop (Englewood Cliffs, New Jersey: Prentice-Hall, 1984), pp. 252, 3.

14. M. Saghir and E. Robins, Male and Female Homosexuality (Baltimore: Williams and Wilkins, 1973), p. 225; L.A. Peplau and H. Amaro, "Understanding Lesbian Relationships," in Homosexuality: Social, Psychological, and Biological Issues, edited byJ. Weinrich and W. Paul (Beverly Hills: Sage, 1982). 15. A.P.M. Coxon et al., "Sex Role Separation in Diaries of Homosexual Men," AIDS, July 1993, pp. 877-882.

16. G. J. Hart et al., "Risk Behaviour, Anti-HIV and Anti-Hepatitis B Core Prevalence in Clinic and Non-clinic Samples of Gay Men in England, 1991-1992," AIDS, July 1993, pp. 863-869, cited in "Homosexual Marriage: The Next Demand," Position Analysis paper by Colorado for Family Values, May 1994.

17. Bill Roundy, "STDs Up Among Gay Men: CDC Says Rise is Due to HIV Misperceptions," The Washington Blade (December 8, 2000). Available at: www.washblade.com/health/a.

18. Richard A. Zmuda, "Rising Rates of Anal Cancer for Gay Men," Cancer News (August 17, 2000). Available at: cancerlinksusa.com/cancernews_sm/Aug2000 /081700analcancer.

19. "Studies Point to Increased Risks of Anal Cancer," The Washington Blade (June 2, 2000). Available at: www.washblade.com/health/000602hm.

20. Mortality and Morbidity Weekly Report (Centers for Disease Control and Prevention) September 4, 1998, p. 708.

21. "Viral Hepatitus B--Frequently Asked Questions," National Center for Infectious Diseases (Centers for Disease Control and Prevention)September 29, 2000. Available at: www.cdc.gov/ncidod/diseases/hepatitis/b/faqb.

22. "Hepatitus C: Epidemiology: Transmission Modes" Mortality and Morbidity Weekly Report (Centers for Disease Control and Prevention) 1998.Available at: www.cdc.gov/ncidod/diseases/hepatitis /c/edu/1/default.htm.

23. "Gonorrhea," Division of Sexually Transmitted Diseases (Centers For Disease Control and Prevention) September, 2000. Available at: www.cdc.gov/nchstp/dstd/ Fact_Sheets/FactsGonorrhea.htm.

24. "Increases in Unsafe Sex and Rectal Gonorrhea."

25. Mortality and Morbidity Weekly Report (Centers for Disease Control and Prevention) January 29, 1999, p. 48.

26. J. Vincelette et al., "Predicators of Chlamydial Infection and Gonorrhea among Patients Seen by Private Practitioners," Canadian Medical Association Journal 144 (1995): 713-721.

27. SPR Jebakumar et al., "Value of Screeningfor Oropharyngeal Chlamydia Trachomatis Infection," Journal of Clinical Pathology 48 (1995): 658-661.

28. "Some Facts about Syphilis," Division of Sexually Transmitted Diseases (Centers for Disease Control and Prevention)October 1999. Available at: www.cdc.gov/nchstp/dstd/ Fact_Sheets/Syphilis_Facts.

29. "Syphilis Elimination: History in the Making," Division of Sexually Transmitted Diseases (Centers for Disease Control and Prevention)October 1999. Available at: www.cdc.gov/nchstp/dstd/Fact_Sheets/Syphilis_Facts.

30. C. M. Hutchinson et al., "Characteristics of Patients with Syphilis Attending Baltimore STD Clinics," Archives of Internal Medicine 151 (1991): 511-516. 31. "Syphilis Elimination."

32. Homosexual advocates object to the use of this term (Gay Bowel Syndrome), which they say unfairly stigmatizes homosexual behavior. Health Implications Associated with Homosexuality (Austin: The Medical Institute for Sexual Health, 1999), p. 55.

33. "STD Treatment Guidelines: Proctitis, Proctocolitis, and Enteritis," (Centers for Disease Control and Prevention) 1993. Available at: /www.ama-assn.org/special/std /treatmnt/guide/stdg3470.htm.

34. Jack Morin, Anal Pleasure and Health: A Guide for Men and Women (San Francisco: Down There Press, 1998), p. 220.

35. Health Implications, p. 56. 36. "STD Treatment Guidelines."

37. Health Implications; See Morin, Anal Pleasure and Health, p. 220, 1. 38. Health Implications. 39. "Table 9. Male Adult/Adolescent AIDS Cases by Exposure Category and Race/Ethnicity, Reported through December 1999, United States," Centers for Disease Control and Prevention: Division of HIV/AIDS Prevention: available at: www/cdc.gov/hiv/stats/hasr1102/table9.

40. "HIV/AIDS Among US Women: Minority and Young Women at Continuing Risk," Divisions of HIV/AIDS Prevention (Centers for Disease Control)November 14, 2000. Available at: www.cdc.gov/hiv/pubs/facts/women.

41. Ibid. 42. "Studies Point to Increased Risks of Anal Cancer."

43. "Young People at Risk: HIV/AIDS among America's Youth," Divisions of HIV/AIDS Prevention (Centers for Disease Control)November 14, 2000. Available at: www.cdc.gov/hiv/pubs/facts/youth.htm.

44. Ibid.

45. Ibid.

46. "Need for Sustained HIV Prevention Among Men who Have Sex with Men," Divisions of HIV/AIDS Prevention (Centers for Disease Control)November 14, 2000. Available at: www.cdc.gov/hiv/pubs/facts/msm.

47. "Resurgent Bacterial Sexually Transmitted Disease among Men Who Have Sex with Men--King County, Washington, 1997-1999," Morbidity and Mortality Weekly Report: Centers for Disease Control, September 10, 1999, pp. 773-777. Available at: www.cdc.gov/epo/mmwr/preview/mmwrhtml/ mm4835a1.

48. "Need for Sustained HIV Prevention." 49. Bob Roehr, "Anal Cancer and You," Between the Lines News (November 16, 2000). Available at: www.pridesource.com/cgi-bin/article?article=3835560.

50. "Studies Point to Increased Risks of Anal Cancer."

51. Rhonda Smith, "HPV Can be Transmitted between Women," The Washington Blade (December 4, 1998). Available at: www.washblade.com/health/9901011h.

52. Ibid.

53. Katherine Fethers et al., "Sexually Transmitted Infections and Risk Behaviors in Women Who Have Sex with Women," Sexually Transmitted Infections 76 (2000):348.

54. Ibid., p. 347. 55. V. Gonzales, et al., "Sexual and Drug-Use Risk Factors for hiv and STDs: A Comparison of Women with and without Bisexual Experiences," American Journal of Public Health 89 (December 1999): 1846.

56. Ibid.

57. "Bisexuals Serve as 'Bridge' Infecting Women with HIV," Reuters News Service (July 30, 2000).

58. Ibid.

59. "Sexually Transmitted Infections," p. 347.

60. Ibid.

61. Rhonda Smith, "Childbirth Linked with Smaller Breast Tumor Size," The Washington Blade (December 17, 1999). Available at: www.washblade.com/health/000114lh.

62. "HPV can be Transmitted between Women."

63. Katherine Fethers et al., "Sexually Transmitted Infections and Risk Behaviors in Women Who Have Sex with Women," Sexually Transmitted Infections, July 2000, p. 345.

64. Joanne Hall, "Lesbians Recovering from Alcoholic Problems: An Ethnographic Study of Health Care Expectations," Nursing Research 43 (1994): 238-244.

65. Peter Freiberg, "Study: Alcohol Use More Prevelent for Lesbians," The Washington Blade, January 12, 2001, p. 21.

66. Ibid.

67. Karen Paige Erickson, Karen F. Trocki, "Sex, Alcohol and Sexually Transmitted Diseases: A National Survey," Family Planning Perspectives 26 (December 1994): 261.

68. Ibid.

69. Lettie L. Lockhart et al., "Letting out the Secret: Violence in Lesbian Relationships," Journal of Interpersonal Violence 9 (December 1994): 469-492.

70. Gwat Yong Lie and Sabrina Gentlewarrier, "Intimate Violence in Lesbian Relationships: Discussion of Survey Findings and Practice Implications," Journal of Social Service Research 15 (1991): 41-59.

71. D. Island and P. Letellier, Men Who Beat the Men Who Love Them: Battered Gay Men and Domestic Violence (New York: Haworth Press, 1991), p. 14.

72. "Violence Between Intimates," Bureau of Justice Statistics Selected Findings, November 1994, p. 2.

73. Health Implications, p. 79.

74. J. Bradford, et al., "National Lesbian Health Care Survey: Implications for Mental Health Care," Journal of Consulting and Clinical Psychology 62 (1994): 239, cited in Health Implications Associated with Homosexuality, p. 81.

75. R. Herrell, et al., "A Co-Twin Study in Adult Men," Archives of General Psychiatry 56 (1999): 867-874.

76. D. Fergusson, et al., "Is Sexual Orientation Related to Mental Health Problems and Suicidality in Young People?" Archives of General Psychiatry 56 (October 1999), p. 876-884.

77. Ibid. 78. Robert S. Hogg et al., "Modeling the Impact of HIV Disease on Mortality in Gay and Bisexual Men," International Journal of Epidemiology 26 (1997): 657.

79. Quoted in Gabriel Rotello, Sexual Ecology: AIDS and the Destiny of Gay Men (New York: Penguin Books, 1997), p. 286.