I lay in my bed, trying to recover from the unreal pain of a bowel movement. Two days before, a surgeon had removed three lesions from the most sensitive part of my rectum. Alone in my home, I started to cry, partly from self-pity and guilt.
Maybe this was no punishment from God for being gay, but it was definitely the result of contracting HPV early in my years of being active sexually. During my first colonoscopy soon after becoming active, condyloma were found in my rectum, a potential precurser to the lesions I now have had removed three times. I had a separate surgery to remove the condyloma. I thought I had erased fears of anal cancer.
In early 2017, I started to see blood during sex with my boyfriend — — a pinkish hue to the lube that he wipes from my ass periodically during our fucking. I was concerned, of course, because that hadn’t happened in years of being a bottom, nor with any other man.
My primary care doctor swabbed my rectum as with a Pap smear. The tests showed abnormal cells. He suggested an anoscopy to remove and examine these lesions. The first procedure found four, but the biopsy indicated the lowest level of concern known as AIN1, so I was told to come back in a year. AIN2 and 3 are considered premalignant, and would have required another procedure in three or six months. My second procedure found the same. Now I’ve had a third and waiting for the results.
Here is the medical description of my condition: AIN 1 is also known as ‘mild dysplasia’, or LSIL, which means ‘low-grade squamous intraepithelial lesion’. Dysplasia is the general term for all abnormal changes in cells. The dysplasia is classified by the severity of the changes, i.e. mild, moderate or severe.
Of course, the progression of such lesions would result in anal cancer — rare but increasingly seen in gay men who have receptive intercourse and especially true among HIV positive men. However, I’m negative.
My surgeon said with each procedure it would become harder to find these lesions in the anal canal because of scar tissue. And now I have found peer-reviewed published research that indicates anoscopies make no difference in the possibility of anal cancer, unlike the removal of polyps during colonoscopies, which can prevent colon cancer.
Like HIV, this seems like a reminder of the dangers of gay sex. But unlike HIV, there was very little I could have done to prevent HPV unless I had remained totally celibate all my life. I had used condoms religiously before the first discovery of the condyloma. And yet living in a society that generally abhors sodomy and made it illegal for decades, I can’t stop feeling guilty about all the pleasure I have found in being a bottom.
There is also a strangely personal aspect to my situation. The bleeding results only from my sex with my BF and no other man. He is especially thick, which is immensely enjoyable, of course, but now I wonder if I should resume having sex with him. We have other problems in our 7-year-old relationship but sex has never been one of them. In fact, of the 100 or so men who have fucked me, he is the best top I’ve known. I want also to say that I don’t have pain during intercourse with him except for the kind of pain-pleasure that comes with having receptive anal sex.
In between all the procedures, bleeding almost always results from our sex, so it’s been going on for several years. My surgeon said I shouldn’t worry as long it’s not painful. But it’s disconcerting to both my BF and me.
So here I sit with one of the most sensitive parts of my anatomy sore from a bowel movement last night, my first since the surgery. Despite stool softeners and a narcotic, the pain left me sobbing and gasping to regulate my breathing.
I never expected the freedom to enjoy my true sexuality would come at this cost.