THE LOG BOOKS
Season 1 Episode 8 “I was an inconvenience”
Date: 23.12. 2019
Presenters: Tash Walker, Adam Smith
Producers: Shivani Dave, Tash Walker, Adam Smith
Music: Tom Foskett-Barnes
Artwork: Natalie Doto
[telephone dial tone, music]
October 19th 1975. Volunteer Alex.
Two months ago, I visited for a check up! And when the doctor discovered that I was gay and “abnormal” - he reacted by getting huffy and attempted to make me feel that I was an inconvenience, wasting his precious heterosexual time, ha!
When it actually came down to the point of analysing my bum, he got very very uptight about me asking him about what lubrication he was using. As it was really very good lube and quite the best I had ever encountered.
That’s astonishing. Well, I have to say I am mortified that some bastard was actually being unpleasant. That person should not have been working in the speciality. Well, I do know that there were a few people like that in those days I very much doubt that there are any nowadays - we have got rid of the fuckers!
AS: Inconvenient -that is the last thing you want to feel when you are trying to deal with a maybe a sexual health problem. I had a bad experience once because I think that the doctor didn’t really know enough about specialist care to a gay man and that was not nice. So, I can sympathise with being made to feel an inconvenience.
TW: Yeah, I think doctors and nurses have such a big responsibility and impact on the patient that they are treating whether you are LGBT or not so to make someone feel judged by their sexuality in addition to that is really awful.
TW: You’re listening to the Log Books – stories from Britain’s LGBTQ+ history and conversations about being queer today.
AS: In partnership with Switchboard: the LGBT+ helpline. I’m Adam Smith.
TW: I’m Tash Walker.
TW: Episode 8 Books - “I was an inconvenience.”
AS: In this episode we are going to be looking through all the log book entries from Switchboard -74 to 82- to do with health.
TW: We are going to hear from a doctor who treated thousands of gay men in the late 70s, people with memories of their own sexual health treatment, and also a trans and intersex woman who transitioned in the early 80s.
AS: All of the log book entries we are looking at in this season stop at 82 - just before the HIV epidemic. So hopefully if we do a season 2 that is when we will cover HIV.
The information about sexual health and clinics was a very important part of the work. I’m Tony Whitehead. I am 65 years old. I never thought I’d reach 65. There were some clinics - we did get information about some places and some doctors that were just frankly nasty. Shouldn’t have been doing that job.
There were some doctors -just one or two that I worked for -who did have a blatant unsympathetic attitude. And the way they would start a consultation is they wouldn’t look at the patient they would look down at the notes and say either words to the effect ‘what have you been doing’ or ‘what’s it this time, then.’ Some disparaging remark rather than the very simple ‘how can I help you?’
I’m Peter Greenhouse. I’m 64 years old now and have been in the NHS for 40 years. I got recruited to do sexual health work as a medical student.
There’s a great fear not knowing what things are like. I was a well-informed person but am trying to remember the first time I had to go to a clinic for a check-up … goodness the first time I actually caught something was … it was … it was difficult -it was this mixture of fear and embarrassment and was not a ... it was not a nice experience, but I got used to it over the years.
Back in the late 70s the principal infections that gay men had would be gonorrhoea and syphilis. I think when you we trying to think which sexual health clinic to go to it was largely a matter of potluck and which was ones your friends had been to and the attitudes that they found. To be honest -there were probably very few clinicians working in sexual health clinics in those days who were manifestly unsympathetic - problem is - that you wouldn’t have known that before you went to the clinic and people would have been worried that they might have been judged in the way that - well the rest of bloody society was judging them at the time.
TW: It is just so important that people know how to get the treatment that they need and over the years Switchboard has helped so many people do just that.
AS: And that’s because - you can see the log book entries Switchboard volunteers are sharing information with each other about treatments, and about clinics, and what’s going on.
This is a log book entry October 7 1975.
Just having been cured of gonorrhoea - the doctor at the clinic advised me that since cases of syphilis in the gay world are rising dramatically - all gay men should have check-ups once every 6 months. The main reason for this is that cases without symptoms are also rising. All one needs is a blood test.
AS: And there’s actually a discussion about whether it should be 3 months or 6 months. I think now -people say -have a regular check but every 3 months. But that is an example of the volunteers of Switchboard sharing information with each other in the pages of the log books.
TW: And also using themselves as sort of test pilots for where’s good to go and there’s another log book entry.
October 29 1975.
Any Switchboard volunteers who have visited a VD clinic recently - can you please write a critique for it “for after lunch.” This is most important as we wish to institute a star rating of all London VD clinics -something equivalent of the Good Food Guide. Please place any contributions in my envelope.
AS: So, what does after lunch mean?
TW: I don’t know. That’s a good question!
AS: Maybe it’s like a review as if you’ve just eaten your lunch in a restaurant and you want to say whether that’s a good restaurant or not!
So, here’s a leaflet that actually pasted into the log book.
October 8 1975 volunteer unknown and the leaflet here says:
‘Help for bisexuals and homosexuals. Contact for five organisations including Gay Switchboard.’ And there’s a note here saying this leaflet is freely available at Westminster Hospital VD clinic the consultant there, Dr Oates, paid for its printing. Westminster probably has the best VD clinic - particular for shy people they even have piped music in the waiting room and Dr Oates and his colleagues are friendly and relaxed.
I like the comment here about piped music as piped music is important for two reasons actually – first of all if you’ve got the piped music in the waiting room then you can’t hear what’s going on through the thin walls of the consultation room door or the walls and so that’s important. Its also just to make you feel a little bit more relaxed and take your mind of stuff.
AS: Wow I never knew that about music in the waiting room.
TW: I’ve been to the sexual health clinic, and they were playing Vivaldi …
AS: I’ve been to a clinic where in the waiting groom they have a radio on and Magic FM and it’s really staticy and really snowy and maybe that is what they are up to. I just thought it was a really bad radio with a bad signal but maybe they are masking private conversations.
Peter actually knew the doctor mentioned in that leaflet - that was pasted into the Switchboard log book and he gave him one of the many important lessons he needed as a junior doctor.
There’s no social bar on getting sexually transmitted infections and I’m actually very proud to see that my old boss is mentioned here in the log book. Titus Oates, Dr J K Oates, who was the boss in Cambridge and also in Westminster. He got interviewed in the 60s and they asked him ‘Dr Oates you are the consultant in the venereology clinic that is closest to the Houses of Parliament, Westminster. Do you ever see people from that establishment in your clinic?’ And he thought about this for a few moments and said, ‘We get all sorts of people in here – all sorts!’ And I think that was probably the most diplomatic answer.
Every person that I could meet and look after - be they a sex worker, be they a gay person, or just person who’d been having lots of sex and got an infection - where societies attitude would be unsympathetic I wanted to be as friendly as I possibly could be and manage them as I would want myself or my best friend to be managed. And each time I did this it was a kick in the balls for the bastards who were unsympathetic.
AS: And how do junior doctors learn? Well, they rely on their patients.
I was put in with a patient by the senior consultation there and he said ‘Peter have a chat to this guy’ he was a merchant seaman and he’d spent his entire career in the Merchant Navy - being bottom I guess is probably the best way to look at it. And he was just so completely open and wonderfully humorous about his life. I felt such tremendous sympathy for him. He’d just had another dose of gonorrhoea and that particular time, but I am sure he’d had plenty before and I think he’d had syphilis a couple of times before -but then who hadn’t?
And he told me in the most graphic terms what he was doing and also in the funniest way that you could possibly do it - and we were almost in tears together laughing. At a time also when I’d had very little understanding about what gay sex, and gay life, was all about and it was just such a wonderful introduction to the whole subject.
This is a log book entry from June 2 1975.
Caller rang to ask if we had a private venereologist or clap doctor on our files. I can see no trace. Do such things exist or is it one luxury the rich have to share with the rest of us?
And there’s a response from another volunteer that says ‘No they do exist, but we do not know of any – I will try and find out.’
TW: So, most of the calls that Switchboard got during this time where about sexual health for men and former volunteer Femi explains why.
I think men and women were different in their approaches to sexual health and I don’t think that lesbians were as alive in the late 70s and early 80s to the need for them to take care of their sexual health. Often the caller would have to be reminded by the volunteer that … if you are using sex toys, for example, you do need to take care about where you are putting them and you are washing them in between. Because there wasn’t enough information around for lesbians around sexual health not in the same way as there was for gay men not in those days.
In my consciousness raising group we used to talk about it quite a lot and one of my first volunteering experiences was in one of my local women’s centres and we used to run pregnancy testing - free pregnancy testing for women. Women centres were focal points for women who were involved in liberation movements. Lesbians had a dual role there because we were the ones least likely to need the contraception and this type of stuff, but we were likely to bet the ones delivering it and that was part of our commitment to the women’s movement.
AS: For many people in the 70s being gay or being lesbian they thought was a medical matter and so many people went to their doctor – actually- to ask about what they should do about that.
I’m Neville. In London one knew nobody and so I got a bit upset about all of this went to my GP and told him I was not as other men were. And after he picked himself up off the floor, he said ‘Well I don’t deal with that kind of thing but I will send you to someone who does’. Literally. And that was the luckiest thing that could have happened to me because I ended up with a chap - Dr Jack Hobson - at the Middlesex Hospital, he was the chief psychiatrist there. He was a chap who was sent in to sort out Christie - the mass murderer- after they caught him. But over a long session he well at the end of it he said three things – one, I can give you aversion therapy it doesn’t work and it is horrible. Two, I can give you drugs to knock off the sex urge that’s pretty horrible too. Three - I suggest that you get out there -get to know people and in the course of time you’ll settle down and there’s nothing wrong with that. That wasn’t bad advice.
May 29th 1976.
A woman, Kerry, rang Switchboard last Monday evening while in great distress. 16 years old. Had been to three counselling sessions with Rose who advised her to accept herself as a lesbian which Kerry decided she did not wish to do. Then wanted a sex change and went to the Portman clinic. She has now changed her mind again and wants to learn to accept herself as a lesbian. I suggested she gets in touch with Rose again.
That log book entries shows the complicated nature of gender identity, sexuality, and health and how every single person is unique. We all have to face similar related issues but each in our own way.
AS: So here’s Diana’s story about that and how her situation was handled in the early 80s.
I went straight into the civil service. I took the job because it was a job - it was interesting work, I was really keen on doing it. But it helped me save up money coz I thought as soon as I came out and said this is what I want to do that was me out the door. But it turned out differently - that the person my section head who was actually religious guy …it was the opposite he said ‘Wow ok what can we do? Do you need time of how can we help? Really want you to stay we don’t want to lose you.’ So, I transitioned in the civil service. Which was so incredibly lucky. I started my transition around 1980. I went through the transition in two years which is really unusual. It was quick then but now its unheard-of because you can wait two years to get an appointment, but my transition was quick partly through being intersex as well I think fed into that that they felt more comfortable to push me through at speed maybe. After my transition I could be who I was. I felt truly fantastic. I could be me. Who I am.
So, when I was going through my transition -is really when I came to know that I was intersex. I had the inkling when I was at school -going through puberty when my body changed in ways that others didn’t. So, I had inkling of that -but not a full understanding. Most people still did not have an understanding of intersex. And many intersex people do not have an understanding of what intersex is - its still something that we are going through. And I’m learning - I’m not an expert on myself let alone other people’s intersex conditions.
But for me it made my transition easier - because my parents had a choice when I was born, and they made the wrong one. I am not blaming them for that - they were given a choice by a doctor who explained things to them - which had their prejudice and then your parents feel they have to make a decision which is a wrong onus to put on them.
And they unfortunately made the wrong one. They could have easily made the right one but they didn’t. So, when I went to my psychologist at Charing Cross at that time, he could see on my medical notes that I was intersex. Even then he didn’t fully explain to me what that was - he just said what it was. And there was no internet for me to look up and find out what does that mean.
I could see it in myself physically and the discomfort that it gave me and sometimes pain that it gave me - after the interventions when I was young, but I didn’t fully understand it. The medical profession at that time didn’t fully understand it. They thought they did, or they bluffed that they did - but they didn’t. And that made my transition perhaps easier in that they could use that as an excuse for me to go fast within my transition ‘Oh that intersex. We are just putting things right. Rather than we are making a wholesale change. That is perhaps one of the reasons why my transition was so quick. But every single intersex person is different we are not the same as each other my experiences are possibly polar opposite to someone else. There is some that the surgeons pick female when they should have been male. It is a difficult thing and it’s still sometimes a difficult thing for me to talk about -because of the pain of the realisation when I went through puberty and the abuse that I went through going through puberty. So I would still in many ways juggling with that and a lot of intersex. I try and be as open about it as I can - but we’ve all got something that we have …that gives us something we’ve not fully 100% come to terms with yet and that’s mine.
TW: Being the first point of contact for so many people Switchboard had to not only give out lot of information about sexual health but have so many internal debates as to what exactly that information and advice was.
AS: And exactly how to handle health scares when they come up among gay men and lesbians at this time. There’s a log book entry February 18 1982 and is actually part of a very long debate that volunteers are having in the log books and it says
“Hepatitis. I know a bit about it. I’m a carrier of the B virus. So was Simon who left Switchboard recently. I am being researched by Charing Cross – he by Royal Free.
This is a log book entry from February 1982:
I’ve just had a call from a guy who was worried -very much- about the epidemic of hepatitis which has struck down six of his friends in the last ten days. He quite rightly is worried about the lack of publicity this spread of disease is getting. All of his friends have been to Subways back room in the last two weeks and are convinced that they contracted the virus there. Do you think it would be a good idea to warn callers about the risk which may be incurred by using the back room facilities in Subway before they actually go there and then it’s too late?
Signed Mark Ashton.
Who was a wonderful man.
AS: The volunteers are having a debate about whether to say there is this disease or you may get this disease if you have lots of sex or causal sex - so therefore you should be aware of that. Or on the other hand there are people who just say don’t have sex or maybe don’t have sex in this particular way and so some of the volunteers clearly think that second one is too alarmists.
TW: Like in point three of this very long pointed argument it says ‘but if you are going to alarmist things telling callers not to go there because of the hepatitis risk we’ll have to tell all callers to refrain from sex other than with a permanent partner. These are risks (though the state of knowledge about transmission of the virus is understand fluid - there have been very rapid advancements recently) but here are far greater risks of contacting other nasty things in such places.
AS: There is a debate in the log books about what advice to give callers about health scares and about particular places and particular nightclubs - if they has been an association with a particular disease that had been contracted by patrons of a particular night club and about whether to give advice which says - no don’’ go to that particular night club which some volunteers say is alarmist or to give more generic health information about how to be healthy and stay safe and that kind of thing.
TW: Yeah there is a really interesting argument in a subsequent entry – again 20 February 1982 - where they are disagreeing saying that what we are doing is not being alarmist to warn callers that casual sex is places where you can contract certain -and in this case hepatitis- they then make subsequent comparison by saying I for one would not recommend the caller to a dangerous club or pub without a warning of police activity and an absolute firetrap which had suffered recent fires - I just think that is such a good argument to make.
AS: That log book entry is written in all caps which I think goes to show the person is trying to be really clear but also you can tell in the tone of the language and in all caps that there is this real fierce debate going on among volunteers about how to handle these particular maters of sexual health. And it will be because they are concerned with sexual freedom but on the other hand, they don’t want people to get the wrong information and they don’t want people to get sick. So that is a real fundamental tension that volunteers have.
TW: One of things I love about the log boos is imaging a volunteer coming into start their shift and the first thing they do is look back over the log books and read the latest entries and then annotate and underline and criticise or compliment and its this wonderful evolution of what the log books became. And so often -as we can see here - a reference point on how to advise people on sexual health.
AS: So, health is this huge topic in the log books in Switchboard from 1974 to 82. Everything from sexual health testing to transitioning and issues to do with gender identify and these are all like separate areas but they are clearly such a huge part of being LGBT+
TW: That’s why we spoke to Dr Tristan Barber at the Royal Free Hospital in London.
Syphilis and gonorrhoea were a problem in the 70s and they continued to be a problem that we see frequently in sexual health services. Incredible isn’t it that 44 years later we are still seeing the same problems. We are getting a little bit more information really around why that is the case - we are perhaps seeing an increased importance of gonorrhoea that is carried in the throat. Perhaps oral sex is happening and treatments to date may be not clearing gonorrhoea so successful in the throat compartment as opposed to the genital compartments.
We also see rising syphilis rates - these are usually concentrated in men who have sex with men but not exclusively. Antimicrobial resistance has obviously become a problem with some -still relatively small outbreaks of drug resistance gonorrhoea for instance- but fortunately we have not seen resistance to treatment for syphilis infection.
I think some of the noise around the sexual transmitted infections have been obscured to us in the last 20 to 30 years by AIDS and by HIV -of course those were more dramatic infections that we really had to focus our research time and attention on. And I think we are gaining better control of HIV - seeing falling rates of diagnoses particular in men who have sex with men in central London. I think our new efforts in terms of testing frequency, in terms of early intervention, in terms of prevention, are going to be around those other infections like gonorrhoea and like syphilis.
So, I think some of the oxygen - if you like in the system- was taken up by HIV. Not that people weren’t researching syphilis and gonorrhoea, but we had such an urgent need to respond to those infections that now we can start to turn some of our focus back to our old enemies in terms of syphilis and gonorrhoea. So, I think it is really interesting thinking about how people look for and access sexual health services in modern times.
I think people used to think about sexual health services perhaps in adverts in magazines or free LGBT press- increasingly of course people use the internet. I think word of mouth is tremendously important. So, people who have had very good sexual health care at a particular clinic are often very happy to recommend that to their friends and to their sexual partners. Geography is very important -I think in the past in the very early days of our joined up sexual health service networks it used to be that was kind of a rising tide that raised all ships -if you like. So initially people at high risk of sexually transmitted infections, high risk of blood born virus would seek out services and access those particularly in metropolitan areas. But we’ve seen a more liberal attitude to sexuality and sexual behaviours that I think is now more pervasive in areas of the country that perhaps were perhaps less well served by sexual health services historically. There are a number of gender identity clinics that are specific to perhaps the transitioning process or helping people and supporting them throughout their defining their own gender identity better. Of course, there are a number of other issues including mental health, including complex long term conditions - things like epilepsy, asthma, diabetes that may affect transgender or gender different identifying communities and I think its very important now that we start to think about holistic health care and not just sexual health care.
Drugs have become used in a very different way. So I think drugs in the 70s and the 80s and into the early 90s were very much around dancing - very much around partying … parties in people’s homes and so on. And in the last ten years the pattern of drug use has changed into the phenomenon we now as chemsex really focus around three drugs in particular crystal methamphetamine, GHB or GBL, and mephedrone. Often with parties that go on for a long period of time and involve frequent sexual partner change and multiple sexual partners. Of course, some of this hand in hand with the development of apps on our phones and websites where people can meet sexual partners more quickly. So those two factors have really combined into increased sexual health problems, I think, and some mental health problems particularly in some very dense sexual networks of gay men in particular.
TW: Looking back over those 8 years of log book entries written by all of those different volunteers there has been so many discussions around sexual health - including the one about an outbreak of hepatitis linked to people having sex in the Subways club back room. They just didn’t know what was coming. No one did.
Well, Heaven opened -I think -in the late 70s and it was there one evening in I think it must have been the winter of 81/82 that I saw on a notice board a reference to an outbreak of Kaposi’s sarcoma among gays in San Francisco. And this was the first reference I ever had to AIDS or what developed into AIDS.
AS: We’d like to continue covering this story in a second season of the Log Books -picking up where we’ve left off in 1982.
TW: But that is the end for now, so we are closing the log books. We hope to be back again with you soon.
TW: Calls to Switchboard are confidential so to bring the log books to life we’ve changed the caller’s names.
AS: The Log Books is produced by Shivani Dave, Adam Smith and Tash Walker in partnership with Switchboard: the LGBT+ helpline.
TW: If you think other people would like The Log Books please rate and review us on Apple Podcasts or wherever you get your podcasts. These ratings and reviews really help others to discover the show. You can send us your feedback and stories to email@example.com
AS: Our music is by Tom Foskett-Barnes and our artwork is by Natalie Doto.
TW: Thanks to Stef Dickers and team at the Bishopsgate Institute.
AS: The folks at Acast,
TW: Gareth Mitchell at Imperial College London,
AS: The staff and volunteers at Switchboard.
TW: And all the contributors who shared their stories.
45 years on Switchboard continues to take phone calls from 10am to 10pm every day. If you are affected by any of the issues in this podcast or need to discuss anything to do with gender identity or sexuality you can call Switchboard on 0300 3300630; email firstname.lastname@example.org; or instant message via switchboard.lgbt where you can also donate money or time to help.