Line ‘Em Up

By Patrick Fratellone, Jallen Rix, David Rosenberg


When is a good time to start Botox? I’ve heard that it’s better to do it preventively, but how young is too young?

Kane via

I get asked a lot about when is the right time to start us- ing Botox for minimizing the appearance of wrinkles. Of course, there is no absolute age (although if you haven’t started by 50, it’s probably too late) because timing varies with skin type and ethnicity. My rule of thumb is that when a wrinkle crease begins to remain even after facial movement has stopped (a static wrinkle, versus a dynamic wrinkle that you see with squinting or smiling), it’s time to start using Bo- tox. This tends to happen between the ages of 27 and 35. There are some who wish to have Botox earlier because they don’t like the way their face moves or wrinkles even with dynamic wrinkles, but this use is less common. If Botox treatment is be- gun later in life, the static wrinkle may not go away completely after treatment, but it may improve over time with continued treatment to relax the muscle. —DR



Elevated Risk

Are gay men really at a higher risk for anal cancer? Is there something preventive we should be doing to protect ourselves; be it colonoscopy or something else?

Doug via

A: Anal cancer is a rare dis- ease in the general population, but among gay and HIV-positive gay men, the incidence of anal cancer is significantly higher and increasing annually. In the general population, the incidence is two out of every 100,000, however in gay men (with and without HIV) the incidence is 40 out of every 100,000. While women fear the human papillomavirus that causes cervical cancer, as gay men we should fear other strains of HPV that cause anal cancer. Gay men get HPV through both protected and unprotected anal intercourse and through skin-to-skin contact. The one way to protect yourself is to wear a condom and know your sexual partner. As men, we can ask our doctors to perform an anal Pap, as studies recommend them every three years. If you have a history of receptive anal intercourse (aka “bottoming”) you are at a higher risk for anal cancer. Smoking also puts you at a higher risk, but another risk factor for developing anal cancer is the use of recreational drugs anally. Using crystal meth or Ecstasy in the rectum can lead to higher rates of anal cell dysplasia which can lead to anal cancer. You should only have a colonoscopy if you have a positive anal Pap or there is a suggestion of other gastrointestinal issues like constipation, bloat- ing and/or diarrhea. But, when it comes down to it, follow the advice of my 22-year-old gay son: “No glove, no love.” —PF



Regular Rompings

I know you’re probably go- ing to say that it is different for every couple, but what is the normal amount of sex for a gay couple to have? My boyfriend and I generally have sex two or three times a week, which I think is fine but friends have said is pathetically low.

Carson in Dallas, TX

A: You are correct, Carson. Because you think that having sex two or three times a week is fine (and your partner agrees) then that’s “normal” for you. It would be one thing if you weren’t having sex at all. It would be another thing if, after several years, you were bored—these are different concerns. In the 1930s, the father of all sexology, Alfred Kinsey, along with his colleagues interviewed literally thousands of people about their sexual practices. He believed that one of the most common threads to hu- man sexuality was that we are all different. This, of course, is rather logical, because none of us are identical, our sexuality included. Almost a century later we’re still preoccupied with the notion of what is “normal,” and everyone from politicians to bullies to so- called “friends” think it’s some- how more important to fall in line, rather than explore the furthest reaches of our uniqueness. Don’t let your sexual passion be defined by what’s “normal” (or defined by your friends). Let your sexuality be guided by your passion for intimacy, both dark desires and mainstream titillations—whatever that authentically looks like for you. Create a safe environment so that both you and your partner can explore, give and receive all that you want in the sexiest man- ner possible. —JR

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