Many of the men Dr Amarasekera sees at the program’s two clinics – one in downtown Chicago and the other in the historically gay neighborhood of Northalsted – are unprepared for a new health crisis. One of them is a 59-year-old lawyer from Chicago who is HIV-positive and who said he was not fully aware of how the removal of his prostate would affect his body.

“There is a waste,” said the lawyer, who asked not to be cited by name because not all of his family were aware of his HIV status. “There is a feminization of the body, a narrowing of the genitals. “

The health care system, he said, “marginalizes gay men, especially when it comes to sexual health, and the prostate is so linked to the sexual health of gay men. It’s a sexual organ, and it’s been taken out.

“A former urologist just said, ‘Go ahead and enjoy your life, and goodbye,’” the attorney said.

Gary Dowsett, professor emeritus at the Australian Center for Sex, Health and Society Research at La Trobe University in Melbourne, Australia, said that such treatment, while not meant to be callous, is not uncommon. It’s just that many urologists don’t realize that the prostate is “kind of a male ‘G-spot”, and gay men are more often aware of it.

“If they don’t understand the prostate’s role in sexual pleasure, that’s rarely a priority discussion,” Dr Dowsett, himself a prostate cancer survivor, said of urologists. “The emphasis is usually on continence and erections, as if sex starts and stops there.”

Jane Ussher, professor at the University of Western Sydney, Australia, has been studying the effects of cancer in gay men for 20 years.