STD Awareness: Can the HPV Vaccine Prevent Head-and-Neck Cancer?

Photo: Heather Hazzan, Self Magazine

The HPV vaccine Gardasil protects against human papillomavirus, a prolific virus that causes many types of cancer. In fact, although it was initially approved to prevent cervical cancer, the most common HPV-associated cancer is head-and-neck cancer. Last month, Gardasil 9 was finally approved for the prevention of head-and-neck cancer.

That certainly took long enough! We’ve known for a long time that HPV is behind the epidemic of head-and-neck cancers, and we’ve known that the HPV vaccine guards against infection with this virus. With HPV causing more head-and-neck cancers than any other HPV-associated cancer in the United States, this approval was long overdue.

Bearing the Burden of HPV


Gardasil 9 is now approved for the prevention of head-and-neck cancer, shining a light on this epidemic.


Although its routine use in boys and men has been recommended since 2011, the HPV vaccine is still primarily thought of as a “girl’s vaccine,” invaluable for its ability to prevent cervical cancer. For the first few years of its existence, Gardasil was only FDA-approved for girls and women, and since then it has struggled to escape its gendered connotations. While this new FDA approval doesn’t change who is eligible to receive the vaccine, it does shine some awareness on head-and-neck cancer, and gives parents more evidence that this anti-cancer vaccine is important to give to sons, not just to daughters.

Head-and-neck cancers can strike anywhere from the lips to the larynx, or voice box, and up into the sinuses and nasal cavity. According to the Centers for Disease Control and Prevention, an estimated 11,300 U.S. men are diagnosed with head-and-neck cancer every year, compared to 2,200 U.S women. Continue reading

STD Awareness: Is HPV Now a “Men’s Disease”?

Human papillomavirus, or HPV, is most notorious for causing cervical cancer — making it, in many people’s minds, a “women’s disease.” But this gender-blind sexually transmitted virus can cause cancer in any cell it infects, and is associated with cancers of the cervix, anus, vagina, vulva, penis, and mouth and throat — aka oropharyngeal cancer.

While oropharyngeal cancers used to be caused mostly by tobacco, as people quit smoking an increasing proportion is caused by HPV. In the 1980s, only 15 percent of oropharyngeal cancers were caused by HPV, but nowadays the virus is behind 70 percent of them. A 2011 study predicted that the number of HPV-positive oropharyngeal cancers will surpass cervical cancers by 2020.


HPV is rapidly gaining prominence among men.


It’s only 2017, but we’re ahead of schedule. Earlier this year, researchers reported that, in the United States, oropharyngeal cancer is more common among men than are cervical cancers among women — and oropharyngeal cancer rates are increasing in the male population, while they are relatively stagnant among women. These rates are projected to continue climbing, which will skew oropharyngeal cancer even more heavily toward the male population. But, in the public’s imagination, HPV is most well-known for its association with cervical cancer — while most people haven’t even heard of oropharyngeal cancer.

Oropharyngeal Cancer and HPV

Oropharyngeal cancer can strike the inside of your mouth and throat. Risk factors include tobacco (including cigarettes, snuff, and chewing tobacco), marijuana use, alcohol, and oral infection with HPV. HPV can be spread by most sexual activities — including vaginal, anal, and oral sex, as well as “French kissing” and rubbing genitals together. There are many strains of HPV, which come in two main categories: low-risk HPV, which can cause genital warts; and high-risk HPV, which can cause cancer. Continue reading

Let’s Talk About … Being the Parent of an LGBTQ Child

The following guest post comes to us from Planned Parenthood Arizona’s education staff. Contact them at education@ppaz.org.

father-and-son-thumbnailOctober is Let’s Talk month, when Planned Parenthood advocates for better parent-child communication around sexuality. Last year we wrote about why it’s so important for any parent to talk to their child about sexuality — early and often. Parents are the primary sexuality educators of their children, and children who can talk to their parents about sexuality wait longer to have sex, and are more likely to use protection.

Planned Parenthood has great resources to help parents talk to their kids. Advocates for Youth also has a comprehensive guide to help parents through difficult conversations. Planned Parenthood also has resources for parents of LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning) youth. You might also ask your friendly local librarian about one of these books recommended by PFLAG, a national organization for families, friends, and allies of LGBTQ people.


Demand LGBTQ inclusivity and comprehensive sex education in your school district.


On November 2, Planned Parenthood will host an interactive workshop in Phoenix for parents of LGBTQ youth, where they can practice being an “askable” parent. Parents of LGBTQ kids may find it a little more difficult to be an “askable” adult. But it’s even more important because your children are at particular risk. LGBTQ youth face significant obstacles in their schools, in the world, and, sometimes, unfortunately, in their own homes. LGBTQ youth experience high rates of homelessness, depression/anxiety, and astronomically high rates of suicides — 3 times higher than straight youth. Study after study has shown that, in schools, LGBTQ youth face much higher levels of bullying, harassment, intimidation, threats, and physical assault than their peers. Stopbullying.gov reports that bullied LGBTQ youth (or youth perceived as LGBTQ) are more likely to skip school, smoke, use alcohol and drugs, and to engage in other risky behaviors.

If your child is transgender, their risks are exponentially higher. Almost all transgender students report being harassed at school about their sexual orientation and/or gender. More than half of transgender students report being physically harassed (pushed, shoved) in school. And about a third report being physically assaulted (punched, kicked, or injured with a weapon). For more information on transgender discrimination in schools, please see Harsh Realities: The Experiences of Transgender Youth in Our Nation’s Schools, available online here. Continue reading

Today Is Transgender Day of Remembrance and Resilience

The following guest post comes to us via Kelley Dupps, public policy manager for Planned Parenthood Advocates of Arizona.

candleNovember 20 is Transgender Day of Remembrance & Resilience — a day that honors the memory of those killed because of anti-transgender prejudice. So far this year, each week a trans woman lost her life to this violence. Targeted simply for who they were, these women should not only be remembered and celebrated but should also be fuel to power the movement that stands up for fairness and equality for trans folks.

Transgender Day of Remembrance & Resilience is also an opportunity for the trans community and our allies to share stories about pervasive crimes against trans folks and to celebrate the resilience of a community often living in the shadows. The 2014 Hate Violence Report, which documented hate crimes perpetrated against lesbian, gay, bisexual, transgender, queer, and HIV-affected individuals, showed an increase in transgender murder victims. Of the murder victims documented in this report, 80 percent were people of color, and 50 percent were transgender women. Transgender people of color were also 6 times more likely than the other groups studied to experience physical violence from police. These reports from the National Coalition of Anti-Violence Programs paint a bleak picture for the transgender community, particularly the trans women of color communities. The FBI also tracks violence against those living with HIV and is able to get a more complete picture of the violence targeted to trans communities.

Findings from the Injustice at Every Turn report, conducted by the National Center for Transgender Equality, showed alarming rates of violence and harassment experienced by the transgender community, including in educational settings, at work, during interactions with police and other authorities, at homeless shelters, when accessing public accommodations, and in jails and prisons.

At this time, 14 states, the District of Columbia, and more than 125 municipalities offer hate crimes protections that are inclusive of sexual orientation and gender identity. Arizona is not currently one of the states that protects LGBTQ people from violence and discrimination; however, several cities in Arizona do have nondiscrimination policies that protect city workers and community members: Phoenix, Tucson, Flagstaff, and Tempe.

After its signing in October 2009, the Matthew Shepard and James Byrd, Jr., Hate Crimes Prevention Act has made it a federal hate crime to assault an individual based on actual or perceived disability, gender, sexual orientation, or gender identity. This landmark legislation both mandates that the FBI track hate crimes based on anti-transgender bias and allows the Justice Department to assist in the prosecution of local hate crimes based on gender identity.

Much more needs to be done to address the level of violence and harassment targeted at transgender individuals. Please take a moment to remember those lost to violence and celebrate the resilient trans spirit. It’s time we commit to creating a world inclusive of all trans folks. Tag your own selfie and transformational message of how you would make your community safer for transgender people and post on social media with the hashtags #TransMonth and #PPAZ.


You can follow PPAA on Twitter @ppazaction and Instagram @PPAArizona.

STD Awareness: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Not to scale: Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.

There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?

All good questions. Let’s examine them one by one.

Is BV an STD?

The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”

On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.

The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).

What about heterosexual transmission? Continue reading

STD Awareness: Gardasil and Gendered Double Standards

male female teens largeDespite the fact that it’s been approved for males for years, Gardasil is still largely seen as a vaccine for girls, and human papillomavirus (HPV) is still thought of by many as a virus that only impacts the female population. The fact of the matter is that HPV can have serious consequence for boys and men, and Gardasil is an important tool in protecting their sexual health. Why, then, does the association between girls and Gardasil persist?


Let’s stop thinking of Gardasil as the cervical cancer vaccine. Gardasil is a cancer vaccine, period.


Before Gardasil’s introduction, the pharmaceutical company Merck launched an HPV-awareness campaign to get a buzz going for their upcoming vaccine. Their talking points could be boiled down to one simple fact: HPV causes cervical cancer. Outside of the medical field, HPV was a little-known virus, and Merck strove to connect HPV and cervical cancer in the public’s mind so that, after it hit the market, Gardasil’s value would be easily recognized.

So the origins of the association between girls and Gardasil lie in its marketing — and the fact that the Food and Drug Administration (FDA) initially only approved its use in females. From its introduction in 2006 until 2009, Gardasil was only FDA-approved for use in girls and women, and its routine use in males was not recommended by the Advisory Committee on Immunization Practices until December 2011.

While Gardasil’s website is currently gender neutral, archives show that before FDA approval for males, it contained photos of young women and female-specific language. This initial focus on female recipients could have “feminized” Gardasil, entrenching its association with girls and women in the cultural imagination. Some scholars say that, by only recommending it for one sex, the FDA implicitly assigned liability for HPV transmission to females, and advertisers framed the woman as a disease vector in taglines targeting females, such as “spread the word, not the disease.” Although a male’s sexual history is a major predictor of a female partner’s HPV status, girls and women were assigned sole responsibility for their HPV status while boys and men were not similarly burdened. Such messages downplayed the male role in HPV transmission as well as HPV’s effect on males. Continue reading

Toward Improved Care for LGBTQ Patients: New Guidelines Shine Spotlight on Addressing Health Disparities

doctorsOn January 5, Florida became the 36th state in the nation to legalize same-sex marriage, joining a movement that is sweeping across the United States. With federal judges striking down same-sex marriage bans left and right, it seems inevitable that we will soon live in a country that recognizes the freedom to marry. Yet, although more Americans than ever support marriage equality, the fight for the full inclusion of lesbian, gay, bisexual, and transgender individuals in our society is not over, as they continue to face significant barriers to quality medical services.


Full equality includes access to high-quality medical care, regardless of sexual orientation or gender identity.


The obstacles that have historically prevented LGBTQ patients from obtaining medical care continue to plague our modern health care system. Sure, the American Psychiatric Association no longer considers homosexuality a mental illness. But a concerning number of health care providers still refuse to serve LGBTQ individuals, and until the passage of the Affordable Care Act, insurance companies were not required to extend domestic partner benefits to same-sex couples. Moreover, the stigma that surrounds homosexuality prevents many patients from disclosing their sexual orientation to doctors. Because the LGBTQ community faces higher rates of certain conditions, including depression and substance abuse, failing to discuss sexual activity can lead to inadequate treatment.

One of the U.S. health care system’s most serious shortcomings is its failure to prepare doctors to work with LGBTQ patients. Young doctors are emerging from medical school ill-equipped to deal with the specific needs of the LGBTQ community. A 2006 study published in Family Medicine surveyed 248 medical students, finding that the vast majority of students held positive attitudes toward LGBTQ patients and hoped to provide them top-tier care. Unfortunately, the same group of students failed spectacularly when tested on LGBTQ-specific health concerns. Another study revealed that most medical schools throughout the United States and Canada devote minimal (if any) instructional time to LGBTQ issues, and that the quality of such instruction varies drastically across institutions. And significantly, many doctors report that they feel uncomfortable discussing sexual behavior with LGBTQ patients. Continue reading