Gay Men: Self Image, Tanning, and Skin Cancer

by Melinda Lejman 


…sexual minority (homosexual) men were as much as twice as likely than heterosexual men to develop skin cancer. In fact, sexual minority men were found to have the highest rates of skin cancer in the survey.
—JAMA Dermatology Journal


The doctor’s office is one place where openness and honesty about sexual orientation can be a matter of life and death. And as in many areas of society, either social taboos or a lack of knowledge can limit our understanding of health risks. A 2015 study published in the American Medical Association’s Dermatology journal, JAMA Dermatology, found significant disparities between the skin cancer rates of heterosexual subjects and those the study’s authors describe as ‘sexual minorities.’ Specifically, the authors found that, among the 200,000 patients reviewed, sexual minority men were at least 50% and as much as twice as likely than heterosexual men to develop skin cancer. In fact, sexual minority men were found to have the highest rates of skin cancer in the survey.

According to the study, this is not the only condition where gay men face heightened risks. They are disproportionately likely to develop other forms of cancer, substance abuse disorders, and mental health issues. A broader theory has developed around the risks faced by sexual minorities and by minority populations in general. The argument is that social pressures, stigma, and discrimination exacerbate both mental and physical illness. In the doctor’s office, social pressure not to acknowledge sexual orientation prevents effective care, discussions of risk, or reporting of symptoms. In the bigger picture, such disparities can extend to public awareness or medical research into diseases associated with sexual minorities. However, in the case of skin cancer, the 2015 study noted a specific behavior that sexual minority men participate in at higher rates than other populations: indoor tanning.

Indoor tanning is a multibillion- dollar industry. In 2009, the International Agency for Research on Cancer rated
indoor tanning as a group 1 carcinogen. As such, there is a high link between indoor tanning and skin cancer rates. Previous studies largely highlighted the rates of indoor tanning among women. However, when broken down by sexual orientation, it is sexual minority men who tan more than other populations. These men are over four times more likely to tan than heterosexual men, and slightly more likely to tan than heterosexual women (sexual minority women tan at a lower rate than heterosexual women, but at higher rate than heterosexual men).

So why do sexual minority men tan more frequently than other groups? The study’s authors suggest this trend reflects high rates of body dissatisfaction and the tendency amongst those facing social pressure to seek outlets that reinforce self-esteem or the perception of health. As of 2015, little research existed to build on this study either in terms of indoor tanning usage or additional causes of the high skin cancer rate for sexual minority men. In addition, significant biases persist in the medical community. However, the study acknowledges this while concluding that doctors who do ask questions about their patients’ sexuality and discuss the challenges sexual minorities face often find patients open to sharing information and help create a better healthcare experience.

The safest time to be outdoors is before 10 a.m. and after 4 p.m. If you can’t avoid those times, try to stay in the shade.

Use sunscreen with both UVA and UVB protection, as well as zinc oxide and titanium dioxide, to protect against cancer-causing rays.

Reapply sunscreen every two hours. If you are swimming or begin sweating, reapply every 30 minutes.

While sunscreen is one form of protection, it can be the least effective. Consider wearing a wide-brimmed hat, swim shirt, and cover your chest, neck and ears. You can also find clothing and sunglasses designed to protect against UV rays.

Indoor tannings (tanning beds) are rated as a group 1 carcinogen by the International Agency for Research on Cancer. If you do use tanning beds, talk to a dermatologist about your specific risk for developing skin cancer.

Worried about a suspicious spot? Here are the ABCDE signs of melanoma, one of the deadliest forms of skin cancer.

Asymmetry One part of a mole or birthmark doesn’t match the other.
Border The edges are irregular, ragged, notched, or blurred.
Color The color is not the same all over and may include shades of brown or black, sometimes with patches of pink, red, white, or blue.
Diameter The spot is larger than ¼ inch across – about the size of a pencil eraser.
Evolving The mole is changing in size, shape, or color.

Basal cell carcinoma


Squamous cell carcinoma