Let us begin with a definition of terms. We take “sex” to be a reference to basic biology. Within a fairly broad spectrum of tests, it is usually possible to classify a person as either male or female. Slightly less than 1% of all babies are potentially indeterminate on birth and it has been the practice to encourage development one way or the other by surgery. “Gender” is all the other cultural stuff about how people are expected to act in their different roles. Hence, some people born to one sex may opt for surgery to allocate them to the other gender. The first ideas for legal intervention in what we now think of as being civil rights, focussed on discriminations based on race, color and religion. But, as from 1964 and the arrival of Title VII on employment opportunities, discrimination on the ground of sex was also outlawed. There have been several other major federal laws and an increasingly impressive pile of appeal and Supreme Court decisions extending sexual discrimination to cover the more general gender discriminations. In the modern mixture of federal and state laws, most everyday situations are covered by antidiscrimination provisions.

It is therefore disappointing to note the reality of clinical trials to test drugs, clinical devices and medical procedures. Almost without exception, they are advertized as being for heterosexuals only. In recruiting, a significant percentage of the community is excluded. In the case of erectile dysfunction trials, this is particularly disappointing. Upon what grounds do researchers assume gay men have no sex lives? Why are their needs ignored with researchers implying that solutions suitable for heterosexuals must be suitable for gays? In a recent survey, thirty-seven trials dealing with sexual function, libido and relationships were identified with express exclusions.

As a part of this research, the manufacturers and leaders of the research teams were asked to explain and, if possible, justify this discrimination. Bayer was asked about a trial of levitra – testing whether it enabled sexual response after radical surgery for prostate cancer. Its response is indicative of some lazy thinking. One of the tools used in research into erectile dysfunction is a questionnaire of sexual performance and personal satisfaction. The questions assume a couple but of different sex, for example asking for detailed information on whether penetration by the man into the woman was achieved. This questionnaire is standard. All research teams around the world use it. So it was impossible to allow gay men into the trial because they could not answer all the questions. Like it was somehow impossible to rewrite any of the questions and have this new set of questions accepted as an international standard.

This is not to say that gays are the victims of discrimination when it comes to accessing treatment. But it is surprising as we enter a new decade in a new century that a significant minority group is being denied the chance to try new drugs and medical procedures. Levitra should work on a man regardless of his sexual orientation. Notice the “should”. Male biology should always work the same way regardless of orientation. But there can be sometimes conflicting psychological issues and failing to take account of these in testing erectile dysfunction drugs does seem somewhat unfair. In general there should be a positive move to include gay, lesbian, bisexual and transgendered people in all medical trials.