If steroid use is thought to be a problem among Toronto queers it's not something folks are rushing to learn more about in a group setting. An info session at the Sherbourne Health Centre (SHC) was cancelled due to low turnout.

"I'm not sure why people didn't sign up for it," says Keith Loukes, a physician at SHC who was scheduled to present the December workshop. "It could be that people aren't very interested in learning anything about it or that they think steroids are completely safe and that there's no risk associated with their use. There are also some people who feel that they know most of what there is to know about steroids — though they continue to use these substances knowing of the potential risks."

But Loukes says reluctance to talk about it doesn't mean steroid use isn't an issue in the local gay scene.

"I have patients that take steroids," he says. "Some disclose but most don't. I'm assuming that on some level they know that there are health risks to doing it and they feel guilty or ashamed.

"It's too bad because the patients that do disclose... I can help them or provide education, see where they're at, do harm reduction and make sure that they are injecting safely. In knowing the entire picture there are ways that I can help."

Human growth hormone and testosterone continue to be the most common types of steroids taken says Loukes, adding that some users combine the two drugs or make high-potency cocktails out of the various forms of the drugs available.

"There are different forms of testosterone that people are taking including a popular one called Deca," says Loukes. "Sometimes people will combine them or use cocktails and take them all at once or use one form and then move onto another one."

Loukes dismisses statements found online at various bodybuilding and antiaging websites that claim human growth hormone is safe for cosmetic use.

"The discussion out there that human growth hormone is without risk and side effects is just a load of crap," he says. "It's a high-potent steroid that your body stops producing or greatly reduces production of for a reason. Reintroducing that into your body after adolescent development is going to have consequences.

"I've seen people with cardiovascular disease, liver disease, even neopsychiatric conditions from taking steroids, not to mention testicular atrophy and the genital and sexual impact from comes from taking them."

Not that steroids don't have their uses. Loukes says he regularly prescribes them to patients who are experiencing wasting due to the effects of HIV/AIDS.

"It's something I don't mind prescribing and routinely do in some cases because you really need patients to try and gain muscle mass back on when the virus has caused excessive wasting and weakness," says Loukes, "but what I'm more concerned with is the nonmedical use of steroids and that's usually involved around body image."

Although there is no way of knowing how many queers in Toronto are taking the muscle-building drugs to get buff Loukes says, "It is so prevalent in the community and it's something that people don't really talk about."

When patients do disclose their steroid use to him Loukes says he informs them of risks involved without being critical or condescending.

"I don't criticize or discriminate against anybody that uses them. We're all adults and if someone chooses to do a particular thing that's their own issue.

"Steroids that you purchase or obtain from other sources [other than through a doctor] have legal implications that you have to be aware of," he says, "but it's not my place to impose that on them. I do try to be as supportive as possible."

After the cancellation of the info session Loukes is thinking of other ways to caution 'mos about steroid use. "What I'm thinking now is perhaps going through providers in the community like counsellors, physicians, nurses, people at The 519, maybe even people that work at the various gyms.

"We failed to get this group up and running this particular way but we'll think of another way of delivering the message."