07/03/2026
An STI testing lab was caught throwing most gonorrhea samples in the trash and simply marking patients as “negative.”
Think about that.
What would happen?
Lawsuits.
Investigations.
National headlines.
People would be furious.
That didn’t literally happen.
Yet in a way, it is happening.
Let me explain.
There are three things you need to understand.
#1. Gonorrhea can be ge***al, a**l, or oral.
Most cases are oral. In screening studies, oral gonorrhea is often about 2x as prevalent as ge***al gonorrhea.
#2. Most people buying STI tests are asymptomatic.
People with painful ge***als usually go to urgent care. Screening customers usually feel fine.
#3. Oral gonorrhea is only detected with a throat swab.
No throat swab = most infections missed.
Now we’re on the same page.
Here’s the ethical dilemma.
Patients do not know this.
I doubt 1% of people shopping for STI testing today understand oral vs a**l vs ge***al gonorrhea, or how site-specific swab testing works.
Testing platforms are financially incentivized to keep testing limited.
If you already have a urine tube or ge***al swab in the kit, running one gonorrhea assay costs far less than running three assays (oral, a**l, and ge***al).
That’s the economic reality.
Yet I have almost never seen a company offering ge***al-only gonorrhea testing clearly explain this limitation to patients.
Let me ask the ethics question another way.
At Shameless Care, we only offer three-site gonorrhea and chlamydia screening.
Today, 86% of our positive gonorrhea cases are oral only.
Read that again.
86%.
Their ge***al test was negative.
If I wanted cheaper test offerings, higher conversions, and better margins, I could switch tomorrow to ge***al-only testing.
Our positive gonorrhea rate would collapse.
Not because infections disappeared.
Because we stopped looking.
And if I didn’t tell patients that this new test would miss most gonorrhea infections for the very disease it claims to detect…
Would that be ethical?
If not, then why is it standard practice for so many labs and telehealth companies to sell ge***al-only gonorrhea testing without clearly explaining that limitation?
That’s the part I struggle to understand.
