The mainstream media and public health officials are being so damn careful not to label monkeypox “a gay disease” that they’re doing a disservice to the gay men who most need important information about the outbreak – while misleading everybody else.
In a July 28 New York Times story of the excruciating symptoms and lack of care available for those with monkeypox in that city, the sexuality of the men profiled isn’t referenced until 11 paragraphs into the story, and even then it refers to them as “men who have sex with men,” which is technically correct but dodgy. Moreover, the article, which supposedly addresses barriers to care, ignores the fact that gay men routinely experience apathy and even judgment from health providers.
Other media stories, and statements from the Centers for Disease Control and Prevention, have mentioned monkeypox cases in the context of “the LGBT community.” Really? Should lesbians be lining up for a monkeypox vaccine, whenever the heck they become widely available? This is happening to gay men. Say it.
Journalist Benjamin Ryan, in his excellent Washington Post opinion piece, draws a hard line between attempts not to unnecessarily stigmatize gay men and the importance of telling the truth about monkeypox, writing that “public health officials cannot be expected to police the public’s reactions to epidemiological facts.”
Ryan lays out those facts plainly:
Here is what we can discern from data collected about monkeypox so far: This viral outbreak isn’t just mostly occurring among men who have sex with men. The confirmed cases, at least to date, have consistently almost entirely occurred among this demographic, which accounts for 96 percent or more of diagnoses where data are available.
Per capita, the few monkeypox cases in women and children remain minuscule compared with the rate among gay and bisexual men. Of course, substantial transmission could always occur among such other groups. But researchers at the WHO and elsewhere have speculated that the monkeypox reproduction rate will likely remain significantly lower in such demographics — meaning the virus will more likely hit transmission dead ends among them than among gay and bisexual men.
An uncomfortable truth, one documented in peer-reviewed papers, is that sexual behaviors and networks specific to gay and bisexual men have long made them more likely to acquire various sexually transmitted infections compared with heterosexual people. This includes not only HIV, but also syphilis, gonorrhea, chlamydia, hepatitis B and sexually transmitted hepatitis C.
Global public health experts agree that skin-to-skin contact in the context of sexual activity between men has been the principal driver of the monkeypox outbreak, at least thus far.
Such experts have also asserted that the risk of monkeypox to the broader population not having multiple sex partners remains low — even “very low.” This is hopeful news, and the wider public deserves to be reassured accordingly. Assuaging fears of contagion will help fight unhelpful hysteria and prevent gay and bisexual men from being subjected to even greater stigma should they be painted as culprits of the spread of virus to others.
Monkeypox didn’t begin with gay men, that much is true. As Yale infectious disease expert Gregg Gonsalves explained to the New York Times, “This is not a gay disease; it has been circulating in West and Central Africa for many years… What likely happened, in this case, is that somebody who had monkeypox had a lesion and showed up at a gay rave in Europe, and it spread to those in that social and sexual network.”
Whatever the origins, we’re now dealing with an outbreak almost entirely limited to gay men in the United States and Europe. And that is worth saying explicitly.
Why? Because identifying those at risk and getting information to them is a basic public health strategy for containing an outbreak. Gay men are getting monkeypox and suffering greatly. When gay men understand the threat, we are more likely to take precautions, get vaccinated, or be informed about treatment.
Will there be stigma and judgements and homophobia? Of course. And we’ll have to deal with that. But that doesn’t mean we bury crucial facts in vague, evasive messaging.
Monkeypox is a gay thing. That’s the truth.
Mark S. King is an award-winning blogger, author, speaker, and HIV/AIDS activist who has been involved in HIV causes since testing positive in 1985.