Contagious misconceptions

How monkeypox affects the LGBTQ+ community

Jackie Marquez / Asst. Opinion Editor / The USD Vista

Monkeypox is a growing concern for many Americans, but for gay and bisexual men it is already a harsh reality. As cases spread throughout the U.S., this disease is primarily affecting male members of the LGBTQ+ community. Now, public health officials are struggling to raise awareness and prevent the spread of the virus, while also avoiding the stigmatization of those who contract Monkeypox. Currently, the conversation about Monkeypox focuses on gay and bisexual men. This needs to change. As officials confront this challenge, it is crucial that they are mindful of the narrative they create around the disease and its consequences.

Although this disease has been around since 1970, this is the first time it has spread throughout the U.S. According to the Center for Disease Control (CDC), Monkeypox is a virus from the same family as smallpox. The main symptom is a rash that resembles pimples or blisters, but it also causes symptoms such as a fever, headaches and body aches. As of Sept. 15, there were 23,117 reported cases of Monkeypox in the U.S. In California, there were 4,453 reported cases, as well as one death, which occurred in Los Angeles County. Compared to COVID-19, Monkeypox is less widespread and significantly less fatal.

The CDC reports that the disease is spread through direct contact with someone who has the disease. This includes touching the rashes or scabs of an infected person, touching objects or fabrics that an infected person has used or making contact with respiratory secretions from someone who has the disease.

Currently, Monkeypox is disproportionately affecting gay and bisexual men and is commonly spread through sexual encounters. According to the World Health Organization, in cases where sexual orientation was known, 95% of those who contracted Monkeypox were men who have sex with other men. In cases where the type of transmission was reported, sexual encounters made up 90.5% of all transmissions. The other 9.5% was reportedly transmitted through “person-to-person” contact, which is nonsexual contact such as hugging or massages. It was also transmitted through contact with contaminated materials. Given the magnitude of these statistics, the approach to limiting the spread of disease is centered around gay men and sexual contact.

Resources such as vaccines are primarily being offered to gay and bisexual men. The California Department of Public Health released a statement that created tiered groups explaining who should be prioritized for the Monkeypox vaccine. Tier one, those who are the top priority for vaccination, includes gay and bisexual men, as well as trans women who have sex with men. To be in this tier, individuals must meet certain criteria, including having been diagnosed with a bacterial STI in the last three months, engaging in group sex with other men, engaging in anonymous sex with other men and other high-risk sexual behaviors. Tier two includes the same demographics as tier one: gay and bisexual men. However, these individuals are considered tier two if they do not engage in the activities mentioned in tier one’s criteria.

While it is important that America’s most vulnerable demographics are prioritized for preventative measures and treatments, it is risky for officials to focus the majority of their resources and messages toward one group. According to the CDC, “focusing on cases among gay and bisexual men may inadvertently stigmatize this population and create a false sense of safety among those who are not gay and bisexual men.”

This stigmatization already began among conservative commentators. In response to the CDC’s advice for limiting sexual contact during a Monkeypox outbreak, conservative commentator Kathy Barnette tweeted, “Chastity. Celibacy. Modesty. Disciplined. Not being gross. Keeping your legs closed. All viable options, people.”

Shaming individuals who contract Monkeypox is counterproductive. It ultimately discourages people from coming forward and getting treatment, potentially causing more spread. It is imperative that public health officials emphasize to the public that the disease can be transmitted in a nonsexual context as well. Afterall, Monkeypox isn’t just spread through sex; it can also be spread through hugs and sharing clothing. Emphasizing this information would alleviate stigmatization, while better educating the public about how Monkeypox is spread.
Public health officials must also highlight the fact that anyone can get the disease, regardless of sexuality. Although gay and bisexual men make up the majority of Americans who contract the virus, women,  heterosexual men, and nonbinary individuals can still catch the disease. Framing Monkeypox as something that affects the LGBTQ+ community gives other groups a false sense of security and can lead to a lack of preventative action.  To prevent this stigmatization, it is crucial that officials emphasize how this disease also affects women,  heterosexual men, and nonbinary people. To overlook this fact is irresponsible.

This framing issue has historically plagued the LGBTQ+ community, specifically during the 1980s amid the AIDS crisis. Monkeypox has been compared to AIDS by commentators and health officials alike, but this comparison is a risky one. Unlike AIDS, Monkeypox is not a new disease. At the beginning of the AIDS crisis, there was no known cause or method of treatment. Today, health officials know about the origins of Monkeypox and have a vaccine to help prevent it. The death rates between AIDS and Monkeypox are also incomparable. Despite this, there are still parallels between the diseases.

In an editorial titled “Monkeypox – Past as Prologue,’’ Dr. Anthony Fauci discussed the similarities and differences of Monkeypox and AIDS. “The emerging epidemiologic pattern of these cases bears a striking resemblance to the early cases of HIV/AIDS,” Fauci writes. Both diseases are hallmarked by a disproportionate amount of cases affecting gay and bisexual men. On top of this, both diseases were met with stigma toward gay men. Examining these similarities allows us to learn from past mistakes.

 In the 1980s the approach to AIDS was political and highly moralistic.  According to a study published in the National Library of Medicine titled “Good Politics, Bad Politics: The Experience of AIDS,” AIDS became political because it highlighted social injustices, like marriage inequality, a lack of legal protections against discrimination and an inability to access healthcare for low-income Americans. This politicization resulted in moral and political judgments being tied to information about the disease. This information then contributed to further stigmatization of the LGBTQ+ community.  

Officials know from the AIDS crisis that stigmatization can be oppressive and deadly. According to a study by Turen et. al published in the National Library of Medicine, “In the case of people living with HIV, stigma has negative effects on health outcomes, including non-optimal medication adherence, lower visit adherence, higher depression and overall lower quality of life.” Comparing AIDS to Monkeypox emphasizes the danger of letting history repeat itself. Approaches to the disease cannot include pushing moral judgment. Officials must share information about how the disease is spread, without shame or judgment.

By overemphasizing the role of sexual contact and the affect on gay men, health organizations shape how we view the Monkeypox virus. While much of the information we have about Monkeypox focuses on the role of sexual contact in transmission, it is inaccurate to communicate information about Monkeypox as if it were an STI that only affects men who have sex with other men. Public health organizations have an obligation to tell the full story about Monkeypox, and to do so they must expand the conversation to include all types of transmission and all demographics of people.