English Version | Within touching distance

01 Sep 2022
By Pedro Vasconcelos

The increase in the number of cases of monkeypox has led the World Health Organization to decree the LGBTQIA+ community as an at-risk population. Faced with the spread of this disease, which manifests itself on the skin, a restlessness is growing that is based not only on fear of the diagnosis but on the discrimination it fosters. As in the past, fear permeates every millimeter of our skin: every wound a worry, every scratch an irremediable source of anxiety.

The increase in the number of cases of monkeypox has led the World Health Organization to decree the LGBTQIA+ community as an at-risk population. Faced with the spread of this disease, which manifests itself on the skin, a restlessness is growing that is based not only on fear of the diagnosis but on the discrimination it fosters. As in the past, fear permeates every millimeter of our skin: every wound a worry, every scratch an irremediable source of anxiety.

 

Photography by Ziqian Liu
Photography by Ziqian Liu

When I was eighteen years old I began to notice spots on my skin, small marks that were randomly distributed all over my arms. I decided to make an appointment with a dermatologist. At the doctor's office, I casually mentioned the fact that I had a boyfriend. After revealing this information, so innocent in my opinion, the rest of my medical history became irrelevant. The diagnosis? Syphilis. Why? It wasn't explained to me, only that the spots on my skin were the result of a sexually transmitted disease. I went into despair. I called my mother, my boyfriend, and my friends to share my disbelief at the speed and severity of my diagnosis. I did the tests, whose results would take a week to arrive, and in the meantime decided to visit GAT-CheckpointLX, a clinic dedicated to sexual healthcare, to understand how I should proceed in the face of a disease about which no other information had been shared. I was given a dose of penicillin and explained the side effects I might experience - which I never did, since, as the tests would reveal, I never had syphilis. After the initial panic, I understood what had happened to me: my voice, my posture, my homosexuality were reasoning enough to warn a diagnosis. The connection is not unprecedented in the life of a queer person; indeed, it is a substantial part of the modern legacy and history of the LGBTQIA+ community. Since 1981, the beginning of the HIV/AIDS pandemic, there has been a latent connection between homosexuality and pathology. Although the crisis of this virus is not over, for the Western world its darkest days are in the past, remaining in the memory of a community that was truly decimated, not only by the disease but by the discrimination it entailed. It is in the wake of these events that monkeypox emerges, the newest public health emergency as declared by the World Health Organization. Mirroring the early days of the HIV/AIDS crisis, the infectious disease affects mostly men who have sex with men. Although distant, the two viruses share some similarities, particularly felt by the queer community which, in this new epidemic, recognizes the patterns of the past.

Monkeypox was identified in the late 1950s among laboratory monkeys. The first recorded human cases occurred in 1970. Although it is not a "new disease," the scientific community believes that in the last four years the virus has mutated, making it easier to transmit among humans. Its symptoms can be varied (fever, headaches) but its hallmark is pimples and sores on the skin that remain for an indefinite time, eventually healing but in many cases transforming into scars. Even though the disease can be transmitted in a multitude of ways (respiratory secretions or direct contact with the sores caused by the virus), scientific studies prove that it is during sexual intercourse that transmission most often occurs. The most recent outbreak began last May and started in the United Kingdom, speculated to be due to a previous outbreak in Nigeria, where the virus has an endemic status. Since it was detected on the continent, its association with homosexual men has been systematic. Even the World Health Organization, which, on July 23rd, decreed monkey pox an emergency on a global scale, listed the MSM population (the term describing men who have sex with men) as a population at risk. The outrage was immediate. Certainly informed by the trauma of the association of the homosexual with the sick, many argued against the association made by WHO, fearing that this link would incite discrimination. While this risk is valid, more important than mitigating the threat of discrimination is to address the real problem: the spread of the virus. Statistics reveal that the overwhelming majority of monkeypox cases arise in men who have sex with men, and to ignore this fact is to disregard the support this population needs. In the opinion of Benjamin Weil, a researcher of modern medicine's role in sex discrimination, the outrage felt by this classification is "misplaced anger."

In an interview with Vogue Portugal, Weil reveals the core of the matter: "The real dilemma is not that they are classifying it as a problem, but the slowness, laziness, and even refusal, to classify it as a problem." This trend reveals what should be the source of the LGBTQIA+ community's annoyance since the inertia described by Weil "mirrors what occurred at the beginning of the HIV/AIDS crisis." More than 40 million people have died from HIV/AIDS-related complications since 1981, a figure inextricably linked to the silence with which the pandemic was approached. Identified as the "gay plague," the virus was, as Weil explains, "considered the biological manifestation of a moral judgment against homosexual men." This notion stymied, for many years, the search for solutions. Interpreted as a problem of the sinful, thousands died before the world was willing to pay attention. In addition to the LGBTQIA+ community, which at the time made up the majority of the infected, and in which death was so massive that an entire generation disappeared, countless lives were lost of those who, by being associated with a disease with stigma, were forced to suffer in shameful silence. The past's laziness to act cannot be compared to that of the present, but it is impossible to dissociate the monkeypox phenomenon from the HIV/AIDS crisis. WHO's decision to decree the current pandemic as an emergency came only after its discovery in children. My high school history teacher constantly reminded me: history does not repeat itself, but in this case, the facts are hard to ignore. The declaration of urgency, the press hysteria, and the warnings by public health officials came only after the discovery that monkeypox could affect children. Understandably, the most vulnerable population is protected more intensively, but in some ways, this action replicates the events of the early years of the HIV/AIDS pandemic. In 1983 it was reported that blood transfusion could infect the "innocent," read, the heterosexual population exempt from the sin of homosexuality, one of the discoveries that most aided the search for solutions. It's not just the fact the World Health Organization took more than two months to report a crisis that was already spreading dangerously fast through the queer community, but several reports reveal, in the West, the inertia of public health institutions to act with any kind of urgency. The world might not have been prepared for an outbreak of monkeypox, but the fact is that there is a vaccine that fights it, usually administered in the treatment of smallpox. It is inevitable to question the relevance of this problem when countries like the United States choose not to distribute the already available vaccines. The government is, according to The New York Times, adopting a "wait and see" policy, a curious choice considering the tragedy that befell the last time such a decision was made.

It is not only institutions that follow the patterns of the past, public opinion replicates their sins as well. Especially when it comes to the child population, Benjamin Weil cautions: "We must be alert to how children can be instrumentalized, cases of monkeypox will inevitably become more and more frequent in the child population, this will be the definitive 'proof' of the sins of the guilty against the innocent, that is, of homosexuals against children." These pretexts are, essentially, nothing more than regurgitated religious discourses, where queerness is a transgression of the highest order. Even though the social and cultural landscape has changed since 1981, and acceptance of the LGBTQIA+ community is a rapidly growing trend, Weil reminds us, "There is something biblical about a virus, a plague, it doesn't take much cultural or intellectual work to convince to the demonization of homosexuality." These speeches are replicated throughout "conservative" press and Internet factions (the expression in quotation marks can easily be replaced by homophobic).

Once again reproducing the patterns of the past, discourses of blaming "homosexual promiscuity" become uncomfortably popular. The boldest of which even propose that vaccines should be disregarded - the way to treat monkeypox is through heterosexual marriage. The virus is interpreted, once again, as a symptom of the "disease" of homosexuality. Even though queerness has, throughout history, been viewed as a problem, it was during the crisis of HIV/AIDS that, as Benjamin Weil reports, "the notion of male homosexuality as a pathology crystallized." These arguments (or rather beliefs) are nothing more than fictitious notions that the scientific community vehemently denies. Unlike the human species, a virus abstains from moral judgments: "The fact that monkeypox spreads in homosexual men is just a result of the laws of epidemiology, the virus is like a wild animal in a cage, it will jump inside the cage, hitting its walls relentlessly until it can escape, spreading to the rest of the world." This is how the response of the LGBTQIA+ community is understood, based on the fear that the virus will be the catalyst for the reversal of queer rights. For Benjamin Weil, what gay men, the greatest holders of privilege in the LGBTQIA+ community, are experiencing is the "fragility of the tolerance we feel at the moment." The researcher elaborates, "With the legalization of marriage, gay adoption, and the entrance of queer culture into the mainstream, we believed that we were protected by the State, that it cared about us, we forgot how dependent we are on the notion that as a group we must contribute to the resources of the State, not the other way around."

Monkeypox doesn't just accentuate sexual discrimination, it also ultimately exacerbates inequalities within the LGBTQIA+ community. In Weil's eyes, the deepening disparity is twofold: in countries like the United States, minority communities, such as the African-American population, are disproportionately affected; on the other hand, the few resources that are being made available to aid the crisis are distributed in a way that rewards the already privileged. "At the moment vaccines are scarce and are being spread through methods such as mass vaccination events or through sporadically and fleetingly scheduled appointments," Weil explains. "When you structure vaccination in this way, you favor those with flexible schedules or the ability to travel." There is yet another form of inequality that the monkeypox crisis exposes: the pattern of global disparity. The virus has endemic status in many of the West and Central African nations, and at one point all recorded deaths were concentrated on the African continent. Despite this, this had not received any of the available stock of vaccines. "When viruses spread to the Global North it is an aberration, but if the same viruses are lethal in Africa, they are interpreted as an inevitability of being African, a truly disturbing and racist view."

Global and local discrimination, stark disparities within the LGBTQIA+ community, hate speech, the revelation of latent trauma: all this even before the monkey pox "got out of its cage." But for how the West is dealing with the problem, the Portuguese case stands out for the positive, a direct consequence of the tireless work of institutions like GAT-CheckpointLX. In an interview with Vogue Portugal, Luís Miguel Duque, part of the medical team at the sexual health center, tells us what the institution has been doing in the trenches of the current crisis. Although initially focused on HIV/AIDS screening, the organization "has been broadening the scope of its activity, offering screening for other sexually transmitted infections and their respective treatment, administration of injectable medication and vaccines. It is natural, given its history, that it was chosen as one of the three vaccination centers in the Lisbon Metropolitan Area. Even though the Portuguese response has been efficient, we still suffer from the immense discrepancy between demand and supply. Luís Miguel Duque, who was also the first doctor to diagnose monkeypox in Portugal, reports on how Portugal deals with the vaccine shortage: "Indications for vaccination are currently limited to very recent contacts with cases of infection with monkeypox virus. But we have been contacted by many users who would like to have the vaccine and are not covered by the current criteria." This enthusiastic demand from the at-risk population - in this case, men who have sex with men - transcends geographical limitations, it is a worldwide phenomenon.

The incessant demand for solutions is one of the significant peculiarities of the monkeypox crisis, something that, for Benjamin Weil, is no coincidence. The justification lies in the "innate and collective responsibility of homosexual men concerning their sexual health," as the researcher informs us. This proactive attitude is exemplified in more than one way and is seen, for example, in the change of habits: caution in attending events, limitation of sexual partners, and, above all, the intense demand for vaccinations. For the researcher, the proactive instinct is an indication of the "ongoing trauma of the HIV crisis, demonstrating the weight this burden has on the LGBTQIA+ community. The community's collective history has socialized queer men to behave in a certain way: part of being a gay man these days involves constant testing, PrEp [the drug that prevents HIV from lodging in the body], extensive knowledge about HIV and other sexually transmitted infections." Benjamin Weil's testimony replicates the lives of most gay men, including mine. Among straight friends, I am the only one who gets tested every three months, takes preventive medication for the HIV/AIDS virus, and has extensive knowledge about sexually transmitted infections. There is a kind of myth about queer promiscuity, one that fosters homophobic discourse and substantiates the current monkeypox narrative. But even if demonized and fetishized by society, the LGBTQIA+ community is distinguished by its caution and responsibility, especially when it comes to public health. With the weight of the HIV/AIDS crisis on our shoulders, the gravity of 40 million lives is felt by the overwhelming majority of queer men. The unfortunate coincidence that this demographic group is once again affected by a sexually transmitted virus is just that, a cruel fate. There is no denying that the monkey pox crisis must be addressed and discussed so that we can ensure the protection of the population. But in matters that blur the distinction between homosexuality and pathology, caution is necessary. The wounds of the past are not yet healed.

 

Translated from the original on The Gossip Issue of Vogue Portugal.Full credits and stories on the print issue.

Pedro Vasconcelos By Pedro Vasconcelos

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