In the weeks since the first Western monkeypox case was discovered in Britain, international public-health officials have warned of a forthcoming wave of "stigma" and "homophobia" in response to the disease's disproportionate incidence among men who engage in homosexual sex.
One health advocate told the Washington Post that he was "worried that Pride celebrations could be endangered" by the "overzealous" response of people driven "by prejudice" and "fears of another public-health emergency." Twitter ran a curated item noting that "medical experts and LGBTQ advocacy groups have expressed concern" about how "irresponsible reporting" on the monkeypox outbreak "could create a new stigma around LGBTQ people."
As of Monday, there were over 700 recorded global cases of monkeypox. And while it is not a "gay disease," there are apparent links between engaging in same-sex behavior and transmission of the virus. In the United States, there are 26 monkeypox cases, 16 of the first 17 of which were men who had engaged in homosexual sex. The United Nations reported that the virus has been similarly concentrated around the globe, with cases "mainly, but not exclusively" being found in "men who have sex with men.” There were several apparent "superspreaders" across Europe at gay events. For example, several positive cases were traced to a Pride parade in the Canary Islands, which was attended by more than 80,000 people from across Europe. Most of the 30 cases in a recent outbreak in Spain were tied to a single bathhouse.
Had either of these outbreaks happened at a church service or a Republican rally, the media response may have been different.
Instead, the public-health authorities have endorsed Pride marches. A World Health Organization spokesman said it is "important that people who want to go out and celebrate gay pride, LGBTQ+ pride, to continue to go and plan to do so."
While the case count is low, the monkeypox case-fatality rate is troubling. In Africa, where the virus is endemic, strains of monkeypox carry upwards of a 10 percent case-fatality rate. The World Health Organization estimated that the global case-fatality rate was between 3 and 6 percent. In America and Europe, the estimated case-fatality rate is mercifully lower, at or below 1 percent. By comparison, the case-fatality rate of the coronavirus in the U.S. is 1.2 percent.
Despite the risks posed by the disease, there has been a concerted effort among public-health experts to avoid a repetition of what advocates insist were failed efforts to fight HIV and AIDS. To counter the idea that monkeypox is a "gay disease," many activist organizations have implied that there is no relationship between homosexual behavior and transmission of the virus.
The Infectious Disease Society of America released a joint statement with the HIV Medical Association decrying the use of "homophobic language regarding the current monkeypox outbreak," claiming that the disease is "spread through close physical contact, and no one community is biologically more at-risk than another." Twitter's curated page on "irresponsible monkeypox reporting" insists, with caveats about physical contact, that "there is no connection between sexuality and spread of the disease."
Of course, the fact that a person identifies himself as being gay or bisexual does not predispose him to monkeypox, any more than identifying as "nice" or "funny" or "handsome" would. What makes him more likely to contract the virus is not his "sexuality" per se, but rather his participation in an act that, as one British infectious-disease epidemiologist said, "facilitates transmission in these networks."
What is more, we do not know whether and to what extent monkeypox can be transmitted by people who are asymptomatic. The CDC is sufficiently concerned that they recommended people mask on airplanes to avoid respiratory droplets from people infected with monkeypox.
Others have called for shutting down gay-sex clubs until the outbreak is under control. A group called the "LGB Alliance" sent a tweet calling for "all commercial sex venues, such as saunas, leather/fetish bars and clubs with dark rooms to be closed for a month." Twitter removed the tweet for supposedly violating its terms of service. While Twitter eventually restored the tweet, several gay activists denounced the Alliance's proposal, like Peter Tachtell, who claimed that “closing gay saunas won’t stop the spread of monkeypox. "
Wouldn't it help, though?
Get weekly emails in your inbox
And while too much can be made of the Covid-monkeypox comparison—the coronavirus is an airborne pathogen, while monkeypox spreads primarily through contact with bodily fluids, open wounds, or respiratory droplets—the two diseases have similar case-fatality rates; in fact, internationally, monkeypox is more lethal than Covid. Shouldn't that color our willingness to entertain restrictions in the name of public health?
The state of California was so committed to preventing coronavirus transmission that it limited the size of graveside funeral services to ten people. It upheld the rule for more than a month after research from Wuhan demonstrated that the virus did not easily transmit outdoors. A 22-year-old California woman mourning her grandmother's death told CNN that she was mystified that "so many public spaces are open, but a cemetery, which is open-air, is limited to 10 per funeral."
If we were willing to prevent people from attending weddings, funerals, and church services for a disease with a 1.2 percent case fatality rate, surely we can countenance closing commercial sex venues until we can, as they say, flatten the curve.