A federal court has blocked efforts by the Biden administration to ensure trans people are never discriminated against by religious doctors when seeking heathcare.
But the US Court of Appeals for the Fifth Circuit unanimously ruled Friday (26 August) that the Department of Health and Human Resources (HHS) mandate is “in violation of its sincerely held religious beliefs” by not letting medical providers withhold care “on the basis of sex”
The three-judge panel upheld a lower court’s ruling that Franciscan Alliance, a Catholic healthcare network covering Indiana and Illinois, was right to seek out a permanent injunction against the policy.
Franciscan Alliance said the network’s nearly 20,000 doctors and medical providers should not have to provide gender-affirming healthcare or abortion treatments.
The group’s lawyers from the religious liberty group Becket said stopping health professionals from discriminating and denying care to trans people was an unlawful overreach, the Washington Times reported.
To do so, they claimed, would also go against the Religious Land Use and Institutionalized Persons Act (RLUIPA) and the Religious Freedom and Restoration Act (RFRA).
And the judges, two of whom were appointed by Donald Trump, agreed.
“We have recognised that the loss of freedoms guaranteed by the First Amendment, RLUIPA, and RFRA all constitute per se irreparable harm,” wrote Trump appointee judge Don Willett in the ruling.
Fellow Trump-appointee judge Kurt Englehardt and George Bush appointee judge Jennifer Walker Elrod joined him in the ruling.
The appeal ended a years-long battle between religious freedom and healthcare access.
Franciscan Alliance lodged a lawsuit against the policy in December 2016 with the district court for the Northern District of Texas, setting the stage for a legal back-and-forth between the network, federal officials and LGBTQ+ activists.
Though Trump scrapped the rule, president Joe Biden brought it back. The district court sided with Franciscan Alliance in 2019, prompting the federal government and the ACLU to appeal the court’s decision.
“This ruling is a major victory for conscience rights and compassionate medical care in America,” said Joseph Davis, counsel at Becket, in a statement.
“Doctors cannot do their jobs and comply with the Hippocratic Oath if the government requires them to perform harmful, irreversible procedures against their conscience and medical expertise.”
The Hippocratic Oath, an ancient oath of ethics, requires physicians, among other things, to “do no harm” and do everything they can to care for their patients.
Study after study has shown that trans people who receive gender-affirming healthcare are significantly less likely than those who have not to experience depression and anxiety, and consider suicide/
The spread of monkeypox is causing men who have sex with men (MSM) to reduce their numbers of sexual partners, according to survey results released this week by the Centers of Disease Control and Prevention (CDC).
The CDC’s survey found that 48 percent of respondents had reduced their number of sexual partners, 50 had reduced their number of one-night stands, and 49 percent reduced the amount of sex they had with men that they’d met through hookup apps, The Hill reported.
The publication noted that local public health officials have been hesitant to suggest that people practice sexual abstinence as a key approach to avoiding possible exposure, noting that the strategy may be ineffective even though the federal government championed it during the HIV/AIDS epidemic of the 1980s and ’90s.
There are just over 15,000 cases of monkeypox in the U.S. as of Monday, according to the CDC. However, infectious disease experts think this number is likely an undercount. President Joe Biden declared a national state of emergency for monkeypox in early August. The World Health Organization (WHO) also declared monkeypox a Public Health Emergency of International Concern in late July.
However, one report suggested that the high case numbers among MSM may have to do with the fact that queer men seek medical treatment more often than heterosexual individuals.
The recent increase in cases nationwide has revealed the fact that the U.S. doesn’t have enough vaccine doses available to meet public demand. To help stretch the current reserve, the U.S. Food and Drug Administration recently approved the vaccine to be administered intradermally — that is, into the skin’s superficial layers — rather than through its usual subcutaneous method which injects the vaccine into the fat and connective tissues between the skin and muscular layers.
The intradermal method could stretch the nation’s vaccine supply fivefold and has been found to be effective when vaccinating against rabies and polio.
However, some LGBTQ individuals have criticized the government for what they say is an inadequate response to the outbreak.
“I’ve been really disappointed in our leaders, especially those who were in office during the onslaught of the AIDS crisis, like President [Joe] Biden and Speaker [Nancy] Pelosi,” nonbinary Queer Eye reality TV star Jonathan Van Ness told USA Today.
“Once again, we’re seeing too little action taken until the situation has ballooned out of control,” they added. “If nothing changes, we’ll continue to experience failures like this response, which has been plagued with too few tests, lack of access to treatments, inadequate vaccine supply, and ambiguous guidance.”
“In many ways, I believe it’s been fueled by homophobia and transphobia,” Ness said. “When an outbreak affects mainly men who have sex with men, some portion of our elected legislators will have no incentive to act… which is obviously messed up because people’s lives are at stake, and there are queer people in all 50 states.”
New research suggests the strain of monkeypox involved in the current global outbreak is predominantly sexually transmitted.
As of Wednesday (17 August), there have been more than 35,000 confirmed cases of monkeypox across 92 countries and territories since the beginning of the outbreak in April 2022, according to the World Health Organization (WHO). Most of these are among men who have sex with men.
In the earlier stages of the outbreak, experts insisted there was no evidence that monkeypox was a sexually transmitted virus, and that it was mostly transmitted by skin-to-skin contact, but mounting research is suggesting otherwise.
On Sunday (14 August), Dr Jeffrey Klausner of University of Southern California and Dr Lao-Tzu Allan-Blitz from Brigham and Women’s Hospital in Boston and Harvard published an essay explaining why they believe the virus is largely sexually transmitted.
‘Mounting evidence’
In their essay, which has been submitted to a scientific journal for publication, the two experts admitted that the issue is still up for debate, but listed several reasons for the “mounting evidence that sexual transmission is the most common mode of transmission” of monkeypox.
It claims people most at risk of contracting monkeypox is the same demographic at risk of contracting other sexually transmitted infections, for example those “attending sex-on-site venues, multiple recent sex partners, and condomless receptive anal intercourse”.
Secondly, studies from the UK, the US, Italy and Spain have documented initial lesions “occurring at the genitalia, rectum, and oropharynx”, indicating that these locations are where the virus first entered the body.
But, the authors add, calling the outbreak a sexually transmitted infection is “double edged.”
“The stigma surrounding sexually transmitted infections in gay men and other sex with men limits healthcare seeking and partner-notification behaviours directly subverting our primary means of outbreak control – namely, early identification and behaviour change in infected individuals.
“Furthermore, such stigma can fuel further homophobia, particularly in areas without human rights protections for individuals who engage in same-sex relationships.
“Conversely, failure to appropriately identify and disseminate to the public the predominant mode of transmission will likely perpetuate behaviours that are driving transmission.”
Other experts have spoken on the topic.
Dr Paul Adamson, an infectious disease specialist at the UCLA School of Medicine, told NBC News: “At this point, I’m not sure we can say it is primarily the sexual transmission and not the skin-to-skin contact that also occurs during sex that is contributing to the most transmission during this current outbreak.
“However, emerging data seems to suggest that monkeypox might be more efficiently transmitted sexually.”
He also suggested that the scientific community may be slow to accept monkeypox as a predominantly sexually transmitted virus because of how it has historically been transmitted in countries where the virus is endemic.
“Historically, the primary mode of transmission of monkeypox was through skin-skin contact, though there might have been some suggestion of sexual transmission in prior outbreaks,” he said.
“It takes some time and additional data to overturn our understanding of transmission.”
At first it was Covid. Now it’s monkeypox. Organizers of a free concert at an upcoming LGBTQ festival known as Southern Decadence in New Orleans have canceled the concert due to the threat of monkeypox.
The larger six-day festival September 1-5 will continue as planned, as it always has since 1973 with the exception of when there were hurricanes and the first two years of the Covid-19 pandemic. The popular event typically attracts about 250,000 people. But organizers of the concert thought that with the rise in monkeypox cases, particularly among gay, bisexual, transgender, nonbinary, and men who have sex with men, it wasn’t worth the risk.
Monkeypox is spread through close skin to skin contact. While not a sexually transmitted disease the majority of cases in this particular outbreak in the US have been through sexual contact, skin to skin, according to the US Centers for Disease Control and Prevention.
The concert is outdoors, but its big name performers like Deborah Cox, Jennifer Holliday and the Weather Girls, draw large crowds.
It is what organizer Chuck Robinson described as “hot, sweaty, people gathered in a street for blocks 21 deep, people have their shirts off. They’re shoulder to shoulder dancing, as they should [to] celebrate a lifestyle through music and the concert, that is wonderful—but danger for Monkeypox,” Robinson told CNN.
Organizers of the festival said they are working closely with the Louisiana Department of Health. The New Orleans Health Department has hosted vaccine pop-up clinics near nightclubs and other venues.
There have been 127 monkeypox cases in the state of Louisiana as of Thursday.
Even with the rising number of cases, the greater majority of LGBTQ events this summer have continued as usual.
The threat of monkeypox canceled a circuit party called Algeria Sunrise Summer Edition in New York in July, according to the company’s website.
Anyone can get monkeypox, but the latest US outbreak has largely been concentrated among gay, bisexual, transgender, nonbinary men and men who have sex with men. It can be passed through close contact and can possibly spread through contaminated clothing and bedding.
When it comes to deciding about attending large events, Dr. David Hamer, the interim director for the US Center for Emerging Infectious Disease Policy & Research at Boston University said it’s important to keep in mind how this outbreak has been spreading.
“Based on what I’m seeing though 95 to 98% of the cases are through close sexual contact, skin to skin as opposed to in a public setting,” Hamer said.
“I think the risk is much much lower (at a concert),” Hamer said.
But it is not “no risk” to attend such an event. Hamer points to a study that came out from researchers at Stanford University that focuses on a man in the UK who said he noticed his first monkeypox lesion two weeks after attending a “large, crowded outdoor event at which he had close contact with others, including close dancing, for a few hours,” according to the researchers. His primary risk factor was “close, nonsexual contact with numerous unknown persons at a crowded outdoor event,” the researchers wrote. He was clothed at the event.
“If this is to be believed, I think organizers though are going to need to take this into account in their planning,” Hamer said.
Hamer thinks organizers may want to communicate beforehand with attendees and encourage anyone who has had any unusual lesions or contact with someone who’s had monkeypox to stay home or to at least be tested and evaluated first to make sure that they’re not infectious and going to get their friends sick.
“But if people are fully clothed and so forth, I don’t think there’s any real significant risk,” he said.
Dr. Amesh A. Adalja, a senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health said with the way in which monkeypox spreads, “most concerts are probably not an issue.” A special event where people are partially clothed and brushing up against each other is though not a “nonzero risk.”
“In general it’s important to draw a distinction between all the ways monkeypox can spread versus what’s driving the cases,” Adalja said. “It’s clearly a sexually associated outbreak in the United States.”
“However, you can see transmission outside of sexual contact. I think canceling it or not canceling is a separate discussion, but you know, is there going to be some nonzero risk of monkeypox? Yes, that would be the case if people are shirtless and rubbing up against each other at an event.”
Decisions to go or not, to have an event or not, are really more about people’s risk tolerance than anything else, he said.
“There’s not a formula to say this event has to be canceled because of XY and Z. It’s more about what is the risk of monkeypox spreading at an event like that,” he said.
He added that the country has learned a lot from how the Covid- 19 pandemic has been handled.
“Risk reduction works much better than canceling events and abstinence only types of approaches,” Adalja said. “I think it’s more about being cognizant of the risks and having the tools deployed, like having tests available or if there’s enough vaccines, these can be places to be vaccinated. But I think it’s important to just know that people know something about risk.”
In June, during Pride Month, the World Health Organization said that monkeypox is not a reason to cancel mass gatherings. Instead these events are the perfect opportunity to reach the community with monkeypox education and protection.
On Thursday, the Biden administration said it was launching a program to make vaccines available at large LGBTQ events.
One of those events is Atlanta’s Black Pride Weekend. Largely an outdoor event that’s held over Labor Day weekend it typically attracts more than 100,000 people.
Organizers have been meeting with the local health department to discuss the best monkeypox and Covid-19 strategy to make sure people stay safe.
The festival will offer monkeypox and Covid-19 testing and vaccines at the event itself and is working with the Fulton County Department of Health to offer monkeypox vaccines even before the festival.
“We believe in the science of things, not just the rumors on Instagram and the fear tactics and clickbait,” said Melissa Scott, Traxx Girls founder and a festival organizer. Scott said they have an advantage with the festival since they have a large outdoor space where people can spread out as much as they want, depending on how close they’d like to be with others.
“You could even be a quarter of a mile away and keep up with what’s going on on our large screens,” Scott said.
Scott said the event is a much needed celebratory weekend, particularly after so many people have had to be isolated during the pandemic. Such events are important for everyone’s mental health.
“It’s important for us to get together. People need to socialize. We’re already on our phones too much,” Scott said. “It’s so important to have some face to face contact again. It’s so important to celebrate.”
The sole supplier of the world’s monkeypox vaccine has struck a deal with an American manufacturer to increase supplies of the much-needed shot.
Bavarian Nordic, a small Danish company, will hand over the production of millions of vaccines to Grand River Aseptic Manufacturing (GRAM), a Michigan-based biotechnology company that makes injectable drugs.
The Department of Health and Human Services said the deal will allow Bavarian Nordic to speed up delivery of the 5.5 million vials the US has ordered to try to tackle rising case numbers.
“This announcement, which is the result of extensive coordination between [the Biomedical Advance Research and Development Authority], Bavarian Nordic, and GRAM, will help bolster our current monkeypox response and enhance our smallpox preparedness,” said assistant secretary for Preparedness and Response Dawn O’Connell.
“We look forward to continuing to work with our partners to ensure successful production ramp up and ultimately delivery of additional vaccine doses to those in need sooner.”
Sharing the complex technology needed to make the vaccine with GRAM has already begun, with officials hoping this can be achieved in three months – rather than the standard nine to allow for production by the end of this year.
A doctor checks on a patient with monkeypox sores. (ERNESTO BENAVIDES/AFP via Getty Images)
Bavarian Nordic’s jab – known as Imvanex in Europe, Jynneos in the US and Imvamune in Canada – remains the only widely available vaccine approved by drug regulators in the US and Europe.
Health authorities don’t have many other options. Other drugs have dangerous side effects, while the rollout of Japan’s LC16 KMB has been slowed down by production issues.
Most of the doses are in their bulk form, meaning they have to be taken out of their frozen bags, and put into vials in a months-long process known as a “fill and finish”.
Monkeypox vaccines not reaching Africa
Nearly all ready-to-go vaccines have been snapped up by wealthy nations, however, leaving middle and low-income countries with next to none.
Africa, where the virus has been endemic for years, hasn’t received a single vaccine since the outbreak began in May.
Global Justice Now, a social justice group, told PinkNews that the deal sounds better on paper than it is in practice.
“This deal is an admission that medicines monopolies don’t work, but it doesn’t go anywhere near far enough to tackle the global monkeypox outbreak,” said Global Justice Now pharmaceutical campaigner Tim Bierley.
“These doses to be ‘filled and finished’ have been entirely bought up by the US, which means that, as things stand, this deal does nothing to protect people anywhere else in the world.
“Given the continent of Africa has seen more monkeypox deaths than anywhere else, this looks like just another case of one country hoarding all the vaccines and leaving the rest of the world to ransom.
“But countries in the global south cannot, and should not, have to rely on the ‘charity’ of firms and countries in the global north to be able to get their hands on these medicines.”
Bierley said the solution to unequal vaccine access is a simple one – Bavarian Nordic must share its vaccine know-how.
“Just as we saw with COVID-19, this slow and deeply unequal vaccine roll-out shows the urgent need to transform a pharmaceutical system that rewards the hoarding of scientific knowledge with enormous profits, rather than collective effort to save lives.”
Boston Children’s Hospital has warned employees about mounting threats and is coordinating with law enforcement after far-right activists on social media began targeting the hospital with false claims about its treatment of young transgender people.
It’s the most recent in a series of attempts to target hospitals for their work with trans youth, adding to an ongoing wave of anti-LGBTQ sentiment that has hit libraries, schools and even a trans-inclusive Los Angeles spa.
The public relations office of Boston Children’s Hospital sent an email to employees with guidance on how to respond to harassment and threats earlier this week, citing an “increase of threatening and aggressive” phone calls and emails sent to the hospital commenting on treatment of transgender patients.” The email was confirmed to NBC News by a current employee.
Boston Children’s Hospital first became the target of activists in recent weeks, when well-followed social media accounts such as LibsofTikTok, which has often promoted “groomer” discourse that falsely linked LGBTQ teachers and parents to pedophilia, began to make a variety of false claims. One allegation said that the hospital offered gender-affirming hysterectomies to children under 18 years old.
Conservative influencers with millions of followers pushed similar false talking points and fanned the flames further. David J Harris, a podcaster and supplement seller, and single-issue activists including Chris Elston, who goes by “Billboard Chris” for the anti-trans statements he wears on sandwich boards, are among the right-wing social media stars who have spread the allegations online.
Last week, fact-checking organizations debunked the claims from right-wing accounts, but many of the same accounts continued to spread the false allegations this week.
“In response to commentary last week critical of our Gender Multispecialty Service (GeMS) Program, Boston Children’s Hospital has been the target of a large volume of hostile internet activity, phone calls, and harassing emails including threats of violence toward our clinicians and staff,” Boston Children’s Hospital said in an emailed statement. “We are deeply concerned by these attacks on our clinicians and staff fueled by misinformation and a lack of understanding and respect for our transgender community.”
“Boston Children’s is proud to be home to the first pediatric and adolescent transgender health program in the United States,” the statement added.
Videos from the YouTube account of Boston Children’s Hospital in which several physicians discuss services provided to trans patients were shared by the accounts to suggest the Center for Gender Surgery was performing genital surgeries on children. The videos, which have since been removed from the hospital’s channel, included one titled, “What Does It Mean To Be Transgender?” and did not suggest such surgeries were provided to minors.
Boston Children’s Hospital houses the Gender Multispecialty Service, the nation’s first pediatric and adolescent transgender health program, which has treated more than 1,000 families, according to its website. Despite the separate Center for Gender Surgery being within Boston Childrens’ Hospital, treatment is only provided to “eligible adolescents and young adults,” according to the center’s website. “All genital surgeries are only performed on patients age 18 and older,” the site reads.
A representative for Twitter said they were looking into the harassment campaign.
Boston Children’s Hospital said in its statement that the online attention “was based on the incorrect statement that Boston Children’s performs genital surgeries on minors in connection with transgender care. For hysterectomies and other genital surgeries performed as part of gender-affirming care, Boston Children’s requires a patient to be capable of consenting for themselves. Age 18 is used to reflect the standard age of majority for medical decision-making. Boston Children’s does not perform genital surgeries as part of gender-affirming care on a patient under the age of 18.”
Nevertheless, the posts demonizing Boston Children’s Hospital quickly spread through the far-right media ecosystem, promoted by right-wing media personalities including The Daily Wire’s Matt Walsh and conservative websites like The Post Millennial and The Daily Caller.
Anti-trans activists also targeted the individual doctors who appeared in the YouTube videos from Boston Children’s Hospital, leaving vulgar and harassing comments on their social media accounts and flooding their online pages with negative reviews. Some hospital staff have since made their social media profiles private.
This isn’t the first time that far-right activists have targeted doctors and medical institutions — or even Boston Children’s Hospital.
Lee Leveille, co-director of Health Liberation Now, a trans rights advocacy group that investigates the effects of policy on trans health, said the hospital was also a target in May 2021 for providing gender-affirming care amid a similar wave of targeted harassment on medical facilities.
“The original organized network that jump started the clinic protests has been slowing down a bit and is more decentralized,” Leveille said over email. “Local pockets will still operate here and there, but they’re less connected to a central organized push than the original ones. Now we’re seeing new faces rallying the cause — including the likes of Matt Walsh and Libs of TikTok.”
In June, Chaya Raichik, the Brooklyn real estate agent behind the Twitter account LibsofTikTok tweeted about a children’s hospital in Omaha, Nebraska, for hosting an informational booth at a Pride event. Earlier this month, Raichik and right-wing activist Christopher Rufo targeted a children’s hospital in Pittsburgh for its informational video about puberty blockers. The tweets directed waves of harassment to the hospitals’ larger accounts.
Under a tweet from the Pittsburgh hospital about children with cancer, commenters’ replies included, “Pedophiles,” and “We will destroy you.”
The targeting of children’s hospitals is just the most recent in a spate of online abuse aimed at institutions that promote pro-LGBT ideas and events.
“They’ve received just an absolute torrent of abuse, oftentimes, with real, in-person, consequences,” said Alejandra Caraballo, a clinical instructor at the Harvard Law School Cyberlaw Clinic and LGBTQ+ advocate.
“We’ve already had months and months of this reinforcing propaganda, that LGBTQ people are groomers, that they’re pedophiles, that they are threats to children,” she said. “It’s very disturbing to see people justify attacking a children’s hospital because of their transphobia and their hatred of trans people.”
Leveille and Ky Schevers, the other co-director of Health Liberation Now, said they feared violence could come next, targeting doctors, patients and medical facilities that provide gender-affirming care.
Boston Children’s Hospital said it was working with law enforcement to ensure the safety of its staff.
“We condemn these attacks in the strongest possible terms, and we reject the false narrative upon which they are based,” the hospital said in its statement. “We are working with law enforcement to protect our clinicians, staff, patients, families, and the broader Boston Children’s community and hold the offenders accountable. We will continue to take all appropriate measures to protect our people.”
The White House will announce today it is zeroing in on the population most at risk currently of contracting and spreading the monkeypox virus: men who have sex with men. A pilot program rolls out this weekend at Charlotte Pride.
The Biden administration’s deputy director for monkeypox response, Dr. Demetre Daskalakis, described the new effort to LGBTQ Nation ahead of the White House announcement.
That starts with bumping up the supply of the vaccine for local health jurisdictions where large LGBTQ events are happening. The program sets aside 50,000 doses of vaccine from the Strategic National Stockpile that jurisdictions can request on top of their existing vaccine allocations and supply.
The Administration is working with North Carolina, Georgia, and Louisiana health departments to determine dose numbers in preparation for upcoming events including Charlotte Pride this weekend, and Atlanta Black Pride and Southern Decadence in New Orleans over Labor Day weekend.
At Charlotte Pride, Daskalakis says, “we’re going to be providing them 2000 additional doses on top of what they’re already allocated specifically for this event.”
State and local health departments are responsible for getting vaccines to where they’ll be administered.
To get doses in arms, “Charlotte is looking at specific events associated with Pride that are going to include, in effect, what will look like vaccine pop-ups, where people entering the event or going to the event will be able to acquire a vaccine.”
The second part of the pilot focuses on education and outreach, along with in-person technical assistance.
“With public health being really local, we’re going to make sure that we provide them what they need in terms of education, outreach materials and any technical assistance to be able to work on the ground to make sure that we’re providing folks with culturally appropriate information about how to prevent monkeypox, and also awareness of the disease.”
“Part of that package is definitely really clear advice around safer sex and safer gatherings. To make sure that it’s extraordinarily clear, given what we know about the data, that this is affecting gay, bisexual and other men who have sex with men, and that a lot of the transmission has been in the context of sex and sexual activity.”
The pilot also provides guidance to local jurisdictions to develop testing strategies and tools for information-gathering from event participants.
Two weeks ago, New York and California were among several states to declare monkeypox a public health emergency.
CDC data as of August 16 indicates 12,689 total confirmed monkeypox cases in the U.S., with New York, California, Texas, Florida, Georgia, and Illinois topping the list of highest infection rates.
Seven-day averages show the number of daily reported infections skyrocketed from 45 in the week ending July 11, to 528 the week ending August 10, when 1391 cases were reported on a single day.
Federal officials have allocated 1.1 million doses of the Jynneos vaccine to states and say they’ve shipped about 600,000 of those.
Clark Simon, president of Charlotte Pride, welcomed the administration’s new initiative: “The more vaccines the better.”
But with a caveat.
“I know health departments need to state where this specific virus is predominantly being seen, the pronouncement of it. But just to clarify, in terms of language and messaging, this is not an STI [sexually transmitted infection]. It is not a gay disease. It is a community-spread disease. And in this instance, showcases itself predominantly in men who have sex with men. But we’re also seeing instances in which there are children getting it at daycares and things like that. Much like COVID, it’s about community spread.”
Daskalakis was sensitive to the messaging.
“Monkeypox is a virus, it’s not a sentient being,” Daskalakis said. “It doesn’t differentiate between people based on sexual orientation or gender identity. And so making sure that we’re serving the folks who are in populations that are overrepresented in the outbreak, like gay and bisexual men, and men who have sex with men, is really important, while also making sure that there’s an awareness outside. Infections don’t heed orders, they don’t heed sexual networks or social networks. So being vigilant, making sure surveillance is really good, and that providers are tuned in is the most important thing right now.”
Atlanta Black Pride president Terence Stewart, next in line for the pilot program, added to Simon’s pandemic analogy.
“It is like COVID. We didn’t think it would either hit the shores of the United States or would be coming in as fast as it was. Because you want to vaccinate as many people as possible, but you also don’t want to scare people, right? So it’s a lot going on.”
Leading LGBTQ+ charities including GLAAD, and pharma company Gilead have teamed up to support responses to the monkeypox outbreak.
The coalition, which also includes the Human Rights Campaign, the National Black Justice Coalition, the National Center for Lesbian Rights, and the National Minority AIDS Council, was announced on 9 August.
Gilead, which makes PrEP pills Truvada and Descovy, has pledged up to $5 million in global grant funding to support a public education and vaccine hesitancy campaign, a public policy response and a global outbreak emergency fund.
The fund will issue grants of up to $50,000 to pre-existing Giliead grantee organisations that work in regions that have the highest active monkeypox outbreaks.
“Funds may be used to cover expenses such as community mobilisation activities specifically addressing MPV outbreak in communities disproportionately impacted by HIV, operating costs related to HIV testing and service interruptions and essential safety materials,” said GLAAD.
Charities such as GLAAD and HRC will focus on providing critical information about monkeypox to demographics and regions that are being significantly affected by the outbreaks, predominantly gay and bisexual man, and those living with HIV.
“As we saw with HIV, COVID-19, and now [monkeypox], disinformation continues to challenge the LGBTQ+ community,” GLAAD president and CEO Sarah Kate Ellis said.
“This new collaboration will enable creating and distributing content and resources to help our community know the facts and to understand prevention and treatment.
“When communities receive accurate, timely information, they are empowered to take appropriate action, leading to long-lasting, positive health outcomes.”
Giliead executive vice president of corporate affairs and general counsel Deborah Telman said the collaboration would ensure that the “immediate needs of impacted communities” were met, while steering groups away from disinformation which can lead to further spread of the disease.
In an interview with Reuters, spokesperson Rich Ferraro said that “with this partnership, we’ll be able to do more.”
There are currently a total of 31,800 confirmed monkeypox cases around the globe, according to regularly updated statistics from the Centers for Disease Control and Provention (CDC), with 31,425 of those coming from countries that have not historically reported monkeypox.
Because the disease has been found to disproportionately affect gay and bisexual men, there is a fear the outbreak could lead to homophobic stigma.
In America, far-right Republican Marjorie Taylor Greene has become notorious for spreading misinformation on the subject, saying that the disease is a “scam”.
“It’s not a threat to most of the population, and so it’s not a global pandemic, it’s really not, and people just have to laugh at it, mock it, and reject it. It’s another scam,” she said.
The CDC has said that research is still determining whether monkeypox can spread through “semen, vaginal fluids, urine, or faeces” and has only currently determined that it can spread through skin-to-skin contact, which can happen during “intimate contact.”
LGBTQI+ individuals are more likely than their counterparts to exhibit suicidal behavior. According to data reported by the Centers for Disease Control and Prevention, in 2019, nearly half of students identifying as gay, lesbian or bisexual reported seriously considered suicide. These students experienced a near fourfold increase in suicide attempts compared with heterosexual students. LGBTQI+ adults are also at greater risk of suicide. According to the Substance Use and Mental Health Services Administration’s (SAMHSA) 2020 National Survey on Drug Use and Health, 15.9 percent of LGB respondents ages 26 to 49 reported serious suicidal thoughts within the past year, and 2.1 percent reported a suicide attempt.
The experiences of stigmatization, rejection, trauma, victimization, microaggressions, homophobia and transphobia all contribute to this elevated risk. Conversely, support and connection between LGBTQI+ youth and their family or caregiver, peers, school and community, can promote better mental health, fewer negative outcomes and stronger resilience. The federal government, along with public and private sector partners, plays an important role toward building this affirming support and connection.
On July 16, SAMHSA led the nationwide transition to 988 as the easy-to-remember number to reach the 988 Suicide & Crisis Lifeline — an important step forward to strengthen and transform crisis care in our country.
Historically there have been notable gaps in accessing needed care for suicidal, mental health and substance use concerns with marginalized groups often facing additional barriers and inequitable outcomes.
SAMHSA is committed to enhancing access to crisis services for LGBTQI+ youth, including through the 988 Suicide and Crisis Lifeline, and has outlined a number of critical activities. These include enhanced training, service linkage to specialized care and creation and testing of direct chat portals and interactive voice response menu options.
In addition, research shows the training and expertise of the counselors who respond to crisis contacts matters. A recent survey of 12- to 25-year-old callers conducted by the Trevor Project revealed that nearly half indicated they called specifically because of LGBT-affirming counselors.
Recent federal appropriations direct $7.2 million to provide specialized services for LGBTQ youth within the 988 Lifeline. SAMHSA has been working closely with its partners to do so. Given both youth preferences for digital tools like text and chat and the particular needs of LGBTQI+ youth, such enhancements in access are critically important strategies to promote engagement.
The implementation of 988 and expanding access to affirming support for struggling LGBTQI+ youth is a critical first step in saving lives, decreasing stigma and linking those in need to compassionate and effective care. If you or someone you know may be struggling with suicidal thoughts, call or text 988 or chat at 988lifeline.org
For most of the six decades that monkeypox has been known to affect people, it was not known as a disease that spreads through sex. Now that has changed.
The current outbreak is by far the biggest involving the virus, and it’s been designated a global emergency. So far, officials say, all evidence indicates that the disease has spread mainly through networks of men who have sex with men.
“It clearly is spreading as an STI (sexually transmitted infection) at this point,” said Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security.
To protect the people at highest risk while trying to contain the spread, public health agencies are focusing their attention on those men — and attacking the virus based on how it’s behaving now.
On Wednesday, the head of the World Health Organization advised men at risk for monkeypox to consider reducing their sexual partners “for the moment.”
But this is a complicated outbreak that may shift in how it spreads and which population groups are most affected. There is also debate about whether monkeypox should be called a sexually transmitted disease, with some critics complaining that the term creates a stigma and could be used to vilify gay and bisexual men.
Monkeypox can spread in nonsexual ways too, and it’s not enough to use condoms or other typical measures for stopping STDs, Inglesby and other experts say.
Here’s what we know.
What makes something an STD?
A sexually transmitted disease is commonly defined as one that mainly spreads through sexual contact. But some STDs can be spread in other ways, too. HIV can spread through shared needles. Syphilis can spread through kissing. A common, parasite-caused sexual infection called trichomoniasis has been found to spread through the sharing of damp, moist objects like sponges or towels.
Monkeypox has not usually spread easily among people, and experts are still trying to understand exactly how it moves from person to person. In Africa, where small outbreaks have been common for years, people have been infected through bites from rodents or small animals.
But in May, cases began emerging in Europe, the United States and elsewhere that showed a clear pattern of infection through intimate contact with an infected person, like many other sexually transmitted diseases.
The public health workers who respond to outbreaks play a large role how they are framed. Much of the work on monkeypox has been done by professionals who operate sexual health clinics or specialize in STDs.
Indeed, the U.S. government’s response needs to be led by people with that expertise, said David C. Harvey, executive director of the National Coalition of STD Directors.
“The STD field has a wealth of knowledge and expertise in these areas developed over decades fighting various outbreaks and diseases affecting the very communities … we’re seeing monkeypox taking a toll on today,” Harvey said in a statement.
Who is getting monkeypox?
WHO officials said last week that 99% of all the monkeypox cases beyond Africa were in men and that of those, 98% involved men who have sex with men. Experts suspect that monkeypox outbreaks in Europe and North America were ignited by sex at two raves in Belgium and Spain.
The statistics are the same for cases reported in the United States, according to the Centers for Disease Control and Prevention. As in Europe, cases have emerged in other groups too, including at least 13 people who were female at birth and at least two children.
Last week, the New England Journal of Medicine published a study of hundreds of monkeypox infections in 16 countries. It found that the suspected means of transmission in 95% of the cases was sexual close contact, as reported by doctors. The researchers noted that it was impossible to confirm sexual transmission.
That idea seemed to be further supported by the finding that most of the men had lesions in the genital or anal areas or in the mouth — areas of sexual contact, the researchers said.
Why is there a debate about calling it an STD?
While there is broad agreement among health officials that monkeypox is being transmitted during sexual encounters, some experts debate whether it should be called an STD. They worry that the term unfairly stigmatizes and that it could undermine efforts to identify infections and tame the outbreak.
When a disease is defined as a sexually transmitted infection that mainly affects men who have sex with men, many people may begin to think of it as “a gay disease” that poses no risk to them, said Jason Farley, an epidemiologist at the Johns Hopkins School of Nursing.
That’s what happened in the early days of the AIDS epidemic in the 1980s, which contributed to the spread of HIV to other groups. Farley said.
“We learn nothing from our history,” said Farley, who is gay.
The WHO recommendation that at-risk men limit their sexual partners is sensible public health advice, he said. But it also amplifies “the message that this is a gay disease,” he said.
“This is the fine line between having a public health approach that focuses on the epidemiology of now, compared to the likelihood of the continued emergence of new cases in” the general community, he said.
“Monkeypox is not a sexually transmitted infection,” he said. “It is an infection that can be transmitted with sexual contact.”
What is known about transmission?
Some researchers have found evidence of the monkeypox virus in semen. A study in Spain found monkeypox virus DNA in the semen of some infected men, as well as in saliva and other body fluids. But the study didn’t answer whether the virus actually has spread through semen.
Sorting that out could affect the understanding of not only how men spread the infection, but also how long they might be contagious. Evidence of some other viruses — like Ebola and Zika — has been found in the semen of some men months after they were thought to be fully recovered.
Meanwhile, scientists believe the primary route of transmission during the current outbreak has been skin-to-skin contact during sexual encounters with someone who has symptoms. In that respect, it’s similar to herpes, some experts noted.
The virus also may spread through saliva and respiratory droplets during prolonged, face-to-face contact, such as during kissing and cuddling — a kind of spread that can occur outside of sex.
Researchers are exploring how often, and in what situations, that kind of spread might happen, said Christopher Mores, a professor of global health at George Washington University.
“We would do ourselves a disservice to try and exclude anything from the realm of possibility at this point,” he said.
Officials also say people can catch monkeypox from touching items that previously touched an infected person’s rash or body fluids, such as towels or bedsheets. That is thought to explain the infections of the U.S. children.
Why are these details important?
It’s important to understand exactly how monkeypox spreads in order to give people the information they need to protect themselves, health officials say.
That said, health officials believe those who are currently at the highest risk are gay or bisexual men who have sex with multiple partners. That understanding has shaped much of the work to contain the outbreak, including prioritization of the supply of vaccines and treatments.
The government has been shipping a monkeypox vaccine, but the supply is limited. So far it’s only been recommended as a post-exposure treatment or for people who have had multiple sex partners in the past two weeks in a place where monkeypox cases have been reported.
The vaccine is new, and officials are trying to gather data on exactly how well it works.
