In this presentation I hope to facilitate a discussion of how the rich palette of gay male sexual expression across the lifespan can perhaps be incorporated into an integral, holistic health movement. From the start I would like us to disavow ourselves of the “men who have sex with men” meme. I can for a quick minute appreciate the possible epidemiological utility of tracking and categorizing HIV infections using this moniker. I think it has however, in ways not so subtle, contributed to a narrow and demeaning view of us as solely sexual beings whose very essence as gay men is how we express ourselves sexually. Think about it. Would you consider it appropriate to define heterosexual women with HIV as “women who have sex with men?”
During our time together today I would like to present some thoughts on the state of being a gay male from four gay pioneers and thought leaders if you will and how their work and thinking could contribute to the creation of a more holistic view of gay men’s health across the lifespan. The creation of a view of the healthy gay man as more rich and complex than simply someone free of STD’s seems a worthy goal. The men whose work I will reference are Eric Rofes, Larry Kramer, Will Roscoe and Harry Hay. As I have delved into this presentation I am reminded of a quote from my favorite philosopher and I would urge us all to keep this in mind: “No one is wrong 100% of the time”- Ken Wilber.
We can start at what some think of as the beginning of the modern queer movement if you will with the formation of the Mattachine Society and the work of Harry Hay specifically his view that we were a distinct cultural minority. Hay and a small band of like-minded comrades, as many of you know, founded the Mattachine Society in 1950 in Los Angles.
On a personal note I had the great good fortune of meeting Hay and his life companion John Burnside in 1978 here in Denver. That proved to be the beginning of an amazing mentoring relationship, he being the mentor of course, lasting until his death in 2002. Many things Harry said to me over the years were at times aggravating but most often thought provoking and one such comment that has stuck with me over the years he made at my kitchen table late one night shortly after we met in 1978; “you know the only thing we have in common with straight people is what we do in bed.” He would on occasion use this phrase as a thought-provoking nugget meant to challenge us to look at our many unexamined assumptions about who we are as gay people. That Harry would have scoffed at the thought that our most distinguishing characteristic is that we are merely “men who have sex with men” is a profound understatement. Hay had three questions he continually raised in his life-long work primarily with gay men and those were: “Who are we? Where do we come from? And what are we for”.
A fellow whose very significant, extensive and valuable body of work has built and expanded on Hay’s thinking is Will Roscoe. In the afterword Roscoe wrote for the biography on Hay he edited called Radically Gay (1996) he very succinctly notes: “Lesbians and especially Gay men trace their sense of difference to their childhoods and to primarily non-sexual experiences….The fact is, for most Lesbians and Gay men homosexuality is not a construction, not something acquired, not an accident of childrearing, but a profound ongoing motivation” (page 338, Radically Gay) Not to overemphasize the point but the profound ongoing motivation experienced by many does not in any way initially involve the desire to put one’s cock in another little boy’s mouth.
I would suggest that the concept of gay men’s sexual health across the lifespan needs to be incorporated into the much richer and more nuanced reality of what factors into being a healthy gay man. In my opinion one of the unfortunate occurrences of the AIDS epidemic, among many, has been the abdication of gay men’s health to the Public Health system especially in the last twenty years. This has of course been expanded beyond just STD’s into tobacco use, substance abuse and mental health concerns. The core of these public interventions though so often seems based in efforts and campaigns to address ‘pathologies’. This is admittedly a noble endeavor and something that probably could only be addressed with the relatively significant governmental resources public health departments bring to the picture. I am grateful for the significant impact the medical and public health communities have had on gay male mortality and morbidity especially around the AIDS nightmare. These educational interventions though are all too often narrowly focused on men having sex with other men and at times the real consequences of that. I might add these efforts are now rarely coming out of gay community-based organizations and quite frankly I think their importance, in regards to certain STD’s in particular, is often overblown. Early on in the AIDS epidemic though the only education and risk reduction messages came largely from grass roots efforts within the queer community. If you have not already done so do see How to Survive a Plague.
The overarching question I would bring to this discussion is whether or not the continued level of dis-ease (not just HIV) in the gay male community is not at least in part due to efforts that do not take into account the many complex facets of growing up and coming out as gay in America in 2013. How do we get to a place where that initial and often very early profound ongoing motivation is not only recognized for what it is but also nurtured and allowed to express itself in a healthy fashion and what role if any would the current health establishment play in this? I would suggest that so much of the efforts and interventions of the medical establishment in regards to gay male health and well being only arrives on the scene long after the horse has left the barn and then is often woefully lacking in gay cultural, racial and class sensitivity.
There are unfortunately even today for many of us years of internal anguish when one begins to deal with their personal profound ongoing motivation. Though this process often begins in the pre-teen years for many it does not become a shared experience often for many years and not infrequently until the twilight years of the lifespan. The sharing of this experience is the coming out process. It is important I think to realize that it is most often not connected to a sexual act at all. I have had the great pleasure to be involved with a group of LGBT elders at the local Community Center in Denver through their SAGE program. I attended and still contribute on occasion to a SAGE group called Telling Your Story. A random word or two is picked as a topic and everyone writes to that from their own life experience. I was a bit surprised over time to realize that not a few of the elders in this group were just now coming out and this is how they were describing their current life experiences emerging into the gay world. Many have been in long-term heterosexual marriages and have children and grandchildren. For some this late blooming has also involved some of their first real same sex encounters.
The journey of these gay elders is perhaps a bit easier though than for young teens today experiencing the same coming out process. In some respects it may be harder for youth today or at least involves very different risks that come with “exposure”. I think there is an exuberance that comes with youth that the elder perhaps has learned to mute and therefore attract less attention. Bullying and teen suicides have always been around but the sharper focus on them today though appropriate still indicates that coming out is not for the faint of heart. For many of us who started getting in touch with our differences say in the 1950’s and 1960’s there was hardly a name yet for us but absolutely many societal prompts and clues that being “different” was not OK and that we best stay under the radar. The pressure to conform was overwhelming and forced many into heterosexual marriages that only came apart many decades later. Though this embrace of pseudo-heterosexuality may have been safer from a physical perspective it had for many devastating psychological consequences.
We can certainly look at the campaign begun by Dan Savage, “It Gets Better” as admirable and very worthwhile. We need though to be striving for a world where it doesn’t need to “get better” but will be supported and nurtured from the outset.
I would now like to focus a bit more specifically on the sexual health of gay men. My own personal work and activist experiences, since the mid -1970’s, have often been focused on gay men and their health issues. My University of Colorado Community Health rotation in nursing school in 1977 involved STD testing in the bathhouses here in Denver, institutions in their glory. Then the last 20 years of my nursing career, up until 2010, were spent in the ID/AIDS Clinic at Denver Health. I will leave the task of addressing the unique sexual health issues for Lesbians and our Transsexual bothers and sisters to others much more qualified than I am.
When thinking about gay men, their sexual health and life issues I often remember a line from an old Jefferson Airplane tune: “We are all outlaws in the eyes of America”. This of course was the actual reality in most parts of this country dating back to the founding of the Republic. It was only in 2003 that the Supreme Court ruled in a landmark case, Lawrence vs. Texas, the Texas sodomy law used to arrest two men in their own bedroom was unconstitutional. That ruling was not unanimous by the way, but 6-3. I would not like to see that revisited with today’s court.
Though sodomy broadly is often defined as putting tongues or penises and perhaps even fingers in orifices they are thought not to belong in, the image most often conjured up is that of “butt sex”. I do not mean to down play any of the many other sexually transmitted diseases common to gay men but AIDS is really in a class all its own. For better or worse AIDS and the risk of contracting HIV have really come to dominate the discussion so often around gay men’s health for almost 30 years now. AIDS has been and continues today the horrible burden it is for gay men almost solely because of being the bottom partner in butt sex without a condom in play. How do we get the often joyous, sometimes rebellious and unfortunately at times dangerous act of getting fucked incorporated into a healthy gay male lifestyle? I would suggest it involves much more of a nuanced and sophisticated approach that simply handing out condoms and it needs to start early.
The elephant in the room that butt sex remains even today within the gay community needs to come out of its own closet. Gay men, for whom it is a form of sexual expression, need to address it throughout the lifespan and not just through sanitized, though often well meaning heterosexual public health and medical surrogates.
I am not high when I say I think it is possible for this to be part of a legitimate, holistic and well-incorporated part of a mentoring program. A community based and nurtured form of support that begins at any age for anyone who chooses to embark on this form of sexual expression whether as part of their early coming out process or, as is more likely the case, something explored in depth later on in the adventure. In my fantasized version of the universe this sex education component would of course only be one element in exploring the complex life tapestry that getting in touch with one’s profound ongoing motivation involves. Another of Harry Hay’s frequent metaphors for how being gay is different from being straight involved looking out of our own window. We are certainly looking out at the same world but through our own window providing us with a unique view of how things are.
I recently stumbled on a piece in the Gay Voices section of the Huffington Post by a psychotherapist named Mark O’Connell with the provocative title of “We Need to Talk About Butt Sex”. One of his opening sentences continued to pull me in: “Without consulting each other about anal sex, we lack the best tips for safety, cleanliness and achieving maximum pleasure, a problem for the young and/or sexually inexperienced, who may have to endure unnecessary confusion, embarrassment or pain during intercourse.” This seemed to me to be a great start but the unfortunately the remainder of the article dealt mostly with the issue of “anal cleanliness” before sex. Learning how to douche may not even be a desirable behavior from a disease prevention perspective but it is only one issue about this decision that it would be nice for the novice of any age to address before taking the plunge. How often is this exciting form of sexual expression only approached drunk, high or in the heat of intense passion in which thoughtful consideration of health risks are out the window?
Where on earth would a sexually naive gay man of any age go to learn the myriad of issues surrounding this particular sexual act in out culture today? Unlikely that this would be a talk you would have with your dad and dare I say almost as unlikely a discussion for the doctor’s office. Facilitated or at least supported peer group discussions would be ideal and that would perhaps be one component of a holistic gay men’s health service.
One man though whose body of work and many community-based efforts challenged the AIDS juggernaut and worked hard to develop a vision of gay men’s health well beyond HIV and AIDS was Eric Rofes. Eric unfortunately died on June 26th, 2006 in the midst of working on a third book of a trilogy addressing at that time a nascent gay men’s health movement, an effort he was largely responsible for birthing. The first two works of this trilogy Reviving the Tribe and Dry Bones Breath are unfortunately no longer in print but copies can be found if you are persistent. Notes and preliminary chapters on this third book are available on the Internet at this link.
“Among the most effective ways of oppressing a people is through the colonization of their bodies, the stigmatizing of their desires and the repression of their erotic energies”.
The historical record documenting the stigmatizing of the “love that dare not speak its name” and the often brutal repression of gay male erotic energies is voluminous. I would challenge us to explore the possibility, though perhaps not at all intentional, that much of the public health efforts aimed at preventing HIV/AIDS and the other alphabet soup of STD’s has helped to perpetuate a subtle message that continues to “colonize our bodies”. Could we perhaps incorporate the important messages and efforts at HIV/STD prevention into a broader and much more integral approach to gay men’s health? How can we facilitate and grow this effort from a gay community based paradigm? In the best of all worlds I would love to see a holistic approach to gay men’s health de-coupled from the public health sphere. Public Health could and hopefully would remain a resource for helping the gay male community itself handle the real issue of HIV/STD’s but only one resource available as needed by the gay man with health concerns.
I actually had the opportunity to encounter Eric on several occasions, at a couple of large conferences held in Boulder Colorado in 1999 and 2000 and a short hour long face-to-face meeting at the Bearbucks in the Castro in 2005. My meeting with him in 2005 was initiated on my part to discuss an effort of mine called Q-City Wellness.
The goal for Q-City was: “Q-City Wellness Project’s mission is to facilitate the health and wellbeing of gay, bisexual and queer identified men.”
In dreaming this up I went on to say: We define health broadly as a multifaceted, ongoing, transformative process one of expanding and evolving consciousness. Our approach to health is an integral one: comprehensive, inclusive, non-marginalizing and embracing. My thinking on these issues at the time was and still is heavily influenced by Eric Rofes, Ken Wilbur, Larry Dossey and my favorite nursing theorist Margaret A. Newman.
Needless to say this rather ambitious project essentially went nowhere. For a variety of reasons I dropped the ball on trying to get anything at all off the ground. I did discover though the local LGBT Center has several programs that could be viewed as at least nascent efforts at a broader approach to the health and wellbeing of Queer people. One of these I have already mentioned is the SAGE group at The Center and it’s various programs: (SAGE Of The Rockies).
Another great program of The Center addressing LGBTQI youth is Rainbow alley. I am however woefully ignorant of their programs. Addressing, nurturing and supporting the concerns one has of their profound ongoing motivation at the earliest age possible seems very wise.
Despite the wonderful efforts of many different LGBT groups and agencies, many of which do foster a healthier more holistic queer lifestyle, the many complexities around being a healthy gay man today do seem though to cry out for something more. I’d like to quote extensively from a presentation by Eric Rofes at a National Gay Men’s Health Summit that occurred in Salt Lake City in October of 2005. Obviously Eric had thought about and developed the concepts and ideas around a gay men’s health movement way beyond anything I have accomplished or anyone else I am aware of for that matter.
Eric presented six foundational principles of gay men’s health summits, projects or campaigns:
- Replace the HIV-centric paradigm of health advocacy for gay men with holistic models that integrate (but do not default to) HIV.
- Rethink the crisis paradigm of HIV work and embrace contemporary understandings, meanings, and implications of HIV for gay men of all colors & classes.
- Challenge deficit based models for work with gay men and replace them with asset-based approaches.
- Strategically and politically confront structural forces challenging the well-being of gay men & bi men.
- Embrace a “big tent” vision of community, respecting diverse ways of organizing sex and relationships among gay men – shame and guilt are health hazards, rather than specific sex practices and sex cultures.
- Launch only efforts that are neither overtly or covertly sanitizing, sanctimonious or moralistic.
In this presentation he then went on to address what he felt were eight core issues confronting queer men of diverse generations, ethnicities, races, locations and social classes:
- Explore the longings for intimacy and connection with other men and the social structures, networks and ideologies that promote or prevent such connections.
- Understand the meanings of anal sex, penetration, & exchange of semen and explore the relationships between various racial, ethnic, and class-based masculinities and anal sex practices.
- Grapple with emotions, pleasures, & wounds emerging from childhood and adolescent experiences with boys and men.
- Tap into sources of resilience, creativity, determination, humor & playfulness in diverse gay men’s cultures.
- Support healing from trauma: violence, abuse, homophobia, racism, poverty, AIDS and addiction.
- Examine the ways transgression, risk, and the taboo interact with queer men’s sexual desires, practices and subcultures.
- Confront ways in which privileged masculinities of youth present challenges to & opportunities for wellbeing as men age.
- Revive and recreate community rituals, social structures, and networks to replace those lost during the most intense crisis year of AIDS
Refference: Eric Rofes, October 19th, 2005: The Gay Men’s Health Movement in the United States (1997-2005).
This obviously represents quite a tall order and for a community that seems obsessively pre-occupied with marriage and military service these days probably on virtually no one’s radar. I would though encourage especially the gay men here today working in the queer community to look and think deeply about these core principles Eric has so eloquently laid out. Simply and in small ways using venues such as a local community center pick just one principle and see how it can be addressed in a manner than will facilitate the health of gay men. Some of these can at least in part be addressed on an individual basis with very minimal resources really. As an example I am personally familiar with I would again reference the local SAGE Telling Your Story group as a way individuals come together and in a supportive queer environment share personal struggles with many of these issues addressed at least at times if only tangentially. For some it is a real start.
I would like to close by returning to certain views of the gay male world in particular that I have directly experienced as a result of my relationship with Harry Hay. This profound ongoing motivation that being queer is should be a wonderful, exciting, healthful and often at times a real threat to the status quo life-long adventure. One of Hay’s frequently emphasized beliefs was, when speaking directly to gay men, that we have many very unique gifts to bring to the human banquet. This can only happen though when we create for ourselves the space to address where we come from, who we are and what we are for. The answers to these questions will never be bestowed on us through “civil rights”.
These questions can I think be addressed in a framework that allows for the development of a healthy gay male community throughout our lifespans and much of this work has already been addressed in part without the benefits of the larger societies approval or legislation. Though the current issues of military service, the ability to marry and the same civil rights as the heterosexual community are important ones unless they contribute to our addressing our own individual queer profound ongoing motivation that does not result in our being broken, addicted, infected or dead at an early age they serve little purpose. A holistic and healthy gay male reality will not be conferred on us from the medical, political or social heterosexual worlds but will be the result of our own internal community efforts. Efforts that Eric so eloquently stated above focusing on “challenging deficit based models for work with gay men and replace them with asset based approaches.”