National
Monkeypox being spread through sex, not brief skin-to-skin contact: experts
Health experts weigh declaring virus an STD
Amid fears monkeypox would spread at an increased rate at the end of summer as gay men gather in close quarters for dance parties and other celebrations, health experts are starting to emphasize that the current outbreak isn’t spreading through minimal skin-to-skin contact, such as brushing up against a fellow shirtless dance partner, but rather through sexual activity and overwhelmingly among men who have sex with men.
With reported cases of monkeypox in the United States this week reaching 15,505, according to data from the Centers for Disease Control, a number of health experts who spoke to the Blade talked about outright declaring monkeypox a sexually transmitted disease as part of this messaging — although they acknowledge such a label would have pros and cons.
Juan Carlos Loubriel, senior director of community health at the D.C.-based Whitman-Walker Health, was among the health experts making the distinction between the negligible risks of transmitting monkeypox through brief skin-to-skin contact as opposed to sexual activity.
“I’ll say that we need to provide the real facts to our community that indicates right now that the majority of the cases are sexually transmitted, right?” Loubriel said. “So transmission is not occurring by casual touch, right? That’s what we know as of today … So the majority of the cases [are] by prolonged skin-to-skin contact, and during sex there is a lot of skin-to-skin contact.”
As health experts at large are beginning to make a distinction in how the disease is transmitted, the Biden administration has also taken up messaging that downplays the risk of monkeypox transmission through minimal skin-to-skin contact.
Demetre Daskalakis, who is the face of the LGBTQ outreach for the Biden administration as deputy coordinator of the White House monkeypox task force, made colorful remarks Friday during a conference call with reporters downplaying the risk of contracting monkeypox through brief contact, quoting a senior policy adviser at the CDC who has studied LGBTQ health issues.
“I think I’m going to quote my friend Robbie Goldstein that sex involves friction, and friction seems to be how this happens,” Daskalakis said. “So, I think, that from the perspective of events, the real risk at an event is low. Of course, you have to gauge that risk based on what you’re doing, so if there’s a lot of clothes out dancing and friction, that could be a mechanism of transmission, but just brushing by someone, I’ve said this many times before, just brushing by someone is probably low or no risk.”
Asked by the Blade during the call about any consideration on declaring monkeypox a sexually transmitted disease, Daskalakis said it’s “really important that the decision around monkeypox and whether it’s designated happen thoughtfully from the perspective of other implications.”
“What’s really important from the perspective of our communication on the ground is that our harm reduction and safer sex guidance really does mention the importance of sexual transmission or the associated transmission of the virus, and also provides guidance necessary, like reminding people that condoms may have a role — not necessarily the full role — in preventing monkeypox, but also reminds folks that skin-to-skin contact in the context of sex can be really a part of how transmission occurs,” he said.
The messaging is consistent with new studies finding cases of monkeypox are overwhelmingly the result of sexual activity. According to a recent report by NBC News, an increasing amount of scientific evidence — such three studies published in peer-reviewed journals, as well as reports from national, regional, and global health authorities — has indicated “experts may have framed monkeypox’s typical transmission route precisely backward.”
“[A]n expanding cadre of experts has come to believe that sex between men itself — both anal as well as oral intercourse — is likely the main driver of global monkeypox transmission,” the NBC News report says. “The skin contact that comes with sex, these experts say, is probably much less of a risk factor.”
With evidence the monkeypox outbreak is overwhelmingly being transmitted through sexual activity and risks from skin-to-skin contact virtually non-existent, experts say discussion on whether or not to label the virus as a sexually transmitted disease are ongoing and controversial.
On one hand, designating monkeypox as a sexually transmitted disease would give the public a clearer idea about the way it’s being transmitted to allay concerns and enable the public to take appropriate precautions. On the other hand, as seen during the height of HIV/AIDS crisis, an emphasis on monkeypox being transmitted among men who have sex with men may have the effect of stigmatizing the community (and the sexual activity) as being responsible for the outbreak.
Loubriel said the issue of whether or not monkeypox should be messaged more as a sexually transmitted disease is “a very good question and also a very big debate around public health, even within the public health sector.”
“The only reason we cannot say it is just sexually transmitted is because we know as a fact that it can be spread by other various avenues like touching clothing, bedding with an infected person or towels being used by someone with monkeypox, potentially contact with respiratory secretions,” Loubriel added. “So that is why it’s probably not been named as a sexually transmitted infection.”
Joseph Lee, a professor of health education at East Carolina University who studies health inequities among LGBTQ people, said there’s “real tension” in finding the right messaging, which he said would strike a balance between being factual while not being stigmatic of the marginalized community affected by monkeypox.
“We see when we have messaging that goes to the general public…that messaging about how a particular group is doing worse triggers negative stereotypes and makes people feel less at risk than they are,” Lee said. “And really importantly, it makes the group at the worst end of that problem feel sometimes like they’re feeling fatalistic or they can’t do anything to protect themselves. You almost feel like you have to give up and you’re just going to get it anyway because the messaging is so clear, how much it’s impacting your community.”
Lee, however, praised communications on monkeypox from the Centers for Disease Control & Prevention, saying the agency has “very useful guidance about promoting equity in monkeypox communication that I actually really like.”
Key points in the guidance, Lee said, is messaging that monkeypox can affect anyone, while going through some of the ways the virus is being transmitted and ways the public can protect itself. The guidance, Lee said, follows the right strategy of articulating a message to the general public, then adding more specific messages about protection against the disease and risk to the communities most vulnerable.
“That’s sort of their big picture strategy that I think is actually the right strategy,” Lee concluded. “How well everyone’s implementing it across the country in our messy, somewhat broken public health system is another question.”
Tennessee
Tenn. lawmakers pass transgender “watch list” bill
State Senate to consider measure on Wednesday
The Tennessee House of Representatives passed a bill last week to create a transgender “watch list” that also pushes detransition medical treatment. The state Senate will consider it on Wednesday.
House Bill 754/State Bill 676 has been deemed “ugly” by LGBTQ advocates and criticized by healthcare information litigators as a major privacy concern.
The bill would require “gender clinics accepting funds from this state to perform gender transition procedures to also perform detransition procedures; requires insurance entities providing coverage of gender transition procedures to also cover detransition procedures; requires certain gender clinics and insurance entities to report information regarding detransition procedures to the department of health.”
It would require that any gender-affirming care-providing clinics share the date, age, and sex of patients; any drugs prescribed (dosage, frequency, duration, and method administered); the state and county; the name, contact information, and medical specialty of the healthcare professional who prescribed the treatment; and any past medical history related to “neurological, behavioral, or mental health conditions.” It would also mandate additional information if surgical intervention is prescribed, including details on which healthcare professional made a referral and when.
HB 0754 would also require the state to produce a “comprehensive annual statistical report,” with all collected data shared with the heads of the legislature and the legislative librarian, and eventually published online for public access.
The bill also reframes detransitioning as a major focus of gender-affirming healthcare — despite studies showing that the number of trans people who detransition is statistically quite low, around 13 percent, and is often the result of external pressures (such as discrimination or family) rather than an issue with their gender identity.
This legislation stands in sharp contrast to federal protections restricting what healthcare information can be shared. In 1996, Congress passed the Health Insurance Portability and Accountability Act, or HIPAA, requiring protections for all “individually identifiable health information,” including medical records, conversations, billing information, and other patient data.
Margaret Riley, professor of law, public health sciences, and public policy at the University of Virginia, has written about similar efforts at the federal level, noting the Trump-Vance administration’s push to subpoena multiple hospitals’ records of gender-affirming care for trans patients despite no claims — or proof — that a crime was committed.
It has “sown fear and concern, both among people whose information is sought and among the doctors and other providers who offer such care. Some health providers have reportedly decided to no longer provide gender-affirming care to minors as a result of the inquiries, even in states where that care is legal.” She wrote in an article on the Conversation, where she goes further, pointing out that the push, mostly from conservative members of the government, are pushing extracting this private information “while giving no inkling of any alleged crimes that may have been committed.”
State Rep. Jeremy Faison (R-Cosby), the bill’s sponsor, said in a press conference two weeks ago that he has met dozens of individuals who sought to transition genders and ultimately detransitioned. In committee, an individual testified in support of the bill, claiming that while insurance paid for gender-affirming care, detransition care was not covered.
“I believe that we as a society are going to look back on this time that really burst out in 2014 and think, ‘Dear God, What were we thinking? This was as dumb as frontal lobotomies,’” Faison said of gender-affirming care. “I think we’re going to look back on society one day and think that.”
Jennifer Levi, GLAD Law’s senior director of Transgender and Queer Rights, shared with PBS last year that legislation like this changes the entire concept of HIPAA rights for trans Americans in ways that are invasive and unnecessary.
“It turns doctor-patient confidentiality into government surveillance,” Levi said, later emphasizing this will cause fewer people to seek out the care that they need. “It’s chilling.”
The Washington Blade reached out to the American Civil Liberties Union of Tennessee, which shared this statement from Executive Director Miriam Nemeth:
“HB 754/SB 676 continues the ugly legacy of Tennessee legislators’ attacks on the lives of transgender Tennesseans. Most Tennesseans, regardless of political views, oppose government databases tracking medical decisions made between patients and their doctors. The same should be true here. The state does not threaten to end the livelihood of doctors and fine them $150,000 for safeguarding the sensitive information of people with diabetes, depression, cancer, or other conditions. Trans people and intersex people deserve the same safety, privacy, and equal treatment under the law as everyone else.”
National
Glisten’s 30th annual Day of Silence to take place April 10
Campaign began as student-led protests against anti-LGBTQ bullying, discrimination
Glisten’s 30th annual Day of Silence will take place on April 10.
The annual Day of Silence began as a student-led protest in response to bullying and discrimination that LGBTQ students face. It is now a national campaign for the LGBTQ community and their allies to come together for LGBTQ youth.
It takes place annually and has multiple ways for supporters to get involved in the movement.
Glisten, originally GLSEN, champions LGBTQ issues in schools, grades K-12. Glisten’s mission is to create more inclusive and accepting environments for LGBTQ students through curriculum, supportive measures, education campaigns, and engagement, such as the Day of Silence.
There are three main ways for the community to get involved in the Day of Silence.
Glisten has a Day of Silence frame, a series of pictures used as profile photos across social media that feature individuals holding signs. The signs allow for personalization, by providing a space to put the individual’s name, followed by filling in the prompt “ … and I am ENDING the silence by…”
Participants are encouraged to post the photo on social media and use it as a profile picture. The templates can be found on Google Drive through this link.
Using #DayOfSilence and #NSCS, as well as tagging Glisten’s official Page @glistencommunity, is another way to participate in the Day of Silence.
Glisten also encourages participants to tag creators, friends, family and use a call to action in their caption, to call attention to the facts and stories behind the Day of Silence.
“Today’s administration in the U.S. wants us to stay silent, submit to their biased and hurtful conformity, and stop fighting for our right to be authentically ourselves,” said Glisten CEO Melanie Willingham-Jaggers. “We urge supporters to use their social platforms and check in with local chapters to be boots on the ground to help LGBTQ+ students feel seen, heard, supported, and less alone. By participating in the ‘Day of Silence,’ you are showing solidarity with young people as they navigate identity, safety, and belonging. Our voices matter.”
South Carolina
Man faces first S.C. ‘hate intimidation’ charge
Timothy Truett allegedly shot at gay club in Myrtle Beach on April 1
A South Carolina man remains in custody on a more than $300,000 bond after he allegedly opened fire at a Myrtle Beach nightclub on April 1, according to WMBF.
Reports say 37-year-old Timothy James Truett Jr., of Clover, S.C., was detained by the Myrtle Beach Police Department after the April 1 incident outside Pulse Ultra Club. He was later arrested and charged with possession of a weapon during a violent crime, discharging a firearm into a dwelling, discharging a firearm within city limits, malicious injury to real property valued over $5,000, and assault or intimidation due to political opinions or the exercise of civil rights.
At 10:57 a.m. on April 1, officers responded to a call about a possible shooting at Pulse Ultra Club, located in the 2700 block of South Kings Highway.
In an affidavit released later, the club’s owner, Ken Phillips, said he was doing paperwork that morning when he heard “five or six” gunshots. He went outside and found a window and the windshield of his SUV shattered by bullets. An SUV with blue plastic covering one window was left at the scene.
Police later reviewed footage that showed a silver vehicle stopping in the middle of the road. The video appeared to capture muzzle flashes coming from the passenger-side window.
According to the affidavit, an officer later pulled over a vehicle driven by Truett and found spent shell casings in the back seat, along with a gun.
Documents do not detail why Truett was ultimately charged under the state law covering assault or intimidation tied to political opinions or the exercise of civil rights.
As of April 1, records show Truett is being held in Horry County on a combined bond of more than $312,000.
WMBF spoke with Phillips after the incident and asked whether there was any prior conflict that might have led to the shooting.
“I don’t know if it’s personal, I don’t know if it’s related to being gay, I don’t know if it’s related to the bar issues,” Phillips told WMBF. “Anybody with a mindset of pulling out a weapon in broad daylight is not right.”
“My primary concern has and always will be the safety of my community and my customers,” he added. “It’s given me great concern … as to how far people will go.”
WMBF also spoke with Adam Hayes, vice chair of Myrtle Beach’s Human Rights Coalition, who was involved in pushing for the ordinance. He said that while the incident itself is troubling, it shows the policy is being put to use.
The ordinance is intended to deter “crimes that are motivated by bias or hate towards any person or persons, in whole or in part, because of the actual or perceived” identity, in the absence of a statewide hate crime law.
“It’s nice to see that something we put into policy is not just a piece of paper, that it’s actually being used,” said Hayes.
He said the shooting underscores the need for a statewide hate crime law in South Carolina and added that the incident has left the local LGBTQ community shaken.
South Carolina and Wyoming are the only two states in the U.S. without a comprehensive statewide hate crime law.
Truett remains in jail as of publication.
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