MSM And The Spread Of Monkeypox

It’s not as if monkeypox suddenly materialized out of nowhere, some heretofore unknown disease that emerged as a novel blight. Not only was it a known disease, but one for which a vaccine already exists. Great news, right? Yes and who knows.

Ever since monkeypox started to sicken thousands of people worldwide this spring, two big questions have loomed: Why is a virus that has never managed to spread beyond a few cases outside Africa suddenly causing such a big, global outbreak? And why are the overwhelming majority of those affected men who have sex with men (MSM)?

A long history of work on sexually transmitted infections (STIs) and early studies of the current outbreak suggest the answers may be linked: The virus may have made its way into highly interconnected sexual networks within the MSM community, where it can spread in ways that it cannot in the general population.

What, you thought MSM meant something else? The novel problem isn’t the disease, but how our brave new world has made it too difficult, too stigmatizing, too incorrect, to speak frankly about transmission. here’s the really hard thing to swallow: The media would rather people get monkeypox than say how it spreads and what can be done to prevent its spread. (Hint: Don’t let unfamiliar penises get shoved into your butt.)

The point isn’t whether this is the sole means of transmission, or that it’s a “gay plague” as AIDS was called, but that at this moment in time, preventing people from getting it and spreading it seems a lot more substantively important than being scared shitless that you might misgender Typhoid Mary or use the wrong pronoun for Typhoid Tommy.

I realized this was a problem seeing the twits of youthful Axios health reporter (meaning, person at a media organization devoted to news for people with 8 second attention spans) Chelsea Cirruzzo.

She opened her brief report with this observation:

Why it matters: Officials have wrestled with how to frame public messaging amid concern that it could contribute to further stigma and falsely imply that monkeypox is limited to being spread among gay men.

The link went to a WaPo story with this lede:

Officials there faced a dilemma. They wanted to warn men who have sex with men that they were at higher risk for exposure to the virus. But they feared unintended consequences: heterosexual people assuming they’re not susceptible, closeted men in a heavily Mormon community avoiding care so they’re not seen as gay, and critics exploiting the infections to sow bigotry.

The solution from the epidemiological perspective seems pretty darn easy. Tell them that while it’s not the only way to get monkeypox, the penis in butts thing is by far the most effective means of spreading it, getting it and suffering from it. And yet, this was so fraught that they would rather risk an epidemic than tell guys to stop shoving their wiener up tushies? So they get monkeypox, but don’t feel stigmatized about it?

Ciruzzo did a pretty decent job of dodging landmines, but covered herself just in case.

Please note: I say gay and bisexual men because a majority of the cases in D.C. are among men who identify as gay. Transwomen and non-binary people assigned male at birth are also high-risk and eligible for vaccination in D.C. Pre-register:

Does Chelsea believe that “transwomen and non-binary people assigned male at birth” are unaware that they have this dangling appendage, typically referred to as a penis, and if they stick it up someone’s buttocks, its sufficiently similar to what gay and bisexual men do so that the monkeypox virus isn’t tricked into respecting their socially constructed and occasionally assigned at birth gender identity?

No doubt it was said with the best of intentions, as someone who simultaneously seeks to help people avoid getting monkeypox and not cornhole them for where they prefer to stick their penis, or be stuck by one. This isn’t about their sexual choices, whether orientations, preferences, identities or any other of the 31 flavors of Baskin-Robbins. It happens, We’re all aware it happens. And it’s totally fine that it happens. To each his own.

But when saving the lives (yes, monkeypox isn’t deadly, but AIDS certainly was, so bear with me) of human beings is at stake, are you really going to dance around the woke landmines and risk people dying to avoid being attacked by the mob for trying to prevent the spread of a disease that’s mostly, if not exclusively, sexually transmitted? Do you really want to stand at the hospital bed of some guy (assigned at birth or otherwise) covered in oozing monkeypox sores muttering, “Well, at least i didn’t call you ‘gay’ when you’re really sexually polymorphic.”

29 thoughts on “MSM And The Spread Of Monkeypox

  1. Bruce Coulson

    The AIDS crisis made a lot of professionals realize just how hated gay men are by some people. As in, they wanted AIDS to kill all the gay people. (Never mind that a new generation would have some gay people in it.) Since then, a lot of doctors have wrestled with the problem of dealing with a disease that targets gay men. (Remember the Chief Surgeon of the U.S. who lost his job because he was advising gay people on how to handle AIDS?) I agree that talking around the subject isn’t a good way to handle this, but I’m not sure there is any good way.

  2. Maurice Ross

    Respectfully it’s not transmitted sexually. It’s from skin to skin contact. The media at least in New York have made it clear that gay men are at high risk because they frequent parties with thousands of shirtless men who touch each other skin to skin. These dance parties are the source of most of the spread. That’s why gay men are most at risk.

      1. NewbieDummy

        It seems the CDC is aware. From the link you provided:
        “How can a person lower the chance of getting monkeypox at places like raves, parties, clubs, and festivals? When thinking about what to do, seek out information from trusted sources like the local health department. Second, consider how much close, personal, skin-to-skin contact is likely to occur at the event you plan to attend. If you feel sick or have a rash, do not attend any gathering, and see a healthcare provider.“

        1. SHG Post author

          Trying to be a deceptive asshole is frowned upon here. Or perhaps you’re just insufferably stupid, in which case it’s not your fault and can’t be fixed.

          1. David

            What you fail to appreciate is how well this works on twitter where one can be guaranteed that no one will check a facile lie that they want to believe. You’re so old, Greenfield.

    1. Ron

      Weird that it’s only a transmission problem for MSM and not PIV sex.

      Maybe birthing persons with uterii are immune.

  3. Rxc

    It started with AIDS, and is being repeated now with monkeypox, but the fundamental issue is telling vulnerable groups that their behavior is killing them. Which they don’t want to hear, because they consider that behavior to be at the root of their identity and existe.

    1. SHG Post author

      If it’s going to kill you, then that’s pretty much the end of one’s identity and existence. More seriously, who cares what anyone does or with whom, but inform people accurately as to medical information so they can live. Would people rather die than not have their gender identity recognized? Would others rather kill them than be decried as transphobic?

    2. Paleo

      Smoking is going to kill you. Steaks and French fries are going to kill you. Monkeypox is not that likely to.

      Yesterday we buried my father-in-law. At post-service lunch we sat with a group that included my wife’s lesbian 1st cousin. 20some years ago she and her now wife visited our city and spent a few hours at our house. We fed them spaghetti and gave them a ride to (near) the place they were staying. Yesterday she told us that on that long ago visit that she tried to hide being gay and didn’t tell us the name of the place they were staying because it catered to gays. We told her we recognized it back then and didn’t care and we all had a laugh about it. Just a very recent anecdote as a reminder of how bad and corrosive stigmas like this are for the stigmatized.

      Still that’s not a problem for public health people and the media. Get the right information widely spread. Jackasses are always gonna jackass. The rest of us will deal with it.

  4. B. McLeod

    Politically incorrect viruses are the deplorables of the epidemiological world. No matter how many media and LGBTQ, etc., support organizations try to educate them, these viruses are simply incorrigible and will not be reasoned with.

  5. Charon

    Just wanted to note your rather vivid descriptions of MSM sex. My guess is that you were so flagrant about it as part of the message that whether it’s vulgar or wrapped up in a box, we know what it is and it won’t hurt us either way. If so, well played. Or did I miss something?

  6. L Phillips

    Twenty-two comments and no one picked up on “here’s the really hard thing to swallow”? I’m disappointed in your crew Admiral.

  7. DaveL

    Of course it’s not so much the way that men have sex, but the number of partners. There is no rational reason to shy away from promoting monogamy in the gay community. Ten years ago, liberals fought a campaign for legal recognition of same-sex marriage. We cannot now turn around and pretend there’s some fundamental, existential incompatibility that makes the very mention of monogamy hateful.

  8. Bryan Burroughs

    You’ll be glad to know that the focus shifted back to what’s important: the possibility that using the word “monkey” in the name of the virus is racist. No kidding, there’s now talk about renaming it.


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