The Spahr Center announces the forthcoming departure of its executive director, Adrian Shanker, who has been appointed by the Biden-Harris Administration to serve in the role of Senior Advisor on LGBTQI+ Health Equity in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services. Shanker joined The Spahr Center in April 2022 and in this short time has led an organizational rebranding with a new logo and website, an expansion of programs for LGBTQI+ families, and the launch of the organization’s Training Institute. He has also been a critical advocate for MPOX vaccine access in Marin County.
Shanker has been serving in a voluntary capacity in the Biden-Harris administration as a member of the Presidential Advisory Council on HIV/AIDS since 2021. He joined The Spahr Center after founding and leading Bradbury-Sullivan LGBT Community Center in Allentown, Pennsylvania for more than seven years.
Executive Director of The Spahr Center, Adrian Shanker comments:
“It has been a tremendous joy to work with the team at The Spahr Center to enhance and expand programs and services for LGBTQI+ and HIV+ community members in Marin. When I started at The Spahr Center, I did not anticipate a short tenure, however I am confident that the organization is in a strong position to continue its positive momentum in service to Marin’s LGBTQI+ and HIV+ communities. I am deeply humbled by the invitation to join the Biden-Harris Administration in this role and I look forward to supporting the administration’s efforts to advance health equity for the LGBTQI+ community.”
Chair of The Spahr Center’s Board of Directors, Denny David, comments:
“When we hired Adrian we knew we were bringing someone in with tremendous expertise in LGBTQI+ health. It turns out that The Biden Administration agrees. For decades, the LGBTQI+ community has fought for a seat at the table and we have seen the devastating consequences of being ignored. While we are sad to lose Adrian, that sadness is tempered by a tremendous amount of community pride. We are glad to have a champion for the health of our community heading to Washington to advise the administration, and at The Spahr Center, we will continue to seamlessly offer the services and programs our community needs.”
The Board of Directors is committed to leadership for the agency through the transition. Today, the Board announces the appointment of Cindy L. Myers, Ph.D., as interim executive director. Dr. Myers brings 30 years of executive leadership experience in the behavioral health and human services fields to The Spahr Center. She has served as an interim Chief Executive, Chief Operating and Chief Clinical Officer for a diverse range of businesses and organizations, including the National Center for Lesbian Rights (NCLR).
Iceland has published its action plan on LGBTQ+ issues for the years 2022 to 2025, which includes an end to discrimination for queer blood donors, training in LGBTQ+ issues for police, “appropriate and unbiased” healthcare for trans people, and more.
The country’s parliament is also pledging 40 million Icelandic Króna (around £250,000) to support ministries’ LGBTQ+ projects within that time period.
The UK used to have an LGBTQ+ action plan, established in 2018 under Theresa May’s Conservative government, which included meaningful reform of the Gender Recognition Act and the banning of conversion therapy in all its forms.
Iceland, which already has strong LGBTQ+ protections in place, and in 2017 was found to be the least homophobic country in the list of members of the Organisation for Economic Co-operation and Development (OECD), pushed forward the 21 progressive measures in June.
A statement about the programme says it is the “first one that focuses solely on LGBTI matters”.
“The purpose of the action should be to abolish the discrimination which blood donors have been subject to on account of their sexual orientation,” the plan reads.
Particular focus was made on wellbeing in the action plan, with steps to help ensure the health and wellbeing of LGBTQ+ youth, elderly people, and disabled people, as well as tackling LGBTQ+ domestic violence.
The plan states: “The well-being and situation of this group [LGBTI disabled people and LGBTI elders] in society should be considered in terms of isolation and expression.”
It added that it would also study the “well-being of LGBTI people in regions outside the capital area… should be given special consideration, where people are in proximity to a great extent and economic life tends to be undiversified.”
‘All of our people are accepted’
Ahead of a visit from the UN’s independent expert on sexual orientation and gender identity on 26 September, Ambassador Bergdís Ellertsdóttir said: “Human rights are a key priority in Iceland’s foreign policy, and LGBTQ+ rights are a particular focus at home where, as a society, we ensure that all of our people are accepted and enjoy full rights.”
Iceland remains high up on Europe’s “Rainbow Map” of LGBTQ+ friendly countries in 2022, however it was beaten to the top spot by Malta and Denmark, with ILGA Europe noting that Denmark is “taking the lead in filling in anti-discrimination gaps in current legislation”.
New York City’s eviction court – the venue of a landmark same-sex relationship decision long before Obergefell v Hodges – is now the source of a legal opinion that comes down clearly on the side of polyamorous unions.
The decision came in the case of West 49th St., LLC v. O’Neill, decided by New York Civil Court Judge Karen May Bacdayan, concluded that polyamorous relationships are entitled to the same sort of legal protection given to two-person relationships.
The case revolves around three individuals. Scott Anderson and Markyus O’Neill lived together in a New York City apartment. Anderson held the lease, but was married to another man, Robert Romano, who lived at another address. After Anderson died, the building’s owner contended O’Neill had no right to renew the lease since he was just a “roommate” of Anderson’s and not “a non-traditional family member.”
The court concluded that there needed to be a hearing about whether Anderson, Romano and O’Neill were in a polyamorous relationship.
Before gay marriage was legalized in any state, Braschi v. Stahl Assocs. Co. was decided in 1989 and made the New York State Court of Appeals the first American appellate court to recognize that a two-person, same-sex relationship is entitled to legal recognition.
“Braschi is widely regarded as a catalyst for the legal challenges and changes that ensued,” Bacdayan wrote in her opinion. “By the end of 2014, gay marriage was legal in 35 states through either legislation or state court action. Obergefell v Hodges (2015), the seminal Supreme Court decision that established same-sex marriage as a constitutional right was also heralded as groundbreaking.”
“However,” wrote Bacdayan, “Braschi and its progeny and Obergefell limit their holdings to two-person relationships.” This case, Bacdayan wrote, “presents the distinct and complex issue of significant multi-person relationships.”
The judge cited legislation enacted since the advent of federally recognized same sex unions. “In February 2020, the Utah legislature passed a so-called Bigamy Bill, decriminalizing the offense by downgrading it from a felony to a misdemeanor. In June [2020], Somerville, Massachusetts, passed an ordinance allowing groups of three or more people who ‘consider themselves to be a family’ to be recognized as domestic partners. The neighboring town of Cambridge followed suit, passing a broader ordinance recognizing multi-partner relationships. The law has proceeded even more rapidly in recognizing that it is possible for a child to have more than two legal parents.”
“Why then,” posited the judge, “except for the very real possibility of implicit majoritarian animus, is the limitation of two persons inserted into the definition of a family-like relationship for the purposes of receiving the same protections from eviction accorded to legally formalized or blood relationships? Is ‘two’ a ‘code word’ for monogamy? Why does a person have to be committed to one other person in only certain prescribed ways in order to enjoy stability in housing after the departure of a loved one?”
The attorney for the property owner characterized defendant O’Neill’s affidavit, claiming himself as a non-traditional family member, as a “fairytale.”
The case returns to court after further investigation of the three individuals’ relationship.
When transgender activist Erin Reed first started transitioning, she found it difficult to locate gender-affirming health centers that provide informed consent around hormone replacement therapy (HRT) and its effects. So, as an adult, she conducted extensive research in trans-inclusive web forums and created a Google Map listing 786 trans-supportive clinics, LGBTQ community centers, and other services across the nation.
A transphobic website called “The Gender Mapping Project” (or “The Gender Mapper”) seemingly reposted Reed’s map — typos and all — in order to help anti-trans activists “name and shame doctors” that support trans clients. The website’s stated goal is to abolish the “gender industry.”
“We are dedicated to delivering the truth about what is happening to children and youth by documenting the hard numbers on how many gender clinics, how many surgical clinics, and recording evidence where necessary. We wish to hold those who are harming to account and we demand justice for the victims,” the website states.
The website — which repeats right-wing falsehoods about “experimental surgeries,” chemical castration, and using gender-affirming care to “abuse” children — was founded by Alix Aharon, a member of the Women’s Liberation Front, a group that opposes trans legal and civil rights.
When Reed became aware of the website allegedly using her map, she tweeted, “I am enraged. I made my informed consent HRT map specifically for people dealing with poverty or lack of access to be able to obtain hormones after a move, or obtain without going for a year of therapy they can’t afford. And this d**k is using it for hate.”
Reed filed a Digital Millennium Copyright Act claim and asked Google to remove the map. But the Gender Mapping Project continues to use it, Reed told The Daily Dot.
Aharon’s website map may have already helped anti-trans groups target gender-affirming care providers. Reed and other trans activists worry that others will use the map to intimidate, harass, or commit violence against care providers and their clients. This possibility seems entirely possible considering that death and bombing threats have targeted at least two gender-affirming hospitals so far.
Aharon’s website, Republican politicians, Fox News, as well as other activists and media figures have claimed that gender-affirming care is a form of “child abuse” even though every major U.S. medical association says such care improves the lives of trans people.
“Given the threats made against clinics and attacks on LGBTQ community centers, this poses an immediate risk to every place listed in this map,” trans advocate Alejandra Caraballo wrote on Twitter. “Anti-abortion activists use similar lists to coordinate bombings of clinics and murders of providers.”
In response to such criticism, Aharon disingenuously told Salon, “My map is subject to interpretation. I don’t express an opinion on the actual map, if someone thinks that child gender clinics are a wonderful thing then my map is simply a resource for treatment.”
She told The Daily Dot that she doesn’t “really have other political views” and doesn’t see how her map can be transphobic seeing as pro-trans advocates have posted similar maps.
While her website rails against gender-affirming care for children, its map contains listings for places offering “’adult advocacy, support & ancillary services’ including support groups, chest binders, and STD testing,” The Daily Dot noted.
The Gender Mapping Project’s Twitter and Facebook accounts have both been suspended. However, the site maintains a monetized YouTube account, meaning that Google and Aharon can both profit from it. Google told the aforementioned publication that it is investigating the YouTube channel and Google Map.
Google also said that anyone can create maps and also report ones that may violate the company’s policies. Meanwhile, Twitter users are sharing the map online, tagging high-profile anti-trans activists who could help direct violence toward gender-affirming caregivers, the aforementioned publication reported.
One Twitter user criticized Google’s inaction against Aharon, writing, “Seriously @google @googlemaps you are putting people in danger by not taking this down. Do something about it. #NoHate.”
California Gov. Gavin Newsom signed a bill Thursday that aims to legally protect transgender youths and their parents if they flee conservative states that have restricted access to gender-affirming care.
The bill seeks to “offer refuge” to trans minors and their families “if they’re being criminalized in their home states,” state Sen. Scott Wiener, who introduced the bill, said on Twitter after Newsom signed it.
Wiener said states like Texas and Alabama “are seeking to tear these families apart,” referring to efforts in both states to bar parents from providing their trans children with medical care like puberty blockers and hormone therapy.
In February, Texas Gov. Greg Abbott called on the state’s Department of Family and Protective Services to “conduct a prompt and thorough investigation” of any reported instances of minors undergoing “elective procedures for gender transitioning.” He also encouraged anyone who works with children in the state and regular citizens to report parents providing such care.
In Alabama, Gov. Kay Ivey signed a bill that makes it a felony for medical professionals to provide gender-affirming medical care to people under 19.
“We should especially protect our children from these radical, life-altering drugs and surgeries when they are at such a vulnerable stage in life,” Ivey said in a statement at the time.
The bill Newsom signed is intended to protect families and children like those from prosecution in their home states if they travel to California for gender-affirming care or if they move to California after already receiving transition-related care elsewhere.
“We believe that no one should be prosecuted or persecuted for getting the care they need — including gender-affirming care,” Newsom said in a statement after signing the measure. “With the signing of this bill, California will ensure that these kids and their families can seek and obtain the medical and mental health care that they need.”
The legislation includes a variety of provisions that are meant to help protect families and trans kids. It prohibits California health care providers from releasing medical information in relation to other states’ laws prohibiting gender-affirming care for minors. It also prohibits the enforcement of a court order “based on another state’s law authorizing a child to be removed from their parent or guardian based on that parent or guardian allowing their child to receive gender-affirming health care or gender-affirming mental health care.”
The bill also authorizes a California court to take temporary emergency jurisdiction when a child hasn’t been able to receive gender-affirming health care elsewhere, which some on social media interpreted to mean that California courts will be able to take custody of children if they flee their home states because their parents don’t want to provide them with gender-affirming care.
But that isn’t accurate, according to Asaf Orr, a senior staff attorney and Transgender Youth Project director at the National Center for Lesbian Rights. Orr said that portion of the bill is related to a court’sjurisdiction in custody matters.
“State courts around the country have the authority to consider whether to retain jurisdiction over a custody matter involving a child who recently came into the state,” Orr told Reuters. “This typically occurs in instances of domestic violence or other crisis situations. This law simply clarifies that courts should retain jurisdiction in situations where a parent brings their child to California so that they can obtain medical treatment for gender dysphoria.” Gender dysphoria is a medical condition that involves a conflict between an individual’s sex assigned at birth and their gender identity.
When Jennifer Eller first began transitioning in 2011, she was an English teacher in Kenmoor Middle School in Maryland. That year, the students began calling her a pedophile. A human resources worker said that her therapist’s note about her transition was “garbage” before insisting that Eller present as male at the school. Another administrator told her not to wear skirts because it’d make others feel uncomfortable.
Eller transferred to Friendly High School, thinking things would get better. They got worse.
Students and parents repeatedly called her a tr***y and a pedophile and misgendered her. Students regularly called Eller “mister,” a “he/she,” an “it,” and “a guy in a dress.” They asked about her genitals. One threatened to rape her and make her “their girlfriend.” She reported the rape threat, but the school principal said he couldn’t do anything about it.
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One parent who accused Eller of “lying to everyone” about her gender came to school to yell at her. The parent had to be removed by school security.
Eller said she filed formal harassment and discrimination complaints with school officials. In response, school officials retaliated against her, she said. The school removed Eller from teaching an advanced English course, accusing her of being too friendly with students. Later, administrators and staff baselessly accused her of shouting at students and making them fear for their safety, Eller said.
She eventually resigned from teaching in 2017, citing a need to protect her own mental and physical health. She later filed a complaint with the federal Equal Employment Opportunity Commission (EOCC). The EEOC determined that Eller’s claims had merit. She then filed a lawsuit against the Prince George’s County Public School district in 2018, stating that officials had done nothing to stop or address the transphobic abuse.
The school district recently settled with Eller for an undisclosed amount. The district also put into place policies and administrative procedures for handling future transphobia. These changes were part of the settlement agreement, The Washington Post reported.
The changes also include school staff resources that explain trans identity and related terms, pronoun use, policies about bathroom and locker room facilities, dress codes, athletic participation, and other related issues.
“If these policies had been in place when I started my process,” Eller told the Post, “I would have known what my protections were and what I can expect from folks. And that’s not to say everybody’s perfect or that everyone would follow it. But I think that it would have been different. I think it would have been a healthier environment for me.”
Eller currently works as part of the U.S. Navy’s Child & Youth Programs where she is treated with respect, her lawyers said. However, working there, she only earns a fraction of what she made as a teacher.
Last Thursday activists, residents and students protested Columbia University’s aggressive expansion into Harlem in Manhattan, New York outside the university steps. The neighborhood is integral to the Black, Latinx, and LGBTQ culture we honor today. The protest, organized by The United Front Against Displacement (UFAD), a tenant organization fighting gentrification throughout US cities, criticized the university’s partnership with the city to continue the privatization of the New York Housing Authority (NYCHA) and the national war on housing in general.
NYC’s reality is common among the country’s 50 largest cities, which the U.S Department of Housing and Urban Development’s latest Annual Homeless Assessment Report states, make up more than half of all people experiencing sheltered homelessness in 2021.
Housing prices and rent increases disproportionately affect BIPOC and LGBTQ people as they’re four times more likely to be in public housing. Housing access is related to deliberate policy choices and underfunding that’s persisted for decades, but has worsened since the Great Recession.
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UFAD protesters didn’t deliberately go into who is affected by homelessness, but they did set a list of demands for those partially responsible. Compliance with these demands, in particular inflation-matched pay for university employees, is a small step toward restoring these “gross injustices”, said the UFAD in an Instagram post.
Ryan Costello, UFAD organizer Lana Leonard
Ryan Costello, an organizer for UFAD, says that Harlem apartments are filled with asbestos, human feces, and broken elevators. Columbia University brags about how much money they’ve made, while they, along with NYCHA, neglect public housing, says Costello. The university raked in nearly $25 billion in net assets in 2021, exceding 2020’s profits by about 15%, despite a global pandemic and rising poverty rates.
“In the long term, my hope really is that we can do something collectively to amend this whole system of injustice. We have a whole series of injustice all together because the elite who are running this country—whether it be Republican or Democrat—have an agenda that is pretty similar in the sense of enriching the few at the expense of the many perpetuating various systems of oppression,” Costello said to LGBTQ Nation.
Nevertheless, Harlem reminds America of what resilience against adversity, homelessness, and injustice looks like. The 70s and 80s gave rise to the Ballroom scene as a new world for homeless trans and queer children to thrive in. The shared homes of royal house mothers and fathers informed culture, joy, and quality of life for all people despite the illegality of balls, drag, and living openly as an LGBTQ person in general.
Today, LGBTQ youth is estimated to be 40% of NYC’s homeless youth. For West Harlem City Councilwoman Kristin Richardson Jordan, an out lesbian, the housing crisis in Harlem threatens the safety of LGBTQ youth seeking homeless shelters as well as hundreds of multi-generational Black and Brown families that have lived in Harlem for decades.
“Developers are entering our community with no accountability for the existing surrounding areas or their socioeconomic impact,” the socialist democrat told LGBTQ Nation.
She adds that developers are doing the bare minimum of affordable units based on Area Median Income (AMI). AMI affects communities throughout the country by skewing the reality of income for most families once high incomes are integrated into the median income adjustment.
For example, when assessed, Harlem’s AMI is $93,400 per year. However, a majority of Harlem families actually make about $37,000 to $57,000, says Jordan. New Jersey uses a similar system. Yet, the state is one of the most expensive states to rent in.
Regardless, those that have maintained their homes in Harlem plan to keep them.
Activists protest outside Columbia University over the school’s planned expansion into Harlem Lana Leonard
Veronica Hickman, a multi-generational West Harlem resident and UFAD organizer, sat on the university steps looking out onto the protest. She said she needed to rest after singing “We Shall Overcome” to protesters. She comes when she can because Costello comes out for Harlem.
“I feel like he’s supporting us, and you know what, if the money isn’t supporting you, you need to do your part. Even if it’s just showing up and doing a song or something, you know, that’s what I need to do,” she said.
The Harlem gentrification project is almost 20 years old. Renzo Piano, a famous Italian architect, announced his plans to former Columbia University President Lee Bollinger in 2003 to “revitalize” West Harlem with what is called The Manhattanville Project: a 17-acre expansion of the university’s business school overlooking the Hudson River. The ivy-league school owned 65% of the neighborhood at this time.
But Columbia University is one of many corporations buying American neighborhoods today. Thirty-three percent of all homes in America were purchased by investors by 2022, according to John Burns Real Estate Consulting. This leaves BIPOC and LGBTQ communities to compete against investors with a wage gap ranging 10-70% lower than the average non-LGBTQ worker, reported the Human Rights Campaign earlier this year.
Moving forward, Councilwoman Jordan has hope for Harlem and the wider world.
“I want to see the upcoming generation that has been raised here, like myself, given fair opportunities to obtain property and invest in the community they have grown up in,” said Jordan. “I aim to use my time in office to advocate for our neighbors; standing up for all the constituents in my district who have consistently been left behind by people who only seek to fill their pockets.”
Sunday October 9 at 4 pm. Abbie Gabrielson & Carol Anne Bosco at Occidental Center for the Arts. Pianist Abbie Gabrielson returns to OCA, bringing with her the multi-talented cellist Carol Anne Bosco. Since meeting in graduate school at the University of Maryland, Abbie and Carol Anne have shared a passion for musical collaboration.Though now located in California and Washington D. C. respectively, they have developed a bi-coastal project, kicking off with a series of October shows here in Sonoma County. Enjoy vibrant classical and contemporary selections by these accomplished young musicians at our acoustic sweet spot on Bohemian Highway! Tickets are $25 General/$20 OCA Members at www.occidentalcenterforthearts.org. Fine refreshments available for sale, Art Gallery Exhibit open. Accessible to patrons using wheelchairs . OCA is following Sonoma County public health rules for optional masking. 3850 Doris Murphy Ct. Occidental, CA. 95465. 707-874-9392
During the four months of the monkeypox outbreak, health care providers, researchers and an anxious public have scrambled to determine how the virus transmits, how to prevent it and how the infection plays out in the body.
Little attention has been paid to what comes after the infection clears.
Following recovery from this skin lesion–causing virus, people often find themselves waiting anxiously over the course of months to see whether monkeypox will leave them with permanent scarring. And in interviews with more than a dozen people who have had the virus and as many health care providers and researchers, NBC News learned that in some people, the lingering scars are not only physical but psychological. Troublingly, it’s also possible the virus could cause permanent damage to sensitive internal tissues and give rise to persistent pain or other onerous long-term symptoms.
“Just because you’re cleared and no longer contagious, it doesn’t mean you’re totally back to normal,” said Matt Ford, 30, a bicoastal actor who contracted the virus at the beginning of the summer and hopes that his scarring, including pockmarks on his face, will continue to dissipate. “It did a number on my body, especially in more sensitive areas.”
Unfortunately, people looking to doctors or health agencies for answers about what to expect post-pox are typically met with an information vacuum. This is the result of the notorious dearth of research conducted prior to the outbreak about a virus that until this spring largely only circulated in western and central Africa.
“I just want there to be more concrete information, but maybe that’s asking too much,” said Brad, 33, a New York City area resident who preferred to use only his first name to protect his medical privacy.
In an emailed statement, the New York City health commissioner, Dr. Ashwin Vasan, acknowledged this lack of health guidance, saying, “It’s still early in the outbreak and the kinds of long-term studies needed to understand these issues better have not been completed yet. We continue to learn from what people who’ve experienced infection and recovery are reporting.”
Since the unprecedented global outbreak was first detected by health authorities in mid-May, 65,415 cases have been diagnosed worldwide, 24,846 of them in the United States, the Centers for Disease Control and Prevention reports. While the weekly case count both nationally and worldwide has declined in recent weeks, raising hopes that the outbreak might be brought under control, concerns remain that at least a fraction of those who have had the virus might suffer long-term impacts of the infection.
For gay men, who comprise the overwhelming share of global monkeypox cases and among whom the competitiveness to look good is famously Olympian, worry over sustaining noticeable scarring in the wake of the infection can be particularly taxing.
“Especially for people who already have body dysmorphia or are hypersensitive to how others see them, there is this hypervigilance” of such cosmetic effects, said Preston Wholly, managing clinical director of behavioral health services at the LGBTQ-focused nonprofit health care provider Harlem United in New York City.
The marks are also signals of an infection that because it largely transmits through sex between men, can be highly stigmatized.
“I think it’s important to be aware of the effect of stigma regarding the route of monkeypox transmission, at-risk groups and disfiguring skin lesions — all of which could contribute to psychological distress,” said Dr. James Badenoch, a physician at the Queen Mary University of Medicine in London and the co-lead author of a paper published Sept. 8 in eClinicalMedicine on neurological and psychiatric conditions linked to monkeypox.
Harun Tulunay, 35, was hospitalized with a particularly severe case of the virus in July. In addition to experiencing extreme proctitis, or inflammation of the rectal tissues, and an inability to swallow, he developed an atypically large purple-black lesion that covered his entire left nostril. The lesion has since healed but has left behind pockmarked scar tissue.
“I am very obsessed with the little scar on my nose and am using lots of creams, scared it won’t go away,” said Tulunay, who, like a substantial proportion of people who contract monkeypox, has HIV.
Harun Tulunay.Courtesy Harun Tulunay
Dr. Howa Yeung, an assistant professor of dermatology at the Emory University School of Medicine in Atlanta, said that while guidance on care for monkeypox lesions may be lacking, what is known about treating smallpox, which like monkeypox belongs to the orthopoxvirus family, can serve as a guide.
Yeung recommended the use of what are known as hydrocolloid dressings on lesions, which help keep them moist and promote healing while minimizing scarring. For thicker scars, silicone gel or patches may help improve their appearance, he said—especially if such treatment is started shortly after the scabs fall off. Later on, lasers and microneedling may further improve their appearance, although such interventions can be expensive.
The dermatologist noted that people with darker skin tones are likely at higher risk of monkeypox lesions leaving lasting dark marks, which he estimated could take three to 12 months to fade.
“Some scars will be permanent,” Yeung said.
He advised the use of skin-lightening agents, which a dermatologist can prescribe, as well as a high SPF sunscreen to keep the sun from further darkening the pigment.
Gerald Febles, 25, reported grappling with such marks, which, although they have been improving, still greatly bother him. Hoping they will recede over the coming months, he’s tried various scar-treatment creams, which don’t come cheap.
Gerald Febles points to a scar left from his monkeypox outbreak.Benjamin Ryan / NBC News
“I was very confident in my own skin before,” said Febles, who is an employee relations manager for the urgent care company MedRite. He said he now has “a lot more insecurity about my body in general. I’ve even gone to bars and some people have asked, ‘Oh, what’s that on your neck?’ So it’s something I’m reminded of whether or not it’s on my own terms.”
Febles was keen to assert that he sees no reason to be ashamed of having had monkeypox. But recalling that the infection caused him excruciating pain, he nevertheless characterized such questions from people as “a trauma trigger.”
The potential for lasting damage
Proctitis, experienced by 1 in 4 people with the virus in a Spanish study and 16% of U.S. cases about which the CDC has data, is one of the most devastating potential monkeypox symptoms. It can cause excruciating pain, in particular when defecating. What’s more, such symptoms might portend longer-term consequences of the infection.
During a July 14 Infectious Diseases Society of America call with reporters, Dr. Mary Foote, a medical epidemiologist at New York City’s health department, raised an early alarm that monkeypox lesions might cause permanent internal damage in some people. This, she said, could include the formation of scar tissue or strictures in the anorectal or urethral tissues, which could affect bodily functioning.
“It’s quite concerning,” Foote said of these potential outcomes, which she recently told NBC News might prompt the need for surgery or other interventions.
Dr. Boghuma Titanji, an infectious disease specialist at Emory University, reported seeing urethral damage or overall pain in the penis, including difficulty retracting the foreskin, due to scarring from monkeypox.
Dr. Boghuma Titanji.Courtesy Dr. Boghuma Titanji
“When we see these cases with urologic involvement, we consult urologists,” Titanji said, noting that “early urinary catheterization and other interventions may prevent complications down the line.”
Brian Rice, 43, reported suffering from a host of bothersome health problems, including the flu, since recovering from monkeypox in mid-August. Having endured penile pain, swelling and discharge during the infection, the attorney has since experienced pain in his pelvic area and the frequent need to urinate. These symptoms eventually resolved themselves, Rice said, following pelvic floor myofascial release treatments. But he’s also experienced a persistent rash in his pubic area that is only recently starting to clear up.
“Nobody knows whether these other symptoms I’m experiencing are related in any way to monkeypox,” said Rice, who is HIV positive and lives in Cliffside Park, New Jersey. “It could be stress and anxiety; it could just be triggering other things.”
Dr. Peter Shalit, who runs an LGBTQ-focused primary-care medical practice in Seattle, reported that one of his patients had a mild case of monkeypox in July, with only skin lesions. Then, in August, the man relapsed and suffered from worse disease symptoms, including proctitis. Three weeks after recovering the second time, his rectal symptoms returned once more, causing him severe pain. Shalit treated both the second and third waves with the antiviral TPOXX, which appeared effective at battling symptoms.
The eClinicalMedicine paper published this month reported that in rare cases people with monkeypox develop neurologic symptoms, including encephalitis, confusion or seizures.
“Encephalitis can cause long-term problems with disability, mood and memory problems,” said Dr. Jonathan Rogers, a psychiatrist at University College London and a co-lead author of the paper. He stressed, however, that he and his coauthors don’t have the necessary follow-up data to determine any extended effects of this condition among people who have recovered from monkeypox.
The CDC reported Sept. 13 the cases of two previously healthy men in their 30s who after contracting monkeypox developed encephalomyelitis, or inflammation of the brain and spinal cord. The men have recovered from the infection, but a month after the start of their neurologic symptoms, they each still require an assistive device to walk.
A difficult transition
Arriving during the Covid crisis denouement, the monkeypox outbreak has triggered pandemic-related anxieties that had only recently begun to abate, by sending people with the virus right back into isolation for the few weeks the infection takes to resolve. And as they grapple with recovering from such a stigmatized virus, many of those who spoke with NBC News said it has taken time for them to regain their confidence and calm within the outside world — be that interacting with colleagues, seeing friends and family, or getting back into dating and sexual intimacy.
These people report having a particularly difficult time disentangling the misery of monkeypox from the joys of sex.
“I just feel like I lost my mojo,” said Harun Tulunay, who, similar to Febles, finds men constantly striking up conversations with him about monkeypox, especially given how much media coverage his case received.
“They don’t seem much interested in dating me after,” he said, ruefully.
In the meantime, Tulunay, who is a training and volunteer coordinator at the HIV nonprofit Positively UK, is trying to get his semen tested to determine if he might still harbor the virus. Monkeypox has indeed been found in seminal fluid, and the World Health Organization has recommended that men wear condoms for 12 weeks following recovery from monkeypox out of concern, pending further research, that the virus might remain in semen and be transmissible for that long.
John Farrey, 32, said what he missed most while isolating with monkeypox was going out dancing with friends. So he thought he’d be jazzed to jump right back onto the dance floor once he recovered.
But, the Brooklyn tech worker said, “I felt very terrified of my own skin” during the immediate aftermath of his infection. Being around other people, he said, “still felt unsafe.”
“It really took me a long time to be comfortable having close contact again,” Farrey said.
For Brad, the New Yorker, having monkeypox was “totally traumatic,” sending him off-kilter emotionally. He’s been struggling to regain his equilibrium since then. A scar on his penis has made him self conscious and has caused him to worry that sexual partners will ask intrusive questions about it.
“Then it’s ‘bye-bye mood,’” Brad quipped of such a scenario.
“I’m still kind of afraid of sex, because my last sexual experience resulted in this, and it still carries so much weight,” he said of contracting monkeypox. “Sometimes it turns into this source of shame that I’ve never experienced before about sex.”
Then there’s the question of when the body is once again ready for the rigors of intercourse. Proctitis, said Dr. Chris Beyrer, director of the Duke University Global Health Institute, “is going have a very big impact on subsequent sexual functioning” for those who engage in receptive anal sex.
“I think the question is: ‘When have you sufficiently healed?’” Breyer said—which, he acknowledged, “is not a question that people have good answers for.”
The importance of support
Given the traumatic ripple effects that monkeypox can unleash, experts highlight the need to provide people who contract the virus with support that doesn’t end when the scabs clear up.
“The anguish experienced by many patients cannot be underestimated. It can be a truly horrible time,” Dr. Hans Kluge, regional director of WHO Europe, said at an Aug. 30 news conference about monkeypox. He called for buttressing “both the physical and mental health of patients during the entire course of the disease, and after. It remains of critical importance.”
Harlem United’s Preston Wholly said he works with his clients who have contracted the virus to cut through the harmful stigma tied to contracting monkeypox.
“We really want to process that it wasn’t their fault and work through the guilt and shame and kind of normalize it,” he said.
Jeffrey Galaise, 41, who said he has persistent nightmares about the infection —“I imagine myself having pox and pain,” he said — is among the many people who have contracted the virus and then established their own support networks. He founded a Zoom-based monkeypox support group for people with the virus he met mainly through social media. This outlet, he said, has been invaluable as he tries to move on.
“I need to get back to my normal life,” said Galaise, who works for a New York City governmental agency. “It has certainly been a transition. I certainly think I’m getting there.”
Brad, who has also found a supportive community of others who have had monkeypox through social media, said he yearns to have the lingering physical and emotional effects of monkeypox behind him.
“I would like there to be a day when I don’t worry about this anymore,” he said. “I just want to be done with it.”
The triumph of a right-wing alliance in Italy’s election has raised concern among LGBTQ advocates, who fear nationalist leader Giorgia Meloni could adopt anti-gay policies as prime minister and set back their efforts to boost equality.
Meloni, who is set to become Italy’s first woman premier at the head of its most right-wing government since World War Two, fiercely denounced what she calls “gender ideology” and “the LGBT lobby” just months before Sunday’s vote.
But she has also played down her party’s post-fascist roots and portrays it as a mainstream group like Britain’s Conservatives.
So what would her leadership of Italy’s new government mean for the LGBTQ community?
What is Meloni’s stance on LGBTQ rights?
Meloni, a Christian, has sprinkled speeches with anti-LGBTQ+ rhetoric and conservative statements on family-related issues.
“Yes to natural families, no to the LGBT lobby, yes to sexual identity, no to gender ideology, yes to the culture of life, no to the abyss of death,” she said as she addressed supporters of Spain’s rightist Vox party in the southern Spanish city of Marbella in June.
But in the past few weeks, Meloni has repeatedly denied suggestions she might roll back legislation on abortion or LGBTQ rights, while reaffirming her opposition to adoptions and surrogacy for same-sex couples.
Days before the election, however, a senior member of her Brothers of Italy (FdI) group suggested same-sex parenting was not normal.
Federico Mollicone, culture spokesman for the FdI, reiterated his criticism of an episode of the children’s cartoon “Peppa Pig” that featured a polar bear with two mothers.
He said further that “in Italy homosexual couples are not legal, are not allowed” — despite the country having legalized same-sex civil unions in 2016, a reform the FdI opposed in parliament.
FdI does not mention LGBTQ rights specifically in its election manifesto, but calls for “support for childbearing and the family.”
In a Facebook message to an LGBTQ activist who confronted her earlier this month, Meloni said: “I believe a child has the right to grow up with a father and a mother.”
What is the state of LGBTQ rights in Italy?
Italy ranks 23rd in the 27-member European Union when it comes to legal protections for LGBTQ people, according to advocacy group ILGA-Europe.
It is the only major country in Western Europe that has not legalized same-sex marriage, though some microstates such as Monaco and San Marino have also not done so.
Italy has legalized same-sex civil unions, but these do not grant gay couples the same rights as married heterosexual couples, particularly when it comes to parenting. Joint adoption is not available for same-sex couples.
“Even if she doesn’t introduce any anti-LGBT laws, she will not speed up what we’re trying to do to improve the current situation,” Roberto Muzzetta, a board member at Italy’s biggest gay LGBTQ group Arcigay, said from Milan.
“In fact, she will slow it down, or do nothing about it, even though we’re already lagging behind our neighbors.”
Last October, the Italian Senate voted to block debate over a bill that would make violence against women and LGBTQ people a hate crime, effectively killing off a proposal previously approved by the lower house of parliament.
The bill, championed by the center-left Democratic Party (PD), triggered fierce discussion in Italy, with the Vatican saying that it could restrict the religious freedom of the Roman Catholic Church.
Arcigay said it records more than 100 hate crime and discrimination cases a year.
Despite lagging most of its EU neighbors on LGBTQ rights, a 2020 study by the U.S.-based Pew Research Center found 75% of Italians think homosexuality should be accepted.
“Still, Meloni’s opponents were just not able … to make these issues more meaningful (and) promote a different, more progressive vision of society,” political analyst Martina Carone at Torino-based consultancy firm Agenzia Quorum said
What are ordinary LGBTQ Italians concerned about?
Some gay, bisexual and transgender people fear Meloni’s nationalist stance could increase discrimination against LGBTQ people in Italy.
“This morning, when I woke up, I had a feeling of strong discomfort. I felt a great uncertainty, as if I had become aware that things could change for me and my safety,” said Cristian Cristalli, a 34-year-old trans man based in the northern city of Bologna.
“I wondered if I didn’t deserve a future elsewhere, perhaps in a country worthy of our lives,” Cristalli added.
In the northern city of Verona, Stefano Ambrosini, a gay 28-year-old PhD student, said he feared Meloni’s election triumph could lead to an increase in homophobic violence.
“A lot of the people who voted for her are the ones who are already perpetuating violence and discrimination against the community,” he said.
“Now that she has won, these people will feel empowered and definitely safe in doing the terrible things that they want to do to our community.”
Activist Muzzetta said a clear majority in parliament could pave the way for the right-wing alliance to introduce anti-LGBTQ policies that have already been discussed in some regions or municipalities, such as LGBTQ-related books and events bans.
But both Cristalli and Ambrosini said they are determined to defend their rights.
“Let’s see how it goes. I’m ready to fight back,” Ambrosini said.
