An anti-LGBTQ group marched Sunday in Istanbul, demanding that LGBTQ associations be shuttered and their activities banned, in the largest demonstration of its kind in Turkey.
Several thousand people joined the demonstration dubbed “The Big Family Gathering.” Kursat Mican, a speaker for the organizers, said they had gathered more than 150,000 signatures to demand a new law from Turkey’s parliament that would ban what they called LGBTQ propaganda, which they say pervades Netflix, social media, arts and sports.
Hatice Muge, who works as a nanny, came to the gathering from Bursa province.
“People are here despite the rain for their children, for future generations,” she said, urging the Turkish government to take action. “They should save the family, they should save the children from this filth.”
The group held banners that read: “Protecting the family is a national security issue.”
LGBTQ parades have not been allowed in Turkey since 2015.
Ahead of Sunday’s demonstration, the organizers circulated a video using images from past LGBTQ Pride marches in Turkey. The video was included in the public service announcement list of Turkey’s media watchdog.
The video and the demonstration prompted an outcry from LGBTQ associations and other rights groups. The organizers of Istanbul Pride called on the governor’s office to ban the event and authorities to take down the video, arguing both were hateful.
ILGA Europe, which works for LGBTQ equality, tweeted it was extremely concerned about the risks of violence.
“The Turkish state needs to uphold its constitutional obligation to protect all its citizens against hate and violence,” it said.
Amnesty International’s Turkey office said public service announcements listing the event violated Turkey’s equality and non-discrimination principles.
Top Turkish officials have called LGBTQ people “perverts” who aim to hurt traditional family values.
Just hours after a Montana judge blocked health officials from enforcing a state rule that would prevent transgender people from changing the gender on their birth certificate, the Republican-run state on Thursday said it would defy the order.
District Court Judge Michael Moses chided attorneys for the state during a hearing in Billings for circumventing his April order that temporarily blocked a 2021 Montana law that made it harder to change birth certificates.
Moses said there was no question that state officials violated his earlier order by creating the new rule. Moses said his order reinstates a 2017 Department of Public Health and Human Services rule that allowed people to update the gender on their birth certificate by filing an affidavit with the department.
However, the state said it would disregard the ruling.
“The Department thoroughly evaluated the judge’s vague April 2022 decision and crafted our final rule to be consistent with the decision. It’s unfortunate that the judge’s ruling today does not square with his vague April decision,” said Charlie Brereton, director of the Department of Public Health and Human Services.
Brereton said the agency was keeping the rule it issued last week in place and an agency spokesperson said the department is waiting to see the judge’s written order before considering its next steps.
ACLU attorney Malita Picasso expressed dismay with the agency’s stance and said officials should immediately start processing requests for birth certificate changes.
“It’s shocking that after this morning’s hearing the department would allege there was any lack of clarity in the court’s ruling from the bench,” Picasso said. “It was very clear that Judge Moses expressly required a reversion to the 2017 policy, and anything short of that is a continued flagrant violation of the court’s order.”
Such open defiance of judge’s order is very unusual from a government agency, said Carl Tobias, a former University of Montana Law School professor now at the University of Richmond. When officials disagree with a ruling, the typical response is to appeal to a higher court, he said.
“Appeal is what you contemplate — not that you can nullify a judge’s orders. Otherwise, people just wouldn’t obey the law,” Tobias said. “The system can’t work that way.”′
The move could leave state officials open to contempt of court charges, which in some cases can lead to jail time for offenders, Tobias said. He added that the attorneys representing the state were likely aware of the potential consequences but were “caught in the middle” between a recalcitrant agency and the judge.
The legal dispute comes as conservative lawmakers in numerous states have sought to restrict transgender rights, including with bans on transgender girls competing in girls school sports.
The Montana law said people had to have a “surgical procedure” before they could change the sex listed on their birth certificate, something Moses found to be unconstitutional because it did not specify what type of procedure was required.
Gov. Greg Gianforte’s administration then created a new rule that blocked changes to birth certificates entirely, unless there was a clerical error.
Moses said during Thursday morning’s hearing that his April ruling had been “clear as a bell” and compared the state’s subsequent actions to a person twice convicted of assault who tries to change their name following a third accusation to avoid a harsher punishment.
“Isn’t that exactly what happened here?” Moses asked. “I’m a bit offended the department thinks they can do anything they want.”
One of the plaintiffs in the case, Amelia Marquez, said she was disgusted by the state’s response.
“We have people that think that they’re above the law and don’t have to listen to the judiciary branch of our government,” she said.
After learning the state planned to defy the court order, Shawn Reagor with the Montana Human Rights Network said the organization “will not stand by while the Gianforte administration blatantly disregards rulings from the courts to continue a vindictive attack on the trans community.”
Only Tennessee, Oklahoma and West Virginia have sweeping prohibitions against birth certificate changes similar to what Montana has pursued, advocates for transgender rights say. Bans in Idaho and Ohio were struck down in 2020.
A Republican lawmaker who voted in favor of the 2021 law suggested Moses was biased in favor of the plaintiffs in the case. Moses was appointed to the court by former Gov. Steve Bullock, a Democrat.
“Like clockwork, Judge Moses issued yet another predetermined order in favor of liberal plaintiffs without thoroughly engaging with the legal issues at hand,” Sen. Greg Hertz of Polson said in a statement.
The ACLU of Montana had asked Moses to clarify his order after the state health department enacted its new temporary rule effectively banning birth certificate changes a month after Moses handed down his temporary injunction in the case. That rule was made permanent last week.
The state argued the injunction did not prevent the health department from making rules, but Moses said under case law the injunction reinstated the 2017 rules and any other changes are on hold while the case is decided.
State officials denied that the new rule preventing birth certificate changes was adopted in bad faith. Montana Assistant Solicitor Kathleen Smithgall said the state came up with the new rule to fill a gap in regulations after the 2021 law was blocked.
“Judge Moses mischaracterized the words of his own order, the parties’ motives, and the state of the law,” said Kyler Nerison, a spokesperson for Attorney General Austin Knudsen.
A new law in California will help military service members who were discharged under “don’t ask, don’t tell” policies because of their sexual or gender identities to reestablish their eligibility for Veterans Affairs benefits, Gov. Gavin Newsom said Saturday.
“For decades, our bravest heroes, men and women who wore the uniforms of the armed services had to hide who they really were, and many were other than honorably discharged if their sexuality was discovered,” Newsom said in a statement after announcing he had signed the bill.
Gays and lesbians were banned in the military until the 1993 approval of “don’t ask, don’t tell,” which allowed them to serve only if they did not openly acknowledge their sexual orientation. Rather than helping, advocates say, the policy created more problems. In its entire history, the military dismissed more than 100,000 service members based on their sexual or gender identities — 14,000 of them during “don’t ask, don’t tell.”
Repeal of the law was approved by Congress and then President Barack Obama in late 2010 and took effect nine months later, allowing lesbian, gay and bisexual people to serve openly.
The Department of Defense subsequently created a path for veterans who had been discharged under the policy to receive the full range of veterans’ benefits.
“But many veterans sadly don’t know or can’t even access this important process,” Newsom said, adding that some veterans trying to reclaim benefits have had to hire expensive legal counsel and other assistance to navigate the process. “We’re taking steps to fix this.”
The law will require the California Department of Veteran Affairs to establish the Veterans Discharge Upgrade Grant Program to help advise LGBTQ veterans who were discharged under “don’t ask, don’t tell” and to help those who qualify to update and correct their records and access veterans’ benefits.
Divisions over LGBTQ-related policies have flared recently at several religious colleges in the United States. On Monday, there was a dramatic new turn at one of the most rancorous battlegrounds — Seattle Pacific University.
A group of students, faculty and staff at the Christian university sued leaders of the board of trustees for refusing to scrap an employment policy barring people in same-sex relationships from full-time jobs at SPU. The 16 plaintiffs say the trustees’ stance — widely opposed on campus — is a breach of their fiduciary duties that threatens to harm SPU’s reputation, worsen enrollment difficulties and possibly jeopardize its future.
The lawsuit, filed in Washington State Superior Court, requests that the defendants — including the university’s interim president, Pete Menjares — be removed from their positions. It asks that economic damages, in an amount to be determined at a jury trial, be paid to anyone harmed by the LGBTQ hiring policy.
“This case is about six men who act as if they, and the educational institution they are charged to protect, are above the law,” the lawsuit says. “While these men are powerful, they are not above the law… They must be held to account for their illegal and reckless conduct.”
In addition to Menjares, the defendants are board chair Dean Kato; trustees Matthew Whitehead, Mark Mason and Mike Quinn, and former trustee Michael McKee. Whitehead and Mason are leaders of the Free Methodist Church, a denomination whose teachings do not recognize same-sex marriage and which founded SPU in 1891.
There was no immediate response to the lawsuit from SPU, though its communications office acknowledged receiving a query from The Associated Press and said a reply was in the works.
SPU’s LGBTQ-related employment policy has been a source of bitter division on the campus over the past two years. One catalyst was a lawsuit filed against SPU in January 2021 by Jeaux Rinedahl, an adjunct professor who alleged he was denied a full-time, tenured position because he was gay.
That lawsuit eventually was settled out of court, but it intensified criticism of the hiring. Through surveys and petitions, it’s clear that large majorities of the faculty and student body oppose the policy, yet a majority of the trustees reaffirmed it in May — triggering resignations by other trustees and protests by students that included a prolonged sit-in at the school’s administrative offices.
At SPU’s graduation on June 12, dozens of students protested by handing gay-pride flags to Menjares, rather than shake his hand, as they received diplomas.
Kato, the trustees’ chair, responded to the protests with a firm defense of the hiring policy.
“We acknowledge there is disagreement among people of faith on the topic of sexuality and identity,” Kato’s wrote to student activists. “But after careful and prayerful deliberation, we believe these longstanding employee expectations are consistent with the University’s mission and Statement of Faith that reflect a traditional view on biblical marriage and sexuality.”
In June, Washington state Attorney General Bob Ferguson notified SPU that his office was investigating “possible discriminatory employment policies and practices” at the school. SPU was asked to provide details on hiring and firing policies related to individuals’ sexual orientation and involvement in a same-sex marriage or relationship.
On July 27, SPU filed a federal court lawsuit against Ferguson, contending that his investigation violated the university’s right to religious freedom.
“Seattle Pacific has asked a federal district court to step in and protect its freedom to choose employees on the basis of religion, free from government interference or intimidation,” the school said in a statement.
Ferguson responded two days later, declaring that his office “respects the religious views of all Washingtonians” but chiding SPU for resorting to litigation.
“The lawsuit demonstrates that the University believes it is above the law to such an extraordinary degree that it is shielded from answering basic questions from my office regarding the University’s compliance with state law,” Ferguson said.
When Joseph Kibbe attended the first Boise Pride Festival in 1989, he and about two dozen other participants wore paper bags over their heads to hide their faces from potentially violent onlookers.
At the first festival parade two years later, Kibbe and his friends were greeted by protesters with nooses in front of the Statehouse.
“Boise was a very different place back then — it was not a safe time to be LGBTQIA,” he said.
Still, for Kibbe — then a junior high student who faced frequent beatings at school, now the vice principal of the Boise Pride Festival board — the event was the one place where he felt like part of a community.
“I could come and be who I wanted to be here, who I actually was,” Kibbe said on Friday, just a few hours before this year’s festival was set to begin. “That was a huge morale booster, and why I’m so passionate about what we’re doing today.”
But this year, a roughly half-hour program on the three-day-long festival schedule called “Drag Kids” has prompted a wave of political pressure and anonymous threats.
Festival organizers envisioned a short performance where kids could put on sparkly dresses and lip-sync to songs like Kelly Clarkson’s “People Like Us” on stage. But others, including Idaho Republican Party Chairwoman Dorothy Moon, expected a lurid scene where children would “engage in sexual performances with adult entertainers.”
The event garnered national attention from far-right websites and podcasts, and by Tuesday organizers realized this wasn’t the “normal” amount of opposition, said festival president Michael Dale.
“The sexualization of children is wrong, full stop,” the Idaho GOP wrote on Twitter. “Idaho rejects the imposition of adult sexuality & adult sexual appetites on children.”
Moon and the Idaho GOP sent out statements directing constituents to ask the festival’s corporate sponsors to pull support. A few did, at least partly — removing their logos from festival fencing and canceling plans for booths. The Idaho Department of Health and Welfare announced it was pulling $38,000 in funding along with resources focused on tobacco-cessation and HIV/AIDS prevention.
A conservative pastor from California began rallying like-minded congregations, asking members to tell the Ada County Sheriff to arrest any festival organizer who “contributes to the delinquency of minors.” A group known for armed protests told followers to show up Sunday.
Others, though, rallied to support Boise Pride. Four Democratic state lawmakers pledged their own financial support, and released a joint statement criticizing what they called “the false, dangerous claims from Idaho GOP Chair Dorothy Moon that stoke violence.” New business sponsors stepped up to fill vacancies.
But the political maelstrom was growing more intense by the hour, and five kids were stuck in the middle. Riley Burrows, a full-time drag entertainer from Boise who was co-producing the Drag Kids event, began getting death threats on social media.
“It’s: ‘We’re going to show up at this festival,’ ‘We’re coming after you,’ ‘I hope you know you have a target on your back,’ and ‘You’re going to be found in a tree,’” Burrows said. “It’s gotten so repetitive.”
On Thursday afternoon, festival organizers made the decision to postpone the kids’ performance.
“We wanted to ask these kids first and foremost, because it affects them, and their confidence and their lives. And they still wanted to do it,” Dale said, fighting back tears. “But it came to be an issue of their health, their wellbeing, and that of the festival-goers.”
Anti-LGBTQ rhetoric has been increasing in Idaho and around the U.S. in recent months, and earlier this year 31 members of a white supremacist group were arrested outside of a northern Idaho Pride event for allegedly planning to riot. The Boise Pride organizers have been working with Boise Police to boost security since the northern Idaho arrests in June.
None of the five young performers are new to drag shows. The youngest is 10, and was inspired by watching her mom get ready to perform.
“She really wanted to copy me and just do the makeup and have fun with it,” said Harley Innocent, who goes by her stage name. Innocent is one of many cisgender women who participate in drag, sometimes referred to as “AFAB” or “Assigned Female At Birth Queens.”
Her daughter’s first performance was in 2019, in the rural Idaho town of Emmett. She loved it, Innocent said.
“She was really looking forward to being able to do it on the Pride main stage — it was a big opportunity for her to share her talent.”
Innocent says her daughter does a “porcelain doll” makeup look, wears a wig and chooses a song that fits her mood.
It’s similar to a glitzy beauty pageant, Innocent said, but more laid back. “In drag you don’t have to be perfect. We’re just trying to have fun and welcome them to this art form.”
Burrows, the Drag Kids co-producer, said the kids are just having fun on stage in pretty outfits.
“It’s like if you were to send your kid to a school of dance, and the performance theme was rainbows — big tutus, bows and fun hair.”
That’s different from an adult drag show, which can have heavier themes, more revealing costumes and be geared toward more mature audiences, Burrows said: “It’s like the difference between a kid’s TV show and an adult TV show.”
Youth performances can give kids a sense of belonging, he said, adding that “it’s not scary to be gay when you’re surrounded by love and acceptance.”
There’s a lot more support available for LGBTQ kids today, said Kibbe, but it was still heartbreaking to tell them the event was being postponed until organizers could find a safer, more supportive venue.
California would present itself as a haven for transgender youth facing discrimination in other states under a bill that advanced Monday, much as it is positioning itself as a sanctuary for those seeking abortions.
The Assembly approved the measure without debate, 48-16, sending it to the Senate for a final vote before lawmakers adjourn at month’s end.
The legislation is designed to provide legal refuge to parents from other states who risk having their transgender children taken away or being criminally prosecuted if they support their children’s access to gender-affirming procedures and other health care.
Democratic Sen. Scott Wiener sought the measure in response to actions in several Republican-dominated states including Arkansas, Tennessee and Texas. He said 19 other states have since introduced similar “trans refuge state” bills.
“Trans kids and their parents are being criminalized and used as political punching bags by right-wing zealots,” he said in a statement. “No one should ever have to worry about being separated from their child simply for allowing that child to be who they are.”
Conservative groups argued the bill could shield parents who use it as a pretext.
The bill mimics a new California law that bars the enforcement of civil judgments against doctors who perform abortions on patients from other states. It’s among several measures designed to make California a sanctuary for people seeking or providing abortions.
The transgender bill would similarly reject any out-of-state court judgments removing transgender children from their parents’ custody because they allowed their children to receive gender-affirming healthcare.
It would also bar California health officials from complying with out-of-state subpoenas seeking medical or related information about people who travel to California for gender-affirming care.
The measure would also prohibit arrests or extraditions of people charged with violating another state’s law that criminalizes allowing a person to receive or provide gender-affirming health care.
Brad Dacus, president of the conservative nonprofit Pacific Justice Institute, said it would allow parents to bring their children to California “under the guise of securing genital surgeries,” a move he equated to “kidnapping children from conservative states.”
It would “make California a safe haven for child abductors and predators” and “condone the taking of children from other states in violation of court orders,” he warned in a fundraising letter to supporters.
The bill would allow judges to take temporary jurisdiction over any child who comes into California for gender-affirming care even if they are brought in by someone other than their parents, objected Greg Burt of the California Family Council.
He said the bill “declares war on parents throughout the country who don’t want their children sterilized because of their gender dysphoria.”
Enormous progress has been achieved in the last 50 years for lesbian, gay, bisexual, transgender and queer people in the United States but unfortunately “equality is not yet within reach and in many cases not within sight” for LGBTQ communities, the independent U.N. expert on sexual orientation and gender identity said Tuesday.
Victor Madrigal-Borloz told a U.N. press conference after a 10-day visit to the United States that he applauds President Joe Biden for “very powerful” executive actions during his first days in office seeking to eradicate discrimination and violence against the LGBTQ community. But he said he is “extremely concerned” about a concerted series of actions at the state and local level based “on prejudice and stigma, to attack and to rollback the rights of LGBT persons.”
Madrigal-Borloz said that in access to health, employment, education and housing, the LGBTQ community suffers.
Among young adults aged 18 to 25, for example, LGBTQ people have a 2.2 times greater risk of homelessness, 23% of LGBTQ adults of color have no health coverage, and in a recent study 43% of lesbian, gay and bisexual participants reported having suffered at least one act of discrimination or harassment, he said.
Madrigal-Borloz, a Costa Rican lawyer and human rights advocate, also expressed serious concern at the disproportionate impact of violence against the LGBTQ community.
He cited the National Crime Victimization Survey that found that 20.3% of hate crimes were related to sexual orientation or gender identity bias, significantly disproportionate to the LGBTQ population in the U.S., which he said is usually estimated at between 5% and 8%. He also cited a Centers for Disease Control and Prevention study that found that bisexual women encountered intimate partner violence at higher rates than other populations, with 46% reporting having been raped and 74.9% reporting being victims of sexual violence other than rape, which he called “extremely worrying.”
Madrigal-Borloz, who was appointed by the Geneva-based U.N. Human Rights Council, wrapped up visits to Washington, Birmingham, Alabama, Miami and San Diego at the invitation of the U.S. government. He said he met with over 70 federal, state and local representatives, more than 100 civil society representatives, and people with “lived experience” in the LGBTQ community.
He stressed that his comments Tuesday reflected his preliminary observations, and his final report with recommendations will be presented to the Human Rights Council in June 2023.
“The conclusion of my visit in this preliminary moment is that there are significant efforts being deployed by the current administration to dismantle systems of social exclusion,” Madrigal-Borloz said. But there is also “a significant risk that LGBT persons will be caught in what I have described as a riptide created by all of these actions at local level.”
He said NGOs and human rights defenders have found at least 280 current legislative attempts at the local level that would lead to a regression of LGBTQ rights, “and which also create a terribly polarizing narrative that exacerbates already high and worrisome risks of violence and discrimination.”
As examples, Madrigal-Borloz cited legislation in Alabama making it a felony to provide gender-affirming medical treatment to transgender youth and legislation in Florida nicknamed “don’t say gay” by opponents that bans teachers from talking about sexual orientation or gender identity through the third grade. He also cited limits on comprehensive sexual and gender education, and on participation in sports for transgender people.
He stressed that typically there is no evidence “that any of these measures need to be considered reasonably under a democratic society.”
Madrigal-Borloz, who is also a researcher at Harvard Law School’s Human Rights Program, said the U.S. Supreme Court decision overturning Roe vs. Wade and a woman’s right to abortion is also “a devastating action” for lesbian, bisexual and transgender women. That’s “because it is members of these communities that actually suffer also disproportionately from unwanted teen pregnancies,” he said.
“They also require statistically more abortions,” he said, “and LGBT persons in general actually benefit enormously from the services concerning sexual and reproductive health provided by abortion providers in different states, and the closure of these centers will affect disproportionately these persons.”
Madrigal-Borloz said suggestions that following the Roe vs. Wade ruling, other precedents could be overturned could have a huge impact on the LGBTQ community, especially if gay marriage was outlawed and homosexuality became a criminal act, as it currently is in more than 65 countries.
He also pointed to early statistics showing that 98% of monkeypox cases are in men who have sex with men, which he said “concerns me greatly because it creates a risk of furthering, and retrenchment of, stigma and discrimination against this population.”
Pope Francis has met with a fourth group of transgender people who found shelter at a Rome church, the Vatican newspaper reported Thursday.
L’Osservatore Romano said the encounter took place Wednesday on the sidelines of Francis’ weekly general audience. The newspaper quoted Sister Genevieve Jeanningros and the Rev. Andrea Conocchia as saying the pope’s welcome brought their guests hope.
The Blessed Immaculate Virgin community in the Torvaianica neighborhood on Rome’s outskirts opened its doors to transgender people during the coronavirus pandemic.
Francis previously met with some of them on April 27, June 22 and Aug. 3, the newspaper said.
“No one should encounter injustice or be thrown away, everyone has dignity of being a child of God,” the paper quoted Sister Jeanningros as saying.
Francis has earned praise from some members of the LGBTQ community for his outreach. When asked in 2013 about a purportedly gay priest, he replied, “Who am I to judge?” He has met individually and in groups with transgender people over the course of his pontificate.
But he has strongly opposed “gender theory” and has not changed church teaching that holds that homosexual acts are “intrinsically disordered.” In 2021, he allowed publication of a Vatican document asserting that the Catholic Church cannot bless same-sex unions since “God cannot bless sin.”
Recently, Francis wrote a letter praising the initiative of a Jesuit-run ministry for LGBTQ Catholics, called Outreach. The online resource is run by the Rev. James Martin, author of “Building a Bridge,” a book about the need for the church to better welcome and minister to LGBTQ Catholics.
Francis praised a recent Outreach event at New York’s Jesuit-run Fordham University, and encouraged organizers “to keep working in the culture of encounter, which shortens the distances and enriches us with differences, in the same manner of Jesus, who made himself close to everyone.”
For most of the six decades that monkeypox has been known to affect people, it was not known as a disease that spreads through sex. Now that has changed.
The current outbreak is by far the biggest involving the virus, and it’s been designated a global emergency. So far, officials say, all evidence indicates that the disease has spread mainly through networks of men who have sex with men.
“It clearly is spreading as an STI (sexually transmitted infection) at this point,” said Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security.
To protect the people at highest risk while trying to contain the spread, public health agencies are focusing their attention on those men — and attacking the virus based on how it’s behaving now.
On Wednesday, the head of the World Health Organization advised men at risk for monkeypox to consider reducing their sexual partners “for the moment.”
But this is a complicated outbreak that may shift in how it spreads and which population groups are most affected. There is also debate about whether monkeypox should be called a sexually transmitted disease, with some critics complaining that the term creates a stigma and could be used to vilify gay and bisexual men.
Monkeypox can spread in nonsexual ways too, and it’s not enough to use condoms or other typical measures for stopping STDs, Inglesby and other experts say.
Here’s what we know.
What makes something an STD?
A sexually transmitted disease is commonly defined as one that mainly spreads through sexual contact. But some STDs can be spread in other ways, too. HIV can spread through shared needles. Syphilis can spread through kissing. A common, parasite-caused sexual infection called trichomoniasis has been found to spread through the sharing of damp, moist objects like sponges or towels.
Monkeypox has not usually spread easily among people, and experts are still trying to understand exactly how it moves from person to person. In Africa, where small outbreaks have been common for years, people have been infected through bites from rodents or small animals.
But in May, cases began emerging in Europe, the United States and elsewhere that showed a clear pattern of infection through intimate contact with an infected person, like many other sexually transmitted diseases.
The public health workers who respond to outbreaks play a large role how they are framed. Much of the work on monkeypox has been done by professionals who operate sexual health clinics or specialize in STDs.
Indeed, the U.S. government’s response needs to be led by people with that expertise, said David C. Harvey, executive director of the National Coalition of STD Directors.
“The STD field has a wealth of knowledge and expertise in these areas developed over decades fighting various outbreaks and diseases affecting the very communities … we’re seeing monkeypox taking a toll on today,” Harvey said in a statement.
Who is getting monkeypox?
WHO officials said last week that 99% of all the monkeypox cases beyond Africa were in men and that of those, 98% involved men who have sex with men. Experts suspect that monkeypox outbreaks in Europe and North America were ignited by sex at two raves in Belgium and Spain.
The statistics are the same for cases reported in the United States, according to the Centers for Disease Control and Prevention. As in Europe, cases have emerged in other groups too, including at least 13 people who were female at birth and at least two children.
Last week, the New England Journal of Medicine published a study of hundreds of monkeypox infections in 16 countries. It found that the suspected means of transmission in 95% of the cases was sexual close contact, as reported by doctors. The researchers noted that it was impossible to confirm sexual transmission.
That idea seemed to be further supported by the finding that most of the men had lesions in the genital or anal areas or in the mouth — areas of sexual contact, the researchers said.
Why is there a debate about calling it an STD?
While there is broad agreement among health officials that monkeypox is being transmitted during sexual encounters, some experts debate whether it should be called an STD. They worry that the term unfairly stigmatizes and that it could undermine efforts to identify infections and tame the outbreak.
When a disease is defined as a sexually transmitted infection that mainly affects men who have sex with men, many people may begin to think of it as “a gay disease” that poses no risk to them, said Jason Farley, an epidemiologist at the Johns Hopkins School of Nursing.
That’s what happened in the early days of the AIDS epidemic in the 1980s, which contributed to the spread of HIV to other groups. Farley said.
“We learn nothing from our history,” said Farley, who is gay.
The WHO recommendation that at-risk men limit their sexual partners is sensible public health advice, he said. But it also amplifies “the message that this is a gay disease,” he said.
“This is the fine line between having a public health approach that focuses on the epidemiology of now, compared to the likelihood of the continued emergence of new cases in” the general community, he said.
“Monkeypox is not a sexually transmitted infection,” he said. “It is an infection that can be transmitted with sexual contact.”
What is known about transmission?
Some researchers have found evidence of the monkeypox virus in semen. A study in Spain found monkeypox virus DNA in the semen of some infected men, as well as in saliva and other body fluids. But the study didn’t answer whether the virus actually has spread through semen.
Sorting that out could affect the understanding of not only how men spread the infection, but also how long they might be contagious. Evidence of some other viruses — like Ebola and Zika — has been found in the semen of some men months after they were thought to be fully recovered.
Meanwhile, scientists believe the primary route of transmission during the current outbreak has been skin-to-skin contact during sexual encounters with someone who has symptoms. In that respect, it’s similar to herpes, some experts noted.
The virus also may spread through saliva and respiratory droplets during prolonged, face-to-face contact, such as during kissing and cuddling — a kind of spread that can occur outside of sex.
Researchers are exploring how often, and in what situations, that kind of spread might happen, said Christopher Mores, a professor of global health at George Washington University.
“We would do ourselves a disservice to try and exclude anything from the realm of possibility at this point,” he said.
Officials also say people can catch monkeypox from touching items that previously touched an infected person’s rash or body fluids, such as towels or bedsheets. That is thought to explain the infections of the U.S. children.
Why are these details important?
It’s important to understand exactly how monkeypox spreads in order to give people the information they need to protect themselves, health officials say.
That said, health officials believe those who are currently at the highest risk are gay or bisexual men who have sex with multiple partners. That understanding has shaped much of the work to contain the outbreak, including prioritization of the supply of vaccines and treatments.
The government has been shipping a monkeypox vaccine, but the supply is limited. So far it’s only been recommended as a post-exposure treatment or for people who have had multiple sex partners in the past two weeks in a place where monkeypox cases have been reported.
The vaccine is new, and officials are trying to gather data on exactly how well it works.
British health authorities said Friday the monkeypox outbreak across the country may be peaking and that the epidemic’s growth rate has slowed.
The U.K.’s Health Security Agency said in a statement there were “early signs that the outbreak is plateauing,” with 2,859 cases detected since May. No deaths have been reported. Last month, authorities estimated the outbreak was doubling in size about every two weeks, but the number of new infections has dropped in recent weeks.
“While the most recent data suggest the growth of the outbreak has slowed, we cannot be complacent,” said Dr. Meera Chand, Director of Clinical and Emerging Infections at the Health Security Agency. She said anyone who thought they might have monkeypox should skip meeting friends, social gatherings and avoid sexual contact.
The Health Security Agency said its most recent analysis of the outbreak “shows that monkeypox continues to be transmitted primarily in interconnected sexual networks of gay, bisexual, or men who have sex with other men.” More than 70% of the U.K.’s cases are in London.
British officials noted a small number of infections among women, but said there was not enough evidence to suggest there was sustained spread of monkeypox beyond gay and bisexual men; 99% of all cases in the U.K. are in men.
Scientists who analyzed monkeypox viruses in the U.K. noted a number of mutations compared to viruses circulating in Africa, but said there was no evidence those genetic changes made monkeypox any more transmissible.
The World Health Organization said this week that 92% of monkeypox cases beyond Africa were likely infected through sex and its Director-General recently appealed to vulnerable gay and bisexual men to consider reducing their sexual partners “for the moment.”
To date, more than 26,000 monkeypox cases have been reported in nearly 90 countries, with a 19% increase in the last week.
In June, British authorities expanded their vaccination strategy, offering vaccines not only to health workers treating monkeypox patients and high-risk contacts of patients, but to some men who are gay or bisexual and at high risk of catching the virus, including those with multiple sexual partners or who participate in group sex.
Last month, the U.K. downgraded its assessment of the monkeypox outbreak and dropped a recommendation for the contacts of monkeypox cases to isolate for three weeks unless they have symptoms. The change was prompted by data showing that only a small number of contacts are ultimately sickened by monkeypox and a lack of evidence that the disease spreads without close, intimate or sexual contact.
Monkeypox spreads when people have close, physical contact with an infected person’s lesions, their clothing or bedsheets. Most people recover without needing treatment, but the lesions can be extremely painful and more severe cases can result in complications including encephalitis and death.