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Tipsheet

Is It 'Stigmatizing' to Convey Accurate Information About Monkeypox?

There was no single catalyst for this piece, but rather an accumulation of headlines, skirmishes and notes I've gotten on the issue.  I thought it was unserious and ridiculous during the pandemic when Polite Society suddenly decided that it was dangerous and offensive to name diseases after the locations they were discovered -- a common practice, dating back years, with no racial implications.  But at some point, it was determined that references to China and Wuhan were inappropriate or even hateful, so the rules shifted.  The same new standard was quickly applied to COVID variants, too.  We are now being treated to finger-wagging and tut-tutting over monkeypox, including from some health officials who've demanded that we stop using that term altogether:

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WHO Director-General Tedros Adhanom Ghebreyesus said at a briefing that the WHO is "working with partners and experts from around the world on changing the name of monkeypox virus, its clades and the disease it causes." The organization will announce new names as soon as possible, he added. A group of over 30 international scientists called for a name change last week, writing in a letter that "continued reference to, and nomenclature of this virus being African is not only inaccurate but is also discriminatory and stigmatizing."

New York's health officials got in on the act earlier this week, prompting this reply:


This sort of battle over nomenclature represents our society's cartoonishly misplaced priorities -- especially as the government has been slow to react to monkeypox in substantive ways, including this outrageous bureaucratic failure:


The vaccines are effective but scarce, with several hotspots limiting doses to gay and bisexual men ('men who have sex with men') with certain sexual habits.  As long as vaccines are hard to come by, that's...entirely appropriate, given that the risk pool for this disease overwhelming falls within those parameters.  So why are some people complaining about 'stigma'?

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It's absolutely correct that monkeypox is not a 'gay disease,' in that anyone who comes in contact with monkeypox lesions can contract it.  It's not even an exclusively sexually-transmitted disease.  It is also absolutely correct that the vast, vast majority of Americans (and others abroad) suffering from monkeypox at the moment represent a very small subset of the overall population, within which it's being overwhelmingly transmitted through sexual contact:

The global monkeypox outbreak is primarily being driven by sex between men, according to the first major peer-reviewed paper to analyze a large set of cases of the virus. The outbreak, which epidemiologists believe initially began in mid-spring gatherings of gay and bisexual men in Europe, has since alarmed such experts by ballooning to nearly 16,000 cases worldwide.  For the new study, a consortium of scores of researchers pooled data on 528 cases of monkeypox that were diagnosed between April 27 and June 24 at 43 sites in 16 countries. These cases included 84 people (16%) in the Americas and 444 (84%) in Europe, Israel and Australia. All the cases were among men, including one transgender man, 98% of whom identified as gay or bisexual. This stark demographic finding is in keeping with data on the outbreak from around the world, such as a recent report from the British Health Security Agency finding that of the 699 monkeypox cases for which there was available information, 97% were in gay, bisexual or other men who have sex with men. New York City, the U.S. epicenter, has seen only one woman diagnosed with the virus out of 639 cases confirmed through July 19....In the new global study, the men had a median age of 38 and ranged between 18 and 68 years old. Three quarters are white, and 41% have HIV. 
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Obviously vaccines and treatments should be targeted toward this group.  The job of public health officials shouldn't be to chase public approval or achieve pristine political correctness.  It should be to convey accurate information as clearly as possible.  It's not "stigmatizing" or "scapegoating" to be disseminate correct information, then craft public policy and set priorities accordingly.  Obviously, warning against bigotry or discrimination is important, and stoking irrational fears of a marginalized group is abhorrent.  Many in the gay community have -- and should have -- long memories about this dark chapter.  But monkeypox isn't AIDS, and 2022 is not the 1980's.  In certain LGBT circles, good medical advice is almost being treated as a hate crime:


It's not pointless"sex shaming." It's not homophobic to bluntly recommend that at-risk, sexually-active gay and bisexual men scale back their sexual exploits, or even abstain from them for a period of time, until they can get vaccinated.  It's sound counsel, based on data and science.  Relatedly, this televised exchange from the other night has gotten a fair amount of attention online, and several people have asked me about it.  Here's what went down:

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Full disclosure: I know all four of the people featured in that segment.  The host, the epically talented and hilarious Kennedy, officiated my wedding.  I've worked or appeared with each of her three guests.  There was a bit of a pile-on against Ned Ryun, a conservative with whom I've agreed and disagreed on any number of issues.  Kennedy, Brad Polumbo (a gay conservative) and Marie Harf (a liberal Democrat) all objected to Ryun's framing of his point.  It's fair to argue that Ryun didn't need to phrase it precisely the way he did.  I think the combination of calling it a 'rule in life,' and singling out gays within that rule, is what touched off much of that kerfuffle.  But his overall point didn't offend me.  The whole context of the conversation was the monkeypox outbreak.  It is just...true that gay and bi male populations are, by far, at the greatest risk from monkeypox right now.  And it's just...true that based on what we know about the disease, a setting like a sex orgy maximizes the potential for its spread.  Urging people to refrain from such behavior -- setting aside any moral judgments outside of this specific context -- is not bigotry.  It's common sense.

I'm glad Kennedy raised the issue (as we did above) of those vaccine doses languishing in Denmark, due to idiotic bureaucratic red tape.  And I strongly suspect that her critique of the Biden administration's motives is one that many in the press would be leveling if it were a Republican administration in office.  Personally, given their identity politics fixation, I don't think the Biden administration is dragging its feet out of callousness toward the LGBT community.  I think it's just their signature incompetence at work.  But there's no doubt that if the partisanship were reversed, every misstep and possible example of a lack of urgency would be loudly attributable by malice -- and LGBT activists would be loudly up in arms.  I'll leave you with whatever this is, as the sitting HHS Secretary (who was picked for the job, in the middle of a pandemic, with zero expertise or experience in public health) tried answer to a reporter's question on Monkeypox:

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