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MSM And The Spread Of Monkeypox


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

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

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

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

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

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

She opened her brief report with this observation:

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

The link went to a WaPo story with this lede:

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

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

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

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

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

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

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


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