Bizarre denialism about monkeypox has spread among queer men

We have been failed and ignored by the official response, but twisting the facts isn’t helping.

James Ball | 28th July 2022

If you’re in at least one queer-leaning WhatsApp group, you’ll know that recently they’ve become dominated by one topic of conversation: where and how to get a monkeypox vaccine.

This old-school word-of-mouth system – sharing which email addresses work for which clinics, how many hours (and it is usually hours) you’ll probably have to wait at a given place, and which sites have already run out – shouldn’t be needed for public health in 2022. We should have already learned the lessons of the last global health emergency.

It is, however, what queer men have been left with. Official information is patchy at best and non-existent at worst, and outside London getting hold of the vaccine at all is all but impossible. Decades after queer men served as the canary in the coal mine for Aids, we are being failed and ignored again as the vast majority of early victims of a new global ailment.

Not helping the situation, however, is a bizarre denialism among our own numbers that this – for the moment – is an ailment mainly affecting men who sleep with men (and so far overwhelmingly men who identify as gay, bi, or queer). This denialism takes multiple, often pedantic, forms that serve to slow down effective responses to it and also mask the extent of official inaction and indifference.

The first thing to stress is that the overwhelming majority of positive monkeypox cases are so far adult men who sleep with men – more than 97 per cent of cases in the UK, and indeed across the world outside areas in which monkeypox had traditionally already been endemic. People have tried to suggest that this statistic is dramatically influenced by who is actually getting tested, implying it is merely because of the idea that monkeypox is an ailment of queer men that queer men are being tested, while other people are going untested and undiagnosed.

This is not supported by the detailed statistics that are publicly available. In the UK it is true that more men are being tested than women: as of 20 July 3,467 men had been tested and just 447 women. However, of those tested, 53.8 per cent of men tested positive – while just 2.2 per cent of women tested likewise.

Similarly bizarre and unhelpful is the suggestion that it is somehow problematic or stigmatising to make it clear that monkeypox is mostly being spread through sexual contact. While it is true that monkeypox is not an STI in the traditional sense – it can be spread through close non-sexual contact too – so far in this outbreak it is sex that is the main driver.

An international study of 528 monkeypox cases across 16 countries found that 95 per cent of the cases were spread through close sexual contact. Just 0.6 per cent of cases came from household transmission, and 0.8 per cent through non-sexual contact. Of those in the study, 98 per cent identified as gay or bisexual. Denying that monkeypox is, so far in its current presentation, primarily spread through sex and primarily among queer men is just denying reality and making tackling a public health crisis harder.

Despite often homophobic insinuations to the contrary, queer men take public health seriously. We are more likely to get regular STI checks, consider choices around protection or PrEP (medication that reduces the chance of contracting HIV), and share candid information among one another with little shyness.

Using this connected and conscientious community to try to stop monkeypox becoming endemic and moving beyond queer males is a huge public health opportunity. It’s time for authorities to take that seriously – and for us to stop policing our language and making that more difficult.