As New York City declares monkeypox a public health emergency, and California and Illinois have also declared states of emergency over the rapid spread of monkeypox, we speak with LGBTQ+ scholar Steven Thrasher, author of the new book, “The Viral Underclass: The Human Toll When Inequality and Disease Collide,” which explores how social determinants impact the health outcomes of different communities. “This disease is one that in theory can infect anyone, but it has worked its way particularly into communities with men who have sex with men,” says Thrasher. “This does not mean that it’s a 'gay disease,' and shouldn’t be stigmatized that way, but we shouldn’t be ashamed to think about who it is affecting and how it is affecting people and to deal with it with a great sense of urgency.”
AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman, with Juan González.
President Biden is naming top officials from FEMA, the Federal Emergency Management Agency, and the CDC, Centers for Disease Control, to coordinate the White House response to monkeypox here in the United States, where the virus has been reported in 47 states and Washington, D.C. New York City has now been declared monkeypox — or, has declared monkeypox a public health emergency. Officials described the city as the “epicenter” of the outbreak, with tens of thousands of people vulnerable to exposure. California and Illinois also issued a state of emergency over the rapid spread of monkeypox. Worldwide, over 23,000 infections have been detected in at least 80 countries, with the U.S. leading confirmed cases, though health experts believe many more monkeypox cases have gone undiagnosed due to shortages of testing. This week, the first monkeypox deaths outside of Africa were reported in Spain, Brazil and India.
For more, we’re joined by Steven Thrasher, an LGBTQ scholar, professor at Medill School of Journalism at Northwestern University, faculty member of Northwestern’s Institute of Sexual and Gender Minority Health and Wellbeing. His new book is out today, The Viral Underclass: The Human Toll When Inequality and Disease Collide.
Steven Thrasher, welcome back to Democracy Now! Congratulations on the release of this extremely important book. You wrote a piece for Scientific American headlined “Blaming Gay Men for Monkeypox Will Harm Everyone.” Talk about why this is so important and what we should understand about the state of monkeypox in the United States and around the world now.
STEVEN THRASHER: Thank you so much for having me, Amy.
I wrote that piece — I started writing it in the end of May. And like many people I’m in conversation with, we were extremely concerned about the way that monkeypox was moving around the world and how we were starting to see cases in the United States. And so, at the time, I was making the case to the Biden administration, to the national government, that we really needed to proactively go ahead and start vaccinating men who have sex with men, particularly considering that we were coming into Pride Month. There were multiple opportunities all through June, beginning where I live normally, in Chicago, with the International Mr. Leather festival, and there were going to be Pride events all through the month, and we really needed to take that opportunity to vaccinate people, because we could see where the outbreak was happening.
That did not happen. As The New York Times reported last week, really enragingly, the Biden administration had the option to purchase 300,000 doses of this new vaccine that works quite well and is easy to administer, but kind of took a wait-and-see approach. And so, that’s why we’re seeing this unfolding disaster now.
And this is a difficult thing to think about and parse, but it’s really important that we think about it and drill down on it, that this disease is one that in theory can affect anyone, but it has worked its way particularly into communities of men who have sex with men. And there are reasons why I think that it’s important to think of it as a sexually transmitted infection. Like other viruses — HIV, hepatitis, herpes, HPV — STIs can move in a variety of ways, but this one is really moving sexually right now.
And I had started looking into last week a couple of different research papers. One was out of London, which showed 196 of 197 cases were from men who have sex with men. That is new information that we didn’t quite understand in a lot of countries in Europe and North America. But also, as NPR was reporting earlier this week, based on a research paper I had also recently read, there is a man, a Dr. Ogoina, in Nigeria who had looked at an outbreak and studied an outbreak in 2017. And in 2019, he started publishing research saying he had reason to think that this virus was moving through genital secretions.
So we have on our hand a situation that has taken a turn. This virus has changed. A lot of people’s reference around monkeypox is thinking of it primarily coming off of close contact with animals and close contacts with other people. But it seems to have changed in a way that it’s particularly moving through sexual contact between men who have sex with men. This does not mean that it’s a “gay disease,” and shouldn’t be stigmatized that way, but we shouldn’t be ashamed to think about who it is affecting and how it affecting people and to deal with it with a great sense of urgency — not with panic, but with a real sense of urgency right now.
JUAN GONZÁLEZ: And, Steven Thrasher, in your book, you break your book up into 12 chapters that look at 12 factors that create the conditions for unequal viral transmission. And some of the chapters: one on racism, on individualized shame, on capitalism. Could you talk about why you structured the book that way, and especially the chapter on individualized shame?
STEVEN THRASHER: Certainly. So, I’ve seen, over my time of reporting on viruses as a journalist and studying them as a scholar, that the same kinds of people are coming into harm’s way. And it’s been alarming sometimes when you look at how different the viruses are. So, I had seen for years in reporting on the criminalization of HIV and on the killing of Black people by police officers and Black poverty that you kind of see the same maps. HIV is happening in the places where police violence happens a lot. And then, when the COVID-19 pandemic began to break out, I started seeing the same maps, both in St. Louis, where I’ve been doing research, and also in New York City. And that seemed strange to me, because HIV and SARS-CoV-2 are extremely different viruses. They move differently. They have very different virological components to them. But they were happening in the same places. And that’s because there are all these social determinants of health that place people in the path of the viruses and also make their bodies less likely to be able to defend them. Even when we look at something like with COVID-19, it’s primarily killing people who are elderly. People who are in nursing homes that are in poor areas are much more likely to die.
And so, we’re seeing something similar again now with monkeypox, that it’s happening to not only men who have sex with men in the United States, but, as The Washington Post reported last week, about two-thirds of cases are happening towards Black and Brown people. And certainly anecdotally — I haven’t seen good research on this now, but certainly anecdotally — white people and professionals, like myself, who have time on their hands have been able to get vaccines. And if we don’t deal with that, then we’re going to see upper-class people getting access to the monkeypox vaccine, while poor people, Black and Brown people get less access to it.
And with LGBT people, something that I think can help viewers understand why it’s the social determinants, you know, we know that there’s some kind of sexual transmission component with something like HIV or monkeypox, but with COVID, LGBTQ people were more lucky to get sick, more likely to die of COVID. And that’s not because there’s any sort of sexual component to COVID; it’s because LGBTQ people are structurally lower-class. We’re poor. We’re more likely to lose our jobs. We’re less likely to have salaried jobs. We’re less likely to have health insurance. And so all of those things make our bodies vulnerable in such a way that viruses have an easier time getting into them. Particularly, anti-trans laws and anti-trans practices make it difficult for people who are trans to get the healthcare that they need, in general, and the healthcare they need around viruses, specifically, much more difficult. And then we become a much easier point of entry and reproduction for viruses.
JUAN GONZÁLEZ: And you also write about the role of borders, because, obviously, viruses do not respect borders of nations. Could you talk about that, as well? And I think we have got about a minute or so.
STEVEN THRASHER: Sure. So, borders themselves create a kind of violence. And when we try to keep people inside of a nation or inside a gender identity, we put up a very strong wall. In the United States, you know, one of the biggest parts of our viral history is that at Guantánamo Bay. It was not founded for 9/11, referring to your stories earlier from today; it was actually founded 10 years before that, when the first Bush administration tried to keep Haitians from coming into the country, and they set up this infinite detention camp in Cuba at Guantánamo Bay. And they tested everyone for HIV, and they sterilized everybody who was positive for HIV. And so, we imagine that the U.S. has no viruses in it, that they’re somewhere else, but with monkeypox and COVID, we are the leading country in the world with these infections. And so, it’s not a matter of keeping them out; it’s a matter of dealing with them inside the borders of our own country and working with other countries to lower transmission.
AMY GOODMAN: We’re showing images by Molly Crabapple, by the way, who illustrates your book. Amazing. We’re going to do more in Part 2, but we only have 20 seconds. Not a single vaccine has made it to Africa?
STEVEN THRASHER: That’s certainly my understanding. I know that none had made it to Nigeria, where Dr. Ogoina had done this really amazing work. And if we had dealt with these countries and helped them earlier, we would not be dealing with this global pandemic now.
AMY GOODMAN: And we’re going to talk much more extensively about this in Part 2 and post it at democracynow.org. Steven Thrasher, LGBTQ scholar and journalist, his new book, The Viral Underclass: The Human Toll When Inequality and Disease Collide. That does it for our show. A belated happy birthday to Rob Young. I’m Amy Goodman, with Juan González. Stay safe. Wear a mask.