Opinions
Sexual abuse may explain high HIV rates in gay men
We must address trauma that undermines self-esteem, good judgment

September 27 is National Gay Men’s HIV Awareness Day.
We’d been messing around since I was about 10 years old. I figured sex with him and his three younger brothers next door was just a part of our friendship, along with our hikes to Bluff Point, on Long Island Sound, and neighborhood kickball, baseball, football, and foursquare games.
Besides, I enjoyed it a lot. I never felt consciously traumatized.
It would take a 2005 HIV diagnosis to open my mind to how my experience of childhood sexual abuse, and the multiple traumas I experienced throughout my life, undermined my self-esteem and good judgment and put me in the way of the same lethal microbe that killed so many of my friends.
The American Academy of Experts in Traumatic Stress (AAETS) says that 30 percent of all male children are molested in some way. There is a well-documented correlation between sexual abuse and later promiscuity. PTSD, depression, poor self-esteem, dissociative disorders, and anxiety are among the other effects of CSA. Sexual abuse survivors often equate sexual desirability with self-worth—and use sex as an analgesic to blunt the edge of shame that is another insidious effect of CSA.
I know these things, not only from reading about them in the research literature, but because they have played out in my own life—and in the lives of so many gay men.
Behavioral scientists have wrung their hands for more than three decades trying to understand why gay men seem so disproportionately vulnerable to HIV. Recent research makes it abundantly clear that trauma, specifically from CSA, is almost certainly the long-overlooked answer.
Consider: Harvard researchers have found that up to 46 percent of gay and bisexual men who report condomless anal sex—the principal act by which HIV is transmitted between men—were sexually abused as boys.
“That is a huge number,” said Conall O’Cleirigh, a staff clinical psychologist in the psychiatry department at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard. His research on gay men has found that the same mental health issues that can put someone at risk for HIV can also prevent someone living with the virus from adhering to his treatment.
In a national study of 1,552 black gay and bisexual men, O’Cleirigh and his colleagues found that men who experienced CSA—or physical or emotional abuse, or stalking, or being pressured or forced to have sex—when they were younger than 12 years old had more than three male partners in the past six months. The men who had been forced or pressured to have sex as boys were likely to have receptive anal sex.
In another study of 162 men with CSA histories, participants reporting sexual abuse by family members were 2.6 times more likely to abuse alcohol, twice as likely to have a substance use disorder, and 2.7 times more likely to report a sexually transmitted infection in the past year. Not only that, but men whose abuser penetrated them were more likely to have PTSD, recent HIV sexual risk behavior, and a greater number of casual sexual partners. Physical injury and intense fear increased the odds for PTSD even more.
“Having that history is repeatedly associated in every sample of gay men with increased likelihood of being HIV-positive,” said O’Cleirigh. He said that since CSA is “very, very common in gay and bisexual men” it appears to be one of the most significant vulnerabilities that accounts for the disproportionately high rate of HIV among gay men.
Prevention educators long have wanted to believe that handing out condoms, or, more recently, the HIV medication Truvada used as pre-exposure prophylaxis to prevent HIV infection, should suffice for men at the highest risk who engage in unprotected anal sex with partners of unknown HIV status. But increasing rates of new HIV infection among gay men—the only U.S. population with increasing, rather than declining, rates—are proof that condoms and PrEP alone aren’t enough.
The only way to arrest the spread of HIV among gay men is to address the trauma that undermines their self-esteem and good judgment.
An effective risk-reduction/health-promotion intervention that addresses the effects of childhood sexual abuse could help make gay male survivors more conscious of what they are doing and where it’s coming from in their psyche. It could also finally reduce the “hardcore” of gay men beyond the reach of more traditional prevention efforts.
At Boston’s Fenway Health, O’Cleirigh helped recruit the nearly 5,000 gay and bisexual men who participated in Project Thrive, an intervention aimed at helping gay men who experienced CSA to increase their coping skills and ability to be more present in—rather than dissociating from (a common effect of CSA)—their immediate situation, and provide specific skills to evaluate and reassess these situations.
“Treatments [counseling and therapy] are geared toward giving the men a more realistic sense of the world,” said O’Cleirigh, which is an important ingredient of resilience. “As we say to our clients, we can’t change the fact that you were abused, but you can change.”
Healed gay men protect themselves and their partners, and take their meds if they are positive.
The message for this National Gay Men’s HIV-AIDS Awareness Day should be that helping gay survivors of childhood sexual abuse to heal from trauma can profoundly reshape the way they think and make choices about sex—and about their health.
This is how new HIV infections among the “hardcore” will stop, and the surest way for those of us living with the virus to stay healthy.
John-Manuel Andriote is a Connecticut-based writer.
Ghana
Intersex lives, constitutional freedom, and the dangerous future of Ghana’s Human Sexual Rights and Family Values Bill
Lawmakers continue to consider draconian measure
There is a dangerous silence surrounding intersex lives in Ghana — a silence shaped by fear, misinformation, cultural misunderstanding, and institutional neglect. Today, amid discussions around the possible passage of the Human Sexual Rights and Family Values Bill, 2025, that silence risks becoming law, reinforcing exclusion and deepening the marginalization of already invisible lives.
Much of the national debate surrounding the bill has focused on LGBTQ+ identities. Yet buried within it are implications for intersex persons that many Ghanaians do not fully understand because intersex realities remain largely invisible.
Intersex persons are born with natural variations in chromosomes, hormones, reproductive anatomy, and/or genital characteristics that do not fit typical definitions of male or female bodies. Intersex is not a sexual orientation or gender identity. It is a biological reality. Ghana’s Commission on Human Rights and Administrative Justice (CHRAJ) has clearly acknowledged this distinction.
Despite this distinction, the bill mistakenly collapses intersex realities into a legal framework linked to LGBTQ+ criminalization.
Although the bill contains only limited references to intersex persons, under certain medical exceptions, these references do not amount to recognition or protection. Instead, they frame intersex bodies as abnormalities requiring regulation, correction, and institutional management. This approach is inconsistent not only with Ghana’s constitutional guarantees of dignity, equality, privacy, and liberty, but also with emerging African and international human rights standards. The African Commission on Human and Peoples’ Rights Resolution on the Promotion and Protection of the Rights of Intersex Persons in Africa – ACHPR/Res.552 (LXXIV) 2023 affirms protections relating to bodily integrity, dignity, freedom from discrimination, and against harmful medical practices. Additionally, the United Nations has repeatedly condemned medically unnecessary and non-consensual interventions on intersex children. Rather than affirming the humanity and autonomy of intersex persons, the bill risks legitimizing systems of surveillance, coercion, violence, and institutional erasure.
This is not protection.
It is managed erasure.
A child born intersex in Ghana already enters a society shaped by secrecy and stigma. Families are often pressured to hide intersex children or seek “correction” to make their bodies conform to social expectations.
The bill risks intensifying this pressure.
Clause 17 creates space for “approved service providers” to support interventions relating to intersex persons, yet offers little protection around informed consent, bodily autonomy, confidentiality, or coercive treatment. Under the language of “correction” or “support,” harmful interventions may become normalized.
The intersex community has documented painful lived experiences of intersex Ghanaians that reveal the devastating consequences of stigma and invisibility.
One heartbreaking case involved intersex twins born in Ghana’s Eastern Region in 1993, who were repeatedly forced to move from village to village because of rejection and ridicule. After losing their father, their main source of protection and support, they became even more vulnerable and reportedly experienced severe emotional distress, including suicidal thoughts linked to years of stigma and exclusion. This is what invisibility looks like in practice.
Another painful example is the story of Ativor Holali, whose lived experience exposed the cruel realities intersex persons face in sports and public life. Ativor Holali endured invasive scrutiny, public humiliation, and social suspicion because her body did not conform to rigid expectations of femininity. Rather than being protected as a Ghanaian athlete deserving dignity and privacy, she became the subject of speculation, gossip, and institutional discomfort.
Her experience reflects a broader social crisis: when society insists that every body must fit a narrow binary definition, intersex people are forced to defend their humanity in spaces where dignity should already be guaranteed.
Intersex Persons Society Of Ghana (IPSOG)’s Ŋusẽdodo research further revealed that approximately 70 percent of intersex respondents reported depression, anxiety, trauma, or severe emotional distress linked to medical mistreatment, family rejection, bullying, and social exclusion.
The bill risks transforming these existing prejudices into institutional policy. Several provisions risk deepening surveillance, restricting advocacy, weakening confidentiality, and discouraging public education around intersex realities. Intersex-led organizations providing healthcare guidance, legal referrals, psychosocial support, and community services may face serious challenges.
This places IPSOG and other intersex-led organizations in Ghana at serious risk.
For many intersex Ghanaians, these spaces are not political luxuries.
They are survival mechanisms.
Governments derive legitimacy by protecting the natural rights of all persons, including dignity, liberty, bodily autonomy, and freedom from arbitrary interference. The bill raises concerns because it risks weakening these protections for intersex persons through surveillance, coercive interventions, and restrictions on advocacy.
Ghana’s Constitution declares that “the dignity of all persons shall be inviolable.” Articles 15, 17, 18, and 21 specifically protect dignity, equality, privacy, expression, and freedom of association. These protections should apply equally to intersex persons.
Intersex persons are not threats to Ghanaian culture.
Intersex children are not moral dangers.
Intersex bodies are not political weapons.
They are human beings deserving dignity, healthcare, safety, and constitutional protection.
The true measure of a democracy is how it protects those most vulnerable to exclusion. At this moment, Ghana faces a choice: deepen fear and silence, or uphold dignity, bodily autonomy, and constitutional freedom for intersex persons.
History will remember the choice we make.
Fafali Delight Akortsu is the founder and president of the Intersex Persons Society of Ghana (IPSOG).
Opinions
A case of retaliation, not stalking
Disbelief in how Capital Pride Alliance continues to portray me
You don’t know me, but you have heard of me. What you’ve heard are rumors, stories, and narratives repeated by others. People often prefer labels and gossip over facts because it is easier than asking questions. But truth does not stay buried forever; it eventually comes forward.
I am grateful to the Washington Blade and Lou Chibbaro Jr., who has written multiple articles about this case. But I want to be clear: This matter is about retaliation, not stalking. Since I raised concerns during World Pride month, several individuals connected to Capital Pride Alliance have resigned or stepped away. One of them was Ashley Smith. Whether he resigned or left under pressure, there has been no clear explanation provided.
What matters to me is that I chose to speak up when I believed I was treated unfairly. Many people stay silent out of fear of backlash or social consequences. I chose not to remain silent. I am reserving many details for trial, where facts will be examined properly. I am confident in representing myself.
Under D.C. law, an Anti-Stalking Order requires two or more qualifying incidents, with at least one within 90 days before filing. That timing requirement is important. CPA intends to present numerous individuals, but I will address how those claims fit the legal standard in court. I recognize only a few of the individuals mentioned, and there are inconsistencies I will respond to in the proper setting.
I do not accept the label often used online to describe me. From the beginning, my position has been consistent: The truth will be established through the legal process.
My concerns began during World Pride when I confided in someone I trusted, June Crenshaw. I believed I was speaking to someone supportive. My experience since then has been one of feeling misled, which I consider a betrayal.
This case is retaliation, not stalking.
Crenshaw wrote an opinion piece published by the Blade that reflected advocacy more than neutral reporting. It suggested broader social implications and directly referenced me. It also framed court rulings in a way that implied risk, even though the order was limited and modified.
Opinion writing can influence public perception while legal matters are ongoing.
The article also questioned my visibility and framed it in a negative way, which feels discouraging to my ability to respond publicly.
The article suggested the court failed by modifying the order and allowing access to community spaces, implying danger simply because the outcome was not fully aligned with CPA’s position. I believe the court acted within its authority.
At this point, it feels as though CPA would prefer my exclusion from their spaces. That is difficult, given that CPA promotes pride, inclusion, and visibility in Washington, D.C.
I continue to believe that accountability and clarification will come.
Truth is established through evidence, not repetition. I will continue addressing these matters through the legal process rather than public speculation. I also want to emphasize that my intention has never been to escalate conflict outside of proper legal channels, but rather to ensure that my concerns are documented and addressed in a structured setting. I understand that public discussion can often blur important distinctions, which is why I am focusing on the court process itself. I am prepared to respond to all claims with evidence and clarity when the time comes, and I expect that process to provide a full and fair opportunity for the record to be examined. My position remains consistent throughout, and I will continue to rely on facts rather than speculation as this matter proceeds forward. I also recognize that misunderstandings can arise when information is shared in fragments, as the legal proceedings move forward in a careful and orderly manner based on evidence in court. I will let the facts speak for themselves in court proceedings.
Darren Pasha is a D.C.-based LGBTQ advocate.
Commentary
IDAHOBiT a reminder we all must stand up against transphobia
Trans rights remain under attack in U.S., around the world
May 17 is the International Day Against Homophobia, Transphobia, and Biphobia.
In 2026, transphobia is the biggest issue out there: all the stereotypes that were used against the LGBTQ community in general in the past are now used to attack the rights of transgender people and to create a moral panic against them. As a person who understood that they were not a girl — despite being assigned female at birth — since they were four, and who in their 30s had to wait in line for a gender clinic, I am obviously worried about this situation. Trans people continue to be seen less as people and more as part of an “agenda,” and there is a greater risk that the international trend of attacks on trans rights is just a first step in a broader attack on the LGBTQ community, and that soon bi, gay, and lesbian people will lose part of their hard-won rights to have the same protections and opportunities as heterosexual people.
When, in U.S. states such as Kansas, trans people face escalating legal and political restrictions on recognition that affect their everyday lives — for example, requiring their driving licenses to match the gender assigned at birth even after transition — while trans people in the U.S. are banned from military service and federal funding is stopped for gender-affirming care for trans youth, it is obvious to everyone that the problem is real. It is also global.
For example, there have been significant attacks on trans rights in the UK in recent years, especially against trans youth, many of whom have been denied gender-affirming care. The day when I finally found the energy to write this story was the day of the local British elections, when surprisingly many seats in city and town councils were won by the queerphobic populist Reform Party, creating some new Reform-dominated councils. Reform Party leader Nigel Farage has praised U.S. President Donald Trump and expressed admiration for Russian dictator Vladimir Putin — both of whom are known for endangering the lives of their trans citizens and rejecting trans identity as something that should be accepted.
So, who can challenge it? The general public often takes cues from public figures. Celebrities play a significant role in shaping public opinion and framing how different social issues are understood.
We need trans celebrities to speak up against transphobia when “anti-trans” celebrities like JK Rowling oppose our rights. It seemed that when conservatives around the globe stood up together to support each other, the trans community should unite, and trans celebrities should protect their trans siblings, while the broader LGB community should recognize the threat and unite around trans rights.
But not everything is so simple. Surprisingly, at a time of the greatest attack on trans rights in this century, many lesbian, gay, bi and even trans celebrities and influencers openly support transphobic policies and ideologies.
One of the clearest examples is Caitlyn Marie Jenner, a retired Olympic gold medal–winning decathlete and public figure known for her participation in the reality show “Keeping Up with the Kardashians.” She is one of the most famous trans people in the world.
From 2015 to 2016, she starred in the reality television series “I Am Cait”on E!, which focused on her gender transition and on telling a story to inspire the younger generation of trans people. In the first episode, Jenner also visited the mother of Kyler Prescott, a 14-year-old trans child who died by suicide earlier that year, and spoke openly about using her privilege to fight for awareness, equality, and dignity for trans people. The idea of supporting trans youth was one of the core themes of her TV series.
That was then.
Jenner’s perspective on trans rights became more and more transphobic. For example, in 2021 she opposed trans girls participating in girls’ school sports. In 2023, she launched a PAC campaign attacking trans youth rights. She also expressed support for Donald Trump and said about herself that she would never be a “real woman.”
Another famous example is transmasculine sex educator and activist Buck Angel, a former adult film actor. He was seen as a modern and progressive person in the 2000s and early 2010s, praised for increasing visibility for trans men through sex education, documentaries, public speaking, and media work. But later he started calling himself “transsexual” rather than “transgender,” following a more transphobic and rigid view of trans identity, and openly showed support for Trump and MAGA.
Of course, there are plenty of trans celebrities who continue to fight for trans rights — the most obvious example is Lana and Lilly Wachowski, notable film directors who gave us “The Matrix” films and the “Sense8” TV series. But the Wachowski sisters were known for being politically left-wing and progressive even before their transition. They are part of a progressive movement, not just a “famous trans person” like Jenner was.
So, why is this happening? Why have more mainstream and conservative trans celebrities, as well as some LGBTQ groups, turned away from trans rights? And what do we need to do?
One of the reasons is fear.
Popular and privileged people — whether they are socialites, actors or leaders of big organizations — are not used to being outcasts, and so they follow dominant trends. For them, the fear of not fitting in, being rejected by the audience and losing their position in society became bigger than their sense of justice. This is probably one of the reasons why some LGBTQ groups, such as the Log Cabin Republicans in the U.S., became more transphobic, or why the LGB Alliance in the UK became more popular.
Another reason is the polarization of society.
Some LGBTQ activists may hate me for saying this, but it is partly our fault. Mainstream trans communities sometimes make trans identity look like a “trend” or part of an ideology. The media — especially tabloids — are even more to blame for this stereotype than the trans community itself. When uninformed people hear about trans people today, many of them imagine left-wing, maybe even socialist, non-religious young supporters of Palestine who are good at understanding ecological issues and worried about global warming. Of course, many trans people are like that. But many are not. And those who are not often feel excluded and become more prone to public self-hatred.
It created a cycle in which people who did not feel part of the community started searching for an alternative that rejected them for being trans and encouraged them to accept transphobic rhetoric, betraying themselves and their trans siblings. This led to greater polarization and hatred against conservative trans people, pushing them even further away.
The International Day Against Homophobia, Transphobia, and Biphobia needs to be a day when we stand up against all transphobia, including the kind expressed by trans people, while at the same time supporting all trans people, no matter how uncomfortable their views may be for us.
