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.
Opinions
Why we need to recognize and celebrate Lesbian Day of Visibility
Fighting erasure inside and outside of the LGBTQ community
Sunday, April 26 is Lesbian Visibility Day. It concludes Lesbian Visibility Week that started this past Monday. Originally founded back in 2008 by the National Coalition for LGBT Health — and separately by a group of American lesbian activists who ran a social media campaign called “I am a Lesbian” that same year — Lesbian Visibility Day fights lesbophobia, or hatred, discrimination, and violence toward lesbians, and the erasure of lesbians inside and outside of the LGBTQ community.
Amid the rise of anti-LGBTQ and reproductive healthcare legislation and court decisions, there has never been a better time to reflect on the intersectionality of fighting for queer people’s and women’s rights and recognizing the queer women who were integral in the feminist movement that made America what it is today.
From the very beginning, lesbians have been critical to American liberation movements. Lesbian and queer women were key leaders and organizers of the women’s suffrage movement, including Dr. Anna Howard Shaw, Jane Addams, Annie Tinker, Alice Dunbar-Nelson, Molly Dewson, and Sophonisba Breckinridge. Some of these women even lived in same-sex partnerships, known as “Boston marriages,” during a time when homosexuality was illegal.
Similarly, during the Second Wave Feminist movement, lesbians were key activists that fought to integrate issues of LGBTQ equality into the women’s movement.
Lesbian and queer organizers like Audre Lorde, Adrienne Rich, Barbara Smith, and Rita Mae Brown fought for intersectional activism, noting how sexism, racism, homophobia, and ableism intersect to keep women and other marginalized individuals down. But many of these lesbian activists faced backlash from the mainstream women’s movement, called a “lavender menace” that threatened the women’s movement’s progress.
Betty Friedan, then president of The National Organization for Women (NOW), first used this term in 1969 — ironically the same year as the Stonewall Riots — to refer to the danger that integrating lesbian issues into the mainstream women’s movement might pose to the success and timeliness of women’s rights. Friedan and other NOW members worried that intentionally including lesbians in NOW and its objectives would create the impression that the movement was full of misandrists and “a bunch of dykes.”
That same year, NOW removed the Daughters of Bilitis, the first American lesbian organization, from their list of sponsors for the First Congress to Unite Women in November 1969.
In response, a group of lesbian radical feminists reclaimed the term during their protest at the Second Congress to Unite Women in 1970. The group, called Radicalesbians, along with people from the Gay Liberation Front and other allied groups, burst into the Second Congress and demanded that NOW accept and intentionally include lesbians and queer women in the feminist movement. Lesbians, queer women, and allies lined the aisles of the auditorium holding signs and shouting “We are all lesbians” and “Lesbianism is a women’s liberation plot.”
As Karla Jay, another member of the Lavender Menace who stood up in the audience, said, “Yes, yes, sisters! I’m tired of being in the closet because of the women’s movement.”
Not only was this moment a critical challenge of the movement’s tendency to foreground white, straight women’s experiences and rights, and was applauded by feminists of color who routinely felt their voices remained unheard and experience unrepresented in the movement, but it also invited members of the feminist movement to confront their own lesbophobia. The rest of the Second Congress to Unite Women was replaced by workshops on issues lesbian women are facing and a dance hosted by the Gay Liberation Front at the Church of the Holy Apostles.
At the end of the conference, members of the Lavender Menaces shared the resolutions that they and NOW members developed in those two days of workshops to the leaders of NOW, and by 1971, NOW passed a resolution to support lesbians. However, Friedan did not acknowledge the critical contributions of lesbian women in the feminist movement until six years later at the 1977 National Women’s Conference.
Many have pointed out how Friedan and other feminists’ fear about and exclusion of lesbian and queer women in their movement is deeply connected to present opposition against including trans women in modern feminist circles. Often called TERFS or Trans-Exclusionary Radical Feminists, feminists prioritizing womanhood based solely on sex assigned at birth perpetuate the same gender policing of women’s spaces that Friedan and others did over 50 years earlier — this time, excluding not just trans women but also intersex women and denying how transphobia is a critical feminist issue. Black cis women are especially vulnerable to transphobic violence.
Never has it been clearer that women’s liberation is lesbians’ liberation is BIPOC women’s liberation is trans women’s liberation. In fact, the fourth and fifth wave feminist movements that first emerged in the early 2000s strive to re-center the movement on collective, intersectional action rather than individual empowerment. Some feminists have even joined the trans-led Gender Liberation Movement, founded by Raquel Willis and Eliel Cruz in 2024, that fights for bodily autonomy and pushes for organizing and policy that frees all people from gendered expectations.
Lesbophobia remains alive and well
Protecting lesbian, bisexual, and queer women’s rights has never been more timely because lesbophobia is not a thing of the past. Recent backlash to Netflix announcing that the next season of Bridgerton will feature a sapphic storyline makes it clear that lesbophobia is alive and well, even as stories featuring bisexual and gay men are receiving critical and fan praise. In fact, television shows featuring lesbian and queer women were significantly cut. In 2022, more than two-thirds of all cancelled LGBTQ shows featured queer women. Lesbophobia is alive and well sadly, along with the fetishization of lesbian and queer women online.
And just how Friedan and other NOW leaders’ fears around lesbians resonate with current TERF action against trans women, the “Lavender Scare” or systematic firing of LGBTQ employees during the McCarthy Era is making a comeback. Many of the people who were fired by the federal government during this time are still alive and have never been given an apology for how they were treated and discarded by the federal government.
The current administration’s attempts to terminate anyone working in Diversity, Equity, and Inclusion initiatives, disband LGBTQ employee resource groups, and earlier this month, requesting access to the medical records of millions of federal workers, retirees, and their family members, recall another history of excluding LGBTQ people.
As CNN reported earlier this month, a notice that was sent to insurers that offer Federal Employees Health Benefits of Postal Service Health Benefits plans this past December asks them to provide “service and cost data,” which the Office of Personnel Management (OPM) argues will be used to ensure “competitive, quality, and affordable plans.”
Michael Martinez, senior counsel at Democracy Forward, told CNN earlier this month that OPM has given no insight into how they would use and protect this information, and warns that it could be used to target people who have sought or had abortions or those who have had or are inquiring about gender affirming care, again tying together trans liberation with women’s liberation and the protection of bodily autonomy.
So as we celebrate Lesbian Visibility Week, it is critical to acknowledge how lesbian women calling for intersectionality (along with Black, Indigenous, and Latina women who have done this work for centuries), fundamentally changed the trajectory of the feminist movement —and how their call for intersectionality is still timely and important.
Emma Cieslik is a museum worker and public historian.
Opinions
How arts institutions built the city that politics couldn’t
Doing the work that politicians have left undone
Washington is often described as a city consumed by politics. The story is usually about power — who has it, who wants it, who just lost it. But that version of Washington barely scratches the surface.
The real texture of this place — its neighborhoods, its memory, its communities, its soul— rarely fits inside the horse-race coverage that so often defines the city from the outside. Much of that texture lives in the city’s cultural institutions: its theaters, choruses, galleries, and community arts spaces.
And right now, that foundation is under threat from pressures such as rising costs, shrinking grants, and uncertain funding cycles. When arts organizations in this city close or cut back, what disappears is not a season of concerts. It is the room where a teenager finds out the city has a place for them. It is the stage where a neighborhood tells its own story. It is years of civic life, built slowly and at great cost.
I serve as the executive director of the Gay Men’s Chorus of Washington, DC (GMCW). We were founded in 1981, the same year the AIDS crisis began reshaping our community in ways we are still reckoning with. Our first public performance was at the District Building, at Mayor Marion Barry’s invitation. Our first holiday concert was a collaboration with the DC Area Feminist Chorus and D.C.’s Different Drummers. From the very beginning, we were not just a singing group. We were a civic statement. And we were part of a city that had been making civic statements through art for a very long time.
In 1965, Frank Kameny and the Mattachine Society of Washington organized the first gay rights picket at the White House. A decade later, Lambda Rising — founded as the first non-bar business in D.C. serving the gay community — hosted the city’s first official Gay Pride event and became what participants called “The Community Building”: bookstore, meeting hall, political nerve center, and arts hub all at once. DC Black Pride launched in 1991, born directly from the urgent organizing that the HIV/AIDS crisis demanded. In a city where queer people had been fired from federal jobs for who they were, cultural space was a form of resistance.
That is the history we inherited when GMCW held its organizing meeting on June 28, 1981, deliberately chosen as the 12th anniversary of Stonewall. We struggled early on to find a church willing to host us. St. Mark’s Episcopal finally said yes. It was the same church that had hosted Mattachine Society meetings. In that small fact, you can see how Washington works: religious space, movement history, and performing arts overlapping to create something the city needed.
Over more than four decades, we have tried to honor that inheritance. We have performed at the White House and at Washington National Cathedral. We were the first queer choral group invited to perform at a presidential inauguration, appearing during Bill Clinton’s second inaugural in 1997. We have partnered with Whitman-Walker Health, the Library of Congress, and community organizations across the District.

Some of the work I am most proud of is the work we are doing for the future. Our GenOUT Youth Chorus, launched in 2015, was the first LGBTQ+ youth chorus in the D.C. area. These young people find in GenOUT a place that tells them they are not problems to be managed. They are artists. They are part of this community. They belong here, and they have something to say.
That is what arts institutions do that no policy document fully captures. They create the conditions for people to recognize themselves and each other. Dance Place turned an abandoned Brookland warehouse into a community cultural center. GALA Hispanic Theatre has tied performance to youth education for nearly 50 years. Woolly Mammoth has challenged and expanded what theater can hold. Shakespeare Theatre Company’s Free For All has drawn thousands to classical performance, free of charge, year after year.
These organizations are infrastructure. Right now, this infrastructure is fragile. Arts organizations run on thin margins, on the faith of donors and audiences and grantmakers, on the labor of people who could earn more doing something else and choose not to. When that support erodes — as it periodically does, often in the name of austerity or political expediency — what is lost is the connective tissue of civic life.
Washington is a political city. But it is also a city where queer people have sung, mourned, celebrated, and organized for decades. It is a city where arts institutions have again and again shown up to do the work that politics left undone.
Justin Fyala is executive director of the Gay Men’s Chorus of Washington, D.C.
A right does not need to be banned to be restricted. Sometimes it only needs to be made uncertain.
That is what emerges from a closer examination of adoption access for same-sex couples across different countries. There is no broad legal rollback. What appears instead is a more subtle pattern: rights that remain on paper but become fragile, conditional, and uneven in practice.
Italy provides a clear example.
Since 2023, under the government of Giorgia Meloni, administrative decisions have limited the automatic recognition of both mothers in female same-sex couples, particularly in cases involving assisted reproduction abroad. In practice, many families have been forced into additional legal proceedings to validate relationships already established.
At the same time, Italy has intensified its opposition to surrogacy, extending penalties even to those who pursue it outside the country. Human rights organizations have warned that these measures disproportionately affect LGBTQ families, particularly male couples.
The judiciary, however, has pushed back.
In 2025, the Constitutional Court ruled that a non-biological mother cannot be excluded from legal recognition when there is a shared parental project. It also removed a long-standing restriction that prevented single individuals from accessing international adoption.
Italy has not eliminated these rights. But it has made them unstable.
When a right depends on litigation, judicial timelines, or shifting interpretations, it is no longer fully guaranteed.
In the United States, the structure differs, but the outcome converges.
At the federal level, same-sex couples can adopt. Yet the system varies widely across states.
Data from the Movement Advancement Project show that while some states explicitly prohibit discrimination in adoption, others provide no clear protections. In several states, licensed agencies can refuse to work with same-sex couples based on religious objections.
Access, therefore, is shaped not only by law, but by geography, institutions, and applied standards.
Research from the Williams Institute further complicates the narrative. Same-sex couples adopt and foster children at higher rates than different-sex couples.
The contradiction is clear.
Child welfare is invoked, yet the pool of available families is reduced. Faith is cited, yet it is used as a filter within publicly funded systems.
The consequences are tangible
children remain longer in care
processes become more complex
families face unequal scrutiny
What is happening in Italy and the United States is not isolated. Across parts of Europe, conservative governments have advanced legal frameworks that reinforce traditional definitions of family while limiting recognition of diverse ones.
Adoption is not always addressed directly. But the impact accumulates.
Options are restricted while the language of protection is used to justify it.
There is no need to soften it.
This is not only a debate about family models. It is a decision about who is recognized as family and who must continue asking for permission.
That is not neutral.
It is political.
And when a right depends on where you live, who evaluates you, or how hard you are willing to fight for it, that right is already being weakened.
