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Sexual abuse may explain high HIV rates in gay men

We must address trauma that undermines self-esteem, good judgment

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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.

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Not all trans people are the same

Media, activists need to do more to challenge stereotypes

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A participant in the World Pride March in Amsterdam on Aug. 8, 2026, holds a sign in support of the rights of transgender youth. The media and activists themselves need to do more to help counter harmful stereotypes against the trans community. (Washington Blade photo by Michael Key)

It’s interesting how the mainstream media, especially the conservative part of it, likes to write about transgender subculture when they should speak up about trans people.

How often do you see mentions of blue or purple hair, Marxism, specific clothing styles and ecology when you see a mention of a trans person?

It happens more often than it should. It looks like the mainstream media, even the ones that don’t demonise us, sincerely believe that being trans means sharing a whole bunch of characteristics that have nothing to do with having a gender identity different from the one that was assigned at birth.

Here are four reasons why it may create problems, and what to do about them.

1. A subculture idea

The assumption that being trans is part of a subculture creates a very specific kind of discrimination, because the mainstream audience who read those stories sincerely believes that being trans is a personal choice or a trend in the same way as being a K-pop fan, a goth, or a metalhead. It basically means that being trans is nothing more than a trend, and trends, as we all know, can change. People who believe in this idea are more likely to speak about “gender ideology” and “propaganda trends” and less likely to listen to scientists and studies around trans issues, or to different experiences of what it means to be trans.

Even if trans people made a choice to be trans, they shouldn’t be discriminated against. In a democratic, free country, no one should be punished for choosing what to do with their body. And hate for subcultures is a real thing that leads to violence. But the problem is that, despite there being a trans subculture, most trans people are statistically not part of it. But where are they in activism?

2. Misleading about goals

Let’s be honest. We are partly to blame for this stereotype. And before you stop reading, let’s just think about the topics most people discuss before the average protest or radical Pride event. Or let’s imagine trans-friendly events. They are mostly leftist, and people at these events share the exact same interests, hobbies, and political positions.

At my last protest about the new draconian Equality and Human Rights Commission guidelines in the U.K. that say trans people can only use public places according to the sex assigned to them at birth, we were speaking about anything else. For example, some speeches were about abolishing “bourgeois democracy,” speaking up for socialist revolution, and saying some other things I definitely couldn’t support.

I’m not against socialism, but I’m against the idea that all trans people are socialists. That is inherently misleading, at best, and harmful, at worst. I support universal basic income and free healthcare, but not revolution or Marxist reform. If I were a cis person who generally supported trans rights but knew too well about the Russian Revolution of 1917 and how it ended for indigenous people and queer people, if I were a bystander, I wouldn’t stop at a protest like that. I probably wouldn’t even believe that the situation is as bad as they are saying.

There is nothing bad about inviting a socialist speaker. The problem begins when all trans events become socialist events. Those protests don’t look like protests for trans rights – they look like protests for socialist revolution or just like a rebel teens gathering.

3. Self-fulfilling prophecy

At the protest I mentioned and at other similar protests, including the ones from the U.S. I saw online, there weren’t a lot of “traditionally” trans people — the ones you may have been able to see in old TV programs about trans experiences, where trans people were presented to be more gender-conforming.

Most activists are young, white, poor but not extremely poor, citizens of the country where they are living, gender-non-conforming, leftist, and non-religious. They like trans horror, drag queen shows, drawing and reading MfM romantasy. And despite the fact that I just finished writing my own trans horror novel, I wonder — where are the other trans people? With different hobbies and lifestyles?

Where are all those “traditional” trans women from old TV shows who like make-up and want to give birth to kids if only it was possible, and trans men who like to spend their time drinking beer in pubs and going to the gym with their bros? I think we need them more than we think. They may give new ideas and perspectives. And they need us. 

Why don’t we see them? Why do we see so few trans refugees who came from Middle Eastern, Asian, and African countries? May they be triggered by the world then because the U.S. had the worst dictatorship on the planet, or that the U.K. is a fascist country when they saw something worse than the British government or even MAGA? For some trans person who survived Bashar al-Assad in the Syrian government or fled Eastern Turkestan, such slogans would feel like gaslighting — and I knew because I met many refugees.

Why, finally, do so many trans activists have similar clothing styles, similar interests, and similar experiences?

Because it’s a self-fulfilling prophecy. When trans activists create this kind of culture, they accidentally gatekeep all other trans people who may feel less comfortable within a subculture that has its own rules, style, and ideology, even if none of those things have anything to do with being trans.

4. Media misrepresentation

When the media — conservative and not very conservative — sees the same thing, it doesn’t matter if we are speaking about a trans man who is traditionally masculine and wants a traditional family, or if we are speaking about soft, nice gay boys who happen to promote socialist revolution like many modern stereotypical trans activists. It is equally misleading.

I hate the idea that we need to pretend to be more convenient and normal in order to be accepted by society, because society has never worked that way. But pretending to be accepted by the community is no better.

Trans people are different — and sometimes problematic — and despite the core of activist trans culture, we can have some distinctions when we speak with the media. We should never try to tell people that all trans people are similar.

Now, when trans rights are under attack, it is more important than ever to show that all trans people are just people. We are different, like everyone else. We have our rights, even if we are wrong. Even if we are ugly. Or struggle with inner transphobia. Or some of us internalise traditional roles, or; the opposite, too weird for any culture and subculture. We can make mistakes. But we are not a political party or a monolithic group. Being trans is not a lifestyle, because we have different lifestyles. 

Trans kids need to see that they can be whoever they are and still be true, real trans people. And the media should always be questioned when they try to push all trans people into the frame of a subculture.

But to do so, we need to look at our activism and at the representation we are creating.

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Black Educated Lesbians: A movement rooted in community

Organization’s annual conference is part of a much larger mission

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When people hear the word “conference,” they often imagine a weekend event that begins on Friday and ends on Sunday. For Black Educated Lesbians (BEL), our annual conference is only one part of a much larger mission.

BEL was founded because Black lesbians deserve spaces intentionally created with us in mind. Too often, we are overlooked in conversations about health, leadership, philanthropy, education, and community. We exist at the intersection of multiple identities, yet organizations and institutions frequently assume our needs are being met by broader groups. Our lived experiences tell a different story.

BEL is a national nonprofit organization dedicated to creating opportunities for Black lesbians and Black queer women through leadership development, wellness programming, research, education, and community building. While our conference has become one of the few events in the country centered specifically on Black lesbians, our work continues year-round.

Throughout the year, BEL hosts virtual wellness sessions, leadership development opportunities, financial education workshops, community discussions, and mentorship programs designed to help our members thrive personally and professionally. We are also investing in the next generation through our EmpowerHER initiative, connecting Black queer youth with mentors, resources, and leadership opportunities.

Research is another critical part of our work. We are committed to ensuring Black lesbian voices are included in conversations about healthcare, mental health, economic opportunity, and overall well-being. Data drives policy, funding, and services. If our experiences are absent from the research, our needs often remain invisible.

Our annual conference, taking place Sept. 18–20 in Hapeville, Ga., brings this mission to life. Attendees will participate in conversations about physical and mental health, healthy relationships, financial literacy, entrepreneurship, leadership, aging, women’s health, and sexual wellness. The conference also creates opportunities to build meaningful relationships, support Black-owned businesses, and connect with professionals and organizations that understand our community.

Creating spaces like this is not easy. As a small nonprofit, every workshop, meal, scholarship, and resource requires fundraising, partnerships, and countless volunteer hours. Yet we continue because our community deserves spaces where they can simply exist, learn, heal, and grow without explanation.

What makes BEL unique is not simply that we serve Black lesbians. It is that Black lesbians lead every aspect of our organization. We understand the importance of creating programs that reflect our lived experiences rather than asking our community to fit into spaces never designed for them.

Community is not built during moments of crisis. It is built through consistent investment, authentic relationships, and showing up year after year. That is the work BEL is committed to doing.

Whether someone joins us as an attendee, sponsor, volunteer, donor, or community partner, they become part of something much larger than a conference. They become part of a movement dedicated to ensuring Black lesbians are seen, heard, valued, and supported.

As we prepare to welcome attendees from across the country this September, we invite readers to learn more about BEL, support our mission, and help us continue building spaces where Black lesbians don’t just survive, they thrive.


LaJoya Johnson is founder and executive director of Black Educated Lesbians, a national nonprofit dedicated to advancing leadership, wellness, and education for Black lesbians and Black queer women.

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I respect AOC, even though I often disagree with her

She should work toward House leadership role and skip presidential run

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Rep. Alexandria Ocasio-Cortez (D-N.Y.) (Washington Blade file photo by Michael Key)

There is a column in the New York Times asking, “Is Ocasio-Cortez ready for the glass cliff?” The author thinks it’s a great idea for her to run for president. I believe it’s a bad idea for her personally, and a disastrous idea for the Democratic Party. However, that is not the only column written recently about Ocasio-Cortez, discussing her options and private life. I think it is cringeworthy what social media, and even some mainstream media, are focusing on these days. 

Politicians have become fodder for what were once just stories about Hollywood, and loud showmen like the felon in the White House. Now, like the showman, those like AOC, can’t claim they aren’t asking for it by striving for the biggest online following possible. They obviously see that as a way to validate themselves; politicians use it as a way to raise money, become influencers, and get their message out. 

But they also open themselves up to even more intrusion into their private lives. Those who do that also open the door for all politicians to have their private lives made public. Running for president, which the column suggests AOC should do, and which she herself has said she isn’t ruling out, is a great way to grab a headline, and leads to reporters digging to find every little fact about her. AOC is trying to get ahead of the curve by talking about a breakup, and then about harvesting her eggs — topics once considered private that should stay that way. There was once just the National Enquirer, but today every news outlet incorporates what the Enquirer did, as it makes for great clickbait.

I feel for her, thinking all this has to be public, when a single woman wants to run for higher office. We have seen married women, including Geraldine Ferraro, Sarah Palin, Hillary Clinton, and Kamala Harris, run and be subjected to dealing with questions about their husbands, their former boyfriends, and in some cases, more reporting about those things than what they stood for. Maybe for AOC, that would be a good thing, as the country is far from ready for a candidate who up until now, proudly represents the Democratic Socialists of America (DSA). Yes, she is trying to step away from them a little, but I don’t think that is possible, which is why I feel it is a disaster for her to run, both for herself, and the Democratic Party. She could decide to run for the Senate if Chuck Schumer (D-N.Y.) understands it is time for him to retire. Even that could be a difficult race. She might win a primary, which another progressive representative, Bella S. Abzug (D-N.Y.), tried and lost in 1976, if she gets a big enough New York City vote. Should she try, we would see how much change there has actually been.

Back when JFK had women in and out of the White House, Ronald Reagan got Nancy pregnant before they married, and George H.W. Bush allegedly had a mistress traveling with him, those were not the headlines. I think we were all better off. Gary Hart asked for it when he told the press to follow him, and they caught him with a woman not his wife. Again, he asked for that. Then we got to the Clinton era and the right wing, actually David Brock, got the information on Paula Jones, and it all exploded, eventually cascading down to harm Hillary. They tried to find anything they could on Jimmy Carter, George W. Bush, and Barack Obama, but couldn’t find the salacious bits they were looking for. But I bet they will find some things that sound salacious on AOC, even if they have to make them up. She appears to be a normal, highly intelligent, motivated, single woman. 

Recent primaries in Michigan and Wisconsin, and general election results, will clearly impact what she decides to do. DSA candidates are not an easy sell to most Democrats, let alone the general electorate. We will find out how Dr. El-Sayed does in the general election. While I didn’t support him in the primary, I do in the general election. Those results, and looking back at other women who have run, may give AOC second thoughts about giving up working toward seniority in the House. I predict she could be much more impactful than one of her idols, Bernie Sanders, has been. He has been there for 40 years and accomplished nothing. I think AOC could accomplish a lot.  


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

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