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Monkeypox being spread through sex, not brief skin-to-skin contact: experts

Health experts weigh declaring virus an STD

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Health experts are now emphasizing monkeypox is being spread through sex, not brief skin-to-skin contact.

Amid fears monkeypox would spread at an increased rate at the end of summer as gay men gather in close quarters for dance parties and other celebrations, health experts are starting to emphasize that the current outbreak isn’t spreading through minimal skin-to-skin contact, such as brushing up against a fellow shirtless dance partner, but rather through sexual activity and overwhelmingly among men who have sex with men.

With reported cases of monkeypox in the United States this week reaching 15,505, according to data from the Centers for Disease Control, a number of health experts who spoke to the Blade talked about outright declaring monkeypox a sexually transmitted disease as part of this messaging — although they acknowledge such a label would have pros and cons.

Juan Carlos Loubriel, senior director of community health at the D.C.-based Whitman-Walker Health, was among the health experts making the distinction between the negligible risks of transmitting monkeypox through brief skin-to-skin contact as opposed to sexual activity.

“I’ll say that we need to provide the real facts to our community that indicates right now that the majority of the cases are sexually transmitted, right?” Loubriel said. “So transmission is not occurring by casual touch, right? That’s what we know as of today … So the majority of the cases [are] by prolonged skin-to-skin contact, and during sex there is a lot of skin-to-skin contact.”

As health experts at large are beginning to make a distinction in how the disease is transmitted, the Biden administration has also taken up messaging that downplays the risk of monkeypox transmission through minimal skin-to-skin contact.

Demetre Daskalakis, who is the face of the LGBTQ outreach for the Biden administration as deputy coordinator of the White House monkeypox task force, made colorful remarks Friday during a conference call with reporters downplaying the risk of contracting monkeypox through brief contact, quoting a senior policy adviser at the CDC who has studied LGBTQ health issues.

“I think I’m going to quote my friend Robbie Goldstein that sex involves friction, and friction seems to be how this happens,” Daskalakis said. “So, I think, that from the perspective of events, the real risk at an event is low. Of course, you have to gauge that risk based on what you’re doing, so if there’s a lot of clothes out dancing and friction, that could be a mechanism of transmission, but just brushing by someone, I’ve said this many times before, just brushing by someone is probably low or no risk.”

Asked by the Blade during the call about any consideration on declaring monkeypox a sexually transmitted disease, Daskalakis said it’s “really important that the decision around monkeypox and whether it’s designated happen thoughtfully from the perspective of other implications.”

“What’s really important from the perspective of our communication on the ground is that our harm reduction and safer sex guidance really does mention the importance of sexual transmission or the associated transmission of the virus, and also provides guidance necessary, like reminding people that condoms may have a role — not necessarily the full role — in preventing monkeypox, but also reminds folks that skin-to-skin contact in the context of sex can be really a part of how transmission occurs,” he said.

The messaging is consistent with new studies finding cases of monkeypox are overwhelmingly the result of sexual activity. According to a recent report by NBC News, an increasing amount of scientific evidence — such three studies published in peer-reviewed journals, as well as reports from national, regional, and global health authorities — has indicated “experts may have framed monkeypox’s typical transmission route precisely backward.”

“[A]n expanding cadre of experts has come to believe that sex between men itself — both anal as well as oral intercourse — is likely the main driver of global monkeypox transmission,” the NBC News report says. “The skin contact that comes with sex, these experts say, is probably much less of a risk factor.”

With evidence the monkeypox outbreak is overwhelmingly being transmitted through sexual activity and risks from skin-to-skin contact virtually non-existent, experts say discussion on whether or not to label the virus as a sexually transmitted disease are ongoing and controversial.

On one hand, designating monkeypox as a sexually transmitted disease would give the public a clearer idea about the way it’s being transmitted to allay concerns and enable the public to take appropriate precautions. On the other hand, as seen during the height of HIV/AIDS crisis, an emphasis on monkeypox being transmitted among men who have sex with men may have the effect of stigmatizing the community (and the sexual activity) as being responsible for the outbreak.

Loubriel said the issue of whether or not monkeypox should be messaged more as a sexually transmitted disease is “a very good question and also a very big debate around public health, even within the public health sector.”

“The only reason we cannot say it is just sexually transmitted is because we know as a fact that it can be spread by other various avenues like touching clothing, bedding with an infected person or towels being used by someone with monkeypox, potentially contact with respiratory secretions,” Loubriel added. “So that is why it’s probably not been named as a sexually transmitted infection.”

Joseph Lee, a professor of health education at East Carolina University who studies health inequities among LGBTQ people, said there’s “real tension” in finding the right messaging, which he said would strike a balance between being factual while not being stigmatic of the marginalized community affected by monkeypox.

“We see when we have messaging that goes to the general public…that messaging about how a particular group is doing worse triggers negative stereotypes and makes people feel less at risk than they are,” Lee said. “And really importantly, it makes the group at the worst end of that problem feel sometimes like they’re feeling fatalistic or they can’t do anything to protect themselves. You almost feel like you have to give up and you’re just going to get it anyway because the messaging is so clear, how much it’s impacting your community.”

Lee, however, praised communications on monkeypox from the Centers for Disease Control & Prevention, saying the agency has “very useful guidance about promoting equity in monkeypox communication that I actually really like.”

Key points in the guidance, Lee said, is messaging that monkeypox can affect anyone, while going through some of the ways the virus is being transmitted and ways the public can protect itself. The guidance, Lee said, follows the right strategy of articulating a message to the general public, then adding more specific messages about protection against the disease and risk to the communities most vulnerable.

“That’s sort of their big picture strategy that I think is actually the right strategy,” Lee concluded. “How well everyone’s implementing it across the country in our messy, somewhat broken public health system is another question.”

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2026 Midterm Elections

Chris Pappas wins NH Democratic Senate primary

Gay congressman running to succeed retiring U.S. Sen. Jeanne Shaheen

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U.S. Rep. Chris Pappas (D-N.H.) speaks at the LGBTQ+ Victory Fund's 2025 National Champagne Brunch in D.C. (Washington Blade photo by Michael Key)

New Hampshire Congressman Chris Pappas on Tuesday won the Democratic primary in the race to succeed retiring U.S. Sen. Jeanne Shaheen (D-N.H.) in the U.S. Senate.

Pappas defeated Karishma Manzur, who was his primary challenger, by a 61.8-36.1 percent margin.

The gay congressman will face off against former U.S. Sen. John E. Sununu, who defeated former U.S. Sen. Scott Brown in the Republican primary.

“Tonight’s victory sends a clear message that voters are looking for leaders who will fight for their rights, their freedoms, and to be treated with dignity and respect,” said Human Rights Campaign President Kelley Robinson in a statement. 

She campaigned for Pappas in Manchester, New Hampshire’s largest city, on Aug. 30.

“Chris Pappas has delivered results, stood up for equality, and showed up for the people he serves,” said Robinson in her statement. “HRC was proud to mobilize Equality Voters across New Hampshire to help power this win. We don’t have a second to waste between now and November. We look forward to continuing our work with Rep. Pappas as he drives toward victory in November so he can help return a pro-equality majority to the United States Senate.”

poll the University of New Hampshire Survey Center released on Aug. 26 showed Sununu ahead of Pappas by a 45-43 percent margin if they were to face off in the general election. The margin of error is +/-2.1 percent.

Pappas would become the first openly gay man elected to the U.S. Senate if he were to win in November.

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Georgia

Everton Blair makes history as first openly gay congressman from Ga.

Former Gwinnett County Board of Education member to serve remainder of David Scott’s term

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Everton Blair, Jr. (Photo courtesy of Blair's campaign website.)

Georgia made history last week when Everton Blair, Jr., was sworn into the U.S. House of Representatives, becoming the state’s first openly LGBTQ member of Congress and the latest LGBTQ addition to the chamber.

Blair, who represents Georgia’s 13th Congressional District, was sworn in on Sept. 1 after winning a special election to fill the vacancy left by the late-Congressman David Scott. Blair defeated Marcye Scott, the late congressman’s daughter, in the Aug. 25 runoff, winning 53.2 percent of the vote to Scott’s 46.8 percent.

He will serve the remainder of Scott’s term through Jan. 3, 2027. Blair is not running in the November general election for a full term.

Blair brings a progressive platform to Congress.

The 34 year-old supports Medicare for All, a Green New Deal, raising the minimum wage, and universal gun background checks. His campaign platform also included positions on LGBTQ rights, reproductive freedom, workers’ rights, climate, and gun violence.

Since joining the House, Blair has joined the Congressional Black Caucus and Congressional Progressive Caucus. He is also a co-chair of the Congressional Equality Caucus.

Before joining the House, Blair served on the Gwinnett County Board of Education, where he became the first Black member and youngest-ever member elected to the board, as well as its first openly gay member. He was later unanimously selected as chair.

Blair also served as a fellow in President Barack Obama’s White House Initiative on Educational Excellence that focused on improving academic outcomes and expanding opportunities for minority students.

The son of Jamaican immigrants, Blair was born and raised in Georgia’s 13th Congressional District. He earned a bachelor’s degree in applied mathematics from Harvard University, a master’s degree in policy, organization, and leadership from Stanford University, and a Doctor of Education Leadership degree from Harvard.

Blair’s campaign received endorsements from a number of organizations, including the LGBTQ+ Victory Fund and progressive Democratic groups such as Future Democrats.

The Equality PAC, a political action committee dedicated to electing openly LGBTQ candidates to office, celebrated Blair’s victory and provided a statement to the Washington Blade about the historic nature of his election.

“This is a historic election for Georgia, the South, and our entire country,” Equality PAC said in an email. “Everton Blair brings a strong record of public service and a deep commitment to making government work for working families.”

The group said Blair would “fight to lower costs, expand access to quality health care, create economic opportunity, and ensure every community has a voice in Washington.”

“At the same time, Everton understands the importance of standing up for equality and defending the rights and freedoms of LGBTQ Americans and every community facing discrimination,” Equality PAC said. “His historic election as Georgia’s first openly LGBTQ Member of Congress and the first openly LGBTQ man elected from the South is a powerful reminder of how far our country has come — and how much work remains.”

Equality PAC said it was “proud to welcome Everton to the House” and looked forward to working with him.

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U.S. Military/Pentagon

Pentagon expands testosterone screening as trans troops face hormone therapy restrictions

Defense Department says updated guidelines to be issued shortly

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Defense Secretary Pete Hegseth (Washington Blade photo by Michael Key)

The Pentagon has announced that new clinical guidance will be released establishing mandatory testosterone deficiency screening for active-duty and reserve cisgender male service members ages 30 and older, advancing a policy that expands hormone-related care for cisgender troops.

The Defense Department said the existing clinical guidelines, which are not currently available on the Defense Health Agency’s website, are being updated and that the final guidance will be issued shortly.

The announcement comes amid a wave of anti-transgender policies from both the DoD and the Trump-Vance administration, which continue to prohibit trans men from receiving the same treatment.

Under the forthcoming guidance, men ages 30 and older will be forced to undergo testosterone blood tests as part of their medical care. Younger male service members will be tested if they request screening or if clinicians identify warning signs of low testosterone.

The new guidelines formalize a screening program Defense Secretary Pete Hegseth announced in July, when he said the Pentagon would begin testing service members to ensure that “you have the right testosterone levels to operate at your absolute best.”

“Taking care of your long-term health means ensuring you remain strong, resilient, and capable — not just for your next deployment, but for the rest of your life, so you can thrive long after you take off the uniform,” Hegseth said at the time.

The Defense Health Agency’s clinical guidance says the program is intended to address “hormonal and energy-availability issues.” Hegseth said in July that testosterone replacement therapy would remain voluntary for service members if treatment is recommended.

The Food and Drug Administration is also scheduled to hold a meeting later this month with experts to discuss the medical use of testosterone.

The Pentagon’s push to routinely test testosterone levels runs counter to current medical guidance, which generally recommends considering testosterone therapy only for men who have symptoms consistent with low testosterone and have documented low hormone levels on two separate blood tests.

Testosterone is a sex hormone naturally produced by people of all sexes. It plays a role in regulating muscle mass, bone density, and sex drive. Testosterone levels in men naturally decline with age and have been associated with symptoms including erectile dysfunction, low libido, mood changes and weight gain, although experts continue to debate when testosterone therapy is medically appropriate.

The policy has drawn scrutiny from LGBTQ advocates because the Pentagon and Hegseth have simultaneously cited hormone therapy as part of the rationale for removing trans service members from the military.

Under President Donald Trump’s 2025 executive order, “Prioritizing Military Excellence and Readiness,” the military has moved to bar trans people diagnosed with gender dysphoria from serving and has begun formal administrative separation proceedings against trans personnel.

The Pentagon continues to pursue implementation of the trans military ban as litigation over the policy proceeds. As a result, some trans service members have had their gender-affirming hormone therapy halted even as the Pentagon expands testosterone screening and potential treatment for cisgender service members.

SPARTA Pride, a nonpartisan nonprofit organization made up of trans service members, veterans and their allies, criticized the disparity to the Washington Blade when Hegseth first announced the screening program.

“If hormone therapy helps warfighters perform at their best, then it cannot simultaneously be used as evidence that transgender service members are unfit to serve,” said Kara Corcoran, executive director of SPARTA Pride. “The same class of evidence-based medical treatment cannot be characterized as readiness-enhancing for one group and readiness-destroying for another.”

On June 1, the U.S. Court of Appeals for the D.C. Circuit ruled that trans service members already serving in the military could continue to do so while allowing the armed services to continue refusing to enlist new trans recruits.

The Blade reached out to the Pentagon when the testosterone screening program was first announced in July, asking why cisgender service members could receive testosterone therapy while transgender service members could not. The Pentagon did not respond.

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