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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 ā€” 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 ā€¦ 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 ā€” not necessarily the full role ā€” 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 ā€” such three studies published in peer-reviewed journals, as well as reports from national, regional, and global health authorities ā€” has indicated “experts may have framed monkeypoxā€™s typical transmission route precisely backward.”

“[A]n expanding cadre of experts has come to believe that sex between men itself ā€” both anal as well as oral intercourse ā€” 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 publicā€¦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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The White House

Four states to ignore new Title IX rules protecting transgender students

Biden administrationĀ last Friday released final regulations

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March for Queer and Trans Youth Autonomy in D.C. in 2023. (Washington Blade photo by Michael Key)

BY ERIN REED | Last Friday, the Biden administration released its final Title IX rules, which include protections for LGBTQ students by clarifying that Title IX forbids discrimination based on sexual orientation and gender identity. 

The rule change could have a significant impact as it would supersede bathroom bans and other discriminatory policies that have become increasingly common in Republican states within the U.S. 

As of Thursday morning, however, officials in at least four states ā€” Oklahoma, Louisiana, Florida, and South Carolina ā€” have directed schools to ignore the regulations, potentially setting up a federal showdown that may ultimately end up in a protracted court battle in the lead-up to the 2024 elections.

Louisiana State Superintendent of Education Cade Brumley was the first to respond, decrying the fact that the new Title IX regulations could block teachers and other students from exercising what has been dubbed by some a ā€œright to bullyā€ transgender students by using their old names and pronouns intentionally. 

Asserting that Title IX law does not protect trans and queer students, Brumley states that schools ā€œshould not alter policies or procedures at this time.ā€ Critically, several courts have ruled that trans and queer students are protected by Title IX, including the 4th U.S. Circuit Court of AppealsĀ in a recent case in West Virginia.

In South Carolina, Schools Supt. Ellen Weaver wrote in a letter that providing protections for trans and LGBTQ students under Title IX ā€œwould rescind 50 years of progress and equality of opportunity by putting girls and women at a disadvantage in the educational arena,ā€ apparently leaving trans kids out of her definition of those who deserve progress and equality of opportunity. 

She then directed schools to ignore the new directive while waiting for court challenges. While South Carolina does not have a bathroom ban or statewide “Donā€™t Say Gay or Trans” law, such bills continue to be proposed in the state.

Responding to the South Carolina letter, Chase Glenn of Alliance For Full Acceptance stated, ā€œWhile Supt. Weaver may not personally support the rights of LGBTQ+ students, she has the responsibility as the top school leader in our state to ensure that all students have equal rights and protections, and a safe place to learn and be themselves. The flagrant disregard shown for the Title IX rule tells me that our superintendent unfortunately does not have the best interests of all students in mind.ā€

Florida Education Commissioner Manny Diaz also joined in instructing schools not to implement Title IX regulations. In a letter issued to area schools, Diaz stated that the new Title IX regulations were tantamount to ā€œgaslighting the country into believing that biological sex no longer has any meaning.ā€ 

Governor Ron DeSantis approved of the letter and stated that Florida ā€œwill not comply.ā€ Florida has notably been the site of some of the most viciously anti-queer and anti-trans legislation in recent history, including a “Donā€™t Say Gay or Trans” law that was used to force a trans female teacher to go by ā€œMr.ā€

State Education Supt. Ryan Walters of Oklahoma was the latest to echo similar sentiments. Walters has recently appointed the right-wing media figure Chaya Raichik of Libs of TikTok to an advisory role ā€œto improve school safety,ā€ and notably, Raichik has posed proudly with papers accusing her of instigating bomb threats with her incendiary posts about LGBTQ people in classrooms.

The Title IX policies have been universally applauded by large LGBTQ rights organizations in the U.S. Lambda Legal, a key figure in fighting anti-LGBTQ legislation nationwide, said that the regulations ā€œclearly cover LGBTQ+ students, as well as survivors and pregnant and parenting students across race and gender identity.ā€ The Human Rights Campaign also praised the rule, stating, ā€œrule will be life-changing for so many LGBTQ+ youth and help ensure LGBTQ+ students can receive the same educational experience as their peers: Going to dances, safely using the restroom, and writing stories that tell the truth about their own lives.ā€

The rule is slated to go into effect Aug. 1, pending any legal challenges.

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Erin Reed is a transgender woman (she/her pronouns) and researcher who tracks anti-LGBTQ+ legislation around the world and helps people become better advocates for their queer family, friends, colleagues, and community. Reed also is a social media consultant and public speaker.

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The preceding article was first published at Erin In The Morning and is republished with permission.

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Pennsylvania

Malcolm Kenyatta could become the first LGBTQ statewide elected official in Pa.

State lawmaker a prominent Biden-Harris 2024 reelection campaign surrogate

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President Joe Biden, Malcolm Kenyatta, and Vice President Kamala Harris (Official White House Photo by Adam Schultz)

Following his win in the Democratic primary contest on Wednesday, Pennsylvania state Rep. Malcolm Kenyatta, who is running for auditor general, is positioned to potentially become the first openly LGBTQ elected official serving the commonwealth.

In a statement celebrating his victory, LGBTQ+ Victory Fund President Annise Parker said, ā€œPennsylvanians trust Malcolm Kenyatta to be their watchdog as auditor general because thatā€™s exactly what heā€™s been as a legislator.”

“LGBTQ+ Victory Fund is all in for Malcolm, because we know he has the experience to win this race and carry on his fight for students, seniors and workers as Pennsylvaniaā€™s auditor general,” she said.

Parker added, “LGBTQ+ Americans are severely underrepresented in public office and the numbers are even worse for Black LGBTQ+ representation. I look forward to doing everything I can to mobilize LGBTQ+ Pennsylvanians and our allies to get out and vote for Malcolm this November so we can make history.ā€ 

In April 2023, Kenyatta was appointed by the White House to serve as director of the Presidential Advisory Commission on Advancing Educational Equity, Excellence and Economic Opportunity for Black Americans.

He has been an active surrogate in the Biden-Harris 2024 reelection campaign.

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The White House

White House debuts action plan targeting pollutants in drinking water

Same-sex couples face higher risk from environmental hazards

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President Joe Biden speaks with reporters following an Earth Day event on April 22, 2024 (Screen capture: Forbes/YouTube)

Headlining an Earth Day event in Northern Virginia’s Prince William Forest on Monday, President Joe Biden announced the disbursement of $7 billion in new grants for solar projects and warned of his Republican opponent’s plans to roll back the progress his administration has made toward addressing the harms of climate change.

The administration has led more than 500 programs geared toward communities most impacted by health and safety hazards like pollution and extreme weather events.

In a statement to the Washington Blade on Wednesday, Brenda Mallory, chair of the White House Council on Environmental Quality, said, ā€œPresident Biden is leading the most ambitious climate, conservation, and environmental justice agenda in history ā€” and that means working toward a future where all people can breathe clean air, drink clean water, and live in a healthy community.”

ā€œThis Earth Week, the Biden-Harris Administration announced $7 billion in solar energy projects for over 900,000 households in disadvantaged communities while creating hundreds of thousands of clean energy jobs, which are being made more accessible by the American Climate Corps,” she said. “President Biden is delivering on his promise to help protect all communities from the impacts of climate change ā€” including the LGBTQI+ community ā€” and that we leave no community behind as we build an equitable and inclusiveĀ clean energy economy for all.ā€

Recent milestones in the administration’s climate policies include the U.S. Environmental Protection Agency’s issuance on April 10 of legally enforceable standard for detecting and treating drinking water contaminated with polyfluoroalkyl substances.

“This rule sets health safeguards and will require public water systems to monitor and reduce the levels of PFAS in our nationā€™s drinking water, and notify the public of any exceedances of those levels,” according to a White House fact sheet. “The rule sets drinking water limits for five individual PFAS, including the most frequently found PFOA and PFOS.”

The move is expected to protect 100 million Americans from exposure to the “forever chemicals,” which have been linked to severe health problems including cancers, liver and heart damage, and developmental impacts in children.

An interactive dashboard from the United States Geological Survey shows the concentrations of polyfluoroalkyl substances in tapwater are highest in urban areas with dense populations, including cities like New York and Los Angeles.

During Biden’s tenure, the federal government has launched more than 500 programs that are geared toward investing in the communities most impacted by climate change, whether the harms may arise from chemical pollutants, extreme weather events, or other causes.

New research by the Williams Institute at the UCLA School of Law found that because LGBTQ Americans are likelier to live in coastal areas and densely populated cities, households with same-sex couples are likelier to experience the adverse effects of climate change.

The report notes that previous research, including a study that used “national Census data on same-sex households by census tract combined with data on hazardous air pollutants (HAPs) from the National Air Toxics Assessment” to model “the relationship between same-sex households and risk of cancer and respiratory illness” found “that higher prevalence of same-sex households is associated with higher risks for these diseases.”

“Climate change action plans at federal, state, and local levels, including disaster preparedness, response, and recovery plans, must be inclusive and address the specific needs and vulnerabilities facing LGBT people,” the Williams Institute wrote.

With respect to polyfluoroalkyl substances, the EPA’s adoption of new standards follows other federal actions undertaken during the Biden-Harris administration to protect firefighters and healthcare workers, test for and clean up pollution, and phase out or reduce use of the chemicals in fire suppressants, food packaging, and federal procurement.

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