It’s been a long day, and sticking swabs down my throat and up my anus is the last thing I feel like doing.
I’ve rushed from a late class at uni across to Thorne Harbour Health, anxious about getting stuck in the inner-city gridlock, and yet miraculously arrive too early. It’s a dark, damp, chilly late-winter day in 2022. At this point in the ‘living with COVID’ reality in Melbourne we’re all pretty inured to that shit show, but still mostly wearing masks, and I’m grateful for the slight anonymity this affords as I enter the waiting room. In terms of scary viruses, COVID isn’t the one preying on my mind today.
“I’m here for a 7pm appointment.”
“Your name?” asks the receptionist.
Noticing the tall, blonde guy to my right, I hesitate for half a second.
“Gideon.” So much for anonymity.
The blonde guy glances over. Do we know each other? He looks familiar but he’s also wearing a mask, so it’s hard to tell. I’m really hoping we haven’t chatted on Grindr. Or hooked up sometime. I don’t need a repeat of the last visit here, and an encounter with a former entanglement.
Slumping into one of the waiting room’s large, black leather seats, I avoid eye contact, reflexively checking through apps on my phone. Without thinking, I open Grindr, then consider whether that’s appropriate. How many people visiting today might pop up on it?
Established back in 1983 as a central part of Victoria’s response to the HIV/AIDS epidemic, Thorne Harbour Health is a LGBTIQA+ community-controlled organisation. It offers a wide range of health services for the community and people living with HIV.
Among them is PRONTO!, a peer-led service helping men who have sex with men (MSM) look after their sexual health through rapid HIV tests, sexual health screenings and prescriptions for PrEP (Pre-exposure prophylaxis, a medication that lowers the risk of HIV infection by 99%). That’s why I’m here – for my tri-monthly check-up. I’m also hoping that I can get a jab of vaccine for an outbreak of a new disease doing the rounds – monkeypox. By the end of the year, the World Health Organisation will urge that it be known by a different, less stigmatizing name – mpox.
Just as our coronavirus anxieties were levelling out, mpox was detected in Melbourne in late May in a traveller returning from the UK where the disease had just surfaced. I’d been following the news but only lately begun to worry that I needed to take it more seriously. At this point there are 25 cases confirmed in Melbourne. Supplies of a vaccine have just arrived, and health authorities are urging people at risk to line up for the jab.
Although mpox isn’t a sexually transmitted infection, it spreads through skin-to-skin contact, causing painful rash and deep lesions. As the World Health Organisation explains, it’s not a new disease – it was identified in humans in the Democratic Republic of Congo in 1970, and appeared in the United States in 2003. There have been sporadic reports mostly among travellers and then this outbreak flared in several non-endemic countries. Studies indicate that outside Africa, 92-98 per cent of cases are among men who have sex with men.
Spending all of July in Berlin, London, and Barcelona, I hadn’t really thought twice about visiting packed, sweaty nightclubs or steamy, gay saunas. It’s only now, hearing that there are cases in Melbourne, that the situation feels too close to home. Literally. All over my social media, queer friends and acquaintances, those who would be categorised as MSM, are starting to post their concerns about the local outbreak.
There’s high demand for still limited supplies of the new vaccine, and the rollout at this point is slow, limited, and confusing due to narrow categories of who is eligible. But a friend told me that at their recent PRONTO! check-up, they were given one immediately. I’m hoping that will be the case for me.
The doctor calls me into an appointment room and we run through a standard check-up. Even with a mask on, his face looks drawn and tired. I must be his last appointment for the night. After he’s finished drawing my blood, he hands me a bag with a cup to pee in and the aforementioned swabs. Before I head off to the bathroom to collect my samples, I enquire about the vaccine.
“There’s a very limited supply available right now,” he tells me.
“We’ll be getting more delivered in September. You can put yourself on the waiting list online on our website.”
Well, shit. That’s not what I was hoping for.
Driving home, I’m feeling a bit dejected. And confused. My friend had no problem getting a vaccine at his appointment, and I’m almost certain we meet the same criteria in terms of recent sexual activity. Trying to access information about this vaccine is proving to be unnecessarily difficult. PRONTO! have been doing their best, but their helpline has been inundated with calls from queer men, as very few organisations are providing us with accurate and updated information.
Conservative media has been downright homophobic, shaming men who have sex with men for their sexual activities. A recent Fox News segment featured a monkey puppet dressed in a doctor’s coat, shrieking that people should stop having sex with monkeys. During another segment, Fox host Greg Gutfeld sneered that monkeypox was being spread through “anal sex at raves”. It’s a chilling echo of the hateful rhetoric around queer sex a generation ago, during the AIDS epidemic in the 1980s.
While more progressive media outlets have avoided this sort of hate speech, they have sanitised their reporting to the point that it’s no longer clear that this is a health issue primarily affecting MSM. Outside of queer, community-led organisations, it seems many people are unwilling, or unable, to have a mature and respectful discourse about queer sex from a health perspective.
I’m realising that the conversation around this outbreak is triggering long-repressed feelings of shame around my sexuality that I thought I’d dealt with. Even as an adult, I still feel as though my sexual education is always tainted with stigma.
Growing up queer at a modern-orthodox, Jewish private school, there were zero resources or support to help navigate my identity.
On a school camp in Year 9, I found myself seated next to our school principal – a rabbi revered within our community – after a Sabbath dinner. During a conversation about the school’s response to bullying, I asked how he planned to tackle the issue of homophobia. I was only open about my sexuality with a select group of female friends at the time and wrestling with the idea of telling more friends and family.
As a father with teenagers of his own, I thought our principal’s response might be empathetic and understanding. I was wrong.
“We won’t tell kids it’s ok to be gay,” he said bluntly in his cut glass British accent. “Because it’s not.”
I retreated deep into a state of shame and suppression that night. It took most of my late teens and early twenties for me to claw my way out of it and undo the internalised homophobia that school hammered into me. A comprehensive sexual education was the last thing I ever received there.
The best we got was in Year 10, when the male students were taken into a classroom, shown graphic photos of STIs and told to use a condom during sexual intercourse. Meanwhile, the female students were taught methods to avoid pregnancy. There was no mention of queer sex or gender or sexual diversity, as our school would rather pretend queer students didn’t exist.
I’m curious to know if my queer friends had a similar experience. I met most of them after high school, so we weren’t together during those formative teenage years. While we have no problem as adults having frank conversations about our sex lives and sexual health, I wonder how we first learned the necessary information, and whether we still wrestle with feelings of shame from our adolescence.
Wanting to delve into this issue further, I’m put in contact with a mutual friend, Milly. A sexual health researcher at the University of Melbourne, she works within the Sexual Health Unit at the Centre of Biostatistics and Epidemiology. Previously, she worked as a sexual health educator, delivering workshops in schools across Australia. She’s around the same age as me and is herself a member of the LGBTIQA+ community, identifying as lesbian.
“There is a national curriculum for sex education,” Milly tells me. “But unfortunately, there is no real kind of watchdog or anybody enforcing how that national curriculum is implemented in schools. And because of that, you see a huge discrepancy in the quality and content of the kind of sex education that’s delivered.”
I share with Milly the lack of queer sex-ed provided at my school, and it emerges that her experience was much the same.
“We never got any kind of education about same sex relationships,” she says. “It was all about pregnancy and getting pregnant, which is obviously very heteronormative.”
“It was really problematic and really harmful for queer people. And I think that is still something that we definitely see in schools today.”
Two weeks after my first attempt at getting a vaccine, I head to the Victorian Pride Centre in St Kilda to try again. I’ve seen on Thorne Harbour Health’s Instagram that they will be hosting a pop up, walk-in, mpox vaccination clinic this weekend. By now, The Age is reporting that Australia’s outbreak has risen to 129 cases, over half of them in Victoria.
I arrive at the centre in the late afternoon, aware my chances are slim but hoping for the best. I’ve never actually visited the centre, as it opened in July 2021, just before the sixth Covid-19 lockdown in Melbourne.
As I enter the atrium-style lobby, I’m struck by its stunning, contemporary architecture – sweeping staircases, curved walls and an enormous skylight ceiling. The space is buzzing with dozens of people, all waiting patiently for their vaccination. Most of them appear to be men in their thirties and forties.
“Hi, have you got a number?” a friendly volunteer asks me. “Oh sorry,” he corrects himself. “I should ask first, are you here for a vaccine?”
I wonder what gave me away? Yes, I most certainly am. But as I’d feared, they’re completely booked out. He recommends that I come back tomorrow at 9am.
Knowing there’s no way in hell I’ll be awake that early on a Sunday (I have big Saturday night plans after all), I politely thank him and leave. I resign myself to the fact that I’ll just have to wait until I can book an appointment on Thorne Harbour Health’s website. This is all becoming more difficult than I’d hoped. Meanwhile, media reporting about the outbreak, and what precautions to take, is also still confusing and messy.
“So many mainstream media outlets and government people and all kinds of things were playing into this,” explains Milly. “People were very hesitant to say, men who have sex with men were more vulnerable to monkeypox.”
“There’s an obvious reason for that, you know – historic homophobia and stigma and marginalization and the absolute devastation that was caused from HIV.” Homophobia and transphobia endure within institutions and the medical industry in particular, she says.
“Even the term men who have sex with men, it feels, I don’t know, inadequate.”
Ideally, Milly believes that we should be able to discuss sexual health from an anatomical perspective in a kind and mature way. Sadly, that often isn’t the case.
“When you’re doing a health campaign, saying something like people with penises and people with vaginas, unfortunately, our society just isn’t ready yet. That stems from inadequate sex education, that stems from institutionalized, transphobia, and homophobia.”
And that’s the crux of the issue. Too many people outside of the LGBTIQA+ community, whether they be high school educators or journalists in mainstream media, seem unable or unwilling to have a respectful, honest discussion about queer sex and sexual health. Instead, queer people rely on each other, as we always have, to learn how to be safe, about the necessary actions to protect our health and our community.
A week after my second, failed attempt, I book an mpox vaccine. Thorne Harbour Health opened a limited number of online bookings a few days after their pop-up clinic. Third time’s the charm, I guess.
Arriving at the clinic, again there’s a crowd. A quick scan – no familiar faces. No previous hook-ups. Small mercies. A kind, softly-spoken staff member sends me upstairs to another waiting room, where we fill out paperwork lined up on plastic chairs carefully spaced 1.5 metres apart. It would be bitterly cruel to catch Covid-19 while trying to get vaccinated against mpox. There’s a Kylie Minogue concert playing on a TV on the wall. They know their audience.
About half an hour (and several of Kylie’s greatest hits) later, I’m ushered into an appointment room to see a nurse. As she prepares the jab, we chat about what we have planned for our Saturday evening. I work casually as a swimming instructor, and I’ll be helping out at the pool’s LGBTIQA+ pride event.
It strikes me in that moment how truly privileged I am. How incredible it is to have access to a free mpox vaccine, provided by an LGBTIQA+ led sexual health organisation. How lucky I am to live in a city that put funding into constructing a gleaming, modern new pride centre. How comforting it is to know that after I leave here, I’m heading to a supportive workplace to run a queer community event.
Even as the needle painfully pierces a vein in my forearm, I’m filled with gratitude. Grateful to live in a city where my rights are protected, where I have access to sexual health resources, and where I belong to a community who look out for one another. Grateful that I’ve moved on from the toxic shame of my adolescence to the queer joy of my adulthood.
Because, despite the lack of support we receive in schools, despite the disrespectful discourse in the mainstream media, despite the ongoing, institutionalised homophobia and transphobia in our society, queer people always have, and always will, take care of each other.
A week after receiving my vaccine, Victoria’s chief health officer, Dr Brett Sutton, will be in the news thanking the LGBTIQA+ community for our response to the mpox outbreak, as no new cases have been reported in the last few weeks.
I thank the nurse and wish her a lovely weekend, leaving the office with a huge grin under my mask. That grin turns to a smirk, as I exit the waiting room and pass a guy who I most definitely have chatted to on Grindr.
Australia’s mpox caseload peaked in August 2022, and in what’s being celebrated as a public health success, only four cases have been reported in Australia since the beginning of November 2022. There have been no new cases in Victoria this year, and there are no active cases, according to Victorian Health Department data. In January Australia’s chief medical officer Professor Paul Kelly downgraded the country’s public health risk declaration for mpox. But health authorities ramped up vaccination efforts in the lead up to the WorldPride festival now underway in Sydney. Experts have warned mpox still presents a risk to Australia, urging GPs and other primary care health workers not to take it off their radar.