A Queer Story
Part 6: Drag at the Cellular Level

(Part 6 of a 6 part story)

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First I explore the most popular HIV web sites. There is universal agreement here that HPV infection in the male, HIV postive population needs consistent monitoring. The more advanced HIV clinics offer anal pap smears —a way of keeping watch for pre-cancerous cell change (dysplasia)— and it is heavily suggested, if not claimed outright, that some of the doctors in these clinics are giving Gardasil to men, regardless of its FDA status. But just how big of a threat has this all become?

Plowing through the numbers is always fun. After jotting down statistics from over fifty web sources, I try to distill a clear picture from the varying figures. Some of it comes as nothing new. Men and women are thought to be infected by HPV in equal numbers through sexual contact. Women develop associated cancers at a much higher rate than the male population, most of whom remain asymptomatic throughout infection. Over the last few decades, however, associated cancers have risen in the male population as a whole, raising brows in the medical community.

For women there is an HPV specific test coming into wider use, but again men are left out. Surely it’s perfectly understandable that testing and vaccines are aimed almost entirely at women? After all, they seem to suffer the worst possible outcome of HPV infection much more than guys? This feeling of plausibility for such unequally deployed measures lasts only as long as it takes me to crunch down the numbers for gay men, where it turns out that not only is HPV infection rampant, but generally more problematic in terms of associated disease. Take the population to the sub-level of HIV positive gay men, and the situation is downright scary, with rates of anal epithelial dysplasia and anal cancer soaring above the general population and even approaching cervical dysplasia and cancer rates in women. Seems like gay men have once again found themselves in female trouble. It wasn’t enough for us that our anuses shared a common embryonic origin with the cervix. Now we were performing drag at the cellular level and developing these pesky women’s cancers. Why couldn’t we just settle for not being taken seriously?

Of the available statistics regarding gays and all things HPV, there was one group of numbers which, rather than saddening me, left me justifiably infuriated and wonder-struck. Up to half of gay males with anal HPV issues claimed never to have engaged in receptive anal intercourse! Adjusting for a fear-based response resulting from self-directed homophobia, this would still leave a large enough number to ask: What is all this talk about butt-fucking? It’s clear that there’s a transmission of HPV to the anal epithelium which doesn’t require a penis to be placed there. What about the straight guys with HPV related anal cancers? Are they all closet queens? Not possible! Unfortunately, I could not find a single engaging discussion of this obvious discrepancy between reality and rampant assumption. Even the pamphleture on HPV in men lists “receptive anal intercourse” as a risk factor, almost without exception. While it may be a risk factor, it carries an amount of weight that seems far in excess of the larger, more realistic, fact-aligned risk factor of just being gay. We have more partners and are therefore at risk for more disease. Is this a campaign to raise awareness of HPV, or is this a campaign to discourage receptive anal sex ——that most subversive, un-American, faggoty act? On conscious and subconscious levels it is probably some of both, and neither campaign is very effective. Head out of a narrow, narrow strip of Gay HIV-Land and HPV awareness for males is anything but aware. In fact, it only serves to distance men from the absolute reality that they too can suffer serious health consequences as a result of HPV infection, while efficiently solidifying notions of a discrete, untouchable, masculine, and marvelously heterosexual identity.

Any doubts I had regarding these conclusions were quickly dispelled when I checked up on the Gardasil trials in men. A quick search yielded at least a dozen articles that appeared in some of our most important, mainstream newspapers. I was pleased to discover that trials had reached stage three, but my delight ended right there. Only one article gave a proper mention to the burgeoning issue for gay men, and of course it did so without even signaling that the issue has now been raised for straight men as well. From here, the articles were interchangeable, never moving outside a narrative beaten into the cultural fabric, and in this case, again carefully refined by pharmaceutical marketing to avoid any potential association between Gardasil and gayness; any potential connection between being vaccinated and being feminized. By getting Gardasil, men were just doing their part in helping damsels across America avoid the suffering and distress of cancer. The last article actually closed with a plea to men: Do your part in making her “one less”. Can’t anyone see how this skews reality? For those of us that are gay, can we see how this story might be killing us and our heterosexual peers? What does it ultimately take to turn this kind of insidious, myth-supported, culturally sanctified complacency on its head? It’s enough to make you wish an anemic child would contract the virus through a blood transfusion.

I am a gay man who’s had an incredible amount of sex. The number of my dalliances is in the low four digits and contains no decimals. Do I believe that only evil dictators and whining, Jesus-perverting evangelicals who have never had a decent lay in all their time on this wicked earth deserve to get syphilis, HPV, or worse? Kind of. But any of my wishful thinking is quickly attenuated by the facts of our shared biological reality, and the fact that it just makes good sense for microbes to exploit our sexual functioning as a bridge to new worlds. No one deserves to get sick from sex, regardless of quantity or perceived peculiarity, but the fact is that we can and we will get sick. This matter-of-fact perception doesn’t mean I wasn’t terribly saddened when —just last month— Dr. Ass told me the condyloma had returned. This doesn’t mean I laughed off the possible implications or stemmed my emotion as I left his office and walked solemnly to my car, my lower lip trembling in fear. It means nothing of the sort. Once I was behind the wheel, I broke down and cried, sobbing into my hands —just like a woman.

by R.H.K, a man in Philadelphia, PA, age 38


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