Category Archives: Current Politics & Media

With last week’s announcement from the CDC there has been a huge uptick in opinion pieces and mixed reactions relating to the prophylactic drug Truvada (or PrEP). In my own life it has become quite the robust conversation topic over social media, dinner parties and happy hour with friends. My broader feelings have been oddly ambiguous, so until now I’ve only commented on smaller, side-issues because I’ve felt so strangely conflicted and underwhelmed by what is surely scientific good news.

As much as I like to think of myself as someone who can just read the medical literature and data (10 years of working for Public Health researchers and epidemiologists has rubbed off on me a little, at least I hope!) I have to confess there are personal, illogical gut-reactions involved too. Either way, this year is establishing itself as the tipping point for the gay community to grapple with several, interlocked issues around this little blue pill.

Way back in distant history–when Bill Clinton was president and web-surfing was something squeezed in at the office–I worked as an administrative temp in downtown Seattle. There was an office manager named Maureen who in so many ways was the prototypical one of that era. Close to retirement and a bit of mother hen to us “kids” (twentysomethings slumming it until we found the proverbial “real job”), she told me a fascinating story that I really hadn’t revisited until lately. She said when she was attending University of Washington, sometime in the early 1960s, she put herself though this peculiar rigmarole to obtain the birth control pill. A Seattle native, she didn’t go to her family doctor who’d treated her since childhood, nor the student health clinic on UW campus. Rather, she made an appointment with yet another, new physician located in Seattle’s Rainier Valley. Not only that, she borrowed a ring from a girlfriend so that she could claim she was engaged at her visit. Fifty years later, Maureen–part of the final slice of the Silent Generation–was laughing with us at how elaborate her performance was. Pretending to be married would have been a more assured way to obtain The Pill with less hassle, but somehow she STILL feared this might get back to her parents via some secret slut-shaming physicians’ network. So Maureen created a back-up plan in case she needed to do later damage control–she could quickly claim she and her boyfriend were secretly engaged (they weren’t and the relationship ended before graduation). Fear of judgement plus some good old-fashioned embarrassment were putting up extra burdens to wise medical prevention. Fear her (male) family doctor would tell her parents she was having sex. Shame that she was having sex and not *really* engaged, much less married. She wasn’t Catholic or against birth control, and probably neither was her family physician, but there was this sense of caution and fear that while The Pill might be a modern science godsend to the *right* sort of girl (married ones who want to responsibly space their children) we must not allow it to be an easy option for the *wrong* sort of girl (unmarried promiscuous ones).

Today Truvada seems to be having some of the same reactions. Some physicians and social commentators are quick to praise it for the *right* sort of gay (HIV discordant monogamous couples) but are very leery of widespread use for the *wrong* sort of gay (unmarried promiscuous ones). In an effective patient/doctor relationship all facts should be on the table, but this is always so much easier said than done. Who doesn’t round-down when even just self-reporting their alcohol consumption, for instance? Talking about Truvada requires being upfront about having condomless sex and taking whatever judgement or awkwardness comes along with that. Because this drug is so new, and is for a narrow niche of the market, it may take a little time–and patients switching physicians–for the awkward cloud to lift. Yet it’s not just the “talking about sex can be uncomfortable” factor that I think is keeping a lot of gay men from embracing this new prevention tool. For the last couple of weeks I’ve been trying to sort out my own feelings. Had the CDC just approved and recommended a vaccine I have no doubt my feelings would have been overwhelmingly positive. Why was I conflicted about a little blue pill that–if taken daily–does the same? My brain has gone through as many justifications and half-truths and second-guesses as Maureen’s did circa 1962: It’s because it won’t protect against OTHER STI’s! Neither would a vaccine, neither does The Pill. It’s because this won’t be affordable for the masses of HIV positive men and women in sub-saharan Africa! Perhaps, but that’s a bigger issue about global health and wealth in general. Sorry, Straw Man. It’s because there could be side-effects we don’t know about yet! Again, that’s true with many drugs. Even if some small portion of people experience side-effects and need to halt usage, surely the greater good (fewer HIV infections, fewer AIDS-related deaths) outweighs that. Those reasons were thin attempts at justifying my lukewarm response to Truvada. I think the real reason the response was so muted in comparison to what a vaccine is something much less

@ UW’s Hansee Hall. Today co-ed, during 1930s-1970s it was the “girls’ dormitory”.

admirable. I was underwhelmed by the idea of long-term adherence to a daily drug precisely because that is the reality of healthy, happy people who are HIV positive. A petulant little voice in the back of head was not pleased that the end result was the same: Daily pharmaceutical intake. Awkward conversations with physicians. Potential battles with insurance plans. “So what was the point of trying so hard to be good (caution & condoms) all these years if we are all ending up in the same boat anyway?“was the niggling voice. Somehow I felt because I played by the safer-rules 95% of the time (okay, 85% of the time) I should get some sort of cosmic credit over the cavalier barebacker. This mindset isn’t logical or pretty. But it was there and I’m over it now. Maureen probably went through irrational justifications of why she, an “almost engaged” college girl wasn’t in the same boat as a promiscuous, picking-up-men-in-bars type. People like to rank and categorize. They also like to engage in magical thinking about “what’s fair” on some imaginary cosmic scorecard (ask anyone who has experienced death or divorce about that one).

I still haven’t decided if PrEP is right for me, and I don’t want to shut down–or merely dismiss as alarmist prudes–those who have sincere concerns about what the future could look like for my community post-Truvada. However, I think it’s worth remembering that people take time to sort through their own phobias and embarrassments whenever the topic is sex. Maybe when I am near retirement, having a doughnut in the office, I’ll be able to have a chuckle with a bunch of 21 year olds about my silly justification-gymnastics around a medical breakthrough that ultimately changed the lives of countless people for the better.

Today’s Johannesburg Memorial for Nelson Mandela has been the culmination of the last few days of presidents, prime ministers, former world leaders and the inevitable celebrities providing commentary and reflections on the freedom fighter and former president of South Africa. One of the first commentators I heard from was former president of the nation (and Nobel Peace Prize winner–jointly with Mandela) F.W. de Klerk. His comments about that crucial period when the transition to democracy fell upon Mandela’s shoulders and its difficulties have been mostly what one would expect, but I was surprised to hear from him before Mandela’s immediate successor President Mbeki.

Obama and de Klerk greet Methodist Bishop Ivan Abrahams at Mandela’s Memorial today.

However, one thing that really struck me is how virtually every news outlet: CNN, SABC, BBC made no hesitation to refer to him as “former president de Klerk”…occasionally even using the honorary title of “president” when asking him a question. This included interviews in the South African press. Think about it. Certain news outlets and commentators can barely stand to call Obama “President Obama” when he won with a clear, fair majority. Yet who is F. W. de Klerk? A leader duly elected in 1989 in a nation where less than 20% of the population–the white population plus a few others–were allowed the franchise. He didn’t even win that minority by a landslide, either, but with a healthy margin to be sure.  So, at best, around 12% of the adult population of South Africa had cast a ballot for de Klerk and his party. If ever there was a situation where the current media could justify ditching formalities it would be the case of an apartheid-era president of South Africa: a regime/era that has long been internationally discredited.

And yet, they haven’t. There have been the asides from commentators and presenters referring to him as “South Africa’s last white president” or even “South Africa’s last minority-rule president”, yet making a point to respectfully refer to the man as “president de Klerk” or “former president de Klerk”. I am not disagreeing with this, but rather whole-heartedly supporting it. It goes to show the wisdom of Mandela in not completely dismantling the old framework as has happened in other transitions.

Yet the last few years in the USA there have been sitting congressmen who see fit to shout out and interupt a State of the Union address mid-speech. The 2012 picture below of the president with Arizona governor Jan Brewer came to mind in sharp contrast with the respect I’ve seen shown de Klerk the last few days. Can anyone provide me a photo of another incident of an American governor doing the same with his/her president? No matter how much they disagree? I am not saying it hasn’t happened before, I just have yet to see a photograph of Johnson, Nixon or Reagan being lectured this openly or crassly. If one exists I’d be much obliged to see it.

The American system has hit a level of crass and open disrespect for the office I would argue we haven’t seen since the middle of the 19th century.  Some of it did begin under President Clinton, and amplified under Bush. President Bush did not win a nation-wide majority vote in 2000. However, he was the rightful president in accordance with system and, as a whole, other politicians and journalists were deferential to the office (if not all folks at the grassroots level).

Another example I would bring up is President Gerald Ford. Remember, upon his swearing-in on August 9th, 1974 not a single American had ever voted for him as president OR vice-president. He was selected by Nixon during his second term as a replacement for VP Spiro Agnew in the light of financial controversies. Yet Ford was given the respect and deference by other political figures, governors, and the media that any majority-elected president would have received. Obama decisively won in 2008 with a larger majority–and a larger % of the white vote–than Clinton did. No sane observer can claim first-term Clinton was treated as an illegitimate usurper in some quarters the same way Obama was in his.

If black South Africans who grew up under the yoke of Apartheid can give former president de Klerk the respect traditionally accorded the office I should think the likes of Justice Alito or Rep. Joe Wilson could handle doing the same in this country.

My neighborhood of nearly a dozen years has recently been subject to much hand-wringing and much national attention for several cities allowing the development of high density housing. While I think the outward appearance of these building could benefit from a little creativity I have to say how amusing I find it that even one of the densest residential areas has trouble embracing an idea that is as American as apple pie.

I have long been a fan of 1930s American popular literature, many of which are out of favor today and probably would get the label of “middlebrow” at best. I heavily mined that same period and genre for my historical thesis of limited scope back in 2002-2004.  A central feature to these novels has always been the boarding house and the urban flat: dwellings for singles, salesmen, kept women, new immigrants, divorcees, spinsters and “confirmed bachelors“, and other colorful characters creating a new dynamic in a busy urban setting. One consequence of the post-war cult of the automobile and flight to the suburbs is, I believe, this concept faded from popular consciousness. When I think of early 20th century US I think of families living in New York apartments with high density, A Tree Grows In Brooklyn, a harried mother getting Mrs So-and-So Upstairs to watch the baby an hour while she runs to the store for something special. This was the era of strict demarcation between urban density and rural life–the American suburban standard that I feel a lot of us still carry with us as the “norm” (yard, garage, basement) hadn’t taken hold.

Seattle aPODments, 2012

The aPODments may end up being the sort of transient housing the NIMBY activists fear.  Also, I really wish the developers would stop trying to defend themselves by claiming they are some sort of community activists set on creating affordable housing. If you compare a shared-full-kitchen 240ish square foot aPODment with a 490ish square foot studio the price comes out to less bang for your buck, not more. However, I think they have a valuable place in the urban core and Capitol Hill of all places–home of beautiful vintage early 20th century apartments–needs to accept them and fold them in as part of the local landscape. Many of the motel-style apartment homes built for the 1962 Seattle World’s Fair (that event that brought us the Space Needle) seemed just as jarringly out of place mingled among the 1920s terra cotta apartment buildings and brick Tudor-style flats. Yet fifty years later there is an Americana nostalgia to these constructions as well. Part of what appeals to me with city living is observing several layers of time on a 20 minute walk. So long as some historic building of note isn’t being demolished, I have no problem with aPODments filling in the gaps and empty lots in an already dense and vibrant neighborhood.

Fannie Hurst and Edna Ferber are two authors whose heyday would have been from about the First World War to the late 1930s. Their novels of immigrants, working-class girls, fallen women, and confirmed bachelors strongly feature the boarding house:

Fannie Hurst in the late 1950s, after her peak in popularity

hallways smelling of foods from different cultures. Washing hanging on iron radiators. Milk delivery doors and ice boxes.  All of these things exist at my current home. Granted, the immigrant neighbors down the hall are more likely to be Somalian or Vietnamese than Polish Jews or Italians, and we all use our 1922 ice boxes as cool built-in liquor cabinets now. The scents in the hallway might also be cannabis (it’s legal in Washington State) but the spirit and connectedness is the same.

I live in a 500 square foot studio apartment built when Warren G. Harding was president. It’s by far the smallest place I’ve ever lived, as a child I assumed the older you get and the more you pay the bigger your place will be! I think a lot of people still assume this. This weekend I am feeding the cats of two of my neighbors: a young couple with a toddler upstairs and a 30-yr old single professional down the hall. This week on two separate occasions I had friends over who live less than three blocks away to enjoy dinner and wine–cooking for one is never as fun as cooking for others. Today I helped another neighbor to hang a picture (and learn from my mistake RE: laff paster and making effective use of the oak picture rail). This is not the life I envisioned I would have at 40 (and yes, I made the early 2000s required detour to Real Estate Bubbleland of condos and granite countertops). Yet, part of the reason I think I am embracing it and loving it is because it is precisely the life a part of me always imagined for myself during my teen years. I just could never reconcile it with modernity. Fannie Hurst died in February of 1968, Ferber died less than two months later.  While neither would recognize many aspects of my modern life I am tickled that the urban lifestyle they so often chronicled–albeit with a modern twist–is more alive in Seattle today than when they died.

Relaxing in my apartment, 2013