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May 7, 2008

Killer Gay Sex!

by Tony Valenzuela


Crystal Meth Uncensored

Just after Valentine’s Day last year, the New York Times published an article called “A Kiss Too Far?” discussing how charged and potentially dangerous a public kiss remained between men. Accompanying the article was a photograph of two men embracing one another standing near Robert Indiana’s famous LOVE sculpture, lip-locked in a kiss. The caption read: “Could a gay couple who weren’t hired models get away with this in Manhattan?” When that article appeared I thought, “If a gay kiss is racy, even unsafe, in Manhattan in 2007, then actual gay sex—the lusty, panting, grinding rhythm of two naked male bodies—is dissolute by comparison.” The discussion of the New York Patient with his “reportedly hundreds” of unprotected sex partners while on crystal meth takes place in the same cultural context where a public gay kiss might incite a gay bashing.  This incredible reality of the taboo of ordinary gay affection biases any discussion of the “party ’n’ play” sexual behavior that is common under the influence of copious amounts crystal. This has never been an objective conversation—not in media, not in public health, not even among gay activists themselves. 

“I lost control,” he told me.  He met an HIV-positive couple from Connecticut with whom he did crystal in the summer of 2003, around the time his meth use became frequent. Throughout the AIDS epidemic he had managed to stay HIV negative by practicing one simple rule: He never bottomed without a condom unless in a relationship with a partner he trusted.  For 20 years he was primarily a top (often without condoms, he told me) and remained HIV negative.  But with this couple on crystal he betrayed his own rules.  “My inhibitions about protected sex went out the window,” he said.

By early fall 2004 he was doing crystal three weekends a month and became concerned. “Then I realized, my God, where am I?  Am I in trouble here?  Do I need to look at this closely?”  At that point he asked his therapist if he was an addict and his therapist said he was borderline. “He told me to stop completely and if I couldn’t, he would find me the help I needed.”  He did stop but within two months fell ill with HIV and has never done crystal again.  As for that couple in 2003, he’s not angry at them and says only, “They're very good people.  I don't blame them.  I blame crystal.”

Susan Kingston is a crystal methamphetamine expert and educator with the Public Health Department of Seattle and King County. “We portray this drug as if it’s its own cognitive entity,” she told me by phone. “We call it Tina. We personify it.”  Kingston is a no-nonsense, straight shooter who has worked on the gay–meth connection for over 10 years and takes a decidedly unfantastic approach to meth in communities where infectious hyperbole dictates the response to this drug.
Last summer she gave a talk she called “Crystal Meth Uncensored—What the DEA and the Media Won’t Tell You,” at Chicago’s LGBT community center, where she intended to set the record straight. “Despite what our hysterical Chicken Little media tells us,” she said, “only about 10 percent of gay men have used meth in the last year.”  She broke down that 10 percent like this: About half use crystal once or a handful of times and never again without any problems; the other half are what she calls “regular users,” and half of these will use meth problematically or have significant dependency, like the New York Patient had.  “So the media has it right for about 2 to 3 percent of the gay community,” she said.

What she’s resisting is the “crisis of the month” approach to gay health, and I think she’s right to do so.  Where some take the position that crystal meth use is so destructive it is worth stigmatizing, Kingston finds the approach counterproductive.  In fact, she discusses what she calls the “myths” of crystal meth—that it is the most addictive drug, hardest to get off, worst ever to hit the community—in an attempt at leveling with a population she understands as savvy around drug use and anti-drug messages.  “It oversimplifies the nature of addiction to say that one drug is worse than the other,” she told me and added with a penchant for catchphrases, “The most addictive drug out there is the one you are addicted to.”

In discussing his crystal use with me, the New York Patient slipped into the redemptive language of psychology:  “I was probably more open to or wanted to be more open to be free with myself, free with my feelings, free of that shame I carried so many years. Crystal gave that to me somehow.”  It is hard for people to understand, myself included, how any gay man in a large city could not know the risks involved with crystal meth.  But this is how the New York Patient described his progression to meth abuse.  Nobody, regardless of the substance, expects to develop a dependency, perhaps because most people don’t. 

Why is victimhood so often the antidote to the pariah status?  Where in the New York Patient’s “victim” profile do we make sense of his close and loving network of friends, some of whom I spoke with,  who stalwartly defend his character?  What of his successful career?  What about his resiliency, that quality that people in the helping services covet in their clients, the conscientious tending to his body and mind, his focused purpose on helping others?  He has risen to the occasion.  He is not a victim.  He, like the rest of us, is a full range of contradictions, experiences and possibilities.  He faltered.  He made mistakes.  He had very bad luck.  But he has responded proactively, imperfectly and profoundly.  The gay community (like every minority) is rife in narratives spun through the stifling categories of “villain,” “victim” and their successful cousin, “hero.”  Is our movement mature enough for complex characters?  Is the language of recovery, of spirituality, of psychology adequate to describe transgression without resorting to metaphors of sin and redemption?

Whatever combination of shame, pleasure, escape, adventure and denial that brought the New York Patient to use crystal, the drug undeniably contributed to his seroconversion, as it has for many other gay men.  But is beating crystal meth the silver bullet to stopping HIV?  “In Seattle we know a third of HIV-positive guys have used crystal,” Kingston said pointing out that the link is not necessarily causal.  “If we’re looking at crystal as the cause of increased HIV transmission and syphilis transmissions, then how do we explain the other two thirds?  We can’t blame all this on crystal.  Increases in unsafe sex and syphilis and HIV in New York City happened long before crystal meth showed up.”

The meta-narrative of the New York Patient’s crystal binges raised once again the specious question: Why do gay men risk their lives for sex?  “I think crystal meth is cart in front of the horse,” said Kingston decisively.  “Crystal meth isn’t fueling unprotected sex and hence HIV transmissions.  Gay men’s desire to have good old-fashioned sex the way it’s supposed to be is what fuels crystal use.”

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