Michael Holder, STI Disclosure, and Avoiding The Gulag of Silence

This is a follow-up post in a dialog with Todd Heywood.  Todd had originally covered the case of Michael Holder who was convicted of failing to disclose his HIV status to his girlfriend. My initial post, Dishonesty in health disclosure: Michael Holder got Justice,  supported a legal deterrent against such behavior,  with a focus on Sexually Transmitted Infections (STI), using the Michael Holder case as an example.  Todd Heywood responded in Do HIV-positive people have more responsibility in HIV prevention?

Todd wraps up his post with a broad description of my post and who I am says:

But I posit that there is more at work here than simple ignorance. Cohen is operating on a level I suspect even he is unaware of. There is a kind of blame the HIV-positives for their condition mentality involved. Thus, a public flaying, such as having to disclose HIV status, is warranted. It is a scarlet letter of the modern world, and Cohen, who is presumably negative since he has not hint at understanding HIV stigma, discrimination and the subsequent violence that attaches itself to such disclosures, wants us to continue to wear the scarlet letter.

According to Todd, because I agree with the majority opinion from the appeals court, I’m racially insensitive.  Because I find the defendant, a convicted burglar who met and infected the plaintiff while cheating on his wife, less credible than the plaintiff, I’m demonizing HIV positive people.   Because this is my first post on STI transmission, and that in an unrelated post about how the lack of democratic leadership in our movement starves non-big-ticket battles, I did not list HIV in a short list of examples, I’m HIV Phobic.

I don’t doubt that there are people that actually think and do what Todd is alleging. I suppose if all you know about me is from my blog, you might find what I have written on this topic to appear similar  enough to what those kind of folks would and assume that’s where I’m coming from.  It isn’t.  As Todd has expanded on his point, and related his person experience, so will I.

I’m not HIV positive, so I can’t truly claim to understand Todd’s perspective from a first hand point of view like he can. True, the dialog with Todd has caused me to learn more about the plight of HIV positive people.  However, HIV positive friends and lovers are not new to me.  As long as someone is open about it, honest, and is agreeable to precautions which minimize the risk of transmission, it’s not something I would necessarily discriminate by.   If there’s any discrimination I’m doing, its against deceptive and unethical behavior, especially when it puts me at risk.

However, as someone who’s been in a relationship situation where there was not appropriate disclosure of an STI (and that was not HIV), and some questionably deceptive and unethical behavior regarding it, I see the issue from a different perspective.  Just because I am not HIV positive, doesn’t mean I have to remain confined to a gulag of silence.

I’ll expand further on my opinions shortly. However, I’m not pushing all the responsibility to the other side, not am I focusing on HIV in particular.  To me, the holder case is just an example of the STI disclosure issue.  In truth, from our dialog and his other public statements, I don’t think we are really that far apart.  Is it unreasonable to expect a person who I am dating who has an STI to disclose that to me before we have sexual contact?

As evidence that we have some common ground:

in 2009, speaking at the Michigan Equality Rally at the capitol, Todd says

For those of us who are HIV positive, we help the gulag [of silence] . We are our own oppressors; we have to stand up and admit that we are HIV positive  each and every time we meet somebody.  We have to be honest if we expect honesty in return.  It’s that simple, and if we’re not, we’re killing ourselves and our brothers and our sisters.  It’s time to end the silence.

Perhaps he’s speaking in a broader context than just sexual relations.  However, if you advocate coming out as HIV positive to help the community and HIV people collectively, isn’t it kind of a contradiction that you wouldn’t also advocate telling those who you will have sex with?

I didn’t quote this solely to support my point about disclosure.  There’s a broader point in Todd’s words that I want to amplify.   There is a lot of ignorance and discomfort in the LGBT community about STIs like HSV, HPV, HEP, HIV and others.  People are being discriminated against because of this, when they needn’t be.  As long as people are honest with each other, there are reliable ways to mitigate the risks of transmission.  Just because one of these is present in a partner does not mean you can’t have a safe, loving and long term relationship.

We must combat the ignorance and discomfort society feels about LGBT people, we must come out.  We need society to experience us, to see us as human beings alongside them.  People often say that their opinions of LGBT changed significantly in a positive direction once a person they knew or family member came out.

I think Todd’s point is that by retreating into the closet, people with these kinds of health conditions are missing a critical opportunity to remedy this ignorance and discomfort.  Todd is one of the few who is taking the risk of outing himself as a leading example. I think that’s extremely brave.  I’ve only included an excerpt of his speech, but think watching the full version is worth your time.

The Holder Case

Just because I agree with the majority opinion from the appeals court, doesn’t mean I’m racially insensitive.

As proof of the fact that this is a clear case of racial bias, He states  that because Judge Karen Nelson Moore says so, that establishes that that this is a clear instance of racial bias and that I am just racially insensitive.  However, Moore wrote her position as part of the Appeal’s minority opinion on Holder’s appeal.   Turns out that the majority did not agree.  The fact that this was a split decision among intelligent people, means that exactly that: reasonable people can disagree without being called names.

When I read through the judgment on the appeal, I examined the court transcripts in question.  I will agree that some things were said that merit additional examination.  In my post, I expressed support for the appeal.  However those transcripts show leading questions that I feel could walk a reasonable person into saying unreasonable things.  There’s also testimony from the potential jurors (who are accused of racial bias) stating that they found the original questionnaire’s wording slanted and confusing.  Normal people who get tapped for jury duty very rarely, can easily be confused by legalistically worded questions.  A few of them specifically called out clever use and placement of pejorative words, along with some fast reading on their part, caused them to answer in a way that did not represent how they really felt, given the further clarification.

Just because I find the defendant, a convicted burglar who met and infected the plaintiff while cheating on his wife, less credible than the plaintiff, doesn’t mean I’m demonizing HIV positive people.

Todd writes:

In fact, the records and Holder’s own statements show that the victim was aware of this marriage and allowed Holder to move in with her anyway.

So much for the innocent victim of the cheating husband meme.

Hardly.   Much of this case, like many others, comes down to “he said, she said” and who’s the more believable witness.  It’s not that she’s a victim because he’s cheating on his wife.  The victim of that is his wife.   It’s the fact that he is cheating on his wife that makes him less credible to me.  It’s purely about him and his behavior that affects his credibility.   It’s just like the burglary conviction. According to Kosecki, who I believe, Holder not only failed to disclose, but lied and denied that he was HIV positive.

Just because this is my first post on contagious disease transmission, and that in an unrelated post about where I argued that the lack of democratic leadership in our movement focuses our resources on marquee issues like “Marriage” and starves others and did not list HIV in a short list of examples, doesn’t mean I’m HIV Phobic.

In an unrelated post where I was arguing (among other things) that perhaps because of less than democratic governance in our movement, we are so focused on the 100% solution of marriage in huge expensive battles, that we are starving other efforts like in smaller states for things like Employment Non-Discrimination or even basic forms of relationship recognition such as hospital visitation rights and smaller communities like Transgendered.  I suppose because I did not specifically list HIV, or forgot to include the words “including but not limited to”, I am HIV phobic.

Reciprocally, if you watch Todd’s speech, it’s focused entirely on HIV, even though many of the same issues arise with other contagious diseases.  Would I like to see him include those other diseases in his public speeches?  Yes.  Because he didn’t include the others, does that mean he’s HSV-Phobic?  No, of course not.

It’s not just about HIV

We talked and emailed a lot before we had the opportunity to have any sexual contact. I did notice there was something visible going on in a place on him that it would not be possible to have sexual contact without significant exposure to myself.  It looked a lot like acne and that was my initial assumption.  During the conversation phase, i did what I thought was right.  At a point where the conversation turned to sex, we shared our sexual histories.  When sharing my sexual history I  brought up the topic of STIs and made it clear that there was nothing going on that he needed to worry about.  I delicately prodded him to reciprocate.  He didn’t disclose anything.   At that point I went with my assumption that what i saw was acne on his face in the chin area.  I felt it would have been offensive to push it further. Eventually, we found ourselves in the right situation, and sexual contact happened.  After that, I felt uneasy looking at it more closely  and specifically asked exactly what that was.  His response was that it was a warts outbreak. I was kind of stunned and insisted on talking about it right then.  I was persuaded with assurances of commitment. I asked for a simple thing to protect me such as wearing a band-aid, but was and scolded for complaining about such a superficial thing.  Essentially I was bullied into continuing to expose myself.  I allowed this exposure to continue .   I’m embarrassed to admit that I allowed myself to end up in such a physically and emotionally risky position.

Those assurances didn’t amount to much.  For months after it ended, I was afraid that the HPV was going to show up.  In my mind, I was sure I was going to get it.   I would scrutinize any  ingrown hair follicle, shaving bump, or odd bump.  I went to the doctor a few times to have things examined.   HPV can take a while to show up, and there’s no simple test for males, like a HEP, HSV, or HIV test to tell if you get it.  The uncertainty was the worst part.  I certainly read up on and learned about HPV alot.  It turns out that there are many different types of warts, and usually ones that show up on the face aren’t the typically known “genital warts”.

[update] It’s been argued that since these types of warts are a different strain of HPV than “genital warts”, and they are not actually on the genitals, that it’s not actually an STI.   To me, that’s a pretty fine distinction.  If it was on an arm or leg, I could more easily agree.  But when it’s in a place that you need to touch to make out, it seems like an unimportant distinction.  Still, its the trust issue that bugs me the most.

It made me think a lot about what I would do if it turned out that i got it.   When i get the occasional cold sore on my lip, it’s not always very visible.  However, I’m strict about not letting someone kiss me when its present.  I’ve stopped people from kissing me and always first disclose.  I do think it’s my responsibility.

Even though in most cases your immune system eventually rids your body of the virus, someone else’s well being comes before my sexual urges.

With HIV, one can (and should) use a condom; it’s a very reliable way to inhibit transmission of HIV.  However with HSV, HEP and HPV, there just isn’t an equivalent think that the potential recipient can do to protect themselves.  They are dependent on the transparency and honesty of the person who has it.

I also felt that because of pressure not to offend or reinforce a stigma or phobia, there is hesitation to be too direct or pushy.  The gulag of silence also has a side effect of discouraging a level of directness which may be appropriate.

In the end, enough time passed without it showing up that I felt that I’d dodged the bullet.  This is now a few years ago.  Though I’d been lucky, many are not, and who knows, down the road, one of those people could be me, you or any of us.

I also own the fact that I made some questionable decisions at the time. I could have refused to continue once it was apparent what was going on. I could have resisted the persuasions.   If I had ultimately gotten it, I would share responsibility.  However, the experience has definitely affected my view of the issue here, and as a result I have a strong position in support of disclosure obligations, and legal deterrent with respect to failing to disclose.  That is why I chose to speak out on my blog.

Legal deterrents can be part of the solution

The person I was involved with should have known better and been more transparent at an earlier time, like prior to first exposure.  Probably above all else, this experience is what drives me to empathize with Maria Kosecki’s position and my support for the conviction.

Todd writes:

Is there a moral obligation to disclose one’s HIV status to one’s partner(s)? Absolutely. That same moral obligation stands with diseases such as herpes, (now linked to Alzheimer’s Disease), HPV (linked to anal, penile and cervical cancers), Hep B and C (linked to liver cancers) and more. Yet, in Michigan, none of those viruses carries a criminal sanction– only HIV carries such a criminal sanction.

Rhetoric and name-calling aside, I don’t think our positions are all that different.     We agree on the moral obligation to disclose.   Todd point’s out that the other STIs are not covered by Michigan’s law.  I agree that is a problem. He doesn’t take a position on whether criminal sanctions are truly necessary, which we may not be totally aligned on.  My opinion is that, some people are not sufficiently motivated to follow trough on the moral obligation Todd does state agreement with.

if you steal my MP3 player, you can be criminally prosecuted.  Aside from being out some money, and maybe feeling violated, I’m fine.  If one person slaps another, they can be charged criminally with assault and or battery.    Aside from perhaps temporary pain and embarrassment, there’s little if any long term effect on the victim’s quality of life.   It’s much less than having to manage HSV, HEP, HPV or HIV or others over the course of a lifetime..  Not only is the physical side harsh, the emotional effects of having this is a visible place or one that is “in the line of fire”, so to speak, in a sexual situation are non-trivial.  So if someone can be charged criminally for slapping, I don’t see why they can’t be charged for this.  That’s why I support a legal deterrent against this.   It isn’t the ideal, or entire solution to maintaining the health of our community, it’s just a part.

Another HUGE part of this solution is honesty.

If one person is entering into a romantic relationship with another, they have the right to know about any health risks.   i I’ll admit that a casual sex situation has lower expectations and things lean more towards “watch out for yourself”.   In either case, there are multiple perspectives and things to take into account when deciding what is appropriate behavior.   Merely saying “wear a condom” is not sufficient protection and implies that it’s all the recipient’s responsibility and that its effective against all STIs.  Similarly, saying “if you have something, you must disclose” without getting more specific about what’s supposed to be said and when .  Everyone has some responsibility and it’s not a simple answer.

The biggest problem I see is that the discussion on this topic out doesn’t happen.  Throwing recriminations about intent back and forth serves no one.  Avoiding the topic because it might offend someone is equally unhelpful.  The result of not being able to have conversations like this contributes to the spread of contagious diseases and damages the overall health of our community.

This gulag of silence hurts everybody, STI Positive or not.

“From now on treat each other with compassion, treat each other with honesty, and talk about [STIs]. demand it of your community, demand it of yourself”, Todd Heywood,  June 2009.

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