INTRODUCTION

      FIGHTING EPIDEMICS AND IGNORANCE

      On a cold Chicago day in the mid-1970s, an employee of Man’s Country, the largest bathhouse in the Midwest, lay in a hospital bed recuperating from a bad bout of hepatitis B. Though doctors and scientists hadn’t yet discovered that hepatitis B could be transmitted sexually, the disease plagued the gay community. Gay men avoided interactions with doctors, however, because such visits often led to misdiagnosis, judgment, ostracism, and treatment for their sexuality rather than their medical ailments. In addition, medical care was often expensive and held the possibility of extortion, since gay men typically paid for their health care out of pocket and avoided using insurance for fear that employers would learn of their sexuality and then harass or fire them. Thus this particular patient was hardly the first gay man to appear at Chicago’s Rush Presbyterian Hospital with the flu-like symptoms and slight yellowing of the skin that signified untreated hepatitis B. In fact, on this day, he even shared a room with a friend, another gay man suffering from the same illness. Like many others before and after them, both men worried how their sexuality might influence the medical staff or their treatment and felt their vulnerability amplified by their dependence on these potentially threatening care providers. They were sick and required treatment but had a healthy and well-founded apprehension about those designated to care for them.

      But on this day, a nurse of a different sort, a representative of a growing gay health network in the city, lifted their spirits and allayed their fears. Drag performer Stephen Jones from Man’s Country, dressed as stage persona Nurse Wanda Lust, made a special visit to the patients, one of whom remembered in an interview later, “All of a sudden, I was laying in my room, and there was Nurse Lust walking through the halls of Rush Presbyterian Hospital [laughs], you know, ten feet tall, and just made no bones about being who he was.”¹ Donning a short and tight-fitting nurse’s uniform, a large oversized clock necklace, fake glasses, a bright red wig, high heels, and a nurse’s hat and hairnet, Nurse Lust arrived to deliver flowers, check blood pressure, and visit with friends. As Nurse Lust walked the halls the patients could hear the hospital nurses giggle as she teased them playfully. The act of visiting in drag proved a potent tool that put the patients at ease but also signified to the hospital staff that gay patients had a community looking out for them. Nurse Wanda Lust acted as an advocate, an ambassador, and a friend in the exact spaces where gay men felt most vulnerable and threatened, and in doing so, she played an important role in changing the relationship gay men had to health care and to sexual health in the 1970s. Remembering Lust’s visit, one person reflected, “He was freedom, in my head. Outrageous could work if you made people laugh and have fun with them…. Wanda was one of those people that helped make me feel good about my life.”² Though Nurse Lust did not visit every gay patient every day, the fact that she visited at all marked a significant shift in attitudes about medical authority, gay health, and the right to quality health care that demonstrates the true importance of the gay health activism of the 1970s.

      Like many other minority communities in the 1970s, gay men faced public health challenges that resulted as much from their political marginalization and social stigmatization as from any virus or disease. The incidence of venereal disease (VD) among the adult population of the United States grew to epidemic proportions in the late 1960s and 1970s, but as I conducted the oral histories that make up the backbone of this book, without exception every gay man painted a particularly bleak portrait of gay health care in that period.³ Many dreaded that disclosure of their sexual activities would not remain confidential with their doctor, leading to ridicule from their families, termination from their jobs, or both, and these concerns had merit. One former client of a city-run VD clinic in Chicago remembered, “They weren’t very nice … the help in that place, the clinic was just foul to gay people, just nasty.”⁴ Furthermore, venereal disease testing at Department of Health clinics in many cities commonly required disclosure of the patient’s name and of all previous sexual partners before treatment was given. If a patient tested positive, the Department of Health systematically contacted each partner to inform him or her of the possible exposure to disease and to facilitate testing and treatment. While this process seems logical for disease containment, it served the opposite function, as many gay men, especially those who were not completely out of the closet, avoided testing because of the notification protocol. Whether because they did not want to deal with ignorant or homophobic staff members, make themselves and all of their sexual partners vulnerable to a very public coming out, or simply did not know the names of their sexual partners, gay men often felt alienated from many city-run health clinics and from mainstream medicine writ large.

      Figure 1. Nurse Wanda Lust with an inset of performer Stephen Jones. Photograph by Thousand Words Unlimited and from the collection of Gary Chichester.

      Figure 2. Nurse Wanda Lust visiting a patient with friends at Rush Presbyterian Hospital. Photograph by Thousand Words Unlimited and from the collection of Gary Chichester.

      Compounding the problem of distrust of mainstream medicine within the gay community was a general ignorance of gay health issues among medical professionals. Until the 1970s, nearly all the medical literature and education on homosexuals focused on homosexuality itself as an illness in need of treatment.⁵ As a result, doctors remained uninformed about how to diagnose and treat actual illnesses within the gay community, particularly those that manifested in slightly different ways than in the heterosexual population. Survey responses from doctors in 1978 showed that more than 84 percent of doctors believed they did not have adequate education in medical school to address these issues.⁶ Consequently, sexually transmitted diseases among gay men often went undetected and untreated until in advanced stages.⁷ Uneducated doctors could easily overlook gonorrhea symptoms in a gay man if the examination did not include a throat culture, a test not included in the standard examination for a heterosexual man. Unless a gay patient felt comfortable enough to inform his doctor of his sexual practices and the doctor knew the appropriate medical response, syphilis could go undetected and untreated.⁸ By the end of the 1970s, some venereal diseases appeared much more frequently among gay men than in the general population.⁹ Desperate for health care but with nowhere to turn gay men looked to one another for medical advice and treatment. A Chicago bathhouse owner became a sought out medical “expert” on how to perform reasonably reliable at-home tests for VD: “Milk the penis and if you get a white discharge, you probably got it.”¹⁰ The rare private doctor that neither price gouged nor violated patient confidentiality quickly became a local celebrity and was in high demand.

      In response to these insufficient solutions, a colorful cast of doctors and activists built a largely self-sufficient gay medical system that challenged, collaborated with, and educated mainstream health practitioners. By decade’s end, the health network included community clinics, outreach programs, national professional organizations, and a research infrastructure. Taking inspiration from the political health rhetoric employed by the Black Panther, feminist, and antiurban renewal movements and putting government funding to new and often unintended uses, gay health activists of the 1970s changed the medical and political understandings of sexuality and health to reflect the new realities of their own sexual revolution.

      The history of this national gay health network challenges our understanding of gay politics in the 1960s, 1970s, and 1980s. The usual declension narrative, in which the leftist politics of the 1960s gives way to a rightward political shift, is insufficient for capturing both the creativity and the effectiveness of those gay health activists in the 1970s and 1980s who were determined to save lives and survive a changing political climate. LGBTQ activists did not tame their politics in the face of strengthening conservative opposition but rather adapted their tactics and political framing to affect change in the new political landscape.¹¹ From this perspective, the relationship

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