We Are Not OK

"There are gay people on TV and we can get married in Massachusetts; aren't things getting better?"

"No, honey, not if you still want to kill yourself."

The gay community is not just in the midst of a crystal meth epidemic. Rather, it faces a far larger spiritual crisis that is never acknowledged and, through its secrecy, grows daily.

To get better, we must start to say that we are not OK.

Some of our problems are self-inflicted but others are a direct result of America oppressing, demonizing, and isolating gay people. The very serious effects of oppression on gay people have been long apparent—those of us living on the West Coast know that crystal meth has been steadily killing gay men for years. Historically, gay people have had significantly higher addiction rates than those found in the straight world. In short, too many of us have been torching our lives for decades now with coke, Special K, GHB, poppers, and even good old alcohol. But the real story is not told in the media, because that would require straight people to take responsibility for the harm they have caused us.

On the other hand, it would be far too easy to say that gay people have simply been victims of the dominant society. Like many other gay men, I have lived in a state of crisis for my entire adult life and have even found pleasure in the sense of purpose these crises instill. While the '80s and early '90s were a devastating time for me, I briefly shared a sense of purpose with other gay people during the marches, fundraisers, and funerals. But by 1994, I had lost my lover of 10 years and burned out on the intensity of activism. Alone again, I found solace in alcohol and drugs, including crystal meth. Had I looked deeper, I would have seen that I had always felt self-destructive and isolated, even from other gay people. I believe many young gay men still feel that way.

I began working at the Van Ness Recovery House in Los Angeles to research a book on crystal meth. The book is now written, but I'm still working there because, for the first time since the days of ACT UP, I feel a sense of connection with other gay people. The overwhelming majority of the residents I deal with on a daily basis are gay men (there are also a few transgenders, lesbians, and even the occasional straight person) who have lost everything to drugs (most frequently crystal meth) and alcohol. Nearly all of them are HIV-positive as a direct result of their drug use, but many of them will die from addiction long before HIV can kill them.

There will always be another drug photo: Robin Nelson/ZUMA Press

It would be wonderful to think that catchy graphics and free condoms would prevent other gay people from addiction and HIV infection. However, having witnessed the amount of work it takes for one person to see that he is killing himself with drugs and alcohol—one person who has already hit bottom—I know that we are beyond the place where any traditional prevention campaign will be effective.

One of the questions I most frequently ask residents is "What is it that you wanted to do sexually that you could only do when you were high?" You might suppose that the answer would be an array of sex acts so extreme and kinky as to be unimaginable. And for some this is true. However, for most, their fantasy is no more than to get fucked and to connect with another man. Albeit in all the wrong places and all the wrong ways, these guys are basically looking for love.

We sometimes forget the difficulty of what we are asking gay men to do. In a world where many of them face an uncertain future, in a country where they are the most hated minority, in a time when they are acceptable only as part of television minstrel shows, we have asked gay men to value themselves enough to talk honestly about sex and to make loving, ethical decisions.

Far from forgetting about HIV, gay men have come to believe that it is the baseline of their existence. While it is true that young gay men may not fully understand the horrific side effects of HIV medications, older gay men (the median age for new infections is around 40) do. These men have simply become used to death as a normal part of daily life. On some level, they see it as inevitable and warranted. And, if that reality becomes too scary, an array of drugs is available to numb the feelings.

Making matters worse, most HIV prevention campaigns targeted at crystal meth users are ridiculously shallow. The government has actively participated in the deaths of gay men by prohibiting funding from being used to disseminate the graphic sexual information needed to make informed decisions. For example, most gay men do not know that crystal use can cause sores and abrasions in their mouths, transforming a generally low-risk behavior like oral sex into a high-risk behavior. Many meth users are also under the impression that they cannot ejaculate while they are high. But if this were true, we would not be seeing continuing high rates of seroconversion for gay men using crystal.