“If you got it from sleeping with a thousand guys, then it’s a judgment on your promiscuity. If you got it from sleeping with one guy once, that’s almost worse, it’s like a judgment on all of us, like the act itself is the problem and not the number of times you did it. And if you got it because you thought you couldn’t, it’s a judgment on your hubris. And if you got it because you could and you didn’t care, it’s a judgment on how much you hate yourself. Isn’t that why the world loves Ryan White so much? How could God have it out for some poor kid with a blood disorder? But then people are still being terrible. They’re judging him for being sick, not even for the way he got it.”
The Great Believers, Rebecca Makkai
One day last year, in a discussion about bioethics and HIV, a professor invited a class discussion about AIDS. To make a point about the ethics of AIDS acquisition, the professor used Ryan White’s acquisition of HIV by blood transfusion versus adult gay men’s acquisition by their sexual activity. The professor was making a point about whose “behavior,” whose AIDS, should be viewed in a problematic light, positioning a blood transfusion patient against a sexually active gay man. Only recently did I read Rebecca Makkai’s The Great Believers and have the opportunity to understand how and why this discussion affected me so deeply, as a queer person, as a provider who cares for queer patients, and as a nascent queer ethicist.
It’s a unique experience as a student to be the one, or one of few, on zoom when the other gallery image is of the rest of the classroom as a whole. This means that usually I can see myself and a few others in enlarged form, zoomed-in, while the professor and the majority of my classmates are otherwise zoomed-out. As a partially-distanced student, this is often how I, quite literally, view the learning environment. I’m able to engage with the zoomed-in others, read their expressions and body language, and watch their immediate responses to things, along with my own, but often have a limited read on the vibe in the room.
When the professor opened the discussion with this example, while on Zoom I watched as my jaw dropped at the cold comparison. Unexpectedly, I witnessed my own shock in real time. Zero context accompanied the discussion of White’s AIDS status, other than acquiring HIV from a blood transfusion. But most alarmingly, zero context accompanied the mention of gay men’s circumstances during the AIDS epidemic in the 1980s, including no mention of their struggles for gay rights, their experiences with oppression and discrimination, politically sponsored hatred, cisheteronormative harm, and even present-day acts of criminalizing queer existence. I found myself, almost disembodied, unmuting and shaking. But at the same time, I did my best to express concern for the characterization of gay men, doing my best to start the discussion with these discussion points, hoping to craft a thoughtful response rooted in queer theory. But inside my heart was breaking. It’s a unique harm to those with marginalized identities to be constantly shocked but not surprised at how our identities are debated in settings like classrooms– queerness and superficial illustrations of AIDS are but one such example.
After class, I sat quietly and cried for a long while. I texted a few folks within my program to hear about their own reactions to the AIDS example and the resultant conversation. I really leaned on my deep bench of queer community in Chicago to process it more fully. Is it that the palpable, visceral heartache of harms wretched by the climate around AIDS is now generationally lost? Is it that (bio)ethics sees queerness this way despite queer theory’s interdisciplinary scholarship for the last (at least) 30 years? Is it that religious environments have conversations like these unchecked unless an atheist queer like me happens to be around? Is it that this scholarly fodder was purposeful, putting me in the ring against most of my classmates to defend the queer theory standpoint as a vocally out queer person?
I was born in the early 80s and grew up in a household distant from discourse about the AIDS epidemic. I quietly came into queerness in the late 90s. When figuring out the specifics of my own identity and coming “out” in the early aughts, I was moved to learn that some theorize that the “L” in LGBTQIA in fact is an intentional arrangement of the acronym to honor the lesbians who cared for gay men otherwise dying alone during the AIDS epidemic. Randy Shilts’ And the Band Played On and Tony Kushner’s Angels in America were a central part of my young adult and medical anthropology canon that became a bedrock for the queer awareness and love of history I’ve held ever since. Discovering that Black and Latine trans women started the Stonewall riots against police violence was my introduction to the fierceness of queerness that is now central to my own selfhood and activism. I cannot count the tears I cried or the body shakes I shook while watching depictions of the queer community during the AIDS crisis in Rent, Boys on the Side, Philadelphia, Dallas Buyers Club, How to Survive a Plague, and Pose. I live and breathe queer theory as a queer person, as a clinician who cares for queer people, as a dedicated sponge to all queer media and scholarship, and as an avid historian of my family* lineage. I have friends, patients, and role models who became infected with AIDS in the 80s who are still alive today by the grace of who knows what. Queerness and AIDS is personal to me. So when discussions about gayness and AIDS fail to center historical and sociopolitical circumstances, not only are they incomplete from a queer ethics lens, they perpetuate harms to my and my community’s modern queer existence.
I do not condemn my professor for their example as I believe it to be a common one within and outside of bioethics. It is important, however, to spotlight this classroom experience as a yet-to- be universally unchallenged paradigm case, illustrative of the work queer bioethics has yet to do to reframe this and similar examples from an inclusive queer ethical lens. Rather than focus on the specifics of this AIDS example in a class discussion, I focus on the conversation I had with my professor. After I expressed a concern at comparing the two circumstances without further contextualizations for queer men in that time period, the professor immediately shifted the classroom example, chatted with me over email after class, and we have met to discuss co-authorship on a paper urging academic spaces to reconsider such paradigm examples on the whole through the lens of queer ethics. This, I believe, is one potential of queer students in classrooms. When we can exist fully as ourselves as well as students and scholars, there is an opportunity to challenge discussion both through our identity and self-knowledge as well as our academic rigor. Queer students, when supported in their lives and in their classrooms like I am, can (choose to, when safe to do so) challenge concerning examples like these by contextualizing concepts not as other but as within ourselves or our communities in ways that may not otherwise exist for learners and educators. Queer students and scholars can offer opportunities to question what might be otherwise neutral examples as very real harms, so that all future students can begin discussion from the same place rather than queer students starting from a place of harm.
My hope for the future is that all Zoom rooms, classrooms, and discussions, particularly those about queer lives, are full of queers and allies. I hope for reflection on harmful paradigm examples and creation of new ones generated by interprofessional and inter-identity engagement. I hope all of the queer people, whose lives were lost at the beginning of the AIDS epidemic are not dulled and reduced to “behavior,” but rather their sparkling existences remain at the forefront of our memories. I hope to move past hopes for safe learning spaces, because unsafe spaces harm thought and subtract time and energy from queer thinkers. I am thrilled by the potential of what we could be creating if we weren’t processing harms, preventing future harms, and anticipating predictable harms. I hope for queer academic futures full of intimacy, friendship, collaboration, spectacular ideas, sensationalist truths, and radical liberation. I’ve been welcomed and supported by my department, and have found joy learning from queer faculty. I have engaged in an independent study on queer theory, and have seen my campus host its first ever queer history month agenda. All of this makes me hopeful for all that is still to come.
My deepest thanks to my classmate Lou Vinarcsik for her insights on this piece and their community in creating queer vibrance, and to my wife Lindsay Tillman for her loving input on the final draft.
*Queer people often lovingly call each other family in recognition of the need to recreate safe family and community when rejected by biological connections. My wife mentioned this in her speech at our wedding.
Stephanie Tillman (she/her), CNM, is a PhD Student at Saint Louis University Center for Health Care Ethics.