'A crutch to continue to prejudice': Montreal's LGBTQ community fears stigma from monkeypox

David Hawkins wasn't alive during the height of the AIDS crisis in the mid-1980s, but decades later, his organization is still working on dispelling harmful myths associated with the disease. 

"All these years later, it is still seen as being the gay disease, and it's stuff like that that people still point to as the reason for the blood ban for men who have sex with men to donate blood ... We're still fighting that," said the executive director of Montreal's West Island LGBTQ2+ Centre.

Now, LGBTQ advocacy groups and experts are concerned about another wave of discrimination hitting the community as several countries, including most recently Canada, are confirming cases of monkeypox, which has so far been identified mainly among men who have had sexual relations with other men. 

"The risk and the fear that this is going to be used to stigmatize against the LGBTQ2+ community further, I think that that fear is very real for a lot of people, and I think it's very well-founded in history," said Hawkins.

Five cases of monkeypox have been confirmed in Quebec — the first such cases in the country — and 20 cases in the province are under investigation. 

"We're still recovering from the stigma that came with HIV and AIDS as a community ... This risk is also potentially there for monkeypox if that continues to be a trend," he said. 

Dangers of stigma, memories of AIDS crisis

Ken Monteith, the executive director of Quebec's network of AIDS organizations (COCQ-SIDA), shares Hawkins's concerns, saying this virus feels like déjà vu. 

"It just underlines the experience we had with HIV ... We have a bad tendency to attach blame and attach shame to diseases," he said. 

Monteith said the danger of stigma in relation to a health problem is that "if people are afraid to be identified with a particular group, then they might not go get tested and they might be transmitting."

Until now, monkeypox outbreaks have been limited mostly to central and western Africa, but in recent weeks, cases have been identified in Canada, the U.S., the U.K., Portugal and Spain

Symptoms can include fever, intense headache, swelling of the lymph nodes, back pain, muscle aches and a lack of energy. People who are infected can also develop a rash and lesions.

Health officials have said the virus is not sexually transmitted but is mainly spread by prolonged face-to-face contact and respiratory droplets. It is also spread by open sores, contact with bodily fluids or by touching contaminated clothes or bedding. 

"It's a virus, it doesn't really matter who it is, who has it. It isn't generated by an identity, it's generated by itself," said Monteith. 

"We have to stop judging and encourage people to do the right thing ... We stop a disease by talking about it and acting on those things and not being silent about them." 

Affecting LGBTQ community 'by chance' 

Dr. Réjean Thomas runs Clinique médicale l'Actuel, a clinic in Montreal's gay village that specializes in caring for people with HIV and other sexually transmitted diseases.

He says he's seen up to six patients with symptoms associated with monkeypox, such as lesions on their genitals, within the past two weeks. But it's not something he's worried about. 

"The disease is not dangerous … at least the form that we're seeing here, it doesn't look severe," he said. 

Thomas emphasized that everyone is at risk of catching monkeypox, and just because it's mainly circulating in the LGBTQ community, that doesn't mean it will stay there or that it is a "gay disease." 

"It's probably by chance that it's in the gay community," he said. 

"It [likely] started in the gay community in the U.K., and in the gay community people travelled — Portugal, Spain — and Montreal has a large gay community. Gay men like to come to Montreal."

When asked about stigma on Friday, Dr. Theresa Tam, Canada's chief public health officer, cautioned against associating the disease with any one group. 

"Certainly we will provide support and information ... but I think people should understand that [transmission is through] close contact and that could happen in different ways," she said, pointing to cases in the U.K., two involving people who lived in the same household. 

But for Hawkins of the West Island LGBTQ2+ Centre, no amount of information saying monkeypox is not an LGBTQ disease will ward off all the ignorance. 

"People are still going to be using this as a crutch to continue to prejudice against queer communities, just the same as people use COVID to prejudice against Asian communities," he said. 

"For a lot of queer people in particular, this is just kind of another thing that is going to be a challenge to overcome."