Before AIDS. Katie Batza

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СКАЧАТЬ 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 between the state and homosexuality appears more nuanced, assimilating, and productive than a simple case of antagonism and oppression might suggest. Though historians have demonstrated the state’s attempts to demand straightness from its citizens, this history of gay health activism suggests that the state can overlook, and at times even nurture, homosexuality as long as it also results in submission to state power.¹² In other words, the state in the 1970s cared less that there were gay citizens than that they left state systems and structures unchallenged. Indeed, the gay health network that arose in this period grew directly out of Great Society programs. The links between gay health networks and the federal state grew stronger throughout the 1970s and set the stage for a strained relationship during the early AIDS crisis.¹³

      Moreover, an examination of the roots of gay health clinics and their central activists brings the interdependence and complementary nature of various radical groups during this period into sharper focus.¹⁴ Gay health activism, which began to emerge in the 1970s, had firm roots in the social movement politics of the late 1960s. Many gay health activists were veterans of these movements, and gay activists employed health as a political organizing tool in ways similar to many movements in the early 1970s. Gay health activism reflected the capitalist critiques of the antiwar and social medicine movements by incorporating free and sliding-scale fee structures in clinics. Building on the examples of the Black Panthers and Brown Berets, gay health activists learned to frame the struggle for health care as a form of political liberation by arguing that health disparities both exemplified and fueled discrimination. Gay health activists also embraced the idea of empowering individuals and communities to be their own health advocates and sources of information, much like feminist women’s health movement activists. In many ways, gay health activists borrowed the best attributes of health activism occurring in other social movements and combined them as they built a national gay health network.

      The analysis of these clinics brings clarity to how concepts of health factored into gay sexual and political culture, demonstrating in particular a much greater concern for sexual health in gay culture in the 1970s than previously depicted. Early AIDS literature, particularly fictionalized depictions of the early epidemic, often portrayed the preceding decade as a carefree decade-long orgy of sorts, paving the way for critiques that blamed “promiscuity” and personal irresponsibility for the early spread of the disease. The relatively meager literature on the gay liberation period has not yet erased this notion, or at least not with enough heft to change public perception of the decade. In fact, histories of gay liberation rightly claim newfound sexual freedom and decreased policing of homosexuality as defining attributes of the 1970s, but in doing so often inadvertently reinforce the portrayal of the decade as a sexual free-for-all with no concerns for sexual health. The work of these clinics and their relationships to the larger communities they served suggest that sexual health was often intertwined with gay liberation and the shifting gay sexual norms of the decade. In short, many men had a lot of sex with a lot of other men without the shame or harassment of previous decades, but they also got tested and treated for VD regularly and saw that as a necessary part of being sexually active. From this new vantage point, the early spread of AIDS becomes not about multiple partners or irresponsibility, but rather about a new disease with poorly understood modes of transmission. While I anticipated that many of these topics would surface in the course of my research, I was often surprised by the nuance my findings bring to the literature.

      Though I desperately wanted to devote equal attention to the health activism of gay communities and lesbian communities, all sources showed that lesbians, though active in women’s health and to a lesser extent gay health activism, worked far less on addressing lesbian-specific health concerns in the 1970s than their gay counterparts. Furthermore, the lesbian health activism that did exist was largely done within women’s health clinics with little regard for, or communication with, gay health organizing. A focus on health issues specifically often exacerbated preexisting political (and biological) differences between gay men and lesbians during this decade so that they commonly approached health from different physical experiences and political frameworks. One gay and lesbian health guide from the 1980s attributed the segregation of gay health services from lesbian offerings, “in large part, [to] lesbian and gay men’s health issues [being] radically different.”¹⁵ With the differences between gay and lesbian health activism far outweighing their similarities, a cohesive narrative arc that could move through time became extremely difficult to develop and maintain. Finally, because lesbian health activism around lesbian-specific health issues was relatively minor in this period, identifying and collecting archival sources that could sustain an equal study of gays and lesbians proved impossible. Here, then, I focus predominantly on gay health activism. Where possible, this history illuminates the difficult and complex relationship between gay men and lesbians in the 1970s, particularly when it came to issues of health and health services, as lesbians were at best left to fend for themselves, and at worst excluded entirely.

      While the gay health network of the 1970s reorients our view of the relations between sexuality and the state and between various political movements, the individual clinics profiled in this study came to gay health from different local political contexts, and different activists propelled them. Over the course of the 1970s more than two dozen gay community health clinics came into existence, many of them lasting from only a few weeks to only a few years and leaving little historical evidence beyond ads scattered across local gay newspapers. Out of these many clinics, three case studies anchor Before AIDS: Fenway Community Health Clinic in Boston, the Gay Community Services Center in Los Angeles, and Howard Brown Memorial Clinic in Chicago. I interweave the stories of these three clinics with brief examples from other clinics around the country, examinations of individuals who were influential at multiple sites, and analyses of national networking among organizations. By focusing on these three cities and revealing them as the three major centers of gay health activism in the period before AIDS, I move beyond a historical narrative that centers on New York City and San Francisco.¹⁶ These three clinics were trailblazers of gay health activism in the 1970s and the most influential, innovative, and lasting organizations of that period. By the early years of the AIDS crisis, when their volunteers, practitioners, and researchers became first responders to an epidemic whose treatment and epidemiology were not yet understood, these clinics had already solidified their significance to the gay and medical communities. They gained that significance and those reputations by navigating unique social and political terrains in ways that resonated with their local clients through ideology, organizational structure, and service offerings.

      Activists determined to protect their neighborhood from redevelopment first started the Fenway Community Health Clinic in Boston as equal parts community-organizing effort and health service. The idea of opening a health clinic in the Fenway neighborhood came to two resident activists after the pair visited a newly opened Black Panther–operated health clinic that earned notoriety in the local press and fame among Boston activists.¹⁷ That clinic, consisting of just a trailer, provided health services to the surrounding community and politically mobilized area residents. It also stood directly in the path of bulldozers slated to raze the СКАЧАТЬ