Homosexuality: Morals and Ethics Catch-All Thread

Fist step? Ouch.

Bonus_Eruptus wrote:
muttonchop wrote:

Fist step? Ouch.

It's a real place (no pics, just an article about it, but probably NSFW).

I read the first page. I decided to not go onto the second page.

I've been holding off on asking this because I've been thinking of a way to frame it without making it sound lke I'm being morally judgemental. However, it seems like an elephant in the room when it comes to talking about ethics and morality is the extremely high rate of STDs in gay men compared with other populations. According to the CDC, HIV rates are 44 times higher among gay men than heterosexual men, and syphilis rates are 46 times higher.

http://www.cdc.gov/nchhstp/Newsroom/...

So, my question is what responsibility the gay community as a whole has to addressing this problem?

jdzappa wrote:

I've been holding off on asking this because I've been thinking of a way to frame it without making it sound lke I'm being morally judgemental. However, it seems like an elephant in the room when it comes to talking about ethics and morality is the extremely high rate of STDs in gay men compared with other populations. According to the CDC, HIV rates are 44 times higher among gay men than heterosexual men, and syphilis rates are 46 times higher.

http://www.cdc.gov/nchhstp/Newsroom/...

So, my question is what responsibility the gay community as a whole has to addressing this problem?

I'm not sure what you're asking exactly, but off the top of my head, I'd say any possible responsibility has been met in that the heterosexual population has benefited from the reaction of the gay community to AIDS with so much education and research. I think that response has had the knock-on effect of making life better for practicing heterosexuals both in terms of harm reduction and, indirectly, family planning. It's possible that if the AIDS crisis had not first arisen among a homosexual population, AIDS would be a far bigger problem than it is now. That community took this public health issue very seriously very early and got out in front of it to a much greater degree than otherwise would have been the case, I think.

jdzappa wrote:

I've been holding off on asking this because I've been thinking of a way to frame it without making it sound lke I'm being morally judgemental. However, it seems like an elephant in the room when it comes to talking about ethics and morality is the extremely high rate of STDs in gay men compared with other populations. According to the CDC, HIV rates are 44 times higher among gay men than heterosexual men, and syphilis rates are 46 times higher.

http://www.cdc.gov/nchhstp/Newsroom/...

So, my question is what responsibility the gay community as a whole has to addressing this problem?

There are a few factors at work here.

For one, the morals and ethics lie at the feet of the individual, not the sexual orientation. Disclosure is key. Protection is key. Treatment is key. Fail to address any one of these, and you're on shaky ground ethically, homosexual or heterosexual, if you're sexually active.

Two, to be blunt, the nature of homosexual intercourse tends to be far more dangerous for transmitting infections. There are many more blood vessels close to the surface and behind thin skin. Overzealous or overlong intercourse, or even a tough BM, could create an inroad for infection very easily. In fact, neither overlong nor overzealous intercourse is needed, really.

In addition, the homosexual community is far smaller. Some men have the idea that they should take what they can get, and get into really small circles. One untrustworthy individual can bring an STI into that circle fairly easily. Also, some gay men have the mentality that they should just get infected (specifically HIV in this case) and then they don't have to worry about it anymore. It's pure insanity.

This is all second-hand information, but I trust the source (Dan Savage's podcast and his bevy of guests whom are medical professionals).

Those reports are also U.S.-based reports. A quick look at the African AIDS epidemic makes it clear that this isn't a problem confined to specific sexual orientations.

A lot of the higher infection rates in the gay community could also probably be attributed to the negative attitudes around homosexuals and homosexual intercourse, driving homosexuals to less-than-ideal sources for sex. When a population is forced to hide in shame, or out of fear, the safety of the practice is likely to plummet.

jdzappa wrote:

I've been holding off on asking this because I've been thinking of a way to frame it without making it sound lke I'm being morally judgemental. However, it seems like an elephant in the room when it comes to talking about ethics and morality is the extremely high rate of STDs in gay men compared with other populations. According to the CDC, HIV rates are 44 times higher among gay men than heterosexual men, and syphilis rates are 46 times higher.

http://www.cdc.gov/nchhstp/Newsroom/...

So, my question is what responsibility the gay community as a whole has to addressing this problem?

I guess I'm generally uncomfortable with equating particular diseases with ethics and morality, but I'll give it a stab.

First, is it really an elephant in the room? Do you know how many total cases of primary and secondary syphilis were reported in 2010? 13,774 according to the CDC.

Do you know how many cases were reported in 1946? 94,957.

So was post-war America Sodom and Gomorrah incarnate since there were so many more syphilis cases or does the number of infected have no ethical or moral meaning whatsoever?

Also, we're talking about just a few thousand cases of syphilis for the entire MSM community. If you follow the CDC's estimate--2% of the population being gay or bisexual men--then you have about 6.28 million MSM in America. As you can see from the following CDC chart, only 8,000ish of those 6.28 million MSM were infected with syphilis in 2010.

IMAGE(http://www.cdc.gov/std/stats10/figs/43.gif)

While the rate of infection rate of MSM is much higher than hetero men and women, but it's not like every other gay or bisexual man is infected. Far from it.

As for HIV, the CDC reported that 48,100 people were infected with HIV in 2009, only 58% of which were MSM. Again, that's just 28,200 out of 6.28 million or so. And that number of new infected has been stable for more than a decade.

Those numbers just don't seem elephant in the roomish.

I guess the question I would ask you is what responsibility should the heterosexual community as a whole have to address the issue since the CDC cited homophobia and stigma as being a part of the problem?

Research shows that a range of complex factors contribute to the high rates of HIV and syphilis among gay and bisexual men. These factors include high prevalence of HIV and other STDs among MSM, which increases the risk of disease exposure, and limited access to prevention services. Other factors are complacency about HIV risk, particularly among young gay and bisexual men; difficulty of consistently maintaining safe behaviors with every sexual encounter over the course of a lifetime; and lack of awareness of syphilis symptoms and how it can be transmitted (e.g., oral sex). Additionally, factors such as homophobia and stigma can prevent MSM from seeking prevention, testing, and treatment services.
jdzappa wrote:

I've been holding off on asking this because I've been thinking of a way to frame it without making it sound lke I'm being morally judgemental. However, it seems like an elephant in the room when it comes to talking about ethics and morality is the extremely high rate of STDs in gay men compared with other populations. According to the CDC, HIV rates are 44 times higher among gay men than heterosexual men, and syphilis rates are 46 times higher.

http://www.cdc.gov/nchhstp/Newsroom/...

So, my question is what responsibility the gay community as a whole has to addressing this problem?

I think the gay community is addressing this problem the best it can. However, in the release you linked, it gives some ideas as to why the disparity in the rates: ignorance, stigma, lack of services, homophobia, etc.

However, I think the question is a bit off the mark, IMO. If the question is about the ethics and morality of homosexuality, then contracting a disease seems to be a bad metric by which to gauge such things.

My PCP has a substantial gay client base, so much so that he works hard to understand "gay medicine." When I go in for any health concern, he asks me questions about my sexual health. He always makes it clear that he is not a judge of what people do sexually because he is a doctor licensed to treat diseases of all types. There are STDs that a person may carry and never know they have them (HPV and Syphilis, for example). Even using condoms may not protect a person from contacting certain STDs even if, during sexual encounters, the activity is fairly vanilla. So, if someone had a fling and contracted HPV and didn't know it but months and months later has another fling and passes it on, does that pass into the realm of ethics and morality? I am not sure it does.

That being said, I sort of cringe when I see STDs for gay or straight people being using as a shaming instrument (note: I am not saying you are doing this, jd; just in general). A few months ago, we had someone show up at work with a high temperature and a raging case of Strep. She ended up taking out her entire team, all seven of whom developed Strep. And yet, we had to beg and plead for Management to establish a policy of allowing HR to send people home who decided to do their best to win an Oscar for their portrayal of Typhoid Mary. There was, quite honestly, no shame, no discussions of morality and ethics, although I admit that there were plenty of people who were rather ticked off that she showed up sick (something that seems to be very common in the workplace). Why the dichotomy?

When I have worn my pastoral counselor hat, I encounter people who run themselves into the ground emotionally if they realize they have some form of STD. They fear the shame, the ostracizing, the feeling that they are failures. A lot of that keeps them from seeking necessary treatment. In two instances, I escorted people to the local free clinic for treatment while wearing my clerical collar to send the message that getting them necessary medical care trumped anything else at that moment. If they wanted a sexual morality lecture, I could give them one (although I am pretty sure they would be disappointed since I don't do the fire-and-brimstone admonitions very well), but that would do little to change the fact that they have a disease that needs to be treated.

I am just not convinced that a sexually transmitted disease is an issue of ethics or morality. But, to be fair, I also don't see sex as sacrosanct.

All excellent points, PR. My entire answer to the question failed to take into account the individual unwillingly and unknowingly infected, despite doing everything else right.

Although, Typhoid Mary was an immune carrier, so she wouldn't have exhibited any symptoms. She just would've infected people.

Ever wonder why you never see the rates of STIs for lesbian couples in these reports? Lesbians are gay as well.

NSMike wrote:

Although, Typhoid Mary was an immune carrier, so she wouldn't have exhibited any symptoms. She just would've infected people. :)

Which is why she wouldn't have won the Oscar.

From a purely public health perspective, the problem isn't homosexual sex, but common multiple partner sex in general. If every person in the population only ever had sexual encounters with one other person, STIs wouldn't be as big of a problem as it is. Speaking specifically to heterosexuals, if heterosexual people only ever had sex with one other person exclusively, then any AIDS in the homosexual population wouldn't really matter would it?

Simply put, an ethical outlook on STIs reflecting the ideal situation of one sexual partner only, ever, would see all STIs as indicators of low ethical adoption in the community at large.

Phoenix Rev wrote:
NSMike wrote:

Although, Typhoid Mary was an immune carrier, so she wouldn't have exhibited any symptoms. She just would've infected people. :)

Which is why she wouldn't have won the Oscar. :)

Oh, I see. Brain fart. You meant people who would go to HR and say, "I'm sick, send me home," but exhibit zero symptoms of said illness. Not that HR departments should EVER be in the business of detecting viable symptoms or diagnosis.

LarryC wrote:

From a purely public health perspective, the problem isn't homosexual sex, but common multiple partner sex in general. If every person in the population only ever had sexual encounters with one other person, STIs wouldn't be as big of a problem as it is. Speaking specifically to heterosexuals, if heterosexual people only ever had sex with one other person exclusively, then any AIDS in the homosexual population wouldn't really matter would it?

Simply put, an ethical outlook on STIs reflecting the ideal situation of one sexual partner only, ever, would see all STIs as indicators of low ethical adoption in the community at large.

Only if you consider multiple partners an ethical problem. Don't get me wrong, having fewer, regular partners would certainly solve the issues, I'm just pointing out that conflating that activity with something as amorphous as 'ethics' is not all that useful. Also, use of protection and regular testing for infection by people who have new/different partners would have a similar effect on the rate of new infections.

Kraint:

No, probably not. Having only one partner, ever, would drastically reduce infection rate. We're not talking about a few, not a handful, not two, just one; for your entire life. Use of protection and testing would not reduce incidence that low, because if that practice is perfectly carried out, the infection rate from intercourse should be just about zero.

Multiple sex partnering can be considered an ethical problem in the sense that it's something the Catholic Church stands behind and preaches. That's one ethical standard we can easily point to and consider. If that's the standard, then it's not homosexual sex activity that's the problem; it's not following that standard that's the problem.

Essentially, jdzappa is asking an ethical question that should, IMO, be leveled at the general public and not gay people.

Assuming that this is not the ethical standard, then the high rate of transmission of STIs involved in anal sex still isn't really a gay people issue; it's an anal sex issue, and it's a public health issue, not an ethical issue.

I suppose it comes of the unspecific nature of his question:

So, my question is what responsibility the gay community as a whole has to addressing this problem?

We could interpret that as less of a general ethical question and more of a gay community question.

Let's assume for a moment that he's talking about the gay community vis a vis its own members and gay people in general. I would say that the gay community, in that instance, has an ethical responsibility as a community to foster an environment where communication and gay expression is free and unhindered so as to monitor and control STI transmission.

Let's assume for a moment that AIDS is a disease you get from having gay sex. I would say then that the gay community has a general ethical responsibility to heterosexuals to make gay sex and being gay socially acceptable, so that gay men wouldn't feel pressured to have sex with women (and lesbians with men) so that the disease is not spread beyond its causes.

Even the latter extreme and unreasonable assumption makes it seem as if making gay people feel accepted, loved, and cared for is an ethical standard that the gay community should champion.

LarryC:
Ethics is defined differently by different people, groups and organizations. No church or society has exclusive claim to defining it. Using one church's definition is inherently problematic, since you must then disregard the ethical beliefs of everyone who does not follow that particular interpretation of that particular deity. This is why I am pointing out that bringing in the ever-changing, vague concept of 'ethics' into this discussion is tangential and does nothing to further the approach. People follow the proposed one-partner (or no partner!) rule for reasons that have nothing to do with the Pope's proposed ethics, or even their own ethics. Love, interest/desire for a unique individual, limited ability to attract/secure other partners, concern over health/disease, etc.

Kraint:

I didn't mean to imply that that was the only ethical consideration worth noting; but it doesn't move the conversation anywhere to just not talk about it, since jdzappa has brought it out. If he wants to narrow the scope, he can provide an ethical perspective himself. You can, too. I was not saying it was the only one worth considering, just offering how it looks like from that angle.

From a practical standpoint, the concept of ethics is not vague at all. It just needs a reference point. You could refer to Wiccan ethics, Jewish law, or your office's employee handbook; all are useful touchpoints, I suppose.

LarryC:

What does the ethical discussion accomplish? Look at it this way: a Christian Scientist says that invasive medical treatment and drugs are unethical. Are you going to stop providing medical care to those that wish to receive it because someone, somewhere has an ethical issue with it, or are you going to continue behaving in a manner consistent with your own ethics?

You can discourage multiple partners by citing the real-world data showing the risks and dangers associated with that free-wheeling approach. Why try and add something into the discussion that will only get the 'unethical' people to disregard and ignore you?

Kraint:

I suppose it's more apparent to me since I've become a policy maker. It's important to discuss specific ethical touchpoints in order to create policies that reflect the needs and real practical issues of your stakeholders. The goal isn't to establish who's right, but to know what the people want to do and how they want to do it; and making sure that your policies are, shall we say, "keeping it real?"

If we had a Christian Scientist here and we valued his POV, his input in a discussion of this nature would be invaluable. This is not the same as saying that we would follow his opinions, but it's important that they're voiced and disseminated and discussed. If nothing else, we could say for certain that we would not give him medical care he considers invasive, because we now know that he considers it unethical.

The point is to have discussion, not to convince everyone that a single POV is the one we'll hammer into everyone and force them to follow at gunpoint. This is the very nature of an ethical question such as jdzappa has proposed.

This:

You can discourage multiple partners by citing the real-world data showing the risks and dangers associated with that free-wheeling approach. Why try and add something into the discussion that will only get the 'unethical' people to disregard and ignore you?

says that the ethical question is irrelevant, and that we ought to push that position from a public health standpoint. I don't generally agree with tactics that push ethical agendas behind selective data mining. If we have an ethical question and an ethical agenda, I think it's best that that sort of thing is disclosed openly.

EDIT: Note also that you're pushing for the pointlessness of ethical discussion in a thread that's centered on ethical discussion. It's just a little bit too meta, maybe.

As far as homosexual men and their incidence of STIs. The US in general accross the board has a STI problem. Alarmingly, per the CDC less than half of Americans will receive a STD test in their lifetime. I wonder what that number looks like adjusted for people admitted for surgery, women who are pregnant, women who are going onto the pill?

Gay men have no more and no less responsibility to get tested and use protection than I do, than anyone else does. Sadly, gay men may pay a higher price because the US does not educate properly on such things, in the same way heterosexual women pay a higher price than heterosexual men for that ignorance. You get to see all of those fun polls from citizens about who believes that you cannot get an STI from unprotected oral sex, or if you withdraw even without using a condom, etc.

LarryC wrote:

This:

You can discourage multiple partners by citing the real-world data showing the risks and dangers associated with that free-wheeling approach. Why try and add something into the discussion that will only get the 'unethical' people to disregard and ignore you?

says that the ethical question is irrelevant, and that we ought to push that position from a public health standpoint. I don't generally agree with tactics that push ethical agendas behind selective data mining. If we have an ethical question and an ethical agenda, I think it's best that that sort of thing is disclosed openly.

EDIT: Note also that you're pushing for the pointlessness of ethical discussion in a thread that's centered on ethical discussion. It's just a little bit too meta, maybe.

I can appreciate the standpoint that you're trying to be something of a statesman in listening to a constituency and representing them as they are. However, not all ethical considerations are created equal. Let's examine one based on its own merits:

Statement to examine: Homosexuality is immoral.

Points in this statement's favor:

  • Traditionally supported by a culture that generally does not accept it.
  • Condemned in the holy books of majority religions (Christianity, Islam)
  • Voters in the U.S. would likely vote to ban both the practice of gay marriage and make gay relationships illegal

Points against this statement:

  • Traditions are subject to change, and are not law
  • Religious condemnation is not sufficient grounds for a national law against a practice (otherwise, many other things, such as adultery, would be illegal and punishable under the law)
  • Voter positions are not good metrics for ethical considerations (see desegregation of schools, interracial marriage, etc.)
  • Homosexuality does no measurable, scientific harm to society at large.

The hypothetical Christian Scientist's views deserve representation, but only in the sense that such representation does not come down upon the populace as a whole from a local, state, or federal institution where it would impinge upon the rights of others.

NSMike:

Frankly, NSMike, the ethical question of whether or not homosexuality is immoral is worth considering based simply on the fact that it's incredibly commonplace where you live, and as far as I can understand it, it has caused you considerable pain in your life. By "considering," I mean that it's an important piece of conversation to have, and we need to suss out all the talking points relative to that ethical viewpoint, not that it should be enforced on the population at large. Discussion is not enforcement.

If nothing else, if that viewpoint is something that you consider antithetical, it's worth something to know your enemy intimately, and to disseminate all its nuances in concrete and fair terms to those who may not be familiar with its specifics.

I understand that this sort of specific detailing is part of the point of this thread.

All I was really doing there, LarryC, was showing that all moral and ethical considerations are not created equal. I used homosexuality as an example because It's cogent to this thread. That's a very basic example, and it wasn't really deeply considered or thought out. I was just throwing it together. But I can change a few things and show similar results.[quote=NSMike][quote=LarryC]This:

Statement to examine: Slavery is moral.

Points in this statement's favor:

  • Traditionally supported by a culture that generally accepts it. (The early U.S., up to the 1860's)
  • Supported in the holy books of majority religions (Christianity, Islam)
  • Voters in the U.S. would likely vote to keep both the practice of slavery and define slaves as non-persons

Points against this statement:

  • Traditions are subject to change, and are not law
  • Religious affirmation is not sufficient grounds for the subversion of the rights of an entire group of people based on skin color alone
  • Voter positions are not good metrics for ethical considerations
  • Slavery does measurable harm to society at large

I think what you're actually doing there, NSMike, is that you're judging an ethical position from your own ethical position. This is necessary to have a personal opinion, but less useful in discussion, and especially useless in persuasion. It goes without saying that an ethical position will view incompatible other ethical propositions unfavorably. Is that point worthy of elaboration?

Oh, Larry. We've already had this argument in another thread and in PMs, and I'm not interested in having it again. We both think the other is wrong. I still stand by the idea that, "It comes from a really old book that a lot of people have followed for a long time," is not a valid, rational position on which to base a moral position that affects a larger population as a whole.

What's more, the pre-dominant holy book of the country I am living in compells me to forcibly "enlighten" the indigenous population of various Southern Asia countries. Historically, the population is supportive of such endeavors, and there is a well established body of scripture-based tradition for doing so. Now, where does that take us?

Is it not completely and absolutely, and perfectly clear that I am NOT saying that all ethical positions will be equally acceptable to everyone?

If it's not, I'm taking this post to highlight that particular content in my messages.

Larry

Homosexuality has not caused NSMike pain. Homophobes have caused him pain. Even by the Christian measure of 'don't do anything sexual', gays are still mistreated. It's possible for gay children - before they are sexually active, just acting 'gay' - to be beaten for who they are.

ANd your assertion that 'it's incredibly common where you live' is nonsense. All you can say about the Philipines is how many out homosexuals you can see. If they won't own up to it through fear - see the first line - then they won't appear in your worldview, or on records.

1Dgaf:

Er, isn't that what I said? I didn't say that homosexuality was incredibly common where NSMike lived. The moral position that it's wrong is, and it is that ethical position which has caused him pain, right? It is worth knowing the processes behind that intimately in order to do something about it, for or against; and especially against.

Is an ethical position that does harm by its very nature even remotely worthy of being considered an ethical position?