Saturday, August 30, 2008

Manhunt, McCain, and the Boyfriend Problem

photo from

I've been thinking a lot about gay male culture while I've been out in Provincetown. Gay male culture here is concentrated, combined, and distilled: here are the Bears, the dads with a kid and a Labrador, the club boys, and the drag queens. In the clinic, gay life becomes both more ordinary and more quietly charming when an old drag queen, i.e., an old queen who is actually old, comes in wearing flip flops and an old t-shirt to discuss diabetes management.

It's been bringing back some memories, but also some new ways of looking. Back in Boston, my life outside of work revolves around Ms. Dr. Hemodynamics and the Hemodynamic Cat. But when I was younger, my personal life and affections were more complicated. And I was doing HIV prevention work in San Francisco. In that time, I was a much closer observer of gay life, and sometimes an observer with more personal stakes in the questions of the day.

Back then, I was also living with a woman for much of the time I was doing that work; I've long been the male equivalent of that time-honored tradition among women's college alumni, the has-bians. But finding love with women has always caused me to reflect on the obstacles my gay male friends have in finding love with men, and to think about how they might solve the perennial Boyfriend Problem which seems to afflict so many. That road not taken looks pretty bumpy from over here on the paved expressway.


I used to see gay life through some notion of gay culture, the community, something greater than the sum of the parts: that was how I saw gay life when I was an idealistic young person, and when I worked as a community organizer and public health worker. That makes sense. That's how idealists and public health workers (and especially, idealistic public health workers) are supposed to think.

Now I see gay culture one gay man by one gay man, each individual coming into my social circles or my clinic in the midst of all of the other people I encounter. I don't see a united culture or community in the way that I used to. Part of that is the product of seeing people through the lens of medicine instead of community organizing; medicine is individualizing.

At this remove, I now think that a lot of what I used to think of as "gay culture" is really mainly about of the lives of single gay men. Once gay men couple up, they remain part of the community, but they are often less visible, live elsewhere, and almost by definition spend more time with each other than they do with other men. They still come to the doctor's office, though, and so I'm reminded of them more than I used to be when I was a community organizer.

It's also true that Boston is different than San Francisco. Gay life is both less visible and less separate from the rest of the city. That doesn't mean that all of Boston's gay men are living in a closet, it just means that they don't all live in the South End, or any other neighborhood. And there is no designated space of outrageousness in the city itself, like San Francisco's Castro District, where any given night might mean an encounter with some crazy drag queen doing some nutty schtick. That space exists for Boston men, but it is 90 minutes away by fast ferry. It is tucked away down here in Provincetown, isolated from everything else, and seasonal. Its location is based, no doubt, on those two cherished New England values: freedom and discretion.

So I've changed my relationship to the gay world, my role in it, and my geographic position. And each of those changes means that I've personally moved much of my day-to-day view of gay life from neighborhood to individuals, from community problems to individual needs.


But the change from community to individual seems to be happening in some other ways, too, which have nothing to do with my shifts in jobs or geography. Around the country, whether your local gay mecca is a distant refuge, or a right-in-the-middle-of-town liberated zone, geography has become less important to gay men. In part this is because the geography of cruising and hooking up with other men has become decentered and electronic, conducted through Internet hook-up sites like Manhunt.

And the rest of the geography of gay life may also be dispersing and diffusing, as younger men stop having to leave behind their straight friends from high school, college, or work behind when they come out. Straight culture's transformation towards increasing acceptance of gay lives in the last thirty years has meant that more and more queer people can lead social lives that have continuity with childhood and young adulthood, instead of requiring either a closet (as in the older days), or a complete break and reinvention (as in the slightly more recent days).

This all may mean that, as a Boston Globe think piece argued, gay bars will go the way of Jewish delis. Only a few iconic delis now survive as "Jewish Delis", living on as places of history built for occasional pilgrimages in from other neighborhoods or suburbs, rather than existing as true centers of community life. I think there could be worse fates for gay bars than for most to close and a few to become "Gay Bars" where men go on third dates for a fun experience of gay culture nostalgia, but not to meet their first date. Of course, the "Gay Bar" will be something less than the original, likely full of straight tourists buying kitschy "Gay Bar" t-shirts and getting their pictures taken with the drag queen at the door. But if you had to choose whether gay bars should be more or less prominent features of our cities and of gay men's lives, I think it's not unreasonable to choose "less." There are others who can sponsor gay softball teams.


But the internet's role is potentially more troubling than whether it may be biting into gay bar profit margins. A recent essay in, entitled "Has Manhunt Destroyed Gay Culture?" by Michael Joseph Gross, is partly an essay that could have been (and has been) written any time in the last thirty years of gay culture. It laments gay men's focus on sex which it argues precludes a focus on longer and more meaningful relationships. I found this article because of my political junkie Internet addiction which led me to the controversy about one of Manhunt's founders donating as much money as the law allowed to John McCain.

The part that could have been written any time since the 1970s and perhaps earlier is as follows:

But the most powerful secrets that live on Manhunt aren’t the ones we keep from the outside world. The most powerful secrets on Manhunt are the ones we keep from ourselves. Practically every gay man has his own version of this secret, which we learned to keep while growing up in the closet: the secret fear that, if we were truly known, we would never be loved.

This is probably as true (but over-simplified) today as it was in 1978 when Larry Kramer was working this angle, though probably not more true. However, because there is so much more capacity to create visual images quickly, including movies and digital self-portraits that require no photo lab technician to see the photo, people are becoming pornified, and pornifying themselves, in a way that they weren't before. The fact that more of the sex is virtual is only good from a strict-constructionist public health point of view. From a broad wellness point of view, I'm not so sure that it's an improvement.

Along those lines, we find the special Hemodynamics angle in another paragraph:

Employers now routinely reject job applicants after checking MySpace and Facebook profiles for suggestions of irresponsible or reckless behavior. Yet the explosion of amateur online porn has given many gay men, particularly younger men, a remarkable sense of security about their choice to perform. Last year a medical student in Manhattan told me he decided to have sex on-camera because “I’m not going to run for the Senate. I’m going to be a doctor in New York City. If anything, being a gay porn star is something to talk about at a cocktail party. That sort of thing here is like, ‘Oh you were in porn? Me too!’”

Personally, I would give this young doctor-to-be the advice that if he's going to sell his body, it should be at a high enough price to pay off his student loans. There must be some rich medical fetishist in New York who wants a highly-trained rent boy. But that's just me: always with the helpful suggestions that no one wants to hear.

The putatively more Internet-specific part of the essay's argument is here:

The seemingly endless stream of available men on Manhunt is, according to marketing director Henricks, “addictive, like a slot machine. You keep hitting next, to see another screen of profiles, thinking you’re gonna get lucky sevens.” This drive, according to Alan Downs, a psychologist and author of The Velvet Rage: Overcoming the Pain of Growing Up Gay in a Straight Man’s World, lies at the core of the appeal of online cruising: “Variable payout schedule, which is used in slot machine designs, is the most addictive form of psychological conditioning, because you never know when you’ll get paid. It could be every 10 times you play, or every hundred.” In the same way, Downs adds, “every time you log on, you never know what you’ll find. That’s why it expands to fill a person’s time. Last night was a bust, but who knows who will be online this morning or tonight.”

How vulnerable are Manhunt users to its addictive quality? “We’re the second-stickiest website in America,” Henricks boasts. “Stickiness,” he explains, is slang for attention ranking, the measure of the amount of time a user spends on a website each time he visits. According to, the Web’s Nielsen equivalent of attention rankings, the average Manhunt user spends 40 minutes on the site per visit. That’s about twice the amount of time the average Facebook or MySpace user spends on those sites. And, back to the slot machines, the only website in this country that is stickier than Manhunt is the wildly popular gambling website

I don't know that this is different than cruising, which itself has always led to variable payouts, and has long consumed a significant amount of some gay men's time. Still, like pornification replacing simple objectification, the internet intensifies this effect and makes it more efficient. The difference is not in what is going on--there were variable payouts in the process of looking around a bar, too--but the effect of its new form in making this process more targeted and efficient, and also more geographically diffuse.


The not-Internet-specific part of this Manhunt essay gets written every few years in new form by an educated gay man who realizes with a start that the way that he and his urban friends conduct their lives does not lead to having long-term stable relationships. He then works out his frustration about this by writing an essay or a novel on the topic, which I hope helps him meet a nice man who agrees with him:

"Looking for Mr. Right,” countless Manhunt profiles claim, but until he comes along, they’re open to playing with Mr. Right Now. Online cruising has its place in gay society: Access to a satisfying number of Mr. Right Nows is part of the pleasure and the privilege of moving to the big city to be gay.

Beyond a certain point, though, perpetually settling for Mr. Right Now becomes a failure of hope. When you came out, you did it because you wanted something. Part of what you wanted was sex, but part of what you hoped for was the possibility of being loved as your true self. And when, as often happens while cruising online, we diminish the hopes that drew us out of the closet, we reduce sexy to a purely physical act.

There is nothing in this that mothers don't tell teenage girls every day of the week, and maybe mothers need to tell their gay sons too, so this idea doesn't come as such a surprise. Still, the combination of emotional vulnerability and sexual availability is especially intense for some gay men.

Barack Obama was a community organizer for people whose lives had been damaged by closing steel plants and plagued by racism. I was a community organizer among people whose lives were threatened by the AIDS epidemic, and injured by homophobia. And, I would argue, chick flicks. I remember with a sense of vivid tragedy a safe sex workshop that I was facilitating, in which a young man said, "Even if I'm in some car giving head to some guy who I just met, there is always some voice in my head that asks, 'Could he be The One?'"

In my work in the South Side of Chicago--I mean, the Castro--I found that there are more gay men than there should be who think this way. Gay men who find themselves in this way of thinking have stumbled into a dumping ground of the worst ways that straight women and men think about love and sex, respectively. It's as important for gay men to realize that chick-flick ideas of romance are nonsense as it is for gay men to realize that true love only rarely begins with a hookup based on a picture of your butt. (Acknowledging, of course, that love can be powerful enough to create exceptions everywhere.)

No one should be surprised that the Manhunt guy gave money to McCain. Figuring out how to turn basic human yearnings into payola is the genius of American capitalism, and McCain is nothing if not pro-capitalism. Manhunt is just another version of that amoral form of genius. And that built-in structural feature of capitalism is so powerful that it's probably folly to think that somehow gay men will break free of each decade's version of the gay bar or Manhunt.

Maybe the only way to solve this problem is for love to reign, for the power of Community, capital "C", to awaken the love in all gay men's hearts. But let's not be sentimental about this. Love is too profound for sentimentality.

And if American capitalism has taught the world anything, it's that nothing is too profound to generate cash. So I hope that some capitalist will figure out how to get gay men to realize they could stop looking for the Magic Boyfriend, but start actually being each other's boyfriends. I'd like to think that the person who solved the gay boyfriend problem would bring in some real money. But capitalism may have already given us the answer: if gay men could bring in a bunch of money by truly looking for love, someone would already be making a lot of money off of it.

One problem is that gay male profits are made off of single gay men. Once gay men couple up and move to the suburbs there is less that is gay about them, and therefore less distinct marketing that can be done to them, and less money that can be made from them as a distinct group. They fade into the Ikea-furnished masses, no longer a distinct target market, no longer a definable profit opportunity. If you make your money from helping gay men fall in love, you have to make up in volume what you lose in repeat business.

It would be nice if the gay wedding industry were to become so lucrative that it could start investing in up-front love generation in order to keep the back end profitable. But it's unlikely. Which leaves us with this unsatisfyingly sentimental and apparently unrealistic and idealistic answer: the only way for gay life to become more filled with long-term loving partnerships is for love to prevail over profits, and for genuine attempts to build human connection to win over the seduction of variable payouts. I don't think that this means that gay men need to rise up and smash capitalism, and thank goodness: that's even harder than finding true love.

But anyone who is paying a business for the chance to meet another person is potentially susceptible to the interests of that business. If the interests of that business are psychological conditioning via variable payouts, then the customers will pay for their own conditioning. Even as gay business hosts each new form of gay male community--first physical space, and now virtual space--it also usually promotes individualism. By designing an environment in which jackpots can be won at any moment, customers will constantly return for more opportunities to hit the jackpot. And since part of the reward of the jackpot is the electric charge of novelty, they will usually return as individuals, as single people.

Any gay business which relies on repeat business by individuals acting in their individual interests has a profit interest in foiling true love. Gay restaurants don't need to pornify their customers; they just need to serve brunch. That's why love-wise, I think you can trust a gay restaurant, more or less: they get paid whether you come there again with your same boyfriend, or a different one. But gay bars and internet sites create a pornographized and individualized world within them, because this yields variable payouts and repeat business. Their profits depend on it.

Much of gay male culture has been produced by this profit interest, and at the same time has often been at war with it. That's because the Manhunt/gay bar business strategy depends on supporting gay community but preventing gay love. For the gay man seeking love, then, we can only say, caveat emptor.

image: The Stonewall Rebellion as immortalized by gay capitalism: the Advocate with a headline reading "First Gay Riots", a naked picture of present-day John McCain supporter Jon Voight, and a teaser for pictures of 18 other groovy guys.

Thursday, August 28, 2008


Gen X, for all of its pretensions, was the most conservative of generations for a long time. People my age are a lousy-ass voting bloc, plus our generational size is tiny. But my sister's generation--you know, the kids today, the Generation Y, the twenty-somethings of the moment--they're a different breed. And I'm hoping that through the power of inspirational slow jams, they will change the world.

(Also, for the hyperattentive, how awesome are Tyra and Landry from Friday Night Lights that they are both in this video?)

Wednesday, August 27, 2008

in memoriam

Anybody who's lived in San Francisco might be forgiven for getting jaded about how many times Del and Phyllis had presided over one occasion or another, or been honored at some other occasion. As the National Center for Lesbian Rights put it, more kindly, "It is difficult to separate Del Martin and Phyllis Lyon and write about only one of them. Their lives and their work have intertwined and their enduring dedication to social justice has been recognized many times."

But the couple deserved their iconic status, and more, and I was sad and moved by Del Martin's death today. And I was even more moved by the fact that Del and Phyllis--a legendary San Francisco couple, and lesbian pioneers--were finally married, by law, when she died.

As many in the media make note of the progress from the March on Washington to Barack Obama, in many ways Del Martin's trajectory is even more improbable and surprising. In 1955, when Martin Luther King was publicly leading the Montgomery bus boycott, Del and Phyllis were starting what was basically an underground lesbian cell, which later became an early civil rights organization. Theirs was a long and amazing road. Condolences to Phyllis Lyon.

Here's the SF Chronicle obit.
And here's the National Center for Lesbian Rights more detailed obituary.

Pictures from Chronicle

Sunday, August 24, 2008

Michelle Obama

How does Barack Obama do all that traveling instead of just hanging at home with Michelle?

That's the question I have tonight.

Not coincidentally, I am in Cape Cod and Ms. Dr. Hemodynamics is not.

Thursday, August 21, 2008


I've been working for the past couple of weeks in Provincetown, at Outer Cape Health Services, getting a taste of a funny kind of rural primary care. Though Provincetown itself has an urban feeling in many ways, because it's a resort and tourist town and a gay mecca, still, the nearest actual hospital is a community-level hospital 50 miles away, and emergency transport to tertiary care (like my hospital) requires a helicopter.

And if the fabulousness of P-town summer means lots of young men walking around the streets with hundred dollar sunglasses and no shirts, looking so relaxed and languid that is seems as if they've never had to work a day in their lives, it also means lots of people working double shifts so they can make the money they'll need when they're unemployed or underemployed in the winter. It means that in clinic, a lot of people want to push their follow-up appointments and specialist referrals a little bit farther away: "Can we do it after Labor Day?" It's like harvest time in other small towns, but the harvest is tips and hotel guests.

Provincetown has an annual Carnival, which is sort of a mixture between gay pride parades and Mardi Gras and a small town parade, except that it happens at a time with no apparent historic or religious significance other than being at the peak of high season, and presumably it helps brings in that last bit of income in before Labor Day. Like gay pride parades, the community's institutions get in the act right along with the clubs, liquor companies (Bacardi had a big float), and random assortments of people who just want to dress up in crazy outfits.

There were lots of guys in their underwear, sometimes with cowboy boots (the theme was "Wild Wild West" this year). My hero was the guy in his underwear, presumably with Type 1 diabetes, who had a device the shape and size of an insulin pump taped to his leg with tubing running up into his underwear. A heroine came while we were waiting around in line: a queen dressed as Ann Richards who was going around shaking hands with everyone and acting like she was the governor of Texas. I assume "Ann Richards" has been doing this schtick for some time now, given that the original Ann Richards is no longer with us, but maybe for your average Wonkette queen, Ann Richards has become a kind of eternal reference point, a nouveau-nerdy Judy.

Anyway, Outer Cape Health Services had a float because that's how these things work; in a gay community, if a community institution doesn' t show up for the parade, it's a troubling hint that the institution may be either a) filled with incompetents who can't get their shit together to organize a float, much less an all-year organization, or b) homophobic, or worse, both a) and b). Outer Cape Health Services has many highly competent and definitely not homophobic staff people, and therefore there was a float, and an enthusiastically staffed float at that.

Of course, I had to represent at the Carnival, not only for myself but also for other residents who will rotate out here; I would hardly want the people out here to think that the residents of my hospital are not ready to be a part of the float at Carnival, since I hope that we too acquire a reputation for being competent and queer-friendly. Other staff members kept asking me if I was ready for what was about to happen, and I acted nonchalant: "I'm from San Francisco," I said, "and I worked a lot of Pride Parades." Which is true. I've thrown a lot of condoms to crowds of hundreds of thousands.

But in fact, I wasn't ready for what was about to happen, because when we took our float down Commercial Street, unlike at San Francisco Pride, there was no wide street and there were no police barricades separating us from the crowd. And we were throwing out Mardi Gras beads to the crowd, as had a number of other floats before us, and for some reason we must have been arriving at the crest of the wave of bead frenzy because there were a fair number of people who had literally become insane with bead-madness. So although the crowd was much smaller, they were right in our faces, shouting, "BEADS! BEADS!" At one point in the route something had happened to the crowd in one particular area; they had clearly made the ugly transition from crowd to mob, crazed for beads, reaching into our float to try to grab beads that were on the floor of the float. We were literally having to push and slap people's hands away from us. It was very Lord of the Flies.

Still, other than the terrible bead mob moment, I had a great time tossing beads to people.

I had visited the nursing home in the morning, and the biographies of some of the residents are reminders that this has been a bohemian outpost for a very very long time. The old people here are not the same old people that I see in my clinic; and the young people are not the same young people either. This is a refuge, a destination, a hide-away and a place to be seen. It is not your average small town. And at the same time, it's still a small town. Two days earlier I'd had a long session with a patient, in which she was talking about secrets and deeply personal things. And this afternoon, as we drove by, I saw her, and she was shouting "BEADS!"

I tossed her some beads.

Saturday, August 16, 2008


I remember that week because the epidemiologist I shared an office with put the headline up on her bulletin board:


We took good long looks at the headline, quietly reflecting, finding ourselves happy to realize that we had definitively arrived in a new era. As a guest opinion in this week's Bay Area Reporter reminded me, it was 10 years ago this week that the BAR ran this headline as a huge banner on its front page. In August of 1997 in San Francisco, none of its readers had to be told what the headline meant.

The BAR is a gay newspaper in San Francisco, and for various reasons it essentially became the newspaper of record for gay men's obituaries there. And so, from early on, it served as an ongoing record of the community's losses from AIDS. The obituaries were written by the friends of the deceased; there were only a few rules, including a strict word limit and the stern instruction, "No poetry." In the worst days of the mid-1980s, the obits went on for pages.

10 years ago, San Francisco already had a couple of years experience with protease inhibitors and the concept of three-drug combination therapy. First they'd appeared in the medicine cabinets of savvy gay men who got them through clinical trials and parallel track access. Then in 1996, more and more people with HIV and AIDS got these medicines from their doctors and the neighborhood pharmacy, just like any other prescription drugs. There were still people dying, especially those who had already accumulated too many medical problems to benefit from the new treatment approach.

But by August 1997, the change that HAART brought was so pronounced that an obituary section that had once run pages long was suddenly gone.

This week, the BAR has two obituaries. Both men died of cancers that don't seem to have been HIV-related. This week, we can't say, "No obits"--but that's because these gay men got older and died of things that older men die of.

I remember some people fussing over the headline in one way or another. Various people who had been highly engaged in AIDS work were afraid that the new era would bring complacency about HIV prevention. They worried that celebrations of the effects of the new medicines would cause HIV-negative people to think that there was nothing that bad about having HIV. And of course, on the day the headline ran, thousands of people were dying of AIDS in other places besides the Castro District, including in neighborhoods of San Francisco where no one sent in obits to the BAR.

But one can always find a dark cloud within every silver lining. Sometimes it's still worth celebrating the silver lining.


It was worth celebrating then, and worth remembering today.

Sunday, August 10, 2008

iTunes has a radio feature, and I'm listening to radio, which plays lots of satisfyingly eurotrashy dance music. Because there is no better place to keep track of eurotrashy dance music than Beirut. The only person I knew who had heard "Dragostea Din Tei" before the Numa Numa Dance swept the Internet was a guy who spent a lot of time hanging out in eurotrashy dance clubs in Beirut. Apparently, that's the epicenter of the good stuff, except if you know where to find the tiki lounge in Oakland where my sister's boyfriend is evidently spinning Italodisco under the nom de guerre of Dr. Fill.

So, I'm listening to, and a familiar chorus comes through: Hey Hezbollah! Eat this! It's a sped-up tinny remix of the Pet Shop Boys singing, "We'll run with the dogs tonight, in suburbia."

"Be kind..."

One of my chief residents was sitting in one of our workrooms, and turned to me and gave me a fortune from a fortune cookie, and said, "Here, Joe, I think this one is for you, you'll appreciate this"--and the fortune said:

"Be kind, for everyone you meet is fighting their battle too."

I taped it to the cover of the binder I carry my notes around in.