The Stonewall Riots, the AIDS Epidemic, and the Public’s Health

Conventional wisdom suggests that the Stonewall Riots of 1969 precipitated the HIV epidemic in our country. This remains an unsubstantiated fact borne on undocumented notions that the majority of gay men began to engage in more promiscuous sexual behaviors after this social revolution. There is no doubt that sexual liberation empowered individuals, including heterosexuals, to love more freely and to experiment with their sexuality and partners. However, this does not fully support the assertion that a sudden rush to promiscuity after Stonewall initiated the ravages of AIDS on the gay community. In fact, gay men were very sexually active before Stonewall, albeit less openly in fear of prosecution. Still, after Stonewall, the ease of engaging with multiple sexual partners at bathhouses by a small subset of gay men may have been one of a multitude of factors that accelerated transmission. Even with this knowledge, the impact of HIV would have been very difficult to predict.¹

The challenge in foreseeing the AIDS crisis was attributable in part to a health care system that was ill equipped and unwilling to meet the needs of the lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) population. The health burdens faced by LGBTQ people were very much present before and after the Stonewall Riots and before the first indication of AIDS in 1981, but services were scarce and underfunded.² These disparities in care were predicated in the invisibility of the population by most health care professionals at the time, a phenomenon that has only begun to improve in the past two decades.³

A DEMAND FOR HEALTH EQUITY

The framing of gay liberation as the catalyst for the AIDS crisis is rooted in a deficit-based approach to understanding the health of our population. Despite a multitude of homophobic characterizations, some state-sanctioned, the majority of gay men in the 1970s did not spend their nights in bathhouses. I espouse a strength-based characterization of Stonewall: the civil disobedience served as a catalyst to the activism of the AIDS era, which in turn has contributed to the foundations of a modern public health paradigm emphasizing social justice and health equity, including an expectation for competent and appropriate health care for LGBTQ people.

The events at the small bar in the Greenwich Village neighborhood of New York City that commenced on June 28, 1969, and lasted for five days ignited a social movement that had been in the making for decades. Some 10 years earlier, a less well-known yet equally powerful clash with police materialized at Cooper’s Donuts in Los Angeles, California, which also aided with the movement. In these and the myriad other actions that are not recorded in history books, we were fighting for our rights, and, in doing so, we were battling for our individual health and for the health of the entire population.

To understand the necessity of the battle, both locally and globally, consider the fate of Alan Turing, the father of the modern computer, and who, less than two decades before the Stonewall Riots, was chemically castrated as a punishment for his homosexuality, resulting in impotence and likely leading to his own suicide in 1954. His legacy serves as an important reminder of why we must continue to fight social inequities and injustices that persist in society in the United States as the current federal government chips away at our rights insidiously veiled under the concept of religious freedom, in countries such as Greece where LGBTQ people are still subjected to unveiled acts of discrimination because of cultural intolerance, and, most notably, in nations such as Chechnya and Uganda where LGBTQ people are brutally victimized and murdered through state-sanctioned policies and laws.

CATALYSTS FOR A NEW PUBLIC HEALTH PARADIGM

The Stonewall Riots of 1969 were a boisterous pronouncement by the LGBTQ population that we would no longer hide, that we would not be arrested, and that we would not have our health undermined by a system that chose to ignore us. AIDS catapulted this social movement even further. As the Stonewall Riots framed the basis for the recognition of our identities as important and viable members of the population, the AIDS crisis of the 1980s and 1990s created the circumstances by which we would come to demand that the government and society attend to our well-being. We would expect to be cared for and attended to like any other member of the population and, in that regard, to no longer be victimized, harassed, or ridiculed—stressors that continue to challenge our health to this day.⁴

The rebellion grew out of frustration and anger at a society that was denying our existence and simultaneously persecuting us for our identities. The reaction was spontaneous and combustive, chaotic yet effective. And when the matter settled, this entropy gave rise to an organizing principle that to this day fights for the rights of the population. It is this very organizing principle that allowed gay men and women to come together in their fight against AIDS, which was framed by some as a vindication on the anomaly of gay life. This ultimately led to the passage of marriage equality as a law of the land in the United States. Without Stonewall we have no AIDS activism, and without AIDS activism we have no marriage equality—a social condition that surely has had a beneficial effect on our health.⁵

The Stonewall Riots and AIDS activism, which would follow a decade later, were intertwined with the Women’s Rights Movement. These social actions along with the African American Civil Rights movement were, and are still, the basis for an urgent change needed in the dynamics of American society. To this day, we continue to challenge this monolith of power and privilege as White, straight, cisgender male Americans fight to hold onto the reins of power and privilege at any cost.

All three revolutions have resolutely demonstrated that social conditions and inequity undermine the health and well-being of people and populations, noting the psychosocial burdens and stressors that diminish the health of LGBTQ people, women, and people of color. It is for this reason that I have stated since time immemorial that HIV is as much a social disease as a biological one, and why a three-pronged approach—one that marries the biomedical with the behavioral and the social–structural—is essential to bring an end to AIDS.⁶

AIDS required that we fight for our lives. And in this fight to control a virus, we have also fought for compassion in care, access to treatment, and equal opportunity to live healthy lives like any other American. The battle we waged against AIDS was also a battle for our rights—a continuation of the struggle precipitated by the Stonewall Riots—with both social justice and health equity at its core.

THE BATTLE CONTINUES

The ethos of the LGBTQ rights movement, nascent in a small Greenwich Village bar and bolstered in the last two decades of the 20th century fighting a viral and social plague, is as relevant today as it was 50 years ago given the cumulative socially produced burdens faced by each successive generation of sexual- and gender-minority people.⁷ These burdens and the ongoing challenges to the health of our population will not be erased until the ultimate promise of Stonewall is realized.