Sunday, October 14, 2007

to LA and back

On Friday, I took a trip down to Los Angeles for the day, to attend a training on using the California Health Interview Study for looking at LGB health issues. The picture of the roof of San Francisco's international terminal is supposed to represent the glamor of travel. Actually, I flew on Virgin America, and highly recommend the experience. The free movie selection was perfect for a one hour flight - a bunch of short films produced by college students.
The training itself was a great opportunity to see old pals, and think about new work to collaborate on. I think I'm slowly building a reputation in the field. Of course, it would help a lot more if I would publish something, anything! It's all well and good to bring new ideas and perspectives to the field, but if nobody can read about it, it's not going to reach people.
Anyway, Susan Cochran presented a really neat overview of the field of health disparities affecting sexual minorities. I'm amazed at what she could accomplish in twenty minutes.
One thing that she pointed out that I'd like to follow up on is that a lot of the domestic violence research has concentrated on who experiences domestic violence, but not on the context in which it happens. So, even though sexual minorities tend to have high levels of having been beaten and assaulted in relationships, the simple fact is that the majority of that violence happens in heterosexual relationships. Susan summed it up beautifully "heterosexual relationships aren't good for homosexuals". So, where I'd like to take that further is to look at the broader social context that makes heterosexual relationships especially fraught with danger. I would imagine that these relationships are more likely to turn violent in areas where homophobia is an accepted cultural norm than in areas that are more liberated. This also ties into another analysis I've wanted to do for a while: my research showed that suicide rates were lower in areas where gay rights protections had been enacted, but really only for young white males in particular. I've long suspected that the homicide rates for women would be more affected by homophobia than suicide, particularly uxoricide, along the same reasoning that straight relationships are particularly dangerous for lesbians.

Another nice potential collaboration would be with Gary Gates, who has done work on the income gap between straight and gay men, using census information. He told me that when he looked at it in relation to whether states had gay rights protections, essentially all the gap (lower wages for gay men) happens in states without gay rights protections. (Makes sense). So we talked about a couple of ways to extend that analysis, using the measures I'd developed in my dissertation. I don't know much about the field of economics, but I do know about measuring normative heterosexuality, so it would be fun to branch out a bit, especially into an area with the potential to influence policy.

In order to catch my flight home, I would have had to leave about halfway through the meeting, but fortunately, my friend Daniel was also at the meeting, so he very kindly offered a bed for me to crash in, and I changed my flight to Saturday morning. I took the subway from Hollywood to the airport, and it was an interesting experience in terms of public transit. They've done an admirable job of trying to make a subway/rail system that is appealing to use, but it took over two hours to get to the airport! If the flight hadn't been delayed, I would have been stuck at the airport until the next one.

Paul and Sasha took great care of Tuna while I was gone. They went swimming in the ocean yesterday! Tuna has been wiped out since she came back home. I owe a great debt to Paul for his kindness. It has been great to get re-connected with him.

Well, off to do laundry, and read through my students' papers.

Friday, October 12, 2007

Zombie Attack!

Earlier this evening, zombies gathered outside the public library across the street from my apartment, and they began staggering and shuffling through the streets in search of "brains... tasty fresh brains!"

Occasionally, willing passers-by were eaten and turned into zombies with a plethora of fake blood and an outcry of moaning from the feeding zombies.

After taking a few photos, I retreated to a safe distance as the horde waddled off towards the subway.

I can only hope that the zombie manifestation has, by now, been contained. Hmmm, it kind of looks like the farmer zombie is sending a text message...

Thursday, October 11, 2007

20 years of gay

Today was a momentous day, and I didn't realize it until I heard on the radio that it was National Coming Out Day. 20 years ago on this very day, I went to Washington, DC, under the nurturing wing of Chris Bartlett and friends. At the time, I was resigned to being gay, but not the least bit excited about it. I could only imagine a life barely skirting depravity and insanity, if not worse.
We arrived in DC on the eve of the March on Washington in 1987, and walked around Dupont Circle.
Before long, I met a handsome blond named Bruce from Cincinnati, and I kissed a man for the first time in my life.
We kept kissing for another 8 hours or so, sitting in the back of a van that some people were driving around from one monument to another.
And my life changed forever. All in one rush, I came to realize that it would be possible to be gay and, well, gay in the 1920's sense of the word. And since I'm not a secretive person, I came out. I went through a bit of a militant phase, painting pink triangles on the back of my hands, talking about being gay with everyone. Including my family. That didn't go over so well at the time, but things have gotten much better since, and there has never been a moment of doubt about the love that binds our family together, even when things were at their most stressful.

Well, as I mentioned, I heard on the radio that it was National Coming Out Day. On my favorite morning radio show, the gay shock jocks Fernando and Greg, were asking if the day really means anything special, does anyone really pick this day to come out just because it's National Coming Out Day?
They asked for anyone to call in who wanted to come out on the radio. I decided to call in with my story, since I figured that coming out on the very first coming out day might be interesting enough. I didn't get on the radio, which looking back on it is best after all, but Greg chatted with me for quite a while about the whole situation. He was such a sweetheart, and has such a great voice, he's very expressive and natural, not butched up like most guys, and he's got a Texas twang rolling over the top of it. I've never understood the South, but the accents make me feel all gushy inside.

Above, I described my experience as "coming out", which is a term that refers simultaneously to "coming out" in the sense of a debutante, presenting oneself to the public as eligible, and "coming out" of the closet, a space where gay men hid like skeletons.
But really, I didn't "come out" except out of the fog I myself was in. It was never really a matter of hiding myself from others, it was only about hiding myself from myself, and others as a corollary.
These days, I'm quite convinced that the term "coming out" has lost all reference to its metaphorical roots. Now that being gay is seen as a possibility for pretty much anyone, there isn't really much difference between "coming out" and just plain old growing up. No longer is there nearly as much need to differentiate oneself from the norm, as being gay has become essentially part of the norm.
And now "closet" and "coming out" get applied to everything, usually things that have a twinge of scandal, but not always.
For many years, I've been describing college environments as post-closet, if not completely post-gay. I don't know what metaphors have stepped in in place of the closet and coming out, if any. Anyone have any ideas?

Friday, October 5, 2007

Routine HIV Tests, the Class' First Test, and the Blue Angels

So, I had my first doctor's visit since I got here today. Here's the front door and elevator bank. Nice building! Especially for a doctor who takes HMO insurance.
My new doctor (physician's assistant, actually) seems like a nice enough guy. Now that I've gotten my back pain under control, there really wasn't anything pressing to discuss, just getting a prescription for my anti-depressant medicine.

This will be the first time I get a 'routine' HIV test. I wouldn't have gotten one under normal circumstances, since there's no reason to be concerned (oh, and I wish there was!). But the CDC has come out with a new policy suggesting that everyone get an HIV test every once and a while on a routine basis.
After some initial hesitation, I have come around to strongly supporting that policy, so I would look a little hypocritical if I supported routine testing on the one hand, and didn't do it on the other.
In the late 1980's and 1990's, while I was active with ActUp/RI, we strongly opposed routine testing, mainly because it would be happening in doctor's offices, and we felt that that was one of the worst places to try to learn anything useful about HIV. Partly because most doctors at the time were extremely uninformed, but mostly because if you got a positive test, the results would be part of your medical record, which despite what it looks like is a very public set of documents for anyone with the slightest incliniation to find out more about you.
Having such a public record would also make you ineligible for health insurance at all. At the time, there was even a fairly widespread policy of denying any HIV-related care even for people with insurance, especially if they fit one of the 'classic' risk factors.
So we strongly advocated for people to get anonymous testing, at one of the specialized HIV testing sites, run either by the Health Department, or by a reputable non-profit agency.

I think that was definitely the right strategy at the time. But circumstances have changed. For one thing, it is not as devastating to learn that you have HIV these days. It's also not anywhere near as hard to find competent care. And also everyone, including doctors and the general public, has gotten much less paranoid and reactionary about people with HIV. And, although it is still legal, and common practice, to deny HIV+ individuals any health coverage at all, at least it is illegal to deny coverage to someone for HIV-related care once they are already insured. So at this point, it makes more sense to offer HIV testing as a routine part of care, while still maintaining the capacity to offer anonymous free HIV testing sites, especially for people who currently have no health insurance.

But here's the big difference in my shift in opinion. Selective testing for HIV just doesn't work. For the same reason that virtually every strategy designed to work only on a high risk population is inefficient, and often counter-productive.
In this case in particular, having a conversation about whether to get HIV testing used to be about having a sexual and drug use risk behaviors. Essentially, several hurdles that have very little to do with whether you should get an HIV test or not had to be surpassed - First, your doctor had to think you were "at risk", which is a strange way to think about someone you care about. Second, you yourself had to think (or be convinced) that you were "at risk". That's also not a fun state of mind to be in. That's probably why the best definition of "promiscuous" is "anyone who has more sex than me". Third, you had to set aside time in the doctor's visit to have that conversation. And these days, with 10 minute appointments, can you really afford to spend 5 talking about an issue that isn't on the top of your priority list?
The other thing that making a big deal out of HIV testing did was re-inforce the idea that having HIV was a dangerous thing, and makes you a bad person. After all, if only high risk people should be tested, that sets up the notion that the risk itself is essentially a disease.
With routine testing, the conversation about getting tested didn't make me defensive about whether I considered myself to be "at risk", that was a non-issue in the process.

Well, I gave my students the first mid-term on Tuesday, and my initial reaction on leafing through them was that it had been a bloodbath. Several hadn't put any answers down at all for large parts of the exam, and others had scribbled things that didn't make any sense at all. Only a handful really "got it". I was despondent the next day, because that meant that 1) I wasn't teaching well, 2) they just didn't prepare, and/or 3) the test was not fair, in that I didn't allow enough time to complete it. I had long chats with some of the important teachers in my life (Rachel, Dad, & Kate) about what to do. I think there's a degree of all three involved, so my strategy now is to cut back somewhat on the scope of the class to make sure we can get through everything, adjust the grading system so that if they bombed, they can learn from the error of not preparing, and recover without a significant "drag" from the first test, and to set up office hours. I've given them my email and cell phone, and encouraged them to call many times, but it hasn't worked. I'm hoping that having drop-in times will help people get over their hindrances about asking for help.

Anyway, a few days later, as I have begun grading them, I'm not nearly as pessimistic. There's a lot to be happy about in their performance, and a lot of the stuff that just looked like random scribblings before is starting to fall into place, there are aspects of it that I can give credit for, so I think they are going to do better overall than I initially thought. So, it's not necessarily even going to be a bad experience overall. But, I'm still going to implement those changes right away.

The Blue Angels were flying over the city today, which was very disconcerting. They were flying right on top of the buildings. Suddenly the sky would rip open, and you couldn't tell where it was coming from because everything was echoing off the buildings. I was downtown, and went home to see if I could head out to the Golden Gate Bridge, so I could at least see them. But by the time I got home, they were done, so no pictures, I'm afraid.

Monday, October 1, 2007

My commute

Here's my typical commute...

Leaving my apartment building on Market Street.

Walking through the Civic Center BART Station.

Paying the fare.

Going down the escalator.

Here comes the train!

Sitting down and doing some work (wearing earplugs to protect my ears from the screeching of the train wheels on its track).

Leaving the station at Berkeley.

And, ready to settle in for a day of work.