A recent CNN investigation found that in the midst of rising case numbers, some phlebotomists in the US have refused to draw blood from patients with suspected monkeypox, preventing these patients from obtaining medically necessary and physician-ordered tests.
Yet the definition of “suspected monkeypox” and the other details around these cases remain murky at best. As CNN noted in its reporting, it is unclear if the phlebotomists refused to perform blood draws, or whether company policy prohibited it. Are these encounters in which gay men are being denied bloodwork simply because they are gay and monkeypox is now associated with this demographic? Or are these situations in which patients with visible and infectious pustules are presenting to diagnostic testing sites where phlebotomists are worried about whether proper safety policies and procedures are in place?
In the first encounter, homophobia is the driving factor; in the second, any reasonable health care provider would similarly have reservations about putting themselves at risk. (Even though the US Centers for Disease Control and Prevention suggests that virus levels in infected people’s blood are low, non-bloodborne transmission routes such as directly touching lesions may increase a health care worker’s possible risk of getting infected without adequate PPE.)
We are gay men, and seeing those in our community denied medical care echoes the early days of the HIV/AIDS epidemic. Originally called GRID (gay related immunodeficiency), the outbreak resulted in discrimination and stigmatization of LGBTQ+ individuals across society regardless of infectious status.
It is discriminatory to assume that an identity is itself a risk factor for disease and that avoidance of complete segments of society is an appropriate safety mechanism. Yet these faulty assumptions remain the cornerstone of homophobia in modern day medicine and account for much of the mistrust that LGBTQ+ people have toward the health care system.
But as medical professionals, we also understand the fear that comes with encountering patients who have highly infectious diseases. Eric has been a frontline physician since day one of the Covid-19 pandemic and is now a physician working with patients with monkeypox. Tom has worked with patients in the intensive care unit during the Delta Covid-19 surge. We understand the real fear of contracting viruses at work, and — as a married couple — we recognize the concern about bringing disease home to…
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