Joycelyn Elders Sheds Light on Gay Health

If you don’t think masturbation is a touchy subject, ask Dr. Joycelyn Elders. During her tenure as the first African-American U.S. Surgeon General, appointed by President Clinton in ’93, she advocated masturbation as the safest form of sex. Her frankness was not appreciated -- even in the backdrop of a continuing AIDS crisis -- and sent some politicians into an orgasmic, gyrating tailspin of their own. As a result, President Clinton asked for her resignation only fifteen months into her new job.

Dr. Elders returned to teaching at the University of Arkansas Medical Center, then retired in ’98. Since the, ahem, sticky situation with the government, is she any less outspoken? Fortunately, no. "I’ve been on the speaking circuit, doing some writing, so I’ve been very busy," Dr. Elders told GayHealth.com. But she did take some time to speak with us about sex education, Dr. Laura, George W. Bush, and -- yes -- the merits of masturbation.

QThe US presidential elections are upon us, and the race is in a dead heat. As someone who’s worked in a presidential administration, what would a Gore administration mean for LGBT health and wellness?

A I think that Vice President Gore is an open-minded person who would listen to the scientific facts, listen to reason and do the right thing.

Q	What about a Bush administration?

AI am very concerned about what a Bush administration would mean because I think that he is so involved in doing what the right wing tells him to do, rather than truly thinking and making decisions on his own. I think his parents raised him right, but I think Bush has sold out to the right wing, and is so dependent on them electing him -- if he gets in -- he’ll do what they tell him to. What we’ve got to have right now is a seasoned -- and I think Gore is seasoned -- statesmen with a vision, and we need a politician with a conscience. And of course, we need a leader who has a brain.

QYour outspoken view that masturbation is the safest form of sex led to your termination as Surgeon General. Do you still hold the same view?

AYes! We need to stop lying about masturbation and accept the fact that 80-plus percent of women and 90 percent of men masturbate, and the rest lie. It’s a normal part of human sexuality. Hair is not going to grow on your hands, you’re not going to go blind or go crazy. It’s far better to masturbate than it is to go out and have sex with somebody you don’t love. Masturbation is far superior, and certainly far safer, 'cause [otherwise] you might end up with some terrible disease. If I was the Surgeon General and was asked that same question again this morning, I’d answer it the same way.

QWhat issues do you see for women who have sex with women?

AI think that it’s important women protect their health, and it’s important they find a provider who they can trust, and who can give them accurate, good information.

QWhat factors contribute to the high rates of depression among LGBT youth?

AProbably the strongest factor is the attitudes we, as a society, have toward LGBT youth. They’re usually verbally abused, they may be physically abused. Their teachers often do not respect them as much. If they go to their ministers, often their ministers will say, "All right, that’s just the devils, we’ll cast out the devils, and this will go away." It’s very hard for [LGBT youth] to get the kind of true acceptance and consultation that they need.

QHow does homophobia in schools affect the development of an LGBT adolescent?

AI think it markedly contributes to anxiety, depression, drug use, and the failure to be able to bond closely [with peers]. I think schools have not done enough to get rid of this problem. We’re supposed to love and accept everybody -- I think we have to make sure our young people understand that. We create the hate crimes – children aren’t born hating people. It’s we, as a society, who have taught them to behave in this manner.

QThe LGBT youth suicide rate stands at three to four times the rate of non-LGBT youth. What would you say to an LGBT youth considering taking his or her own life?

A[I would first try] to convince them their life is important. I would tell them that no matter what is bothering them, the only way we can do something about it is for them to be alive. God loves every one of us, and he wants you to be just the way you are. And he certainly does not want you to take your life -- you’ve got too much to give.

QAs Surgeon General, you said the Boy Scouts discriminate against its gay members. Were you surprised when the Supreme Court ruled against an openly-gay Scout leader?

AI’m not surprised about anything that happens anymore. I might be disappointed, but that doesn’t mean I’m surprised. I think the Boy Scouts do a lot of very good things. It’s probably the people at the top [who] create some of the problems that are being experienced at the bottom, and I don’t think we should take that at all as a slam dunk against the Boy Scouts.

QAccording to ’98 government data, about 100,000 to 200,000 youths age 13 to 24 are infected with HIV. How did we get to this point?

AWe have not educated our youth about the importance of not engaging in risky sexual behaviors. We haven’t even taught our youth about the importance of using latex condoms, if they choose to engage in sex. To not provide comprehensive health education programs in our schools, from kindergarten to twelfth grade, says that we do not want healthy people. If everyone was failing totally in math, wouldn’t you feel the need to teach it?

QSome say that as soon as you educate adolescents about anything but abstinence, you’re basically saying, "Go have sex."

AOnly a person who’s very ignorant about sexuality will think like that. Nobody needs to teach anybody how to have sex. I think we [need to teach adolescents] how to be responsible, how to protect themselves.

QShould sex education include a gay-positive message?

AAbsolutely. We need to give young people a healthy outlook and a healthy respect for their sexuality, whatever it is.

QHow do you answer to groups that say homosexuality is a choice, and that by teaching people about homosexuality, we’re fostering homosexuality and influencing their choice?

AIt’s my understanding that it really is not a choice. I didn’t choose that I was going to be a girl. My brain was imprinted early, and however it was imprinted, well, this is what God intended for me to be. I feel that we should respect each and every person for who they are.

QShould minors be allowed to get tested for HIV without parental consent?

AYes. If minors are concerned enough about it to go in and get the test, that means they feel [they’ve been exposed to] some risk. I would much rather them go in and get the test, and find out and know [their serostatus], than for them to be afraid to get the test and not receive counseling and educational treatment when they need to.

QIn light of a rise in unsafe sex among gay and bisexual men, some feel that the safer-sex message is no longer being heard.

AIt was working wonderfully, then came HAART. All of a sudden, people [mistakenly] said, "Oh, you can cure it now." We don’t know how long HAART is going to work, we hope forever. But we’re seeing some resistance, and we’re all fearful. HAART is very excellent therapy, but we also know this virus has an uncanny ability to change. And when it changes, it might return in a way that [doesn’t respond to] HAART therapy.

QSome men who used to adhere to the safer-sex message are now having anal sex without condoms…

AThis is why fear-based tactics will never work. If you don’t educate people, and get them to change their attitudes, then as soon as they get over their fear, they fall back to their same old ways.

QSo how do we reach them now?

AWe have to keep talking, keep getting them involved, and try to make them understand how important it is to protect not only their lives, but the lives of their partners. You reinforce this over and over, and make it a part of our acceptance, our life and our attitudes. [The prevention message] has got to be everywhere -- in church, at school, at work, on our billboards.

QRates of HIV are rising in the Hispanic and African-American communities. Why?

AIt’s education, education, education. We have to remember that HIV is a sexually transmitted disease, yet we have not educated our young people about their sexuality, and we have done less for the black community. We refuse to teach our young people in school about how to protect themselves. And we don’t do it in our black churches. Our ministers are trying to do more now, and open their eyes and realize that we don’t have to let all of our people die for lack of knowledge.

QWhat role has activism played in HIV and AIDS issues?

AThe reason we have the kind of funding we have for AIDS -- and moved as rapidly as we did [with treatments] -- was directly related to the gay and lesbian community and ACT-UP. We all got mad at ACT-UP, but you know, government does not respond unless they’re made to.

QWhat’s your take on HIV reporting and partner notification?

AIt’s a matter of what’s best for public health. I think until we get rid of some of our laws [that allow discrimination] in regard to hiring and insurance -- and some of the other attitudes about HIV in our community -- I’m very concerned about having laws that require notification.

QSome transgenders have trouble getting quality health care. How would you instruct physicians to better meet transgenders' health needs?

AWhat we’re trying to do in medical schools, through the AMA (American Medical Association) and through literature, is to inform and educate our physicians. We know that our physician society is just as biased as our society as a whole. In our medical schools, we’ve not taught about transgenders -- we’ve just not talked about it. Consequently, physicians don’t know how to treat them. Now we’re realizing that our medical schools did not produce the kind of doctors our community needed, and we have a responsibility to do that. We are now trying to shift our curriculum to train the kind of doctors that our country needs.

QAnd where are we along that road?

A[Laughs] We’re just getting started, but we’re working hard.

QAs a physician with a Master’s in biochemistry, how would you respond to Dr. Laura Schlessinger, who said, "If you’re gay or lesbian, it’s a biological error."

AI would say that Dr. Schlessinger has no data to say that it is a biological error. This is the way God meant it to be. I don’t think we have any data to call anybody an error.

QChristianity is an important part of many people’s lives, including gay people.

AIncluding my own.

QIts teachings incorporate tolerance, forgiveness and non-judgment. But right wing groups like the Christian Coalition condemn homosexuality in the name of God. Is religion a blessing or a curse for LGBT people?

AI think religion is very important to all of us. We need a power higher than ourselves. I can have all the religion in the world, but if I still don’t do right by people, and do right in my heart, and if I use the Bible to condemn other people, then I’m not doing the right thing. I feel they’re using their religion to condemn, and that’s certainly not being Christian.

QLooking ahead, what’s the biggest challenge to LGBT health and wellness?

AI think the greatest challenge is to get some real, solid research about LGBT health overall, so we’ll know what to do, where to go -- and to [make it] available and accessible. We’ve got to make sure we can get an agency in Federal government that’s responsible for getting this data, so that we can use it to educate people.

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Updated: Friday, 2 March 2001