On January 31st, 2025, several educational webpages on LGBT youth suicide, health disparities amongst LGBT youth, and HIV transmission and awareness were removed from the United States Centers for Disease Control and Prevention (CDC) website, the US federal agency responsible for public health and safety. The articles were brought down to comply with President Donald Trump’s Executive Orders reversing Diversity, Equity and Inclusion (DEI) programmes in the US federal government.
The January 20th Executive Order ‘Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government’ mandated the termination of DEI programmes related to ‘gender ideology’. This was followed by a January 29th memorandum detailing how: ‘[to] take down all outward facing media (websites, social media accounts, etc) that inculcate [teach] or promote gender ideology’. By equating gender to biological sex, Trump’s so-called ‘gender ideology’ rhetoric is a harmful attack on transgender people. This rhetoric legitimises attacks on transgender people’s material conditions under the guise of protecting women from a harmful ‘ideology’. Under the pretext of ‘defending women’, the January 20th Executive Order required the removal of educational CDC webpages which included transgender healthcare.
Attacks on queer healthcare and public education – including the prevention of HIV/AIDS – are neither new nor unique to the Trump administration. In this article, I turn to the debates on the prohibition of US government funding for AIDS education at the peak of the AIDS crisis (1981-96) to contextualise current ongoing attacks on queer – and specifically transgender – healthcare in a larger history. To historicise AIDS education and the community-led opposition it faced, I look at both federal education programs alongside education pamphlets and posters from AIDS activist spaces. An important part of this story is how queer AIDS activists resisted, forging community care networks and support in the wake of state failure and catastrophic death. Showcasing their resistance to government censorship and the anti-queer moral panic of the 1980-90s provides a foundation on which responses to the Trump Administration’s attacks on transgender healthcare today can be built.
The state-sponsored campaigns against queer healthcare today primarily target the transgender community. These attacks reflect the moral panic once surrounding gay men in the latter decades of the twentieth century, when the ‘gay lifestyle’ was viewed as the cause of HIV/AIDS. In 1987, molecular biologist Peter Duesberg stated, ‘all these infections go with lifestyles which enhance them’. Today’s anti-queer moral panic targets the transgender community as the term ‘gender ideology’ has replaced ‘gay lifestyle’. The language used against gay men during the AIDS Emergency Years (1981-96) echoes in the January 20th Executive Order – particularly the notion that transgender queerness is anti-American. It states, ‘the erasure of sex in language and policy has a corrosive impact not just on women but on the validity of the entire American system’, claiming that ‘gender ideology’, a misleading term used to deny transgender existence, has replaced biological sex, threatening the nation.
In the late 1980s, Reagan’s Secretary of Education, William Bennet, called federal government attempts at AIDS education (particularly education in schools) ‘homosexual propaganda’, feeding into the Conservative Right’s rhetoric painting homosexuality and AIDS as anti-American. Soon after, government funding on AIDS education or prevention materials was restricted with the 1987 Helms Amendment, which prohibited CDC materials that could ‘promote, encourage, and condone homosexual sexual activities’. By tying discussion of queer sexual activities to federally funded AIDS education, the Helms Amendment prevented the inclusion of educational information on safe homosexual sex. As a result, at the height of the AIDS epidemic, federally funded AIDS education campaigns could not tailor their education to the queer community, harming gay men.
Despite the amendment, in 1988 the CDC produced an educational pamphlet titled Understanding AIDS. Every household in the United States and Puerto Rico received a copy – the largest distribution of US AIDS education materials totalling 126,453,800 prints. Understanding AIDS maintained a view of AIDS prevention aligned with the Helms Amendment, advocating abstinence from sex and drugs, and encouraging monogamy. As a federally funded national educational resource, Understanding AIDS focused on combatting HIV/AIDS myths, including that AIDS could be contracted through saliva or pool water. To fulfil the requirement to prevent the ‘promotion’ of homosexuality, only two references to homosexuality throughout the eight-page pamphlet were made, detailing safe-sex methods that could apply to both hetero- and homosexuals. Despite the success in disseminating AIDS educational resources to heterosexual Americans, the censorship of homosexuality in Understanding AIDS meant it failed to provide cohesive educational strategies to the queer community and IV drug users.
In a similar state-sponsored campaign, the Oregon Health Division televised a series of advertisements which advocated for abstinence and monogamy, feeding into the ‘gay lifestyle’ moral panic on the basis that frequent non-monogamous sex caused HIV/AIDS. Unlike Understanding AIDS, rather than provide information on HIV/AIDS prevention, these advertisements intended to instil fear into viewers. Whilst showing the hands of a mortician caressing a corpse before covering them with a sheet, a voiceover read, ‘sex with multiple partners is how people like you get AIDS. And every new partner you have increases your danger. It’s time to stop loving dangerously. AIDS is a killer. Protect yourself’. Directing the message at the viewer, this form of advertisement exacerbated the rhetoric that a promiscuous lifestyle caused AIDS diagnosis, a lifestyle many in Middle America would associate with gay men in urban areas.
Yet, educational campaigns led by queer activists demonstrate how marginalised communities resisted the challenges posed by the Helms Amendment. Historicising AIDS education requires discussion of the education and prevention efforts of queer activists at the forefront of the epidemic throughout the 1980-90s. AIDS education has often been left to the hands of those affected, as government decisions forced disenfranchised communities to advocate for their own healthcare. Activist campaigns provide People With AIDS (PWA) autonomy in their own narrative and history, demonstrating how in the wake of censorship and repression, community care and education flourished.
Community-led educational resources and initiatives have long existed in the queer community. In the context of AIDS, two 1980s publications provide some of the earliest safe-sex education material. Play Fair! was published in 1982, five years before Reagan even publicly addressed the AIDS crisis. It was created by the San Francisco based Sisters of Perpetual Indulgence (SPI), a protest group, community service, and performance organisation satirising the Catholic Church founded in 1979. The pamphlet provided prevention advice on sexually transmitted diseases (STDs), including condom usage. Play Fair! offered information on ‘Karposi’s Sarcoma and Pneumocystis Pneumonia’, two of the symptoms of AIDS, rather than AIDS itself – as the acronym (for Acquired Immunodeficiency Syndrome) was coined in July 1982. Karposi Sarcoma (KS) refers to a type of cancer often found on the skin and lymph nodes, whilst Pneumocystis Pneumonia (PCP) is a form of lung infection. Back then, KS and PCP were referred to as “gay cancer” and “gay pneumonia” respectively. Play Fair! highlights how queer activists have always provided healthcare information to their own community.
Subsequently, the 1983 publication How to Have Sex in an Epidemic provided a framework for gay men to navigate the risk of AIDS. Written and published in New York City by activists Richard Berkowitz and Michael Callen with Joseph Sonnabend, an early doctor treating PWA, this publication also advocated for the use of condoms during sex and provided risk estimates for different sexual acts. In 2013, Berkowitz argued that ‘How to Have Sex in an Epidemic was more conservative than it needed to be. It basically said that all safe sex means for a gay man is “don’t get sperm inside your rectum when you don’t know your partner’s status”’. As with state and federally funded AIDS education, How to Have Sex in an Epidemic noted that the ‘lifestyle of a sexually active urban gay man’ put men at risk of HIV/AIDS. But the focus on ‘gay lifestyle’ in this publication was largely due to a lack of public education about AIDS. In particular, it focused on the multifactorial model of HIV transmission pushed by Sonnabend, which argued that ‘an interaction of multiple environmental factors’ caused AIDS. Despite this, How to Have Sex in an Epidemic’s particular focus on protecting gay men showcases a desire to help the community Berkowitz and Callen (both PWA) were a part of, rather than exclusively placing blame on queer men’s lifestyles.
The art collective Gran Fury was at the forefront of HIV/AIDS prevention education and activism in the 1980s. Named after the car model favoured by the NYPD, Gran Fury were guerrilla artists associated with ACT UP (AIDS Coalition to Unleash Power), creating political artwork in response to the ongoing epidemic. Their most recognisable work is the 1987 poster Silence=Death, which features the Pink Triangle worn by gay men persecuted by the Nazis, imagery intended to compare the federal government’s inaction to the Holocaust. It drew a parallel between silence surrounding the persecution of homosexuality which led to the deaths of thousands of gay men. In contrast to both Play Fair! and How to Have Sex in an Epidemic, Silence=Death invoked the notion that the federal government was responsible for AIDS related deaths rather than gay men themselves.
Gran Fury’s work shows how queer activists and advocates for PWA, opposing harmful fearmongering tactics, have transformed federal AIDS education through collaborative campaigns. Gran Fury’s 1991 poster Women Don’t Get AIDS was originally pasted onto the side of a bus stop in Los Angeles. As public art for ACT UP’s campaign for the CDC to expand the definition of AIDS, it reflected ongoing direct action throughout the early 1990s to increase awareness about the impact of HIV/AIDS on women. Gynaecological conditions were only recognised in 1993. A 1994 court case S.P. v. Sullivan gave women with AIDS access to Social Security benefits they had previously been denied. Lawyer Terry McGovern, founder of the HIV Law Project in Manhattan, later joined ACT UP. ACT UP supported McGovern with their press capabilities, with members writing the press releases for the lawsuit. Queer community organising crucially contributed to securing vital wins. Notably, Gran Fury’s work remains in the public domain. It provides a baseline for how to conduct queer activism in the wake of the Trump Administration, using easily replicable, radical, forms of artwork, education to influence legal and public health landscapes.
To quote cultural historian Frank Mort’s 1987 text Dangerous Sexualities, ‘to miss the cultural messages surfacing around AIDS is to fail to grasp an important agenda in current health politics’. The historicisation of AIDS education within the context of the removal of ‘gender ideology’ from HIV education webpages points to a sinister future comprised of fearmongering, moral panics, and propaganda around gender affirming care and protection for queer youth in the name of public health. However, this future is not fixed, as the activist response to censorship throughout the AIDS crisis demonstrates. The history of queer, community-based networks and campaigns shows us that like the 1980s, with an array of creative tools at their disposal, queer activists and their allies must band together to resist harmful state-led campaigns, provide community support and transform education on queer public health.