The theme selected by Schools OUT, a UK charity that promotes LGBT equality in education, for LGBT+ History Month 2024 is ‘Medicine - #UnderTheScope’. The aim of this selection is two-fold. Firstly, it aims to highlight and celebrate members of the community who have significantly contributed to the medical field in the face of institutionalised bias. Secondly, it aims to acknowledge the history of inequality that the LGBT+ community has faced in their access of medical treatment. Discrimination against LGBT+ people continues to persist in healthcare settings, posing a danger to lives and societal development.

A report by NHS Greater Glasgow and Clyde, NHS Lothian and Public Health Scotland highlighted the stark health inequalities that continue in Scotland, only exacerbated by the pandemic. In addition, LGBT+ medical professionals still face prejudice at work, relying on charities like GLAAD, Stonewall and LGBT Health and Wellbeing for advice and support.

An essential consideration in any discussion of the community’s medical history is the HIV/AIDS epidemic, beginning in the 1980s and inflicting damage on countless LGBT+ lives.
Although the crisis was medical, the response was inherently political. Intense hostility towards gay people condemned those living with HIV/AIDS as ‘immoral’. As such, the fear of harassment prevented many from being tested, contributing to the community’s disproportionate death toll.

This stigma persists, with homophobia continuing to deter the youth of today from testing, resulting in many remaining unaware of their HIV status. The lasting psychological and traumatic effect on survivors is also prominent. Indeed, it has been said that nearly all older gay men alive today, regardless of their HIV status or when they came out, have been impacted in some way.

While breakthroughs in HIV treatment continue and new research by UNAIDS suggests there may be significant progress in treatment and preventative methods, it is important to acknowledge the persistence of the stigma and struggles of survivors.

This LGBT+ History Month, Shepherd and Wedderburn is reflecting on these breakthroughs in HIV treatment and highlighting individuals who have contributed to the LGBT+ community, including award-winning actor Billy Porter’s HIV/AIDS activism and the work and legacy of mental health nurse and drag queen George Ward (otherwise known as Cherry Valentine).

Breakthroughs in HIV treatment

As mentioned above, in recent decades the landscape of HIV prevention and treatment has undergone remarkable advancements and vastly improved the quality of life for those living with the virus. Among these breakthroughs is the development of pre-exposure prophylaxis (PrEP), a trailblazing preventative approach that significantly reduces the risk of HIV transmission.

Since the 1990s, antiretroviral therapy (ART) has been pivotal in HIV management, effectively suppressing the virus and enabling individuals with HIV to lead long, fulfilling lives. Over time, research and innovation have led to the development of more potent and tolerable antiretroviral drugs, resulting in simplified treatment programmes with fewer side effects, enhancing patient adherence and overall well-being.

Moreover, major healthcare developments have transformed the outlook for those living with HIV. With effective ART regimes and comprehensive care, individuals with HIV can achieve viral suppression, leading to improved immune function and a life expectancy comparable to that of the general population.

This remarkable progress shows the transformative power of modern HIV treatment and the potential for individuals with HIV to live completely normal lives that are not overburdened by the virus.

PrEP has emerged as a crucial component of HIV prevention strategies, empowering HIV-negative individuals (whether LGBT+ or not) to proactively reduce their risk of acquiring the virus.

When taken consistently, PrEP has demonstrated exceptional efficacy, with studies reporting up to a 99 per cent reduction in HIV transmission risk. Indeed, the acronym “U=U”, which means “undetectable = untransmissible”, is now used widely to help explain the high efficacy rate of PrEP to others. It complements existing prevention methods and strengthens public health efforts to curb transmission.

In Scotland, the NHS has taken proactive measures to ensure PrEP accessibility since 2017. Through its PrEP Scotland program, individuals at high risk of HIV transmission can access the drug free of charge, showing the government’s commitment to equitable healthcare provision. This initiative not only facilitates access to preventive interventions but also reduces disparities in HIV outcomes, reinforcing Scotland’s dedication to ending the HIV epidemic.

HIV stigma, once widespread, is fading away as education, advocacy and the visibility of people living with HIV increases.

High-profile individuals, such as Magic Johnson and Jonathan Van Ness, have publicly disclosed their HIV status, challenging stigma and continuing to raise awareness of the virus. Continued research and innovation drive the evolution of HIV treatment and prevention, promising even greater strides in the future.

By addressing barriers to care and promoting access to preventive interventions, HIV has the potential to no longer be a threat and those living with the virus can lead healthy, fulfilling lives, regardless of their status.

A spotlight on Billy Porter

“Why was I spared? Why am I living? Well, I’m living so that I can tell the story.” – Billy Porter

Billy Porter is an Emmy, Grammy and Tony award-winning actor and activist known for raising awareness of HIV/AIDS.

Porter came out as gay at the age of 16 in 1985, in the middle of the AIDS crisis. During this time, AIDS was mislabelled as ‘gay-related immune deficiency’, resulting in the widespread use of the phrase ‘the gay plague’. This stigma placed the LGBT+ community directly in the line of fire. Crosses were burned outside people’s homes; mail would not be delivered in fear that any contact would spread the disease and people would not eat in restaurants with waiters whom people perceived to be LGBT+.

In his youth, Porter participated in one of the largest HIV/AIDS protests of the 1980s, in response to ‘AIDSphobic’ comments made by the Catholic Church.

Living through the crisis gave Porter the drive to seek a better future for the community, with Porter highlighting the severity of the crisis: “I buried more friends by the time I was 21 than my 85-year-old grandmother”.

Porter also starred in the Emmy award-winning TV show Pose, centred around the gay and trans community in New York in that era. Porter’s character was living with HIV/AIDS and as a result, the show has been hailed for bringing awareness to the disease.

In real life, Porter was diagnosed with HIV/AIDS in 2007. While he kept his diagnosis quiet for 14 years, he finally told his story in 2021, following a lifetime of activism against the condition.

Porter has since been awarded the Elizabeth Taylor AIDS Foundation’s Commitment to End AIDS award. He is also an ambassador for the foundation. In 2021, Porter was awarded Attitude’s Man of the Year award. In his acceptance speech, he stated: “This is what HIV looks like now. This is what courage looks like now. This is what bravery looks like now. This is what activism looks like now”.

A spotlight on George Ward/Cherry Valentine

In addition to the significant contributions made by members of the LGBT+ community to the HIV/AIDS epidemic response, it is important to also acknowledge the efforts of other community figures during the pandemic and mental health crisis.

More widely known as Cherry Valentine, George Ward was born in Darlington, County Durham and grew up in an English Traveller community. After graduating from Lancaster University, where they also started to experiment as a drag queen, George worked as an NHS mental health nurse in a children’s psychiatric unit.

Ward left their nursing job in 2020 to appear as Cherry Valentine on season 2 of RuPaul’s Drag Race UK. Bringing “dark and silly” humour and an unforgettable laugh to the show, Cherry was an instant favourite. Though fans only saw Cherry on three episodes, they quickly warmed to her humility and infectious sense of humour. Cherry’s instantly recognisable red and black outfits were her trademark and earned her praise as some of the season’s best.

Shortly after Ward’s rise to fame on Drag Race UK, they featured in the BBC documentary Cherry Valentine: Gypsy Queen and Proud. Their journey to reconcile both parts of their identity, which they ultimately left at the age of 18 after coming out as gay, was the driving force behind the programme. It was shortlisted for best “Authored Documentary” in the National Television Awards 2022.

Returning to the medical world as a front-line vaccinator during the pandemic, Ward talked about their passion for nursing: “I think being a mental health nurse put me in that right position to understand people a bit more and if you’re a drag queen, you’re working with people. And to understand people, I think you go the extra mile.”

Sadly, Ward passed away, aged just 28, in September 2022. Following George’s death, fellow season 2 queen Bimini paid tribute to their contribution to the medical world: “We were so proud of Cherry’s work as a mental health nurse for the NHS. It was second nature to them – being there for people and nurturing them was just part of who they were. Cherry had this natural empathy and would be able to listen, which was such an incredible trait.”

Conclusion

To conclude, it is clear that the medical landscape of the LGBT+ community is starkly different in 2024 to any other time in history. The positive developments in both the treatment of HIV and efforts to combat the stigma are remarkable, paving the way for the LGBT+ youth.

Moreover, the work of figures such as Billy Porter and George Ward (otherwise known as Cherry Valentine) acts as an embodiment of the continued contribution of community members to the medical field in the face of adversity.

This LGBT+ History Month we celebrate this progress, while ensuring to acknowledge and remember that the history of the community continues to affect many and that issues of medical inequality and discrimination persist in 2024.

This article was co-written by members of Shepherd and Wedderburn’s Pride Network: Trainee Solicitor Sarah Cosslett, Solicitor Zachary Stewart, Trainee Solicitor Morgan McSherry and Solicitor Matt Andrews.

Sarah Cosslett, Zachary Stewart, Morgan McSherry and Matt Andrews are lawyers at Shepherd and Wedderburn