The Patient Body

Pathological Sex

Published on May 26, 2015

“The Patient Body” is a monthly column by Ann Neumann about issues at the intersection of religion and medicine.

By Ann Neumann

On Anthony Petro’s After the Wrath of God: AIDS, Sexuality, and American Religion (Oxford University Press, 2015).

In December 1987—nine years after a rare syndrome was first identified in young men in major cities across the US and five years after it was given the name AIDS (Acquired Immune Deficiency Syndrome)—the United States Catholic Conference (USCC) released “The Many Faces of AIDS,” a document meant to “confront a significant pastoral issue.” More than thirteen thousand Americans had already died of AIDS. Another three hundred thousand would die over the next decade.

“Many Faces,” instructed Catholics and non-Catholics—“sisters and brothers in the Lord and all people of good will”—how to care for those directly affected by the epidemic. The statement includes education and an “authentic understanding of human intimacy and sexuality as well as an understanding of the pluralism of values and attitudes in our society” as necessary to the prevention of new infections. “Many Faces” opposed “safe sex,” a term the authors found “misleading” despite its popularity, and framed the epidemic as one of the “moral dimensions of public policy” that the Church was required to weigh in on. The document identifies abstinence and heterosexual monogamous marital sex as the only “morally correct ways” to prevent infection but also states that, “we acknowledge that some will not agree with our understanding of human sexuality.” It notes that the use of condoms for those who do engage in sex outside of marriage may prevent infection.

“We are not promoting the use of prophylactics, but merely providing information that is part of the factual picture.” The USCC’s acknowledgement that condom use could prevent infection seems like a vital and necessary deviation from Catholic moral teaching, given the extent of the epidemic. Thousands were dying. Also the language of “Many Faces” was snugly couched within a disclaimer: the writers felt they were obligated to address a “pluralistic” citizenry. Still, the media erupted, proclaiming the statement a significant change in church teaching.* Conservative Catholic leaders immediately denounced the document—and the way that it was characterized by the media—and two years later, this time with Vatican oversight, a new statement was published, “Called to Compassion and Responsibility: a Response to the HIV/AIDS Crisis.” 

In his new book, After the Wrath of God: AIDS, Sexuality, and American Religion, Anthony Petro,** an Assistant Professor of Religion at Boston University, examines the ways in which the AIDS crisis helped shape the role of religion in American public health as particular dominant ideas of Christian sexual morality were fused with public policy. After the Wrath “reinterprets the last thirty years of American religious history through the AIDS crisis” by chronicling government, religious and activist responses to the epidemic.

Petro compares and contrasts the two statements the Catholic Church made regarding the AIDS epidemic, “Many Faces” and “Compassion and Responsibility,” to show the Church’s “continued boldness” in the 1980s to speak “about political issues of concern for American society as a whole rather than for Catholics alone.” (He uses Jose Casanova’s term “public Catholicism.”***) Petro writes:

Two central tensions emerged in the Catholic statements on AIDS. The first arose in the use of medico-scientific versus moral-religious epistemologies to discuss AIDS care and prevention. The second pitted the language of pluralism espoused by the first statement against the language of universalism more strongly pronounced in the second.

The effort to foreground evangelical and Catholic moral teaching in the national and global approach to AIDS is not an artifact. Petro uses this point to poignantly frame After the Wrath of God. “The ability to shape notions of morality in American discussions of AIDS, sexuality, and public health has grown into a source of religious power in America. This form of power is perhaps most visible in cases where it has been translated into a conventionally secular vocabulary, in both the moral language of health and medicine and in rhetoric about American citizenship and its limits,” he writes in the introduction.

The Wrath of God explains how evangelical and Catholic leaders came to consider AIDS  “both a viral and a moral crisis.” They argued that it was only through the use of a “predetermined moral code,”—one reliant on a “traditional” or “moral past” that never existed—that the epidemic could be stanched. It’s a worldview—with accompanying political, sexual, gender, economic and racial politics —that has historically been applied to other epidemics like teen pregnancy and sexually transmitted diseases. Anything outside of procreative sex was pathologized, and such behaviors considered punishable for their immorality. Thus, AIDS became a “tool of moral pedagogy,” even as it was tied to homosexuality and despite its various methods of transmission.

In an introductory section titled, “Moral Citizenship,” Petro tells us that by “linking sexual discipline to the idea of the American nation, religious leaders promulgated no less than a national sexuality.” A good nation, under such a formulation, had no room for those who “deviated” from sexual behaviors that were defined and policed by a government beholden to a particular idea of “normal” or “authentic” sexuality. Even the Supreme Court had designated sodomy as “not protected by the Constitution” in their 1986 decision in Bowers v. Hardwick. The decision stood until 2003, when it was overturned in Lawrence v. Texas.

The book opens with a discussion of the current voluntary and national policy for AIDS relief, both marked by a “biblically based” approach to sexual morality, as exemplified by Rick and Kay Warren, influential evangelical church founders who have made AIDS part of their global mission, and the prominence of abstinence education in the President’s Emergency Plan for AIDS Relief (PEPFAR), a global health initiative founded by George W. Bush in 2004 and continued today through President Obama’s Global Health Initiative.

Petro then returns to the Reagan era, when AIDS was first identified, to examine the religious and political backdrop against which Surgeon General C. Everett Koop addressed the epidemic. In recent years, Koop’s legacy has been given a bit of a dress-up by liberals who see his adamant actions—instructional mailers sent to every US home, sex education, support of “safe sex”—as praiseworthy. Petro reexamines the gloss that many have given Koop in subsequent years, closely documenting the doctor’s actions, statements, and evangelical bonafides, and finds that Koop was merely pragmatic rather than progressive; a well-meaning surgeon general, but nonetheless, one with strong evangelical convictions and intentions. The latter section of the book looks at activist responses to religious morality imposed on national discussions and policies regarding sexual practices.

Still from "We We Here" by David Weissman

Still from “We We Here” by David Weissman

Petro’s discussion of protests against the Catholic Church by activist groups ACT-UP (AIDS Coalition to Unleash Power) and WHAM! (Women’s Health Action and Mobilization) is particularly helpful to understanding how the church formulated its current language regarding religious freedom. He describes one infamous action, staged in 1992 at St. Patrick’s Cathedral in New York, home to Cardinal O’Connor, a vociferous proponent of “traditional” sex, that involved the crumbling of a Eucharist. Petro writes,


“These debates increasingly posited the religious freedom of American Catholics against the sexual freedom of gay AIDS activists. Construed this way, the [Stop the Church] demonstration became a case study of the American culture wars and the battle to define American citizenship and public morality.”

This formation of two sides pitted one against another, wiped away any tolerant understanding of pluralism in US culture and allowed political and religious leaders, the group with authority and power, to be turned, ironically, into victims.

Throughout the book, Petro peels back the “laminations” of religious rhetoric applied to particular sex acts and behaviors. The reminder that “homosexual sex” is a contrived category—as if anal or oral sex, even with same-sex partners, is only for “homosexuals”—is both a throw back and a refreshing reminder of just how codified moral language has become. More than once I scratched “whoa” into the book’s margins, like I did next to Petro’s discussion of the term “sodomy,” traceable to 11th century theologian Peter Damian who combined Genesis 19’s punishment of the Sodomites with sinful “diverse acts, many of them having to do with the genitals” in the Roman luxuria and a perversion (I’m sorry) of Paul’s First Letter to the Romans that defines some sex acts as “beyond nature.” “The connection suggested that specific acts must be avoided to prevent God’s wrath,” writes Petro. The afterlife of “sodomy,” the practice of “those who could expose a society to contagion” influenced the Reagan administration’s application of religious morals to AIDS. “The sodomite no longer threatened only Christian communities, but political states as well,” Petro tells us before providing some quotes from David Noebel, an evangelical author who linked the AIDS epidemic with the pending downfall of the nation:

“…Homosexuals in sensitive positions have a tendency to place their own sexuality above national security and end up giving government secrets to the enemy.”

The “homosexual subculture… destroys lives, families, institutions, and nations.”

Petro has a knack for distilling such complicated histories or social changes into accessible language. Don’t miss his explanation of how the conflation of morality and health provided cover for expressive or charismatic faiths (subject to “an often unacknowledged Protestant bias in defining what constitutes proper religion and the exercise of religious freedom”) to become part of liberal conversations about autonomy and personal responsibility. Religious and political changes were taking place in the decades before the outbreak, shifting American’s affiliation from church denominations to politicized issues. Petro writes, “This political and cultural realignment even helped melt divisions among Protestants, Catholics, and Jews, as religious identity came to matter less than one’s moral and political positions regarding a host of key issues, including abortion, premarital sex, birth control, divorce, and homosexuality.”

The rhetoric of the 1980s doesn’t seem so long ago or far away when you consider how “moral” behavior continues to be conflated with ideas of a healthy population. For some, fitting gays inside the institution of marriage has made them palatable for society, parenting, and other benefits afforded to married, monogamous citizens. For some normative family fun, Google “children mother and father.” Or take a look at how sex education continues to be dominated by Christian ideas of moral, and therefor healthy, behavior. According to a May 1, 2015, Guttmacher Institute brief, thirty-seven US states still require that abstinence be taught in schools. Nineteen require that “instruction on the importance of engaging in sexual activity only within marriage be provided.” Today, more than three decades after AIDS was first detected, only thirty-three states require instruction on HIV transmission.

Moralizing of a particular religious stripe seems indelibly attached to some of the most dire public health issues of our time. We know this surely as we know that abortion’s constitutionality has nothing to do with affordable, safe and easy access. What After the Wrath does is demonstrate how and why this moralizing has wiggled into even our most enlightened and progressive health policies. Behavior judgments—particularly of sexual behavior—continue to shape public policy but Petro provides us with a useful tool for identifying those judgments, and parsing their meaning.

***

*All quotes from “Many Faces of AIDS” are taken from Petro’s After the Wrath of God.

**Here’s a good place to note that I have known Anthony Petro—and looked forward to this book—since he was an Assistant Professor/Faculty Fellow at NYU’s Religious Studies Program from 2010 to 2012.

***Casanova, Jose. Public Religions in the Modern World. chicago: University of Chicago Press, 1994.

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Past “The Patient Body” columns:

Choosing Childlessness

Old Man in Winter

Oh Canada!

End-of-Life Books, 2014

The Great Organ Shortage

Tending to One Another

Moral Highs and Lows

Old Philosophical Certainties

On Suicide

Reading HuffPo’s “Hospice, Inc.”

The End of Eating

Wakeful Unawareness

Faith, a Chronic Condition

A Special Sustaining Power

Your Ethical and Religious Directives

Hospitals and the Pretense of Charity

A Closely Held Business

What’s a Kidney Worth

An Irresistible Force

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Ann Neumann is a contributing editor at The Revealer and Guernica magazine and a visiting scholar at The Center for Religion and Media, NYU. Neumann‘s book, The Good Death, will be published by Beacon Press in February 2016.

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