My boyfriend gets a little annoyed when I proclaim that I
don’t really care much about gay marriage.

I am sorry, I just don’t.

The issue that makes my heart race, the reason I crawl out
of my crypt every morning and stay in the office way too late, is gay men’s
health – LGBTI health – and I am frustrated that so much of our community’s
attention is given over to marriage rights, an issue that has, somehow, been
collectively anointed the most important, the most critical (and woe to the
ones who dare to criticize this narrow focus), sucking energy – and resources –
away from health advocacy.

To all of you who say “we can do both” – prove it!

Of course I think marriage rights are important, and no, I
wouldn’t turn down a shiny rock on my finger and going to the chapel of love
with my honey – legal or not (hint hint darling). But hello, health and
well-being is for ALL of us – the marryin’ kind and for those of us who
organize our loves, lusts, friends and relationships with different models.

Health and healthcare access is a fundamental human rights
issue. We must put the same activist fervor and creativity into support for
comprehensive, culturally competent, quality, responsive healthcare. How many
of us share LGBTI health issues on Facebook, tweet them on Twitter, blog them?
When was the last time (was there a first) when you marched and rallied and
yelled long and hard for healthcare that 
counts us, respects us, and provides the care and prevention services we
need and deserve.

Let’s just look at the “G” for a moment. In these United
States, gay men and other men who have sex with men have AIDS at a rate more
than 50 times greater than women and non-gay/bi men.  Gay black men suffer
from HIV rates similar to those found in sub Saharan Africa.

We smoke, experience anxiety and depression, engage in
self-harm, and feel suicidal at higher rates than non-LGBT people and we face pervasive
societal and structural homophobia that limit – and prohibit – resources and
access to healthcare.

But I am not going to lay out a laundry list of problems
here. We have been deficit-based too long, have looked at ourselves, and
allowed ourselves to be examined, as damaged, as sick, as reckless. Our
community has a wealth of assets – creativity, intelligence, resilience – to address
the challenges we encounter around our physical, emotional, sexual and
spiritual health.

We created safe sex for heavens sake. No public health
authority did that – it was queers and drag queens!

At the 2009 National LGBTI Health Summit held in Chicago
August 14 – 18, I was delighted with the vigorous discussion around the Gay
Men’s Health Agenda
and the steps we need to take to move it forward at the local, state, and
community levels.

The Agenda was created through a lengthy process throughout
much of 2008 in which we (a group of gay men’s health leaders) solicited input through
posts and comments on the LifeLube blog, a
plenary session at the 2008 Gay Men’s Health Summit, teleconferences, and via a
number of social networking tools. “What is your vision for a gay men’s health
agenda?” we asked.

The Agenda was unleashed on the world in February of this
year, and it lays out eight priority areas of work. Included in that list is
the pressing need to expand social, behavioral, and biomedical research –
especially among African American and Latino communities, as well as
Asian/Pacific Island, Native American and other communities of color, and the
impacted youth of those populations, all transgender men, and men outside urban
centers – all of whom are often unacceptably absent from the data and
statistics we do have on gay men.

Calling for national campaigns to combat homophobia,
biphobia and transphobia, the Agenda also demands the immediate elimination of
“no promo homo”- namely Section 2500 of the federal Public Health Service Act
(42 U.S.C. Section 300ee(b), (c), and (d)), which does not allow the
“promotion” of any type of sexual behavior – heterosexual or homosexual. This
language debilitates programs that are funded to reach sexually active adults
of all backgrounds.  It does not
allow us to discuss sex in any ways other than disease prevention – and even
there we have to tread carefully.

I don’t know about you, but the idea that “keeping it real”
language around sexual behavior “promotes” sex is laughable. We are an
extremely successful species in part because sex has never needed ANY promotion.
Did you start getting horny because you read or pamphlet or was it the
inexplicable release of hormones? The fact that we can’t talk about sex being
pleasurable (at least with the Fed’s money) turns off the very people we need
to reach with accurate information. They know sex is more than the absence, or
management, of disease.

As our Administration and Congress addresses health care
reform, leaders of the gay men’s health movement are partnering with the
National Coalition for LGBT Health and
other allies to advocate for these and other policies and resources described
in the Agenda to advance the health and well being of gay, bisexual, and
transgender men.

Gay men’s health – and LGBTI health – must be part of the
health discussions happening right now.

Go to a town hall and LGBTI-it-up – make sure the discussion
counts us, includes us, and highlights us, if only to provide some sanity in a
“debate” around “death panels” and keeping government’s “dirty hands off my
Medicare.”

Join the over 127 organizations and 203 individuals in
endorsing the Agenda. [mailto:[email protected]]
You will be added to the list and looped in on local, national, and
international activities underway to push the Agenda.

Take the Agenda to your organization and begin working on
the issues locally. Encourage community leaders who work on other issues
(youth, political equality, homelessness, poverty) to include LGBTI health in
their work. And include their issues in yours.

Talk to your elected officials at the state and federal
level – let them know that HIV/AIDS continues to ravage gay male communities.
Show them that resources (too) often don’t match the epidemic because of
political calculations and institutionalized homophobia that devalue our lives.
At the same time, tell them that gay men’s health needs are more than “navel to
knee” and demand culturally competent substance abuse treatment and mental
health services.

Hold everyone in power accountable. Hold yourself
accountable.

Gay men, and all LGBTI people, deserve healthy lives. As a
gay man living with HIV for the last 14 years, slightly bipolar, rather
asthmatic and decidedly allergic to cats, I want the ability to walk down that
aisle with a spring in my step if and when the wedding bells ring.