Lymphogranuloma venereum (LGV) is a sexually transmissible infection (STI). It has occurred in outbreaks in Western Europe and North America. Since talking about sexual health lately is no longer a taboo in our area, I visited a clinic in Hamra (close to Costa cafe, same building as SGBL) recommended by a friend to talk to a young doctor who reported recently the first case of LGV in Lebanon in an HIV-negative MSM (Man who has sex with a man). A very calm and welcoming environment you get its vibes once you get the “blue-ashy” clinic of Dr. Ismaël Maatouk, a Dermato-Venereologist who works in Beirut, and welcomes all patient with no discrimination based on sexual orientation and gender identity for more than 3 years. Dr. Maatouk, have in his records more then 40 publications and several appearances in worldwide conferences talking about STI’s.
Below are his answers to some of my questions:
What is LGV?
It is an infection caused by three types (L1, L2 and L3) of the bacterium Chlamydia trachomatis.
IS it the same Chlamydia we know?
Yes, the same bacteria, but different sub-types.
Is it a new described infection?
No, it is an old infection and since 2003, initial clusters of LGV cases in MSM were reported in the Netherlands followed by a series of outbreaks in Europe, North America and Australia, mainly among HIV-positive MSM. However, it is not an MSM disease: it can infect sexually active people.
Is this infection frequent in MSM in those countries?
A large study in MSM from London and Brighton showed an estimated prevalence of LGV of 0.90% in the rectum and only 0.04% in the urethra.
Is it also present in the pharyngeal area, like the other types of Chlamydia?
Yes, Chlamydia is known to be found during standard STI screening of the urethra, rectum, pharyngeal mucosa. The prevalence of pharyngeal Chlamydia in London MSM is 1.2%.
What is the clinical presentation of this infection?
The classical presentation of LGV is inguinal lymphadenitis and abscess formation sometimes preceded by anogenital ulceration. Which means that we rarely find the genital ulceration associated with LGV because it is transient. Following this transient ulceration, we have an inflammation of the lymphatic ganglia that drains the region, which can be painful and can lead the patient to ask for a consultation. This inflammation looks like an abscess.
Is there any test we can perform to confirm the diagnosis?
Yes, a test based on PCR.
Is the treatment difficult?
No, it is a 3-week course of doxycycline.
Do we search for this disease in Lebanon?
In a routine consultation, No. The test is expensive.
I have read that recently, you reported the first case of LGV in Lebanon. Was it in a HIV-positive MSM as well?
No, it was in a HIV-negative MSM. However, it can infect any patient, regardless of HIV status and sexual orientation.
Do you see other STIs in your clinic? I mean severe cases like syphilis? Are these cases frequent?
We have syphilis, they are definitely not frequent, but they exist.
What do you think of LebMASH?
I really appreciate the work that these doctors are doing. Helping and being there for the LGBT community is what we need in our days. I support them to the maximum.
Special thanks to Doctor Ismaël Maatouk
An “A to Y” Explanation of the Hammam Al Agha Raid: Awaiting the Trial
by Rabih El Koussa
Within the effervescent city of Beirut, and among the ever-vibrant touristic stops of the streets of Hamra, lies a bathhouse so care-free that only the most stressed of men would visit. Having a fallacious reputation of only being frequented by homosexual men, Hammam Al Agha, on Saturday the 9th of August, was not as calm as always. After receiving a tip-off from an arrested man, explains colonel Tony Haddad of Hbeich Police Station, the Internal Security Forces (ISF) proceeded onto raiding the bathhouse and arresting 27 men, including the owner of the Hammam, the employees, and the clients, on the allege that Hammam Al Agha is a venue commonly visited by men who seek sexual encounters with other men, hence, a possible offense of Article 534 of the Criminal Penal Code which prohibits “unnatural sexual intercourse.”
It is necessary to recall previous landmark ruling of Judge Naji Al-Dahdah who considered that Article 534 is irrelevant as gender is based on self-perception, and to consider the preceding decision of Judge Mounir Suleiman in December 2009, who found that article 534 is no longer applicable in circumstances of homosexual sexual intercourse, as homosexuality might be defying the prevalent norms of society, yet is absolutely not against the laws of nature. Since when has a set of legal advisers been able to dictate what nature deems natural or unnatural?
To a great surprise, the unfortunate incident had only come to the attention of civil society two days after the arrest, on the night of Monday the 11th of August. And to a greater surprise, the improper raid and detention, (a clear breach of humanitarian logic and moral) was only considered a relevant issue by NGOs concerned with the physiological and psychological health of LGBT people.
The first question to be asked: Why is the legal system corrupt? Why are detainees considered guilty until proven innocent? This, from this point on, is no longer a fight the LGBT community must hold. It has become the moral obligation of anyone who believes in a system of ‘innocent until proven guilty’ instead of ‘guilty until proven innocent.’ Subsequently, a press release which was written as a collaborative work of Helem, the Arab Foundation For Freedoms And Equality, M-Coalition, Marsa – Sexual Health Center, and LebMASH confirmed the detainment of 27 men and started an investigation on the reasons of the raid and the status of the detained.
When asked, Col. Haddad denied that any of the detainees were subjected to any physical or verbal violence or abuse – nor to the anal probe test – throughout the investigation. Col. Haddad also informed us that “the investigators were able to obtain confirmations from some of the detainees concerning their sexual orientation,” explains the press report, on the basis of what Col. Haddad has claimed, which cannot be confirmed beyond his word.
The files of the detainees have been transferred to General Prosecutor Bilal Dinnawi who will be presiding over the case and following up on the charges. Mr. Dinnawi has expressed an unlikeliness of charging the detainees with an offense of Article 534, and will be accusing the still-in-custody men of an offense of Article 521, an infringement of public decency. After getting acquainted with legal perspective regarding the trial, it is safe to say that Article 521 is not applicable in such a situation and would be considered an invalid interpretation of the law. “Unless serious evidence is available, the charges must be dropped immediately,” added another lawyer.
A law instructor at the Lebanese University (LU) clarified that any activity occurring within the bathhouse with the consent of the owner technically renders the action “private” which eliminates any possibility of “public” indecency. Following up on the lack of media attention to the subject, it becomes a responsibility to highlight MTV’s homophobically inaccurate article headline “Collective Homosexual Acts in a Beirut Hammam”, and LBCI’s news remark “The protection of public decency in Lebanon has been revolving around raiding cinema halls, night clubs, and homes, and now, Turkish bathhouses. The protection of public decency has become a means of exploiting personal sexual freedom by a law which by itself contradicts the laws of nature.”
The defendants have been contacted by several NGOs and have expressed great discomfort and disorientation regarding their present status and the process of the investigation and the trial. At the time this article was written, the NGOs collaborating on the lobbying for the release of the detained had contacted Ghida Franjieh from the Legal Agenda and had inferred that the 27 detainees will be charged with both, an offense of Article 534 as well as several offenses of Article 521.
Additionally, and with a sudden twist of preliminary charges, the owner of the Hammam will be accused of soliciting sex work and prostitution. Concerning the trialled men, six had been able to obtain a release form and were let go, sixteen had requested continual support and follow up from the civil society regarding bail aid and legal representation, and two trans-women have been added to the list of detainees after being held in custody for 20 days without any advancement with their cases.
Prosecution has set a bail of 5,000 USD and a trial date due Monday, August the 18th. The bail funds are yet lacking and NGOs are requesting financial aid through Marsa‘s “donate now” section or through deposits at Bardo under the name of Joseph Aoun. The critique boiling up from within NGO employees and activists has been truly degrading to Proud Lebanon and its involvement in the case. It has been said that interference and cooperation have been minimal.
“Financially, we are trying to get funds for that via our connections,” insisted Bertho Makso, Founder/Director of Proud Lebanon. Proud Lebanon is soon expected to publish a press release revolving around a pertinent action plan.
As a final request, we demand that security forces, who have raided yet another bathhouse, Hammam Shehrazade, in the morning of Thursday August the 14th, deal with the problems which are more critical, more mandatory and contribute to the betterment of society. Has fighting drug abuse among youths become too mainstream all of a sudden?
Lastly, as expressed by activist John Abou Elias, “it is important for LGBTQI individuals to be acquainted with their rights, before, during, and after trials in case of detainment; Therefore, there must be more legal outreach and awareness campaigns in the very near future.” We await Monday’s trial. Impatiently.
By: Lisa R. Riskalas
As homosexuals in an Arab country we all go through the same stages of coming out, denial, fear, carelessness and eventually pride. But some of us get stuck on the second stage due to some surrounding force; it can be anything from family and friends to employment.
At the age of nineteen, I found myself stuck in that exact stage, I told myself and many others that I would never come out to my family unless I am heading off to the airport and never coming back.
It was around that same time that I heard of Mashrou3 Leila. I recall the first song I heard, “Fasateen”; my jaw dropped at the sight of the video and the lyrics. For once I found myself attracted towards the Arabic language, the music simply hypnotized me, and as time went on I sank into the Mashrou3 Leila sea of causes, astonishing music and absolute raw honesty, and I was not the only one.
About five years later, I stood at the entrance of the Zouk Mikael Amphitheater, staring at the sight of cops and security guards everywhere. My heart pounded as I waited for the event to start, eyes carefully scanning the surroundings for a sign of disturbance and protesters but none were found.
The area was surprisingly peaceful, filled with just a few people, most of them sitting in the lunch area. Others already running to the gate, waiting for it to open so that they can jump on the first chance they can get to sit in front. I immediately ran after these people and took my spot in the front of the stage.
The bands started right on time despite the fact that barely a few people had arrived, first came Jammit the band, and then Sandmoon and by the end of each performance you could feel the vibe changing. People started moving closer to the stage and the place became far more crowded. And by the time Loopstache and Pindoll started performing people were surrounding the stage with their arms up, dancing and singing in joy.
Finally Mashrou3 Leila arrived after a few minutes delay. The screaming got louder and I was one of the people screaming at the top of their lungs. You could feel the energy shifting from musical to an astounding show of love and support for Hamed and the gay community in general. The band’s performance had a lot of heart, you could see it on their faces as they stood on stage staring at the crowd that it wasn’t simply the fans that knew that this performance was more than a concert, it was a fight against haters. As fireworks started, Zouk Mikael Amphitheater metaphorically turned into a battlefield where Hamed Sinno kicked Fouad El Adem’s ass by simply dedicating one song to him “Eskandar Ma’louf.”
As their performance ended, I walked towards the backstage entrance hoping to catch a glimpse of my personal hero where I could actually tell him the one hundred things I’ve always wanted to say. As I waited, I naively asked a cop “how’s it going?” and he nodded back at me with a very cold facial expression, I couldn’t tell whether he thought I would turn into a zombie and bite him or if he simply was disgusted by my homosexuality, and either way I didn’t care.
I walked back to stage after a few minutes of no one coming out besides whoever got backstage passes. I started watching the last performance of the night, Who Killed Bruce Lee playing their energetic and enthusiastic music on stage when I received a text from my friend who stood at the backstage entrance telling me to come quick. I ran passed dancing people, nearly tripping a couple of times until I finally arrived and saw Hamed standing with a bunch of people surrounding him and taking pictures. At that moment, I forgot everything I ever wanted to say, I simply walked up and said “Can I hug you?” and the answer was yes.
After a group photo with my friends, I asked for one more by myself where I surprised him with a kiss that I had held for years until I finally got to meet him. His reaction brought me even more joy as the photo was taken, all those words I wanted to say simply came out in a couple of hugs and a kiss to a person I deeply consider a hero, as him, his music and his band helped me (and surely many people) get through the second stage of coming out and get to the most wonderful and freeing one of all, Pride.
All in all, the performances were wonderful and the bands all did magnificently, hopefully my detailed experience could at least put the people who couldn’t attend stand in my shoes. See you at Mashrou3 Leila’s next performance, at Wickerpark on September 7th, get your tickets at http://www.ihjoz.com
Back Stage Interview with Hamed Sinno from Mashrou’ Leila
by: Rabih B. El Koussa & Lisa R. Riskalas
We were lucky enough to be able to interview Hamed Sinno backstage at Light FM’s 25th anniversary celebratory concert at Zouk Mikael. Our sincere apologies for the delay, and we hope you’ll let us know of any questions you would like us to ask in an upcoming interview.
Q: Surely, you’re used to homophobic comments here and there by now. But what was your reaction to Fouad Al Adem’s campaign to keep you out of Zouk Mikael due to your sexuality?
Hamed: Honestly Al-Adem didn’t say anything that I don’t see anywhere on my Twitter notifications board or YouTube comments on a daily basis. At first I dismissed it, the way I’ve grown accustomed to doing, but then started to panic a little bit when I saw how much of a big deal the media was making of it. I feel like in these situations, when homophobes are given so much legitimacy and affirmations for their statements, they are given more incentive to actually commit non-verbal hate crime. It was also interesting to see this happening in Zouk because it re-affirmed my take on these things being that hate stems from all sorts of fanaticism, not just the age-old-tale stereotyping the Islamic community as the sole force of bigotry in the Middle East.
Q: Were you surprised by fans’ reactions? And do you think that Fouad Al Adem influenced this performance’s crowd in any way possible?
Hamed: I’m always overwhelmed when I see so much support coming from the LGBT community during these events. It means much more to me than would be easy to articulate. I think in some twisted way Al Adem actually made the performance better, in that it reminded the audience of the politics that are actually always there in the fabric of events leading up to a stage performance. It’s easy to forget about the courage that it takes for a performer, queer-identified or otherwise, to get up on stage and subject themselves to the terror of social observation.
Q: Despite fans’ requests (including myself,) to hear Shim el Yasmine, you didn’t sing that song. Is there a certain reason behind that?
Hamed: The reason is very simple: we were doing our job, which was to put on a good show, and we were trying to keep the show as upbeat and pumped as possible. Save for Ne Me Quittes Pas, which was played as one of our two covers for the evening (the framework for all the bands involved,) we only played our more up-tempo tracks.
Q: On your first album, we find a cause in every one of your songs, from LGBTQ rights, to domestic violence, to dealing with corrupt political system, which would you consider the ultimate cause?
Hamed: The ultimate cause is to keep making music, in whatever shape or form.
Q: In the light of the homophobic movements, what can you advise the LGBTQ community?
Hamed: Do not tire. And never disregard the value of creating sustainable queer networks and support systems, even when they are for personal purposes, they have the power to renegotiate the entire foundations of the societies we inhabit.
The “Queer” Community Crashes the City of “Culture”
By: Rabih El Koussa and Lisa R. Riskalas
To formulate a synopsis of the events of the previous weeks, we asked many people at Light FM’s 25th anniversary celebratory concert, which was part of the Zouk Mikael International Festival, about what they have heard of the Free Patriotic Movement member Fouad Al Adem vs. Mashrou’ Leila dispute. Surprisingly, most people were not even aware of what has been going on. Yet after a brief explanation of the issue at hand, it was obvious that the Lebanese youths were supportive of the gay rights movements happening.
Previously, Al Adem has shown homophobic action requesting to boycott Mashrou’ Leila from Zouk Mikael and its renown festivals, clarifying that the city is religiously intolerant of “unnatural” acts of homosexuality. (Do we need to mention that homosexuality has been prevalent decades before Jesus Christ?). His posts have been given quite the attention by both sides of the struggle, the LGBTQ community as well as some locals.
Although the concert attendees were predominantly queer, we did get our hands on people who considered themselves straight. A group of straight AUB students considered that homophobia is a social disease, and that anyone who assesses the band based on Hamed Sinno’s sexuality is not even remotely fit to be part of the political community. We also interviewed a young straight man who lives in Zouk Mikael. His thoughts on the issue were clear. “Fouad Al Adem does not represent the majority of the city. He is entitled to his own opinion, yet has no right to label it as Zouk Mikael’s stance.” The supportive comments were overwhelming.
To not be considered one-sided, we also asked members of the general security what they thought was righteous. As expected, cooperation was minimal. Out of the six we questioned, only one responded. And what a response it was! He believed that for a political activist, Fouad Al Adem had to have more to worry about than a silly band playing a few songs. In accordance to what has been happening in Lebanon and the region, it is sad to see him giving attention to an issue which affects no one in particular, he added.
Moving on to the performance itself, Mashrou’ Leila was great! Their modern dance moves fused with the classical feel of the accompanying music left the crowds on their feet the whole time. The full house sang along to their most notable melodies. Their first performance was the infamous ‘Lil watan’ which all on its own fuelled the crowd, it continued with a few of their original songs ‘fasateen’, ’Imm el Jacket’, ‘Raasuk’, ‘Bahr’, ‘Wa Nueid’, ‘Abdo’, ‘Taxi’, among many others, and included their amazing Arabic cover for ‘Toxic’ (originally by Britney Spears).
Halfway through their exquisite performance, Hamed decided to dedicate a rather controversial song ‘Eskandar Ma’louf’ for none-other than Fouad Al Adem, giving their concert an even more enthusiastic state towards the gay community that filled the amphitheater both for musical and equality reasons.
Video of the above: https://www.youtube.com/watch?v=drrx-Ej_IRg&feature=youtu.be
And because we believe that Mashrou’ Leila is not only about about Hamed Sinno, we find it necessary to mention that Haig Papazian’s contribution (from the violin) to the instrumental aura was delicately well-crafted and intricately magnificent!
Well done boys! And to the surprise of most, the band did not play ‘Shemm El Yasmeen’. Was that one of the guidelines set by the Zouk Mikael International Festival organising committee? No one knows. According to an inside source, Mashrou’ Leila’s performance was not confirmed until a day before the concert. We can’t imagine what would have happened if they had cancelled.
Only one band was left to perform after Mashrou’ Leila. But before Who Killed Bruce Lee even started, more than half of the people had left. Let’s just say attendees were tired, because Who Killed Bruce Lee was awesome! Luckily, we managed to interview Hamed Sinno backstage after the concert, and ask him some of the questions roaming every fan’s mind which we will be posting soon.
In recent days, it has become evident that anal tests or “Shame Tests” have returned to Lebanon, as Dr. Ahmad Mokdad, a Lebanese forensic doctor, has been examining individuals using the abusive test in order to determine their sexual orientation. The test, banned on August 7th 2012 by the Lebanese Order of Physicians, includes the forcible insertion of a metal egg-shaped object into the anal rectum, which supposedly tells if an individual had anal intercourse. Obviously, the test is a sham, as it fails to prove anything. Firstly, consensual anal intercourse does not leave permanent scarring or result in deformities of the anus or penis. Secondly, homosexuality, which is what the test is intended to prove, is not only about anal sex but is a much more complex concept, based on attraction, behaviour and identity.
In August 2012, the Lebanese police arrested 35 men (which is reported here, on the Daily Star website) at a cinema in the Bourj Hammoud district of Beirut, as they had received a tip-off that the men were watching homosexual pornography. All the men were subjected to the test and forced to pay the $85 which the test costs. Three of the men were later charged of ‘unnatural sex’ under the archaic and condemned Article 534 of the Lebanese Penal Code. Whatever the conviction, the anal probe still scarred all 35 men. The Lebanese Order of Physicians, politicians and human rights activists came out strongly against the tests; there were protests staged around Beirut, denouncing the tests of shame, as they came to be known. Apparently the “Provincetown of the Middle East” (a claim made by the New York Times) is only a “gay haven” for tourists, not for locals, and definitely not for refugees (which became evident after the Dekwaneh scandal).
The Lebanese Medical Association for Sexual Health (LebMASH) just released a position statement (http://lebmash.wordpress.com/2014/07/07/anal-tests/) on anal tests to assess someone’s sexual orientation. LebMASH has responded to the Legal Agenda’s report on shame tests still being performed in Lebanon, where 5 men recently were subjected to the test (in Arabic). LebMASH urges the Lebanese Order of Physicians (LOP) to discipline Dr. Ahmad Mokdad and offers to provide the LOP’s members with cultural competency training and scientifically sound educational sessions on the topic.
I, Jonathan Lawrence, thank Raynbow.info for hosting my post. I decry the lack of media attention to this story. There are regular reports in Western media concerning homosexuality and homosexual rights, yet these outrageous invasive and abusive tests, which can permanently damage an individual, both mentally and physically, have largely been ignored by Western media outlets.
For almost a year, an item about LGBT (lesbian, gay, bisexual and transgender) health has been denied entry to the agenda of the World Health Organization (WHO) Executive Board meeting. The item is simple: “improving the health of lesbian, gay, bisexual and transgendered persons.” Deliberately unfortunate, countries belonging to the AFRO (Africa) and EMRO (Eastern Mediterranean) regions have been repeatedly refusing to even discuss this item, let alone add it to the WHO agenda.
International health and human rights organizations, including the Lebanese Medical Association for Sexual Health (LebMASH), congregated and have been discussing over the past year the best approach to tackle this issue. For all this time, the work has been done in secret and was especially kept away from the media. After diplomacy efforts did not lead to inclusion of the item on the agenda, a decision was made to bring the issue to the public’s attention in order to rally organizations, especially in the global south and the EMRO and AFRO regions to get involved.
The main problem posed is unequal access to health care for LGBT individuals. People who express their sexual orientation, their gender identity, and their sexuality are more-often-than-not denied health services and are subject to harassment, shame, physical and verbal violence, and sometimes arrests. Some expose themselves to “underground” care and often put their lives at risk as a result.
Other consequences of such discrimination include cases of depressions, substance abuse, and disregard to STI protection and prevention.
A petition (to be signed by organizations) is circulating the net today, urging Director-General of WHO Dr. Margaret Chan to push for a continued dialogue regarding these issues and to encourage the EMRO and AFRO regions to take them into consideration. Furthermore, it demands further studies and researches to be conducted on LGBT health services.
This petition needs our signatures. Follow the link below, read it, sign, and spread the word to ensure a safe and healthier environment for our fellow LGBT. Quoting Dr. Hasan Abdessamad, a human rights activist and president of LebMASH, who has written about this issue today:
Health care is a right, we should not allow it ever become a privilege.
Sign Your Organization Here: http://www.msmgf.org/index.cfm/id/65/alert_id/21 before March 10 2104.
Sign On for WHO Consensus on LGBT Health!
Dr. Margaret ChanDirector General World Health Organization Avenue Appia 20 1211 Geneva 27 Switzerland
Dear Madam Director General:
We, the undersigned civil society organizations from all regions of the world, respectfully write to you today to show our support for the complicated work you have undertaken of finding consensus on how to discuss issues related to access to health for lesbian, gay, bisexual, and transgender (LGBT) individuals. We are dismayed that the topic has become so contentious and difficult to discuss, but we write to encourage you to persevere and bring these very important and appropriate health concerns to the work of the World Health Organization.
We represent a variety of health, HIV, human rights, and LGBT organizations which all work in some manner on the real impact of discrimination against individuals based on actual or perceived sexual orientation and gender identity. This discrimination is rampant in all of our societies, despite differences of culture, economics, politics, or legal status of homosexuality. Such discrimination directly impacts the health outcomes of these communities. Whenever any group of people—no mater how marginalized—experience disparate health outcomes, that is of legitimate interest to the WHO and deserves to be studied and understood fully. We appreciate that you have personally taken the time to ensure that the Executive Board of the WHO will address these issues appropriately.
As you know, reports from every region of the world show that LGBT citizens lack equal access to health care, and experience real discrimination based on exposing their sexual orientation, sexuality, gender identity, gender expression, or bodily diversity in health care settings. Such discrimination takes many different forms including outright denial of services, harassment, embarrassment, violence and arrest, as well as internalized stigma and shame. Such experiences lead directly and indirectly to bad health outcomes, such as higher incidents of depression, drug and alcohol use, lack of HIV prevention and treatment, and even suicide. Cancer-related health disparities for lesbian women have been indicated in a variety of studies, and transgender individuals receive particularly poor or no appropriate health services specific to their needs.
We write today to encourage continued dialogue and discussion of these important health matters, and to make sure that the item does not get permanently postponed or deleted from the agenda of the Executive Board. We further urge the Secretariat of WHO to engage in further study and research on the health outcomes for LGBT communities in all parts of the world, since a disproportionate amount of existing data comes from Global North countries. It is imperative that the WHO encourage thoughtful and unbiased study in all regions of the world.
This is an important moment in the evolution of global health to address the particular health challenges of LGBT populations. This is indeed a critical next step for WHO to help improve the vital and universal access to health for LGBT people.
Should there be anything we can do to support this effort, please let us know.
With respect and hope for a healthier world,
SIGN ON HERE: http://www.msmgf.org/index.cfm/id/65/alert_id/21/
By Steph El-Haddad for Raynbow.info