Before AIDS: Gay Health Politics in the 1970s by Katie Batza (review)

Katie Batza’s Before AIDS dramatically expands our portrait of the gay 1970s and of the relationships between gay liberation, the US state, and the politics of health. Through three case studies and a tightly argued, absorbingly written analysis, Batza shows that health activism was central to gay politics well before the beginning of the AIDS epidemic. In tracing the creation of a gay health infrastructure, she shows how activists interacted with the state, and she makes a compelling argument for the state’s role in shaping—rather than simply suppressing or incorporating—gay politics in the 1970s. Through her analysis of activists’ negotiations with state power, Batza illustrates how the emergent neoliberal order incorporated certain aspects of gay organizing even as it worked to demobilize gay liberation.

Batza’s work overturns any assumption that gay health activism began with responses to AIDS. From the outset of her narrative, she emphasizes the connections between gay health activists and the other radical movements of the 1970s. As multiple scholars have shown, gay liberation and lesbian feminism held close ties to antiwar activism, women’s liberation, and Black Power.¹ Batza adds to this work by showing that such links found practical expression in health activism. Gay health activists drew inspiration from the work of the Medical Committee for Civil Rights, Black Panther clinics, and feminist self-help and antipoverty organizing. In these examples, not only did doctors become activists, but activists without prior health care training challenged medical authority and at times provided medical care themselves. Members of the radical health movement saw disease as driven by poverty and discrimination, and they worked to achieve preventive health through participatory democracy and community projects. Batza argues that gay activists, informed by this model and fueled by doctors’ ignorance of their needs, created “a largely self-sufficient gay medical system that challenged, collaborated with, and educated mainstream health practitioners” (5).

Batza’s case studies examine the Fenway Community Health Clinic in Boston, the Gay Community Services Center in Los Angeles, and the Howard Brown Memorial Clinic in Chicago (HBMC, now Howard Brown Health). Through each site, Batza investigates distinct political relationships and approaches. She contends that the variety of political strategies reveals the ways that gay liberation functioned as a local rather than national movement.

Boston’s Fenway clinic had its roots in community organizing against urban redevelopment. Embracing an anticapitalist and feminist vision of medicine, the clinic was initially staffed largely by volunteers and served a variety of clientele; its services for gay men centered on venereal disease testing and treatment. Fenway volunteers situated gay health in an ethos of self-help and multi-issue progressive politics. Eventually, but reluctantly, they professionalized the structure and practices of the clinic to meet state regulatory and funding requirements. Batza cogently argues that these strategies demonstrate that gay health activism was not suppressed by what Margot Canaday has termed a “straight state”; instead, it was corralled into an “antiqueer state . . . [that] encouraged assimilation while quashing the possibility of structural transformation” (67).²

The Gay Community Services Center of Los Angeles was also inspired by radical politics, but, as distinct from the Fenway example, it focused its efforts on gay men. Its founders conceptualized gay men as suffering from “oppression sickness,” which necessitated a broad range of programs to address needs from sexual health to mental health to financial well-being. The center rejected the idea of homosexuality as an illness and sought to mobilize social services to fight antigay bias. Yet its leaders turned away from broader leftist coalitions in order to secure state funding. They also repeatedly defined health needs in ways that assumed gay to be only white and middle class. Thus the Los Angeles example provides a different kind of evidence for Batza’s concept of the antiqueer state.

The structure of Chicago’s HBMC reflected gay health activism’s earliest and closest relationship with the...