Understanding & Addressing Mpox-Related Stigma from an Intersectional Lens

In recent months, mpox (formerly known as monkeypox) has re-entered public discourse. Canada, among other countries, was affected by the 2022 global outbreak, with cases disproportionately impacting Two-Spirit, gay, bisexual, and queer men, as well as trans and gender-diverse people (2S/GBTQ+)[1]. Now, with an emergency declaration from the World Health Organization and extensive media coverage, 2S/GBTQ+ communities face yet another blip in cases. While mpox rates have been increasing again in Canada this year, it is important to recognize that mpox and its accompanying stigma never really left. With greater rates of mpox infection among 2S/GBTQ+ communities, we also face greater vulnerability to mpox-related stigma from our communities and society at large[2]. As our understanding of mpox continues to evolve, we owe it to our communities to ensure we address this blip and any future outbreaks from an intersectional lens with the aim of reducing mpox-related stigma.  

Mpox–related Stigma: What is it?

The term “stigma” refers to the pervasive presence of negative beliefs, judgments, and biases that individuals or societies hold against specific groups, characteristics, or behaviours. Through stigma, individuals or communities are labelled and devalued based on perceived differences or deviations from societal norms. Often this leads to discrimination, exclusion, and marginalization[3]. In the case of mpox, there is no collective definition of mpox-related stigma; however, literature has conceptualized it as the societal disapproval of mpox and its affected social group(s) (i.e. 2S/GBTQ+ communities) that manifests from larger socio-structural practices (i.e. homophobia, heterosexism etc.)[4].  Mpox-related stigma has manifested through the dissemination of homophobic rhetoric through social media and mainstream media[5]. Within our communities, mpox-related stigma has impacted 2S/GBTQ+ communities’ willingness to report symptoms or possible infection and access clinical care[6].

The ways in which 2S/GBTQ+ communities experience mpox-related stigma can have significant implications for minority stress[7]. Minority stress theory posits that marginalized and stigmatized communities experience additional stressors that negatively impact health and well-being. It is important to note, however, that minority stress theory only poses a limited framing that obscures the intersecting identities that 2S/GBTQ+ communities hold while living through the age of mpox outbreaks and its accompanying stigma[8].

Intersectionality & The Future of Mpox

Despite the growing body of literature examining the impact of mpox among 2S/GBTQ+ communities, often the socio-structural context and analysis of mpox is missing. Intersectionality is a critical framework examining micro-level social identities that are shaped and reinforced by interlocking, macro-level socio-structural systems of power, privilege, and oppression (e.g., homophobia, transphobia, racism) that exist in how we see and move through the world[9]. Using an intersectional lens, mpox-related stigma poses that 2S/GBTQ+ communities are not only marginalized due to disproportionate rates of mpox infection, they also historically carry negative mpox-stigmatizing narratives (i.e. promiscuous, “dirty/immoral”, HIV/AIDS) that in such cases could cause confirmation bias [10].

Applying an intersectional lens in addressing mpox and its accompanying stigma provides an opportunity to use a critical lens in understanding how socio-structural systems of power, privilege, and oppression intersect with 2S/GBTQ+ communities’ social identities when experiencing this blip and any future mpox outbreaks. Without this lens, we face critical deficits in our mpox response for 2S/GBTQ+ communities[11].

Our communities have tremendous experience rallying in response to infectious diseases and STIs. Mpox is no different. CBRC is committed to ensuring our mpox response takes an intersectional lens in its approach. To ensure our communities are well-informed, CBRC has developed several mpox resources to protect the health and well-being of our communities.

Visit mpox.ca to learn more about mpox and stay up to date.

 

[1] Epidemiological summary report: 2022-2023 mpox outbreak in Canada. Epidemiological summary report: 2022-2023 mpox outbreak in Canada - Canada.ca

[2] Turpin, R. E., Mandell, C. J., Camp, A. D., Davidson Mhonde, R. R., Dyer, T. V., Mayer, K. H., ... & Boekeloo, B. O. (2023). Monkeypox-related stigma and vaccine challenges as a barrier to HIV pre-exposure prophylaxis among black sexual minority men. International Journal of Environmental Research and Public Health20(14), 6324.

[3] Acharya, A., Kumar, N., Singh, K., & Byrareddy, S. N. (2024). Mpox in MSM: Tackling Stigma, Minimizing Risk Factors, Exploring Pathogenesis, and Treatment Approaches. Biomedical Journal, 100746.

[4] Takenaka, B. P., Kirklewski, S. J., Griffith, F. J., Gibbs, J. J., Lauckner, C. K., Nicholson, E., Tengatenga, C., Hansen, N. B., & Kershaw, T. (2024). "It's another gay disease": an intersectional qualitative approach contextualizing the lived experiences of young gay, bisexual, and other sexual minoritized men in the United States during the mpox outbreak. BMC public health24(1), 1574. https://doi.org/10.1186/s12889-024-19062-z

[5] Dsouza, V. S., Rajkhowa, P., Mallya, B. R., Raksha, D. S., Mrinalini, V., Cauvery, K., Raj, R., Toby, I., Pattanshetty, S., & Brand, H. (2023). A sentiment and content analysis of tweets on monkeypox stigma among the LGBTQ+ community: A cue to risk communication plan. Dialogues in health2, 100095. https://doi.org/10.1016/j.dialog.2022.100095

[6] Sachdeva, H., Shahin, R., Ota, S., Isabel, S., Mangat, C. S., Stuart, R., Padhi, S., Chris, A., Mishra, S., Tan, D. H. S., Braukmann, T. W., Eshaghi, A., Mejia, E. M., Hizon, N. A., & Finkelstein, M. (2024). Preparing for Mpox Resurgence: Surveillance Lessons From Outbreaks in Toronto, Canada. The Journal of infectious diseases, 229(Supplement_2), S305–S312. https://doi.org/10.1093/infdis/jiad533

[7] Turpin, R. E., Mandell, C. J., Camp, A. D., Davidson Mhonde, R. R., Dyer, T. V., Mayer, K. H., ... & Boekeloo, B. O. (2023). Monkeypox-related stigma and vaccine challenges as a barrier to HIV pre-exposure prophylaxis among black sexual minority men. International Journal of Environmental Research and Public Health20(14), 6324.

[8]  Takenaka, B. P., Kirklewski, S. J., Griffith, F. J., Gibbs, J. J., Lauckner, C. K., Nicholson, E., Tengatenga, C., Hansen, N. B., & Kershaw, T. (2024). "It's another gay disease": an intersectional qualitative approach contextualizing the lived experiences of young gay, bisexual, and other sexual minoritized men in the United States during the mpox outbreak. BMC public health24(1), 1574. https://doi.org/10.1186/s12889-024-19062-z

[9] Ibid

[10] Ibid

[11] Ibid

Disponible en français.

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Community-Based Research Centre (CBRC) promotes the health of people of diverse sexualities and genders through research and intervention development.
Understanding & Addressing Mpox-Related Stigma from an Intersectional Lens
Understanding & Addressing Mpox-Related Stigma from an Intersectional Lens
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