Commentary : Agony of a Decision: Weary of Deaths, Gay Doctor Votes to Close Bathhouses

On Jan. 20, the San Diego County Regional Task Force on AIDS voted 11 to 5, with 4 abstentions, to recommend to the county Board of Supervisors that bathhouses be closed. I was one of those who voted in favor of closure, but my decision was not easily made.

As a gay man, I had believed that the existence of a place where gay men could go to have sexual contacts was a part of our liberation from sexual oppression. As an individual, the idea of regulation of sexual behavior ran contrary to all my beliefs in our rights as humans to conduct our private lives without interference; and I am still not comfortable with even the concept of such regulation.

But as a physician who has been involved in the AIDS epidemic for more than four years, I have grown tired of seeing patients and friends become sick and die.

Proponents of the status-quo for bathhouses (that is to say, self-regulation by each bathhouse owner) would have us believe great changes have occurred in them in the past few years. We are told many people who go to bathhouses do so for recreation or exercise and not for sexual contact. If they do in fact have sexual contact, we are assured that it is almost always safer sex and, furthermore, that the bathhouses are festooned with literature and posters about responsible sexual practices and condoms are readily available, presumably fostering an environment that encourages safer sex.

Bathhouses are presented as the only viable way to reach bisexual and closeted gay men with AIDS-prevention education. And, finally, we are warned that the dire consequence of closure or regulation of the bathhouses will be to drive all their clients to other locations of sexual activity (parks, bathrooms and bookstores are frequently cited) where it will be impossible to reach them with education.

I must admit some bathhouses have made significant changes in an attempt to promote safer sexual activity within their walls. Posters and pamphlets promoting responsible sexual activity are evident in some bathhouses, and I am aware of at least one in which free condoms have been readily available for years.

Unfortunately, recommendations do not necessarily translate into actions, and I have had enough people tell me that unsafe sexual activity continues in bathhouses that I must believe it is so. Of course, such activity also occurs in private homes, but mandating regulation of sexual activity in private dwellings is inappropriate and unacceptable.

On the other hand, bathhouses are publicly licensed, commercial establishments, which exist only for the purpose of providing a place for people to meet for sexual liaison. As such, they should then be under the regulation of the authority licensing them.

To present bathhouses as the only method of reaching bisexual and closeted gay men with AIDS-prevention education is fallacious. I will grant that these men are unlikely to be adequately reached by the massive and well-coordinated effort of education which has occurred in the gay community. However, a proper, well-coordinated, frank and culturally sensitive public program of AIDS education certainly would have the potential to reach these men. To believe they are not reachable except in the environment that encourages the very activities we are educating against is dangerously naive.

I am not convinced that a significant number of men who regularly attend bathhouses will in fact flee to other venues of sexual activity should the bathhouses be closed or regulated. The environment of the bathhouse provides an easy, comfortable and convenient surrounding for sexual activity. Parks, bathrooms and bookstores do not. Many men will be unwilling to take the risks associated with these areas, and therefore much of their sexual activity may be curtailed.

The bathhouse issue is really a minuscule one. A small percentage of gay men attend them on even an occasional basis. The majority of gay men have been educated regarding AIDS and many have become more responsible in their behavior. Those few who continue to frequent bathhouses, many of whom may still be indulging in unsafe sexual practices, are no more likely to change their behavior if they are educated in the bathhouse than if they are educated through the media.

By my vote, I intended to send a very clear message to the entire public. We are living in the midst of an epidemic, and under these circumstances unsafe sexual activity is precisely that, unsafe. I cannot in good conscience, support establishments that exist solely to provide a location for sexual activity, regardless of whether that activity is gay or straight.