Part of the brilliance of Quammen's book, "The Tangled Tree", is that he instinctively uses the metaphoric tunnelling device of following the trail of diligent people, but he's also acutely aware of the endless and eternal background of Time sliding the sheets of code through geology, oceanography, volcano vents, climate change, and all the inhabitants of all the niches identified. No niche goes uninhabited. No inhabitant -- well, very few -- ignores code because they are made of code.
A curve-ball. The personal emotions of people slammed by stigma or poverty or emergency are valid. But they are also against the reality of what happens so that they know their own hardships are not necessarily their fault, might be small in terms of the whole, and might even turn out to be openings into new life never imagined before. Code characteristics may make a person different from the rest. The creature impulse is to destroy all difference.
Let's make this real. No one imagined that the cultural explosion of San Francisco gays would happen or what it would be like if it did. Then, to be followed so immediately by AIDS -- suffering and death, scattering, and the demands of compassion -- shaped a body of human beings. Not all the ones who were caught by HIV that equals male, because there were plenty of people who were NOT male, NOT polyamorous, not even THERE, but who were affected anyway. Like, the whole culture. The men who fit the pattern didn't all die but carried their values throughout the world to which they had access.
Now there is a body of survivors who as boys suffered at least suppression and confusion, maybe active violence; who then escaped to settings where they could pass or it didn't matter; carrying ideas acquired as they were driven deeper into concepts -- maybe Asian, maybe arcane European ideas, maybe unique small knots of people in sympathy. Today they are often remarkable. One even showed up in Quammen's survey, not just gay but also attracted to children, which is a whole different and scarier kettle of fish. But he was an achiever.
When one tries to explore this guarded category of men, "sex" as in performative flesh interaction, is a distraction. It's hard to get past "fisting" to think about anything else. But if one takes on "sex" either in the sense of universal reproduction with its tumult of variations in number and method -- sea creatures and insects and exotic animals -- the human rules about what is "in" and "out" become clearly arbitrary or at least unjustified in terms of behavior. Some things defined as criminal and justifying death turn out to jack up the prices for commercial acts. Some old or isolated tropical island cultures draw the lines quite differently. Heck, even in one city or other it's accepted to be outside the line if you're rich and important, so it becomes a marker of importance if you are immoral. We see in the news everyday.
Such a situation breeds peripherals (the massage parlor) and imitations (young women dressed as for sale in high schools across the country). Bookkeepers and commercial hosts and shops and a media that loves scandal, both for the front page and as grist for the story mill. They don't want their income threatened.
Gay men step aside from the politics and poetry of fertility to some extent, but they are still part of the world population. Their values pertain, except that survival is always the criteria, so that surviving is what determines what tomorrow will be like. The gay men who have survived the era of AIDS have real impact. Even stigmatized they can be respected So now MRSA happens. ("Methicillin-resistant Staphylococcus aureus refers to a group of gram-positive bacteria that are genetically distinct from other strains of Staphylococcus aureus. MRSA is responsible for several difficult-to-treat infections in humans.") We're told that today MRSA kills more people annually than does AIDS. One "catches" MRSA in hospitals. Hospitals must be scrutinized. They are becoming stigmatized. Low pay. Immigrants.
One thing veteran gays have learned is that it's not just the physical facts -- sanitation, technology, surgery -- that make the difference with disease but also the attention paid, the empathy working, the emotional conversation with the afflicted. The balance between individual and community makes a difference. The same is true across the world, for instance with ebola, which is so scary that is terrifies people into self-destruction. But consider that Doctors Without Borders go there anyway, and die with their patients. Consider that patients who recover and therefore are immune, often stay to help those who are dying.
What the world needs desperately in the face of climate change and national boundary shifts is the courage to survive. This is what the HIV elders know about. It seems like one of the first things to do is to get rid of stigma. But that was what drove them into an enclave of vigorous, experimenting, wildly colorful and rule-breaking community in the first place. The stigma that justified beating one's own children or throwing them out for being gay, was a door opening when they found each other. It's just that the stigma now ought to be stamped on a corporate government of personal enrichment which is killing many, many people, whatever kind they are.