informed the development of gay health activism in two ways. First, they created a mind-set within struggling communities that community members could create solutions to their problems and that the government would help. Second, and more practically, Great Society programs encouraged the creation of community health clinics for underserved communities through direct funding and fund-matching programs. In this context, state initiatives actually provided, albeit unintentionally, for gay and lesbian health activism.
Against this larger backdrop, Before AIDS makes five central claims, with one chapter dedicated to each. First, gay liberation emanated from distinctly local circumstances and is better understood as local gay activism happening in multiple locations across the country rather than as a unified national movement. Second, and relatedly, gay health activism emerged from a wide variety of 1960s social and political movements, such as feminism, antipoverty programs, and civil rights activism, and often reflected a local political context more than any national gay political agenda. From these two perspectives, gay liberation is one among many contributing factors in the development of gay services and institutions, rather than the sole impetus. Third, despite the continued marginalization of gays in U.S. society during the period, the state actually contributed significantly, though often unintentionally, to the health activism of gay men in the 1970s. This occurred through funding and policy making that led indirectly to the founding and evolution of gay community health clinics throughout the decade. Fourth, as a consequence of community clinics, outreach programs, and research efforts, the meanings of sexuality and health within both gay political and mainstream medical communities changed significantly over the course of the 1970s. Finally, a substantial and multifaceted gay medical infrastructure predated the AIDS crisis of the 1980s, a fact that is, with few exceptions, overlooked in the vast literature on AIDS (not to mention my initial daydreamed history of gay community health clinics). This existing infrastructure made significant contributions to gay health and mainstream medicine in the 1970s and was well positioned to serve effectively on the frontlines of the early AIDS epidemic of the 1980s.
CHAPTER 1
REIMAGINING GAY LIBERATION
Arising in the late 1960s, gay liberation sparked the exponential growth of gay institutions and services, including those for health. As a movement, gay liberation championed and personified a militant gay and lesbian politics that redirected the blame for homosexual oppression to society rather than to homosexuals themselves and celebrated gay and lesbian sexuality. Taking advantage of diminished policing of gay spaces and a larger political context that challenged the status quo, gay liberation embraced the concept of “gay is good,” a complete shift from earlier political and medical framings of homosexuality. The movement also witnessed the proliferation of businesses, newspapers, and social outlets by and for gay communities in cities across the country. Nevertheless, it was local politics, activists, and contexts that directed the evolution of these services and institutions more than any national gay liberation movement or politics. Indeed, the gay health activism of the 1970s demonstrates that gay liberation played, at times, only a minor role in the development of gay health services and the resulting gay institutions.
Among gay health activists and in the clinics they started, gay liberation rarely conformed to the imagined history common in today’s LGBTQ communities, which homogenizes and romanticizes 1970s gay experiences by suggesting that gay urban communities across the country acted similarly, held shared beliefs, and deployed common tactics to fight the same battles. Gay liberation as a cultural and political movement mattered as gay communities began to take on new shapes and meanings in the 1970s, and gay health activism does not discount its significance. The history of gay health activism, however, demands a reimagining of gay liberation, replacing the national movement with local examples of vaguely similar rhetoric sculpted by local contexts. This new vantage point provides a richer and more accurate understanding of the meanings of gay liberation while also revealing that many organizations and services that came to epitomize gay liberation were only gay through circumstance.
“Already Part of the We”
In Boston, gay liberation appears as only a tangential factor in the Fenway clinic’s origins and early growth. Rather, it was locally oriented opposition to gentrification that unified the neighborhood and propelled its activism. After the city approved the Boston Redevelopment Authority’s Fenway Urban Renewal Project in 1965 and began razing portions of the neighborhood in late 1967, local residents created a wide array of social services to unify the community and resist the Redevelopment Authority’s plan.1 Along with a food co-op, a newspaper, a childcare center, and a community playground, a small clinic emerged as yet another form of resistance through community building. The thinking behind these enterprises was simple: if the Boston Redevelopment Authority wanted to redevelop the neighborhood through razing, residents sought to revitalize the neighborhood themselves, eliminating the need to raze. They took advantage of federal funding through Great Society programs and deftly used photo opportunities and political optics to make destroying the neighborhood unsavory for local politicians. Thus, on a summer evening in 1971, the first in a long line of Fenway residents in need of medical care arrived at the Boston Center for Older Americans, a senior drop-in center located on the neighborhood’s eastern edge operated by the First Church of Christ, Scientist. Clinic cofounder David Scondras had decided to use the center’s space for an after-hours community clinic despite the Christian Science church’s teachings that members should maintain their physical and mental health through the use of prayer rather than medicine. Unbeknownst to center management or church officials and with the Black Panther Clinic as a model, Scondras, with the help of nursing graduate student and Fenway resident Linda Beane, began offering health services to Fenway residents, including gay-friendly VD testing to the resident gay community.2
Scondras, a recent Harvard graduate, antiwar activist, and computer pro grammer, had come to live in the neighborhood while working as an economics instructor at Northeastern University on the neighborhood’s eastern border. In the Fenway, he continued his work in the antiwar movement that had begun at Harvard and took the job at the Center for Older Americans as a way to get to know neighborhood residents. At Northeastern, the young instructor and political activist with a bushy black beard befriended Beane, who led a student group that was dedicated to the community health movement and provided free medical care. A fellow Fenway resident and also a veteran of the antiwar movement, Beane applied her political acumen to neighborhood issues, including organizing Fenway residents at the area’s Westland Avenue Community Center.3
Tensions with the Church of Christ, Scientist and the rapidly increasing number of patients made it impossible for the Fenway clinic to operate out of the Boston Center for Older Americans for long. As a result, in early 1973, the group found and rented the basement of a small building, “a defunct antique shop,” with an alleyway entrance off Haviland Street in the heart of the Fenway neighborhood, to house a new community clinic.4 The basement on Haviland Street was a far cry from a clinic at the time Scondras rented it. As one activist reminisced in an interview, “They got my brother-in-law to be their pro-bono lawyer who got them their lease for a dollar a year.”5 Community members cleaned and painted the abandoned basement and constructed makeshift exam rooms, a filing area, a waiting room, and a lab. One remembered, “I helped with some of the physical stuff when they were building, putting some of the flooring down and things like that, which was all done by probably some people who knew what they were doing and most people who didn’t and were just helping.”6 They furnished the clinic with a hodgepodge of secondhand and donated furniture, including seats from a defunct movie theater on Boylston Street that served as waiting room chairs and medical equipment from a retired Back Bay doctor, and opened the clinic’s doors to the community in August 1973.7 Medical supplies were often “acquired” by volunteers who were also physician’s assistants, nurses, doctors, or medical students dedicated to providing free health care. A longtime volunteer physician at the Fenway clinic remembered, “I’d filch stuff from the hospital and bring it over.”8 Nearly everything in the clinic was borrowed, used, or homemade,
