A Word about the Writer
and the Reader
I am a clinical psychologist, a gay man, and a member of the gay com-
munity in San Francisco. I am writing here as a psychotherapist who
has worked individually and in groups with many gay men over the past
years, and who has lost more than three dozen psychotherapy patients
to AIDS.
a gay man, I have also lost a number of close friends, and as
a member of the gay community, I have seen the awful toll this epidemic
has taken on those who have so far survived. My work here is largely
for the general, nonprofessional reader who is concerned with AIDS and
the issues that now face gay men and the future of the gay communities.
But it is, I fear, also a work about the sad future of this country as a
we continue to respond to AIDS along the paths of ignorance,
hatred, and neglect that we have tried for the past twelve years, the gay
communities will no longer be alone in the tragedy explored here, but
merely a harbinger.
Because I believe psychological clarification is a useful approach to the
issues of the AIDS epidemic-both within gay communities and society
at large-I also write in part for the psychologist and psychotherapist.
However, I have tried throughout to keep specialized psychological lan-
guage to a minimum, and have made every effort to explain it when I
could not find better words with which to express my ideas.
The text contains much first-hand clinical material, and it comes from
several sources. When the material is from other than my own clini-
cal work, the footnoted reference identifies the source. Material that is
unreferenced is from my clinical work, from notes made immediately
after psychotherapy sessions. Though I rarely take notes during sessions,
notes made after sessions help record what has happened, my thoughts
on the material, and thoughts about where the therapy is going. I am
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