Syphilis Is Back, Babe: What the Queer Community Needs to Know
- Raine Lovebright
- Jun 5
- 4 min read
If you’ve been paying attention to sexual health news lately, you may have heard something surprising: syphilis is on the rise, and not just a little. Syphilis (aka that sneaky little bacterial baddie Treponema pallidum) is a sexually transmitted infection that can show up through all kinds of queer play. It’s been around for centuries, but don’t let the vintage vibes fool you, it’s still very much a thing, and it deserves our attention, not our shame.
In the last decade, cases across Australia have increased sharply, affecting a wide range of communities, including gay and bisexual men, trans masc folks, and others engaging in queer sex, and Aboriginal and Torres Strait Islander people. According to health.gov.au data, cases have tripled between 2014 and 2022 which is not a slay.
As someone working in sexual and reproductive health, I’ve been diving deep into the latest research, and what I’ve learned is both urgent and hopeful. We’re seeing dangerous gaps in testing and care, but we also have powerful tools to turn this around.
If you’re queer and confused about how this affects you, you’re not alone. Let’s break it down.
What’s Happening?
Syphilis rates have skyrocketed in Australia since 2010, particularly in urban areas and among high-risk populations.
Gay and bisexual men (GBM), especially those using HIV prevention tools like PrEP, are seeing the highest rates of infection and reinfection (Traeger et al., 2024).
In people with cervixes, syphilis cases have risen sevenfold, with a serious consequence: a return of congenital syphilis, a preventable but potentially deadly infection passed from mother to baby during pregnancy (Borg et al., 2023).
Aboriginal and Torres Strait Islander people continue to be disproportionately affected, with syphilis rates 6 to 30 times higher than in non-Indigenous Australians (Phua & White, 2024).
Why This Matters
Syphilis might sound like a relic from the archives, but she’s alive, well, and doing laps through our communities. Left untreated, syphilis can work her way through multiple stages (primary to tertiary) and cause some serious health issues think nerve damage, vision problems, and for pregnant people, really serious risks like stillbirth.
The good news? She’s curable. Most cases are treated with a single injection of benzathine penicillin (yep. usually in the butt cheek. iconic, no?). With regular testing, queer-informed care, and a bit of community team-work, we can shut syphilis down and keep each other safe.
The Myths (and Why They’re Dangerous)
One of the biggest barriers is misinformation. Many people, including queer folks and women, simply don’t think syphilis is something they need to worry about. Some common myths I hear:
“Only gay men and victorian-era wenches get syphilis. “I’m not having sex with a man right now, so I’m not at risk.” “I got tested a while ago, I’m good.”
Here’s the truth:
Syphilis is spread through any genital skin-to-skin contact, not just through penetrative sex.
Around 50% of people will have no symptoms and will only be diagnosed by screening with serological testing (blood tests).
Yes, you can get syphilis from kissing! Especially if one person has a syphilis sore (called a chancre) in or around their mouth. While it's more commonly passed through genital skin-to-skin contact, oral contact can still spread the infection. That includes deep kissing, oral sex, and rimming if a sore is present. So if you notice something unusual , like a painless sore, get it checked out. No shame, just facts and care.
Once you've had syphilis, you're more likely to get it again, especially if your partner hasn’t been treated.
Where Are the Gaps?
Based on the research, some serious gaps are putting people at risk:
Testing isn’t happening often enough, especially in women, who are often diagnosed late or during pregnancy.
Most women are diagnosed in general practice settings, not sexual health clinics, meaning frontline clinicians need better support and awareness.
Aboriginal and Torres Strait Islander communities face additional barriers due to stigma, lack of culturally safe care, and structural inequality.
Congenital syphilis cases are rising because people are falling through the cracks, often acquiring infection later in pregnancy and not getting timely treatment.
What Can We Do?
If you're a clinician, nurse, educator, or community member, there are clear actions we can take:
1. Promote Regular Testing
If you're sexually active, get tested at least every 3 months if you're at higher risk (e.g. on PrEP, multiple partners, or have had STIs before).
All pregnant people should be screened for syphilis early in pregnancy, with retesting later if at risk.
2. Create Safe Spaces for Care
Culturally safe, trauma-informed, and LGBTQIA+ inclusive care is not optional. It’s essential.
Ask your clinic what training they’ve done, or better yet, choose a queer-friendly provider.
3. Talk About It
Stigma thrives in silence. Let’s normalise conversations around testing, reinfection, and prevention.
Encourage your friends, patients, or community to get tested and ask questions.
4. Support Community-Led Outreach
Especially in Aboriginal and Torres Strait Islander communities, we need to work with, not for, community to ensure respectful, accessible care.
You Deserve to Know (and Be Cared For)
Syphilis doesn’t care about your gender, sexuality, or postcode, but the healthcare system often does. That’s why it’s so important that we prioritise equity in our response.
As a trans woman and nurse, I know first hand how easy it is to delay testing when clinics don’t feel safe. But we deserve better, and we can demand it.
Got questions? Curious about where to get tested? Reach out to your local sexual health clinic, Aboriginal Community Controlled Health Organisation, or LGBTQIA+ health service.
The information provided in this blog post is intended for general educational purposes only and does not constitute professional medical advice, diagnosis, or treatment. While I am a registered health practitioner, this content is not a substitute for consultation with a qualified healthcare professional who can consider your individual circumstances.
This blog reflects my personal views and professional experiences and does not represent the views of my employer or any affiliated organisations.
In line with AHPRA guidelines, no testimonials are included, and this blog post is not intended to advertise or promote specific services or treatments.
Glad to hear it's easily cured! But still a bummer (pun intended)