(Washington Blade photo by Michael K. Lavers)
New York City lawmakers are pushing to repeal a decades-old prohibition on adult bathhouses, arguing the regulation was created during the height of the AIDS crisis and no longer reflects modern science or public health practices.
Erik Bottcher, the openly gay New York state senator who represents the 47th District that includes the Upper West Side, Chelsea, Hell’s Kitchen and portions of the West Village in Manhattan, is leading the charge to remove the decades-old ban. (Openly gay state Assemblymember Tony Simone has sponsored the repeal bill in the New York State Assembly.) Bottcher sat down with the Washington Blade to discuss why he is advocating for more bathhouses in New York City.
“This is simply about ensuring that our public health policy is in line with today’s science,” he told the Blade. “The prohibition on adult bathhouses was put into place in 1985 at the height of the the AIDS epidemic, when there was very little information, very little treatment options, few treatment options, and great deal of fear. Science has changed. Treatment has changed, and the laws need to change too.”
The proposed legislation would direct the New York State Department of Health to repeal the 1985 regulation and establish a new framework for regulating bathhouses.
“Municipalities around the country and all around the world allow for adult bathhouses. There’s no reason why New York City alone needs to maintain this outdated prohibition. Our bill orders the New York State Department of Health to strike the 1985 regulation and replace it with a regulated public health framework that’s grounded in science.”
Under the proposal, bathhouses would operate as licensed and regulated facilities subject to health and safety standards. Backers of the proposal say that framework could also give public health officials greater access to people who may otherwise be difficult to reach through traditional health care settings.
“What the Department of Health would do is work with public health experts and advocates to develop a regulatory framework that allows licensed regulated facilities to operate under clear health and safety standards — and under this — it would allow public health agencies to have greater opportunities to provide STI and HIV prevention resources, connect people to testing and treatment, conduct instructions, and address legitimate health concerns.”
Supporters of the repeal also argue banning bathhouses does not eliminate the sexual activity that takes place in them or elsewhere. Instead, they say, it pushes those activities into the shadows, where public health officials have fewer opportunities to provide life-saving services that include STI and HIV testing.
“This is also about a safer alternative than pushing activity into unregulated settings where there’s little opportunity for public health engagement because these activities are happening, but they’re happening in the shadows,” Bottcher continued. “We know that the best public health policy is to establish clear public safe public health guidelines that allow for public health intervention.”
Demetre Daskalakis, a physician and longtime HIV prevention advocate who has worked to create sexual healthcare opportunities in bathhouses, also worked with Bottcher on the proposal.
Daskalakis was a high level Centers for Disease Control and Prevention employee until 2025, when he left federal health landscape after the Trump-Vance administration ousted then-CDC Director Susan Monarez. There he worked as director of the National Center for Immunization and Respiratory Diseases and was director of the Division of HIV Prevention at the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
Daskalakis explained his experience has shown him the potential for these spaces to become points of contact for people who do not regularly access traditional health care.
“I’ve seen what happens when you push sex into the underground,” he said. “From my perspective, this is a great opportunity to be able to reach people who really will not come to normal clinical care and won’t go to normal routine places for testing or screening.”
“As a public health person, I look at it as a great opportunity,” added Daskalakis. “If there’s like regulation of those venues, and if there’s like a prevention plan that sort of sprouts in those places with really solid public health and clinical partners, I think it’s a great opportunity for public health good.”
Daskalakis said a regulated bathhouse could offer more than HIV and STI testing, potentially creating spaces where people could access prevention medications and other health services.
“The bottom line is if there is a good relationship between the government and the venues, we can develop spaces in the venues to actually deliver services,” he said. “It’s not just infectious disease services — I mean yes, you can do HIV testing, STI testing. You can provide doxypep and pre-exposure prophylaxis for people who are HIV negative and at risk for HIV.
“As an example, at Callen-Lorde Community Health Center (in New York City), where I’m the chief medical officer, we developed a prevention pack in a very low threshold way. We gave people enough doxypep and prep to get through Pride. You can also have Narcan and other things to reduce the risk of overdose.”
Daskalakis said that approach reflects what public health should be striving for: meeting the community where they are.
“If you have this sort of relationship with the government that’s not antagonistic, and the government, as New York is one to do, provides some regulatory oversight to these venues, I think what you’re going to have is a place that supports LGBTQ culture — which also which does include sexuality, and also creates a platform to be able to do like very solid prevention work.”
The public health landscape surrounding HIV has changed dramatically since the bathhouse regulation was adopted, Daskalakis said, pointing to advances in treatment and prevention.
“The bottom line is that HIV treatment and prevention have really converged. If you are someone living with HIV and you’re on HIV medicines and your viral load is undetectable, you don’t transmit HIV. That’s called undetectable is equal to untransmittable, or U = U. People who are on prep also have very low risk of acquiring HIV, and so you know the world is very different,” he said.
“Back in the 80s, when there was no way to impact transmission of HIV because we didn’t have effective ways to prevent it — or didn’t know very much about it at that point. It’s a very different world where we know a lot about HIV and have a lot of tools to be able to prevent transmission. Same with STIs,” added Daskalakis. “If you create a holistic strategy for prevention that is sex positive and aligned to these venues, you’re going to prevent HIV and STIs. Period.”
For supporters of the legislation, that public health argument is central to the effort to repeal the ban. Bottcher also sees the proposal as a way to restore LGBTQ community spaces at a time when many queer venues have disappeared and social interaction increasingly takes place online.
“In this era of social isolation created by social media and streaming services, people are desperate for third spaces,” Bottcher said. “Places for people to come together in person, to be together in person. That’s what this would help provide.”
Daskalakis echoed Bottcher’s point that bathhouses could transform from underground, tabooed spaces into venues that combine sexual health services with broader LGBTQ culture.
“When you make them illegal, they become seedy and dark. When you make them something that is allowed, they actually then become sites that may have sex on premises but also support other sorts of cultural things, and in a universe where people are trying to make LGBT folks seem invisible, creating a safe space for them is exactly what we need right now.”
That community-space argument is also tied to health disparities, Bottcher said, arguing that greater access to health education and prevention services could help people who are less likely to seek care through traditional medical settings.
“Creating opportunities for in-person public health education, prevention, treatment that will help improve health outcomes when you push people into less safe settings without any opportunities for education, prevention tools, or treatment. That’s when we see these disparities, these health disparities grow. So it’s very important that we be laser focused on opportunities to address these disparities and reduce them.”
He continued, explaining the proposed change is ultimately about updating public health policy as medical science evolves, just as other practices are updated when new information comes out.
“This is a matter of an outdated public health regulation and the government has a responsibility to continually revisit its public health regulation and ensure that they’re in line with modern day science,” Bottcher said. “Science and healthcare are continually evolving, and the HIV/AIDS prevention and treatment landscape has changed tremendously in the last few years. Our public health regulations need to keep pace with science.”
For LGBTQ New Yorkers who lived through the AIDS crisis, however, changing the policy could carry a different meaning.
Bottcher says the experiences of those who lived through the epidemic — one that killed nearly 300,000 gay men since the 1980s — should inform how any new system is implemented, rather than being dismissed.
“These are in order to help prevent the spread of HIV and AIDS and other STIs,” Bottcher said. “We have to bring people engaging in these activities out of the shadows and into safe settings that provide the opportunity for public health entities to engage with education, treatment, prevention — that’s what this would do.”
Daskalakis said those concerns should be approached through what he described as trauma-informed care.
“My response is that of trauma-informed care,” Daskalakis said. “We have totally been through it, but we need to sort of move past the trauma and realize that the science has changed. I’s not it’s not the ’80s anymore, but we definitely need to look at those folks who have gone through the experience (of the HIV/AIDS crisis) to make sure that what we’re building, from a public health perspective, are effective programs.”
“There’s a great opportunity to learn from folks with experience rather than to alienate them,” he added.
Bottcher also pointed out this policy revision and effort to bring regulations in line with modern science is not only happening in New York. Multiple other cities across the U.S. have moved away from bathhouse prohibitions.
“Minneapolis just passed their ordinance in June,” he said. “San Francisco, despite the fact that they repealed their prohibition some years ago, they are still working to change the policy … However, around the country, even in red states, they have bathhouses … and they haven’t presented a detriment to public health in any way.”
The proposed change could also revive a part of New York’s LGBTQ cultural history, Bottcher said.
“Bathhouses were a big part of gay culture for decades. We all know the legendary stories of Bette Midler and Barry Manilow performing at the Continental Baths. I envision a resurgence of bathhouse culture that includes things like live music, arts, and entertainment. So it’s exciting to think about.”
And if that resurgence happens, Bottcher already has a dream performer in mind to be the first to take the stage.
“Oh, that’s such a good question … Cher.”
Daskalakis picked a similarly essential female singer of gay culture that he’d like to see in the bathhouses of today.
“I feel like my list could be so long, but I think that would be a great place for Madonna.”
The debate over New York’s bathhouse regulation ultimately reflects a broader question about how public health policy should respond as science, medicine, and LGBTQ communities change.
For Bottcher, regulation, rather than prohibition, would give health officials more opportunities to provide prevention and treatment while allowing LGBTQ people to gather openly.
For Daskalakis, the central lesson from his extensive healthcare work in bathhouses is that pushing sexual activity underground will make public health outreach more difficult — the opposite of what the government and healthcare providers should be doing.
“The opportunity to create safe spaces means that we’ll have more opportunities to reach people, not just for public health, but for so many other things … The strategy of banning things that are natural really doesn’t tend to help you very much. It ends up creating misalignment between the community and policymakers.”
The National LGBT Media Association represents 13 legacy publications in major markets across the country with a collective readership of more than 400K in print and more than 1 million + online. Learn more here: NationalLGBTMediaAssociation.com.
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