In this article, Kaj touches on similar topics addressed in the video interview above and goes into more detail on some of those topics.
By Kaj Johnson
“So, which of your parents passed down AIDS to you?”
When I first moved to my town of 11,000 in Lower Austria to serve as a USTA for nine months, I had many concerns buzzing in my head. How will I deal with the Austrian dialect for the first time? What if I mess up my residency permit appointment? Will my students like me? But coming from the healthcare hellscape that is the United States, I wasn’t worried in the slightest about booking appointments and getting medications under my new Austrian insurance plan. Sure, there might be an onerous day or two of getting prescriptions recognized by my town’s clinic and explaining my health history in my far-from-perfect German, but after that, Austria’s renowned medical system would surely grant me smooth sailing. If I could get pre-exposure prophylaxis (PrEP) for free in the US exclusively via telemedicine, how hard could it be in a country with universal healthcare?
Hard, evidently.
My hopes were squashed when, after requesting a prescription for PrEP, my local Hausarzt threw me a curveball into the form of the AIDS question. After explaining to him the purpose of PrEP medication, which is to prevent HIV-negative individuals from contracting HIV, I was met with a gentle but pessimistic reality check: because the nature of PrEP is preventative rather than treatment for a diagnosis, medications such as Descovy or Truvada would only be accessible with a private prescription. This meant that the burden of coverage would be on me, which would amount to €1,400 a year at the minimum. I had previously been reassured that my health insurance plan was top-class and would result in little (if any) charges or complications in getting the care I needed. I had clearly taken that for granted.
What followed was a personal learning experience of what it means for a country to be “queer friendly” and how personal ideas of a country’s tolerance of the Ausländer are merely that: ideas that can easily be challenged on the ground. My experience with the Austrian healthcare system typified the feeling that I had living as a queer person in Lower Austria’s Mostviertel region: I felt safe and generally welcomed, but never quite like I belonged.
Which is maybe to be expected as a participant in the USTA Program, which places teaching assistants in schools across Austria for nine months at a time—a period just long enough to get into a routine, figure out your favorite bakeries in town, and begin to grasp the (in)famous Austrian dialect, but not quite long enough to feel like a true resident. From reading the testimonies of former teaching assistants at Fulbright Austria and other commissions, I had anticipated this feeling and accepted my teaching position knowing that the year ahead would come with frustrations, challenges, and blessings in equal part. What I didn’t expect was the additional feeling of alienation that came from being queer. My perception of Austria as a liberal, progressive country with legal marriage and a slew of protections for queer people had been problematized, and I began to wonder whether I had shot myself in the foot by accepting such a provincial placement without thinking twice.
Isolated but repeated incidents of homophobia in the classroom contributed to the chilling effect of not being granted adequate healthcare. What began as simple but frank questions like “Are you gay?”, which, although a bit intrusive, didn’t bother me, turned into under-the-breath utterances of Schwul and other words that were clearly being used as slurs. When I accepted the USTA position, I knew that entering the classroom as a cultural ambassador would elicit many questions from curious students who had never been to North America or even met someone from the United States. Even though my primary business in Austria was serving as a teaching assistant, I didn’t mind also serving as an example of a young queer person for those who would benefit from seeing that—which, in a town of 11,000, I think is nearly everyone! Unfortunately, the side comments from students discouraged me from being as open as I would have liked. During these moments, the linguistic and cultural barriers made it hard to advocate for myself. Did I hear what he said correctly, or am I just assuming the worst? What if that word has a different meaning in Austria? These hesitations prevented me from addressing the behavior in real time, but after the third or fourth snide comment, I approached my mentor teacher and made him aware of the issue. His response, which was to remove the class from my schedule if another incident occurred, was satisfying. After all, these weren’t children who needed a reminder of what was nice and not nice to say, but young adults who were jeopardizing their chance at English immersion and support by commenting on my appearance and comportment derogatorily. They knew better.
Even amidst these trials in the classroom, the most affecting aspect of living queer in Waidhofen was the struggles I faced seeking healthcare. Scheduling countless appointments for bloodwork, STI tests, and other consultations made me feel like a burden at my doctor’s office. It was clear that the staff there were not equipped to deal with queer healthcare needs, and as such, being gay began to feel like a diagnosis in and of itself—one that couldn’t be addressed with the skillsets of my Waidhofen practitioners. When my partner came into town from Germany and needed a similar preventative HIV medication, he was met with a shrug and a “maybe try Linz?” Though he easily got a prescription there, queer people shouldn’t have to travel hours to the next big city in order to find practitioners who can tend to their needs.
Thankfully, things are already beginning to improve on this front: since April 2024, PrEP patients are eligible for a refund of up to €59/month, though it must be done through a thorny process of mailing in receipts each month and doesn’t always cover the entire cost of the medication. Still, it’s recognition on behalf of the government that queer people across Austria deserve medication that makes sex safer—and can even be life-saving. And even though social attitudes towards queer people can be stubborn, I have hope that the younger generations will usher in more queer acceptance and open presentation, even in small-town Austria. After all, for every instance of bigotry I faced at the micro and macro scale, I was met with students, fellow teachers, and community members who treated me as one of their own—and who, in the case of my teachers, would inquire about my partner, how I was holding up in Waidhofen, and if there was anything I needed to feel more comfortable. The things I loved about living in small-town Austria—the close-knitness, the landscape, the traditions—are things that can and should be enjoyed by queer people too. Despite the day-to-day struggles, I’m leaving Waidhofen as a more confident teacher, German speaker, queer man, and global citizen.
For those interested in seeking queer healthcare in Austria, the following websites may be of help: