Stephen Fry's documentary about gay life across the globe is unexpectedly absorbing

It was his stay in St Petersburg that touched and horrified most. The reedy young activists he met were so brave – they made me think of silver birch trees in a violent ice storm – and we got a frighteningly authentic whiff of the prevailing atmosphere.

Stephen Fry: Out There
BBC2

I didn’t have high hopes for Stephen Fry’s two-part documentary about gay life across the globe. There’s some part of Fry that I can’t ever quite warm to and when, early in the first film (14 October, 9pm), he went off to see Elton John and David Furnish – cue the loud crunch of tyres on sweeping gravel – my heart sank.

It may well be true that, for Fry, Elton’s decision to come out was a “game-changing moment” but I can’t believe it was for many. Elton is another person to whom it’s rather hard to warm, for all his “bravery”, for all his fundraising white-tie balls. The clue to some of my distaste on this score lies, I think, in the words “white tie”. What do Elton and Furnish represent in our culture? The word that floats unbidden into my mind is “excess”. So kill me! I’m a puritan at heart – though not, I hasten to add, a sexual one.

After this, however, things picked up. The films were moving, absorbing and often blackly funny, and all praise to Fry, who managed to stay calm during several encounters that would have left me punching the walls. In Uganda, a country where politicians still hope to legislate against homosexuality, Fry enjoyed a bizarre conversation with a pastor who muttered darkly about carrots.

“Oh, gracious!” said Fry, mildly.

“You’re not using your penis the way you should use it!” continued the pastor, upping his game. “But I’m not interested in anuses and penises,” Fry said. He then listed his preferred sexual practices, none of which involved penetration. From the tone of his voice, he might as well have been reading aloud from the menu at the Garrick Club.

Next, to the US, the home of “reparative therapy”, which seeks to “cure” gay men of their urges. In Los Angeles, Fry met Joseph Nicolosi, the psychologist who is one of the technique’s leading lights and who believes that homosexuality is the result of childhood trauma. For a while, they batted the arguments (I use the word loosely when it comes to Nicolosi) back and forth. It was all a bit desultory, and I was worried; Fry seemed to be losing heart. But then a coy look moved over his face. Taking in Nicolosi’s tanned visage, carefully trimmed beard and surprisingly dark hair, he told the good clinician that his appearance was distinctly metrosexual: he could very easily pass for a gay man. Nicolosi, silent now, looked stunned; his mouth actually fell open a little. Goal!

I’m joking around, but in fact Nicolosi’s “therapies” are at best cruel and at worst dangerous. Fry’s second film (16 October, 9pm) ventured into more upsetting territory: in Brazil, a gay person is murdered every 36 hours; in Russia, it is illegal to “promote” homosexuality, a law that has far-reaching and monstrous consequences for the parents and children of gay people (who are “promoting” homosexuality by being alive); in India, the hijras (men who, broadly speaking, identify as women) are forced to live on the outer margins of society. Fry proved a kind and thorough reporter on these matters – though I wish he had not cried so often, which I found self-indulgent.

It was his stay in St Petersburg that touched and horrified most. The reedy young activists he met were so brave – they made me think of silver birch trees in a violent ice storm – and we got a frighteningly authentic whiff of the prevailing atmosphere.

In Russia, nationalism has brought with it religious zealotry, incense seeping into the crevices of the political life, noxious as gas. Fry was granted an audience with Vitaly Milonov, a politician who has suggested that gay athletes could be arrested at next year’s Sochi Olympics. They spoke for some minutes. Milonov is training to be a priest, and kept going on about angels.

“How do you sleep at night?” asked Fry, exasperated. “I can sleep after I pray,” Milonov replied. Fry’s references to St Petersburg’s glorious past – he mentioned Tchaikovsky and Diaghilev, both of them gay – fell on deaf ears, which was hardly surprising.

I looked at Milonov, blunt as an old penknife, and tried to conjure his hinterland. I could see him lighting candles in an oniondomed church and I could see him rocking out to Deep Purple or Smokie (of Bradford, who are huge in Russia) as he drove home through snow-streaked boulevards. But I could no more picture this unthinking homunculus at the ballet than I could imagine him striding across the room and kissing Fry tenderly goodbye.

Stephen Fry outside the city parliament in St Petersburg, Russia. Image: Getty

Rachel Cooke trained as a reporter on The Sunday Times. She is now a writer at The Observer. In the 2006 British Press Awards, she was named Interviewer of the Year.

This article first appeared in the 17 October 2013 issue of the New Statesman, The Austerity Pope

Davide Restivo at Wikimedia Commons
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Scientists have finally said it: alcohol causes cancer

Enough of "linked" and "attributable": a new paper concludes that alcohol directly causes seven types of cancer.

I don't blame you if you switch off completely at the words "causes cancer". If you pay attention to certain publications, everything from sunbeds, to fish, to not getting enough sun, can all cause cancer. But this time, it's worth listening.

The journal Addiction has published a paper that makes a simple, yet startling, claim: 

"Evidence can support the judgement that alcohol causes cancer of the oropharynx [part of the throat], larynx, oesophagus, liver, colon, rectum and [female] breast"

So what's especially significant about this? 

First, scientists, unlike journalists, are very wary of the word "causes". It's hard to ever prove that one action directly led to another, rather than that both happened to occur within the same scenario. And yet Jennie Connor, author of the paper and professor in the Preventive and Social Medicine department at the University of Otago, New Zealand, has taken the leap.

Second, alcohol not only causes cancer of one kind – the evidence supports the claim that it causes cancer at seven different sites in our bodies. There was weaker evidence that it may also cause skin, prostate and pancreatic cancer, while the link between mouth cancers and alcohol consumption was the strongest. 

What did we know about alcohol and cancer before?

Many, many studies have "linked" cancer to alcohol, or argued that some cases may be "attributable" to alcohol consumption. 

This paper loooks back over a decade's worth of research into alcohol and cancer, and Connor concludes that all this evidence, taken together, proves that alcohol "increases the incidence of [cancer] in the population".

However, as Connor notes in her paper, "alcohol’s causal role is perceived to be more complex than tobacco's", partly because we still don't know exactly how alcohol causes cancer at these sites. Yet she argues that the evidence alone is enough to prove the cause, even if we don't know exactly how the "biologial mechanisms" work. 

Does this mean that drinking = cancer, then?

No. A causal link doesn't mean one thing always leads to the other. Also, cancer in these seven sites was shown to have what's called a "dose-response" relationship, which means the more you drink, the more you increase your chances of cancer.

On the bright side, scientists have also found that if you stop drinking altogether, you can reduce your chances back down again.

Are moderate drinkers off the hook?

Nope. Rather devastatingly, Connor notes that moderate drinkers bear a "considerable" portion of the cancer risk, and that targeting only heavy drinkers with alcohol risk reduction campaigns would have "limited" impact. 

What does this mean for public health? 

This is the tricky bit. In the paper, Connor points out that, given what we know about lung cancer and tobacco, the general advice is simply not to smoke. Now, a strong link proven over years of research may suggest the same about drinking, an activity society views as a bit risky but generally harmless.

Yet in 2012, it's estimated that alcohol-attributable cancers killed half a million people, which made up 5.8 per cent of cancer deaths worldwide. As we better understand the links between the two, it's possible that this proportion may turn out to be a lot higher. 

As she was doing the research, Connor commented:

"We've grown up with thinking cancer is very mysterious, we don't know what causes it and it's frightening, so to think that something as ordinary as drinking is associated with cancer I think is quite difficult."

What do we do now?

Drink less. The one semi-silver lining in the study is that the quantity of alcohol you consume has a real bearing on your risk of developing these cancers. 

On a wider scale, it looks like we need to recalibrate society's perspective on drinking. Drug campaigners have long pointed out that alcohol, while legal, is one of the most toxic and harmful drugs available  an argument that this study will bolster.

In January, England's chief medical officer Sally Davies introduced some of the strictest guidelines on alcohol consumption in the world, and later shocked a parliamentary hearing by saying that drinking could cause breast cancer.

"I would like people to take their choice knowing the issues," she told the hearing, "And do as I do when I reach for my glass of wine and think... do I want to raise my risk of breast cancer?"

Now, it's beginning to look like she was ahead of the curve. 

Barbara Speed is a technology and digital culture writer at the New Statesman and a staff writer at CityMetric.