Shilts graduated near the top of his class in 1975, but as an openly gay man, he struggled to find full-time employment. After several years of freelance journalism, he was finally hired as a national correspondent by the San Francisco Chronicle in 1981, becoming "the first openly gay reporter with a gay 'beat' in the American mainstream press.
In addition to his extensive journalism, Shilts wrote three best-selling, widely acclaimed books. His first, The Mayor of Castro Street: The Life and Times of Harvey Milk, is a biography of the first openly gay San Francisco politician.