Undoing Minority Stress: Rethinking Queer and Gender-Diverse Substance Use

This article queries statistical ways of knowing about “LGBT substance use” and the subject positions they produce. We engage critically with how quantitative knowledge on this topic is generated across social science, psychology and public health and consider its disciplinary effects. This literature reports “higher rates of substance use” among sexual and gender minorities but struggles to explain the disparities it proposes. The most prominent explanation is Ilan Meyer's Minority Stress framework, which conceives substance use as a form of self-medication: a way of coping with the stressors of societal stigma, discrimination, and prejudice. We question whether self-medication adequately encapsulates the characteristic patterns of queer and gender-diverse substance use identified in prevalence studies, suggesting it betrays serious limitations in the professional imagination of psychoactive substances and their uses. Drawing on qualitative research among queer and gender-diverse drug-takers in urban Australia, we argue that the discourse of “disinhibition” gives better expression to their uses of substances to suspend or transform the clutch of heterosexual and gendered norms—an enduring problem for queer and gender-diverse self-formation that given measures of minority stress fail to capture. These uses of psychostimulants have as much to do with energization as self-palliation; connection with others as negative self-coping. The disciplinary effects of psychosocial, quantitative discourse compound the impacts of drugs on individual health, producing people who take drugs as isolated, passive, docile subjects at the expense of registering the part psychostimulants may play in collective activities of queer worldmaking.