As part of our ‘MedHums 101’ series, Chase Ledin and Benjamin Dalton signpost the emergence of the queer medical humanities, setting out basic concepts, methods, and reasons for ‘queering’ critical medical humanities scholarship and practice.
The queer medical humanities is an emergent sub-field that brings together critical medical humanities and queer studies. Queer medical humanities draws from a rich and diverse queer scholarship across literary theory, cultural studies, performance studies, sociology, and anthropology, and applies foundational theories from these fields to medical and healthcare practice and theory. This sub-field critically integrates queer experiences of illness and medical treatment within healthcare institutions and care practices, pharmaceutical innovation, and medical ethics, and insists on the centrality of queer ways of knowing, doing, and being with/in health, care, and medicine. Alongside and beyond engaging with LGBTQIA+ health and medical contexts, this sub-field interrogates the evolution and operation of (hetero)normative structures such as gender and sexuality and the constraints and oppressions associated with medical and wider social structures. As such, it brings queer analytical precision to the growing interdisciplinary studies of health and medicine in society.
In this overview, we signpost core and emergent epistemologies (or ways of knowing about the world), methodologies, and analytical tools that queer perspectives offer the broader critical medical humanities. Some queer epistemologies include consideration(s) of identity and performativity, relationality and normativity, and embodiment (or ways of being in the world). Some queer methods involve critical and close reading, ethnography, interviews and focus groups, and creative and reflective writing. We suggest that these epistemologies and methods enhance the analytical precision and power of the critical humanities by introducing queer encounters with dominant and marginal genders and sexualities in the social and cultural construction of medicine and healthcare.
Background to the queer medical humanities
Definitions, sites of inquiry, and directions of travel for the queer medical humanities are evolving, as illustrated by new research hubs and networks like the Queer Medical Humanities Network at Lancaster University (Dalton and Ledin 2024). Existing medical humanities research has already pointed out the rich, symbiotic intellectual genealogies between queer theory and critical engagement with medical institutions and forms of knowledge. For instance, Wahlert and Fiester (2013, 86) point towards the central presence of the clinic in Michel Foucault’s History of Sexuality, which became a foundational text for early queer theory. As we detail below, more of this work is needed to encourage critical and equity-driven responses to growing medical power and influence in everyday life.
Significant research on the impact of the AIDS crisis on the LGBTQIA+ community has demonstrated how queer critique and expression emerge through diverse, and often violent, encounters with medical science, institutions, and policies. Influential texts of queer theory and literature, including Leo Bersani’s ‘Is the Rectum a Grave?’ (1987) and Hervé Guibert’s To The Friend Who Did Not Save My Life (1990), reveal ways in which queer modes of care emerged alongside new modes of queer critique and activism. Similarly, Lisa Diedrich (2013) has explored queer modes of care present in the clinic prior to those which emerged in the AIDS crisis, demonstrating the breadth and diversity of queer histories of medicine still to be uncovered and explored.
The what of queer medical humanities
The queer medical humanities draw from a rich tradition of queer analytical inquiry, especially from English literature and cultural studies in North America. ‘To queer’ means to attend to the centres and margins of social and cultural experiences in society, especially related to marginalised individuals and groups like transgender and LGBTQ+ people (Muñoz 1999), and to de-familiarise dominant paradigms and practices in the social world (Warner 1991; Butler 2006). Queering health and medicine, then, means attending to: who appears in the centre and at the margins of healthcare provision; ways of knowing about and experiencing health and illness in society; and alternative ideas about dominant medical paradigms from the perspectives of gender and sexual minorities (Wahlert & Fiester 2013).
Queer perspectives are particularly useful for raising critical questions about how/why normative structures (such as how doctors might assume patients are straight until stated otherwise) reify social inequalities, such as poverty and poor public infrastructure in communities. This is because a queer approach centres queer (including normative, non-normative and anti-normative) experiences to locate core aspects of social life that both burden queer communities and, conversely, enable them to flourish.
As Paul Preciado’s (2013) trans body auto-ethnography illuminates, for example, the queer medical humanities have the potential to interrogate and experiment with dominant epistemologies, practices, and interpretations, by actively tweaking and reconfiguring normative practices through self-practice and storytelling. As we detail below, this work involves a wide range of methods across traditional humanities and social sciences disciplines – and increasingly includes empirical encounters with biomedical and clinical sciences. This sub-field seeks to alter hegemonic institutions and fixed ways of being/knowing within scientific and healthcare systems and to encourage equitable access to treatment, intervention, support, and care for all people. As such, it is driven by the values of critical inquiry and equity that live at the core of the broader critical medical humanities (Whitehead & Woods 2016).
The how
A queer approach can start out with a core question: ‘Who is at the centre, and who is marginalised by the dominant order of things?’ By asking this question, a queer approach attends to how experiences, embodiments, orientations, affects, performativities, and objects operate within society. For instance, as Lisa Duggan (2002) has argued, neoliberal capitalism has centred white, able-bodied, wealthy, and family-oriented (or adjacent) homosexuals and de-centred non-white, disabled, neurodivergent, and working-class queers in a ‘normative’ culture of ‘acceptable’ queers integrating into mainstream society. This centring/decentring perspective is particularly useful for understanding in the contemporary moment how and why transgender identities and experiences are mediated by normative assumptions about ‘acceptable’ behaviours, upbringings, biological enhancement(s) and reproduction – and especially the role that medicine and healthcare play in mediating and serving as gatekeepers for transgender normativity and acceptability in society.
Once the centre and margin have been explored, a queer thinker may then ask: ‘Given the role of power in centring and marginalising individuals in society, how can we counter and improve queer experiences?’ Traditionally, this approach employs scenarios, auto-ethnography, case studies, interviews, and stories to understand how non-normative (Rodríguez 2014) and anti-normative (Wiegman & Wilson 2015) experiences of queerness intersect with issues of racism, sexism, heterocentrism, ableism, and other forms of oppression. For example, Mel Chen (2011) considers the role of industrial and environmental toxins, interrogating their impact on normative subjects in society and their potential to destabilise health itself within the general population, opening up all bodies to a ‘queer exposure’ and thereby becoming queer. Chen reflects on the process of attending to contamination and intoxication, and invites readers to consider not simply the social role of intoxication – including medical and scientific responses to environmental contamination – but also pushes us to understand how these industrial and social processes have a ‘racialising’ effect that is wholly overlooked in health science and medical research.
Finally, having considered the centres, margins and potential responses, a queer thinker can ask: ‘If queer experiences can be improved, how do we ensure equity for all?’ Given that queer theory has been built on 20th Century social justice movements, a central aim of existing and emergent queer approaches involves considering not only how to put queer lives at the centre of healthcare and medical practice, but how to shift institutional care practices to ensure that better treatment (potentially) afforded queer individuals will also be expanded and enacted for all people in society. For instance, Jih-Fei Cheng, Alexandra Juhasz and Nishant Shahani (2020) critically examine the unequal distribution of HIV medicines globally. They defamiliarise the notion that these medicines should necessarily be solely available in the Global North and re-orient the global health narrative to invite critical attention about what constitutes a ‘crisis’. Their queer theory foregrounds the multiplicity of crises (past and present) and advocates for more equitable thinking and practice for distributing and accessing medicines globally.
The why
We suggest that queering the medical humanities plays a crucial role in developing and expanding the tradition of critical theory and inquiry within the medical humanities. Given the discipline’s entanglement of research and practice, we would argue that queer approaches and perspectives enable scholars and practitioners to challenge existing hierarchies of authority and unchecked forms of power, particularly as they relate to intersectional queer experiences, including gender, sex, and sexuality; age, ability, and disability; race and ethnicity; social class; and labour. To that end, a queer medical humanities is necessarily in allegiance with disability studies, critical race studies, labour studies, and transgender studies, in a movement to tackle social inequalities within healthcare and medicine.
More specifically, the queer medical humanities provide both scholars and practitioners with the tools to recognise cisgender and heterosexual privilege within clinical and community health spaces. It raises ideas about how practitioners can reflectively and reflexively understand their work in relation to competing priorities and social practices that inform how individuals and communities make meaning in their lives in tandem and outwith healthcare institutions. Taking a queer approach means not attending to sex, sexuality, and gender as fixed categories that can be treated or indeed mediated by medical transformation, but instead as lived experiences that both inform and supersede medical knowledge and practice(s) in meaningful ways. A queer medical humanities, then, provides for both researchers’ and practitioners’ insights into how to listen to these ways of knowing, doing, and being queer within healthcare settings and their situated context(s) in society. The queer medical humanities holds the potential to create positive impacts upon LGBTQIA+ healthcare reform and benefit diverse groups of people in deconstructing and figuring responses to the operation of power within medical knowledge and practice. As Shon Faye argues in The Transgender Issue:
The liberation of trans people would improve the lives of everyone in our society […] Full autonomy over our bodies, free and universal healthcare, affordable housing for all, power in the hands of those who work rather than those privileged few who extract profit from our vastly inequitable system, sexual freedom (including freedom from sexual violence) and the end to the mass incarceration of human beings are all crucial ingredients in the construction of a society in which trans people are no longer abused, mistreated or subjected to violence. Such systemic changes would also particularly benefit anyone else forced to the margins of society, both in the UK and across the world.
(Faye 2021, xi).
A truly emancipatory queer medical humanities, similarly, would seek to empower not just LGBTQIA+ people within healthcare contexts, but all people, through deconstructing limiting constructs and structures.
Future directions
Recent years have seen the rights of gender and sexual minorities come under attack, from the rolling back of access to abortion in certain US states to threats to trans healthcare rights across the world (Butler 2024). Noone and colleagues’ (2024) critical interrogation of the Cass Review – an NHS-commissioned report into healthcare provision for trans and gender non-confirming children and young people – has raised the need for robust, interdisciplinary challenge to healthcare policy and practice, using critical perspectives from the social sciences, ethics, and humanities. Hence the queer medical humanities will play an important role in examining and contesting the forms of power and intervention(s) that dis/inhibit gender and sexual minorities’ treatment and care within contemporary public and private healthcare provision.
The queer medical humanities can serve as a platform for uncovering queer and anti-queer healthcare pasts for the emancipation of healthcare futures. Diedrich (2013) demonstrates the importance of uncovering and mapping queer medical histories, and Jayna Brown has shown how the critical holding-to-account of colonial and racialised histories of medicine can suggest avenues for reappropriating biomedical science to ‘explore the queerness of the biological’ (Brown 2015, 323). Recent documentaries and speculative fiction have allowed insight into real and imagined queer and feminist healthcare practices of the present and future, including Claire Simon’s documentary exploration of gender affirming care in a hospital gynecology department in Paris in Our Body (2023) and Martin Winckler’s imagining of radically de-hierarchised hospital spaces and modes of care for women, intersex and gender non-conforming patients in his novels Le Choeur des Femmes (2009) and L’Ecole des Soignantes (2019). We believe critical examination of these multiple texts, discourses, encounters, performativities, experiences, and perspectives will contribute to a robust and insightful pathway to more inclusive and queer futures for healthcare innovation and reform.
About the authors
Chase Ledin (he/him) is a Lecturer in Social Science and Medicine at the University of Edinburgh. His work explores social and cultural aspects of HIV/STI innovation and health promotion in the UK and Europe. Follow Chase on Twitter/X @chaseledin.
Benjamin Dalton (he/they) is a Lecturer in French Studies at Lancaster University. His work explores how contemporary French thought and culture engages with biomedical knowledge and contexts. He is particularly interested in how contemporary philosophy engages with and might have the potential to transform hospital environments. He founded the Queer Medical Humanities Network at Lancaster University in 2023. Follow Ben on Twitter/X @BenBGDalton.
About MedHums 101
Our ‘MedHums 101’ project explores key concepts, debates and historical points in the critical medical humanities for those new to the field. View the full ‘MedHums 101’ series.
References
Bersani, Leo. 1987. “Is the Rectum a Grave?” October, 43: 197-222.
Butler, Judith. 2006. Gender Trouble: Feminism and the Subversion of Identity. New York: Routledge.
Butler, Judith. 2024. Who’s Afraid of Gender? London: Allen Lane.
Brown, Jayna. 2015. ‘Being Cellular: Race, the Inhuman, and the Plasticity of Life.’ GLQ, 21(2-3): 321-241.
Chen, Mel. 2011. ‘Toxic Animacies, Inanimate Affections’. GLQ 17(2-3): 265-286.
Cheng, Jih-Fei, Alexandra Juhasz and Nishant Shahani. 2020. AIDS and the Distribution of Crises. Durham: Duke University Press.
Dalton, Benjamin and Chase Ledin. 2024. ‘Queer Medical Humanities.’ The Year’s Work in Critical and Cultural Theory, https://doi.org/10.1093/ywcct/mbae005.
Diedrich, Lisa. 2013. ‘Qu(e)rying the Clinic Before AIDS: Practicing Self-Help and Transversality in the 1970s.’ Journal of Medical Humanities, 34: 123-138.
Duggan, Lisa. 2004. The Twilight of Equality?: Neoliberalism, Cultural Politics, and the Attack on Democracy. New York: Beacon Press.
Faye, Shon. 2021. The Transgender Issue: An Argument for Justice. London: Allen Lane.
Guibert, Hervé. (1990) 2021. To the Friend Who Did Not Save My Life. Translated by Linda Coverdale. London: Serpent’s Tail.
Muñoz, José Esteban. 1999. Disidentifications: Queers of Color and the Performance of Politics. Minneapolis: University of Minnesota Press.
Noone, Chris, et al. 2024. ‘Critically Appraising the Cass Report: Methodological Flaws and Unsupported Claims.’ OSF pre-prints. https://coilink.org/20.500.12592/fxpp322. Accessed 28 Aug 2024. COI: 20.500.12592/fxpp322.
Preciado, Paul. 2013. Testo Junkie: Sex, Drugs, and Biopolitics in the Pharmacopornographic Era. New York: The Feminist Press.
Rodríguez, Juana María. 2014. Sexual Futures, Queer Gestures, and Other Latina Longings. New York: The NYU Press.
Wahlert, Lance, and Autumn Fiester. 2013. ‘Queer in the Clinic’. Journal of Medical Humanities 34(2): 85-91.
Warner, Michael. 1991. ‘Introduction: Fear of a Queer Planet.’ Social Text (29): 3-17.
Whitehead, Anne, and Angela Woods. 2016. The Edinburgh Companion to the Critical Medical Humanities. Edinburgh: Edinburgh University Press.
Wiegman, Robyn, and Elizabeth Wilson. 2015. ‘Introduction: Antinormativity’s Queer Conventions.’ differences: A Journal of Feminist Cultural Studies 26(1): 1-25.
Winckler, Martin. 2009. Le Choeur des Femmes. Paris: P.O.L.
Winckler, Martin. 2019. L’Ecole des Soignantes. Paris: P.O.L.
