People who are LGBTQIA+ are at least twice as likely as heterosexual people to experience a mental health condition according to the American Psychiatric Association. With the expansion of both scientific and mainstream public understandings of how psychedelics can support an array of mental health conditions, conversations have emerged around how psychedelics might support the LGBTQIA+ community in healing from the impacts of homophobia and help people embrace self-discovery.
Queering Psychedelics to Support Mental Health
The conversation is complex. Psychedelics have been used in the past as a tool of oppression against people who were not heterosexual. In the early days of research, LSD was used in harmful gay conversion therapy in the 50s and 60s. As psychedelic research has expanded, people began to bring to light a pattern within the psychedelic community of “instantiated essentialized gender norms, queer exclusion, and fraught access to psychedelic study design and participation,” as notes the anthology Queering Psychedelics: From Oppression to Liberation in Psychedelic Medicine. The anthology was produced by Chacruna Institute and published by Synergetic Press in 2022. It seeks to ”foster accessibility and diversity in psychedelic science, practice, and discourses by addressing and dismantling sexist, heteronormative, transphobic, and homophobic forms of oppression in the psychedelic movement.”
Chacruna Institute has also hosted two Queering Psychedelics conferences to explore the history of psychedelics from queer and non-binary perspectives and to uplift “queer visionaries,” the most recent of which took place in April 2023 in San Francisco. The two day conference was part of Chacruna’s “Women, Gender Diversity and Sexual Minorities.”
Psychedelics for Demoralized Gay Men with AIDS
While the blind spots of the psychedelic research community begin to come to light, there has also been progress. The study, Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: An open-label safety and feasibility pilot ,” was published in 2020 in The Lancet, looking at the efficacy and safety of psilocybin to support gay men with AIDs. Researchers in the study made it a point to take into account the dark history of psychedelics when conducting the study, as notes study co-author Chris Stauffer.
“As researchers, we were very aware of the historic use of psychedelics to propagate harm, including having been used as an adjunct to conversion therapy for gay men and women in earlier decades,” he told MUD/WTR. This is one reason, he says, that lead researcher Brian T. Anderson “so thoughtfully involved the community in the research every step of the way.”
Many of the researchers who participated in the study had previously worked with long-term AIDS survivors as mental health providers in San Francisco, which was an epicenter for the early AIDS epidemic.
Researchers conducted most of the preparation and integration sessions for the study in a group therapy format, which Stauffer notes happened to be the first psychedelic group therapy clinical trial of the 21st century. All of the psilocybin-assisted therapy sessions happened individually, however, and Stauffer says “participants frequently expressed how they wished the psilocybin sessions could have been conducted in a group format as well.
“The power of group therapy is pronounced in cahoots with a shared background, a shared trauma, which was experienced both individually and collectively as a community,” he says. “Especially during the early days of the AIDS epidemic when an AIDS diagnosis was a death sentence and the disease was being dismissed by the government due to its prevalence in gay men. The men in our study had experienced profound loss, moral injury, and many of them were on their deathbeds and antiretroviral medications came out just in time to save their lives. Even though this happened in the late 80s/early 90s, the participants in our study had carried with them a chronic existential dread for decades, and many of them avoided community because it reminded them of these earlier traumas. The profound healing we witnessed during our study period was remarkable, and I feel that this healing of collective wounds was enhanced by the group, community, format of the study.”
He says at first the cohorts of six older gay men, who had survived the early AIDS epidemic, were fairly isolated and averse to engaging in group therapy.
“Interacting with other long-term AIDS survivors was a harsh reminder of earlier traumas and had been largely avoided,” he says. But by the end of the study, many of the participants had formed deep bonds.
“Many of the men have stayed in touch with each other, have even gone on group vacations together," he said.
The idea for the study came from Dr. Anderson, who led the study with “such grace and respect for the community we were enrolling in the study,” Stauffer notes.
“Dr. Anderson involved long-term AIDS survivors from the study planning phase all the way through the publication of study results, and he really listened to their feedback and requests,” Stauffer says. “We were familiar with the evidence for psilocybin-assisted therapy for anxiety and depression in cancer survivors, and we wondered if psilocybin-assisted therapy would help this population work through complicated grief, PTSD, and demoralization.”
How Psychedelics Could Heal the Impacts of Homophobia and AIDS
The results of the study, which was ultimately conducted to assess safety and feasibility of psilocybin to support this particular demographic, were generally positive with no unexpected adverse events—but that doesn’t mean the experiences of the participants were easy.
“The experiences of both group therapy and psilocybin were challenging for many of our participants,” Stauffer notes, adding that they were also nuanced, powerful and moving.
For instance, he shared the story of one participant who was able to grieve a partner he’d lost during the early AIDS epidemic and to finally get married to his partner of 19 years.
Stauffer mentioned that an upcoming study he is working on, slated to start in early 2024 pending funding, will be looking at MDMA-assisted group therapy for transgender and gender diverse people.
“Transgender individuals experience trauma and PTSD magnitudes above non-transgender people, and there has not yet been a single PTSD intervention trial aimed at treating trans/gender diverse people,” he says. “As hostility and violence against this population grows with more and more anti-trans bills across the country, it will be important to bolster the resilience of this community and address gender minority stress and trauma.”
He reiterated that he believes “traumas inflicted on a communal level are best healed on a communal level as well.”
April M. Short is an editor, journalist, and documentary editor and producer. She is a co-founder of the Observatory, where she is the Local Peace Economy editor. Her work has been published with the San Francisco Chronicle, In These Times, LA Yoga, Pressenza, the Conversation, Salon and many other publications.
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