Mad and Queer studies: interconnections and tensions

A guest blog post by Helen Spandler and Meg-John Barker

With the recent emergence of Mad Studies we thought it timely to explore some connections with Queer studies – another critical field of enquiry.  We wanted to examine their similarities and differences; any points of tension; and what each could learn from the other.

Helen has been part of the recent emergence of Mad Studies in the UK and has a long standing interest in critical approaches to gender and sexuality. Meg-John has recently written a book about queer theory as part of the ‘introducing…’ series of Icon press comic books, and has a long standing interest in critical approaches to mental health.  This piece arose out of discussions between ourselves on this subject.

Summary of key points

  • Mad and Queer Studies have lot of common ground – especially in terms of challenging existing binaries (for example, gay/straight and mad/sane); subverting negative connotations of Queer/Mad; and critiquing prevailing normativities (ways of being ‘normal’).
  • However, we have to be careful to think critically about new normativities which develop when we move away from old ones, and who is included and excluded in any movement.
  • Therefore, both projects could do more to question the ‘alternative’ norms and binaries they introduce which may have unhelpful effects.
  • In addition, madness poses new and significant challenges to Queer activism/studies.
  • As a result, Mad / Queer scholars and activists would benefit from greater dialogue with each other – and with other critical fields of inquiry (like critical disability studies).
  • Finally, we recommend foregrounding practices of consent and kindness as part of our political strategy to achieve our desire for more liberated social relationships and societies.

We start by briefly outlining a history of the two disciplines.

What is the history of Queer theory and Queer studies?

Queer Studies/Theory is not easy to summarise.  There are actually so many different queer theories (and understandings of what it means), and these are even contradictory in places. Also, many people who are thought of as queer theorists have denied that they are, or denounced it subsequently. This, of course,  isn’t dissimilar to many other radical traditions. For example, people like RD Laing denied being anti psychiatrists.

Most people chart queer theory from Teresa de Lauretis’s conference of that name in 1990, which led to a special issue of the journal Differences. The thinkers that are perhaps most associated with queer theory are Michel Foucault (who is a big philosopher/writer in relation to madness, as well as sexuality, of course), and gender theorist Judith Butler. Queer theory built on their ideas particularly. The 1990s were a major decade for queer theory, with publications of many important texts in the field by people like Eve Kosofsky Sedgwick, Diana Fuss, and Michael Warner. By 1997 the first introduction to queer theory was published by Annamarie Jagose.

There is queer studies as well as queer theory. This developed out of lesbian and gay studies (a bit like gender studies developed out of women’s studies) to be more inclusive of all sexualities, and to turn attention to those that were regarded as ‘normative’ (for example, heterosexual people) as well as ‘non-normative’. Queer studies is multidisciplinary and whilst people in it are likely to draw on queer theory, it could encompass other approaches too.

Does Mad Studies have a similar history?

Mad Studies is usually seen as a more recent development, specifically arising out of Canadian Mad scholarship and activism. For example, the Madness, Citizenship and Social Justice Conference that was held in British Columbia, Canada in June 2008, and the Mad People’s History course was developed by Mad activists at Ryerson University in Toronto. Subsequently, the publication of Mad Matters: A Critical Reader in Canadian Mad Studies in 2013 is seen as a major breakthrough in Mad Studies ‘going international’.  However, we can see the history of Mad scholarship going back at least to the early 1970s with the birth of the Mad movement and Mad liberation, and then in the 2000s with the development of Mad Pride.

Both histories have links with Queer politics. The birth of the Mad movement was inspired by the Gay Liberation movement as well as the black civil rights movement. For example, when Mad Pride was founded in the UK, mental health activists said: “There’s Gay pride, why can’t we have Mad Pride?”  However, the idea of Mad Studies – as a specific scholarly discipline – is probably a more recent development. Moreover, it was inspired by other counter disciplines especially Queer studies. Like Queer Theory, Mad Studies is multidisciplinary – drawing on social sciences, humanities and cultural studies.  In addition, like Queer Studies, it has been heavily influenced by the concept of intersectionality – the importance of seeing  Mad oppression as being inseparable from other social dimensions such as gender, ethnicity, social class, age, disability etc.

It’s probably fair to say that anti-psychiatry, critical psychiatry and critical psychology were mostly led by dissident professionals. Mad Studies, on the other hand, seems to be largely led by self-defined Mad people, alongside critical academics and their allies. In fact, it has arguably been pioneered by Mad people within academia (rather like Queer studies being pioneered by LGBT+ people within academia). The massification of higher education has perhaps facilitated this development,  as has the user/survivor/mad (and LGBT+) movements which has encouraged people to be ‘out’ about their madness (and sexuality).

What are the central tenets of Queer theory?

Even though it’s a complex field, It seems that queer theorists generally agree on the following three things:

  1. Identities (such as sexual and gender identities) are neither essential nor fixed but are constructed through available ways of being in our particular time and place. They can feel fixed and essential because we repeatedly perform them.
  2. Normativities are kept in place through associations between binary oppositions where one side is privileged over the other  (man/woman, straight/gay, sane/mad, etc.)
  3. All of this is embedded within current economic and social structures and the ways in which power operates within these.

Does Mad Studies have shared tenets?

Again, it’s very early days: Mad studies is still an emergent discipline. However, you could say Mad Studies advocates probably agree on the following:

  1. A critique of the dominance of bio-medical psychiatry and of other professions associated with psychiatry (often called the ‘psy disciplines’ including psychology, social work, mental health nursing, psychotherapy etc).
  2. A desire to question, subvert or disrupt what is culturally understood by madness (and sanity).
  3. A politicisation of the experience and identity of Madness.

It is worth noting that Mad studies has slightly different emphasises according to its specific contexts of emergence.  For example, the recent UK version of Mad Studies is influenced by British welfare-left traditions and is more concerned with defending welfare provision. This is especially the case with key figures like Peter Beresford championing Mad Studies in the UK.

What are the similarities between Queer and Mad Studies?

To a degree, Mad Studies shares a similar sets of understandings to Queer Studies – about identity, subjectivity, binaries, and normativities.  Probably the most obvious parallel is that they do not posit Queer or Mad as identity categories but as strategies of critique and resistance. That is signified by the capitalising of Mad and Queer (like Black or Deaf).  For example, Richard Ingram, one of the first people to advance the notion of Mad studies in Canada, argued that it was not the study of madness from the inside, but using madness to study the outside world. This is similar to Queer studies, which engages in Queer critique without essentialising or fixing queer experience.

Therefore, both see the experience (of Madness or Queer) as socially constructed.  In addition, like Queer, Mad Studies is critical of binaries, the most obvious being mad/sane and normal/abnormal. In addition, the Mad studies critiques of psychiatry highlights the way that psychiatric taxonomies are often based on damaging gender and sexuality normativities.

The other similarity is Mad Studies’s concern with challenging prevailing normativities rather than studying non normative ways of being (e.g. Mad people).  So whilst Queer theory likes to problematise  ‘heteronormativities’, Lucy Costa has argued that: “Mad studies is about flipping the micro-scope. Let’s stop studying mentally ill people and start studying sane people, normals, well-adjusted, balanced and secure people”.

Are there other critical disciplines (similar to Mad and Queer studies)?

There are many other critical disciplines that have similar concerns to Queer and Mad studies; for example, critical disability studies, critical race studies, Crip studies, Fat studies, Asexual studies. Crip theory and fat studies are two examples  that have drawn some of the critical ideas of queer theory into considerations of disability and body shape/size, respectively.  In addition, critical disability scholars explore able-bodied subjectivities, disablism, and discourses and practices of what has been called ‘normalcy’ (impositions of what is deemed normal behaviours and expression).  Normalcy can be seen as equivalent to heteronormativity in Queer.  A related recent development is critical autism studies which arose out of the neurodiversity movement. This has interesting similarities due to its focus on affirming alternative ways of ‘being in the world’ which have been historically subjugated and pathologised.  The links between neurodiversity, Mad and Queer have been explored in a recent symposium at Lancaster University.

What is the relationship between Queer theory and  LGBT+ movements?

Not surprisingly, there is a complex relationship between Queer theory and the LGBT+ movement. There are multiple LGBT+ movements, and queer theory is much more allied with some than others.  There have been a lot of tensions with the mainstream LGBT+ movement because gay rights has often been argued for on the basis of essential identities, for example the idea that people are ‘born gay’ and that gay is a fixed part of a person’s identity. Assimilationist gay rights also often argues for inclusion of gay people into wider society (marriage, the military, consumer culture, etc.), whereas queer theory would often critique those institutions and the normativities they uphold (even if gay people are included in them).

Queer theory is probably closest to queer activism which opposes assimilationist agendas of trying to show how ‘normal’ LG(BT) people are, and generally celebrates difference and diversity, and challenges things like the commercialism of the gay scene. However, it’s still easy for binary identity ideas to slip back in around questions about who is and isn’t queer, for example.

Gayatri Chakravorty Spivak and others have argued that, politically, there might be an important place for ‘strategic essentialism’ and identity politics, given that we arguably need to operate within existing systems to get human rights for all, for example. Queer theory has been criticised for paying too little attention to the material realities of oppression, and to people’s lived experiences, as well as for being very dense and inaccessible to those without a high level postgraduate education.

Are there similar tensions between Mad Studies and the psychiatric user/survivor movement?

The most obvious parallel with Queer Studies is the tension between the grassroots service user/survivor movement and Mad Studies. Just like many LGBT people resisted the terminology of “Queer” because they saw the language as pejorative and oppressive, many users and survivors have similar concerns about “Mad”.  This tension was epitomised by the title of the important user/survivor led documentary in the mid 1980s:  We’re not Mad, We’re Angry.  So the psychiatric user/survivor movement is diverse too and, like Queer, Mad Studies is more allied with some parts of the movement than others. We’ll say more about this later.

It could also be argued that there is a tendency within Mad Studies to instil a new set of binaries and dualities. For example, around the mind/body; the social/medical model; and psychiatry/anti-psychiatry.  Arguably, whilst these may be helpful for campaigning activities, ultimately such binaries can create new problems and simplifications.  In addition, whilst critiquing identity categories, there is still a sense of some identity categories being privileged over others, for example, Mad people who celebrate their madness, or allies who are ‘Mad positive’.  So, there are some key similarities between Queer and Mad studies – both in attempting to challenge and subvert binaries, normativities and fixed identities – as well as the problem of these ‘slipping back in’.

Finally, like Queer, Mad studies has a tension around identity politics. For example, the tension between wanting to break free from identity categories – in this case diagnostic ones – but also needing them to be able to make political demands. Some Mad scholars argue that we shouldn’t use diagnosis categories at all because they reinforce the pathologisation of individuals. Others argue that we need to use them – strategically – in order to argue for services, support and welfare entitlements.  There has been much work linking Mad and Disability politics as a political strategy – but this raises other tensions – such as whether or not Mad people are happy being categories as Disabled. Exploring this tension was the focus of the book Madness, Distress and the Politics of Disablement.

What are the tensions and exclusions in Queer theory?

The big debate within queer theory over the last decade or so has been about race – bringing queer theory together with critical race theory and postcolonialism. Queer theory generally focused on sexuality and gender, but many have argued that it is impossible to tease those things apart from race, given that the early scientific attempts to categorise and police sexuality and gender were entirely entwined with imperialist attempts to classify humans according to race and police racial purity. White western binary/essentialist models of sexuality and gender have been imposed on cultures globally as part of colonialism. There are also important questions about whether it’s appropriate to theorise global understandings of sexuality and gender from the starting point of a white, western queer theory.

Conversations about class have been much quieter than those about race in queer theory, but in general there’s a strong sense that queer theory needs to keep becoming more intersectional (recognising all of the intersecting power dynamics that shape our identities or subjectivities).

It is worth noting the bisexual erasure in queer theory, and the way in which queer theory has engaged with trans. Despite bisexual people troubling the binary of gay and straight, queer theory has a poor history in relation to engaging with bi people, theories, or politics, and many queer theorists are dismissive of bisexuality in a way that they are not about lesbian, gay, or trans. This is disturbing given that bisexuality is erased in wider society (which insists that people are either gay or straight), but also within queer (which insists that they should get beyond labels).

Trans experience has been central to the development of queer theory, but there has been a tendency of queer theorists to co-opt trans experience to support their theories, rather than engaging with the lived experience of trans people themselves. Queer theory on this topic can risk falling into a celebratory/critical binary: either trans people are the epitome of queer radically challenging the gender system, or they are dupes of heteronormativity just reinforcing binary gender roles and fixed identities.

There’s also a tension around the inaccessibility of the language of much queer theory – which can make it very hard for LGBTQ+ activists to engage with it unless they have a high level of education (and all of the privileges necessary for that).  That was one of the motivations for Meg-John producing Queer: A Graphic History in the form of a comic book – to help to bridge this gap a little.


Are there similar tensions and exclusions in Mad Studies?

Like Queer studies, Mad studies could be accused of being primarily white, western and middle class.  There are certainly concerns about whether Mad Studies might exclude or alienate some users and survivors. This is partly because of the language issue noted above.  But more importantly, some users and survivors feel alienated from Mad studies because of its overt criticism of psychiatry and the psy professions. For example, some users/survivors who feel excluded from Mad studies and feel guilty, ashamed or judged that they use and appreciate mental health services, psychiatry or medication.

There also similar tensions around the elitism and possible exclusionary consequences of the academic language associated with Mad Studies. There are also some concerns about the ‘other side’ of this – about whether Mad Studies will be colonised by academics or marketed by Universities as a ‘sexy new courses’ (see for example, Russo & Beresford‘s article).

So whilst both Queer and Mad Studies reject identity categories, they both have a tendency to privilege certain identities and exclude others. In Mad Studies there is a tendency to divide people up into (‘radical’) Mad positive ‘psychiatric survivors’ who are anti psychiatry and/or are more celebratory about their madness, in contrast to (more ‘conservative’) ‘service users’ who seen as defenders or apologists of psychiatry and may seek their services in order to ‘recover’. This has some similarities to the radical and assimilationist division in Queer.  So, in both fields, it’s easy for new hierarchical binaries to emerge about assimilationist versus radical strategies, or who is Queer/Mad enough.

Ultimately, these divisions are not very helpful. They tend to fix people into positions that most people don’t really occupy in reality. We would suggest that both Mad and Queer studies could do more to question and problematise the “alternative” binaries and privileging they engage in. It’s important here to consider the power implications of who has access to certain activist strategies, certain ways of expressing – or not – their queerness or madness, and the degree of safety necessary to be openly queer or mad.

What are the key differences between Madness and Queer?

This is where it gets very tricky. However it is defined, Madness poses particular troubles and challenges, both for the designated ‘mad person’, as well as the people around them.  This is why some service users and survivors such as Anne Plumb have suggested that it might be preferable to use the term MaD – Madness and Distress – to signify the complexity of mental health difficulties – that it is more than a celebration of difference and challenging normativities.

Whilst people may be unsettled by Queer expression, we think there is an important difference here.  For example, whilst Queer activists don’t have to be actively ‘Queer’ (whatever that might mean) it is certainly not an impediment to Queer activism or scholarship.  However, many people who experience ‘madness’ would probably have to take time out of activism, at least temporarily. Arguably, this could mean that many Mad scholars are usually not very Mad, or at least they are acceptably mad or temporarily not Mad.

Of course, this is very difficult territory.  What constitutes Madness? And who decides? (if it’s not psychiatry, psychology or other psy professions?)  Despite what many psy critics argue, psychopathologising usually happens in the lay arena first, before professionals rubber stamp, and specifically medicalise, madness. Whilst this has similarities to debates over who is isn’t ‘Queer’, it is distinct  because of the distress Madness usually involves – which we don’t think can be easily reduced to stigma, oppression or ‘sanism’ (unlike Queer).  This relates to what Nev Jones and Tim Kelly have called ‘inconvenient complications’ to Mad politics. In a way, of course, this is precisely what makes Mad studies so exciting, important and challenging,

Finally, whilst there is general agreement about the problem of heteronormativity in LGBTQ+ movements, the value of the ‘psy disciplines’ is much more contested within the mad/user/survivor movements. For example, there is a general consensus amongst LGBTQ+ movements about not seeking a ‘cure’ for marginalised queer sexualities. However, most user/survivor activists do seek some kind of mental health support and ‘recovery’ has been a key demand of the movement (even if there is much disagreement about what this means).

What kind of society are Queer activists fighting for?

We can trace this back the early days of Gay liberation where the ideal was the sexual liberation of society as a whole, not just lesbian and gay people. The creation of a society where sexual/gender identities are no longer important and where people are free to express their gender and sexualities in whatever way they choose. Rather than ‘flattening out’ difference so we’d all ‘look the same’  – this could create a much more diverse, fluid and multitudinous array of gender and sexual expressions.

What kind of society do Mad activists want (and is it similar to Queer)?

Mad activists are fighting for a society which accepts and embraces psychological diversity. Specifically a society which doesn’t resort to the bio-medical treatment of individuals, reliance on psy expertise or specifically coercion (sectioning, and treatment against the person’s will). Like Queer, this ideal would potentially benefit society as a whole and not just mad people – as it would challenge what are perceived as generally unhelpful and harmful psychological normativities. It would free us all up from the tyranny of normalcy.

So, it would be argued that there is a unified aim of creating psychologically and sexually enabling societies, societies which are not heteronormative or psychopathologising.  A psychologically enabling society would presumably also be sexually enabling – in the sense of allowing more diversity and fluidity in sexuality and gender expressions. Equally, a more sexually enabling society would also be more psychologically enabling. This is an exciting and challenging prospect.

Are there limitations to this ideal – of sexual and psychological freedom?

With both Queer and Mad Studies there is the tricky issue of negotiating our freedoms – how we cope with diversity, un/acceptable behaviour, and its impact on ourselves and others. These issues will not necessarily disappear once we get rid of prevailing heterosexual and/or psychological norms. We would still have to find ways of negotiating these issues somehow.

For example, we would need to find new and alternative ways of negotiating the the psycho-social complexities of madness and distress. This work is already well underway, especially in relation to how we now understand experiences like hearing voices and self harm.  However, there are still expressions of madness that are far less acceptable and understandable, especially when they involve perceived harm to others, such as certain expressions of altered states, psychosis, psychopathy, or sociopathy. But we think it’s a task Mad studies needs to attend to, with all seriousness and all our humanity.

Similarly, there’s increasing emphasis in queer activism on consent, and on developing more sophisticated understandings of consensual cultures and practices. For that reason, sexualities which involve an inevitable large power imbalance tend to be excluded from the conversation – although line drawing becomes tricky of course, as it does with madness.

Recent queer theory has turned its attention to at least some potentially harmful practices – such as unprotected anal intercourse – as part of its ‘antisocial’ turn.  This has also questioned the ways in which LGBTQ people have often attempted to prove that they can be part of the normative neoliberal capitalist project of become a happy, successful, productive ‘self’. Some queer theorists have argued that, instead of buying into these (hetero)normative ideals we should embrace the negative side of the binaries that we’re often relegated to (unhappy, unstable, unproductive) thus challenging the cruelty of the whole neoliberal capitalist promise which isn’t really available to many people.

There are clear resonances here between Queer and Mad studies. A colleague once suggested that, in the world we live in today, people can either be ‘sanely mad’ or ‘madly sane’. Perhaps a strand of both recent Queer and Mad studies is about pointing out the madness of those who are seemingly ‘sane’ (how that ‘sanity’ is often built on the suffering of others, and the pretence that it is not, for example), and – to some extent – embracing the inevitable madness, or at least distress, involved in being part of the LGBTQ or any other marginalised community.

This antisocial turn is certainly engaging with questions of distress (for example, Sara Ahmed’s work on emotions and happiness is particularly helpful on this), but there has been, as yet, limited dialogue with Mad studies.

What can Queer learn from Mad Studies?

There does appear to be a lack of critical non-binary thinking around mental health in queer communities. It is perhaps surprising that communities which think so critically about sexuality and gender often seem not to engage at all with the critical perspectives on mental health that we’ve been talking about. Often in those communities fairly individualistic, essentialist and mainstream understandings of mental health seem to be taken at face value, with little awareness of the role of social oppression in distress, or problematising of mad/sane binaries, for example. For that reason there’s a lot of scope to bring Mad activism into greater dialogue with Queer activism.

What can Mad Studies learn from Queer?

In a world in which madness is seen as always negative and dangerous, the idea reclaiming Mad (like Queer) is potentially challenging and subversive. This was, of course, the strategy of Mad Pride in the 2000’s. More recently, some proponents of Mad Studies have proposed the idea of ‘mad positive’.  This is often used to express an allegiance with the Mad movement, even if one isn’t identified as Mad.  This has some parallels with the idea of ‘sex positive’ which arose in the 1980’s.  So it’s worth looking at what can be learned from this.

In a society which demonises certain sexual expressions, being sex positive could be a useful corrective. However, it did have some unfortunate consequences. For example, it had a tendency to reinforce a sexual imperative which made life very difficult for both asexual people, and those many people who didn’t have an unproblematically positive experience of their sexuality. A related example was the insistence in some queer communities that kinky sexual practices were always always ‘safe, sane and consensual’ (to counter the sex negative view that they were ‘dangerous, harmful, and abusive’). This lead to the damaging situation where people didn’t feel able to talk about experiences which were damaging or non-consensual. Given what we’ve already said, the parallels here with Mad should be obvious, in that Mad studies needs to be able to address the damaging as well as the celebratory experiences of madness.  Our friend, the survivor researcher Dina Poursanidou, describes herself as ‘Mad ambivalent’, which we think neatly sums this up.

However, a more nuanced perspective doesn’t necessarily mean that sex (or madness) is necessarily positive. The following quote from Carol Queen illustrates this (note how ‘sexuality’ could quite easily be replaced with ‘madness’)

It’s the cultural philosophy that understands sexuality as a potentially positive force in one’s life, and it can, of course, be contrasted with sex-negativity, which sees sex as problematic, disruptive, dangerous. Sex-positivity allows for and in fact celebrates sexual diversity, differing desires and relationships structures, and individual choices based on consent.

Similarly, Lisa Downing uses the concept ‘sex critical’ as an alternative to the sex positive/negative binary. This is about regarding sexuality as diverse and challenging the idea that ‘non-normative’ sexualities should be scrutinised any more than ‘normative’ ones. So here a ‘mad critical’ perspective would regard mental health and distress as diverse and fluid, and would scrutinise ‘sanity’ just as much as it does ‘madness’.  This is very much part of the Mad studies project.

Final thoughts: foregrounding consent and kindness in Queer/Mad politics

We have each come to the conclusion that it would be mutually beneficial – to both Mad and Queer studies – to think about ways of foregrounding practices of consent, kindness and self compassion: both in terms of process and the desired outcomes of activism and critical scholarship. This draws on the idea of prefigurative politics – being the change we want to see in the world, so that our activism prefigures the kind of society we want to achieve. We are reminded of Kate Bornstein (the mad/queer activist) and her deceptively simple proposal that people should do ‘whatever you need to make our lives more livable, just don’t be mean’. Julia Serano’s queer activist writing points in a very similar direction

This would help us to ethically assess Mad or Queer expressions, without recourse to medicalisation, and would avoid an ‘anything goes’ relativism. For example, some mad/survivor activists are foregrounding practices of self/other compassion, for example in relation to hearing voices.   For those of us with experiences of queerness and/or madness the question of how we treat ourselves and each other is hugely important, especially given that communities (‘alternative’ and ‘mainstream’) can be places of re-traumatising and painful fragmentation just as they can be places of support and solidarity. We would like to see a lot more about how kind and consensual practices might operate in our everyday queer/mad lives and communities. 

Further Reading

Cat Fitzpatrick in collaboration with Jijian Voronka: Trans Activists, Don’t Throw Mad People Under the Bus!

Brenda LeFrancois & Shaindl Diamond: Queering the Sociology of Diagnosis

Brigit McWade book review of Sally Hines (2013) ‘Gender Diversity, Recognition and Citizenship’




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