“I Don’t Feel High Risk”: Biomedicalization, Queer Knowledge, and Contemporary Sexual Health

• In Event: LGBTQIA2S+ Studies in the Sociology of Sexualities

Abstract

In this article, I examine how queer communities innovate and drive social change in the context of biomedicine. In my work, queerness operates as a source of knowledge that reshapes how institutions approach risk and responsibility. I ask: How do queer perspectives on sex and health challenge institutional definitions of risk and pleasure, and what do they reveal about categorization, measurement, and inequality within sexual health? Existing research shows how biomedical technologies such as PrEP and treatment-as-prevention disrupt sexual norms and open new possibilities for sexually active adults. Yet less attention has been paid to how emerging standards of sexual health are negotiated, stabilized, and made actionable across clinical and community settings. Drawing on interviews with 25 sexually active queer adults and 10 clinicians, as well as a year of ethnographic fieldwork in San Francisco, I investigate how sexual health is made meaningful as medical technologies are negotiated and under the right circumstances, transformed by both the biomedicalization of queer sex and the queering of sexual health care. I conceptualize queer sexual health as a strategic action field in which actors contest expertise, authority, and the provision of care. I argue that “queering the toolkit” is a transformative process of knowledge production and implementation through which biomedical prevention technologies shift to align with community-based norms around sex, pleasure, and wellbeing. Providers navigate institutional constraints while incorporating community knowledge, reshaping clinical practice in response to lived experience. Biomedicalization thus operates as an interactive process in which biopharmaceutical prevention reshapes sexual practices and clinical relationships, while queer communities and clinicians actively transform these technologies. By tracing this process, I refine theories of biomedicalization and advance strategic action field theory, deepening our understanding of how the study of queerness and the work of LGBTQ+ communities shape institutional change within contemporary sexual health.

Author

• Ryan DeCarsky, University of Washington