Queerness and psychedelics have always been intertwined in complex ways. From their historic exploitation in research to develop coercive so-called “conversion therapies”, to their naturalistic role in facilitating spiritual, creative and community experiences (including inspiring the Pride flag itself), these substances have carried both harm and hope for LGBTQIA+ communities.
Despite this, academic research into queer psychedelic experiences remains sparse, often focused on risk and pathology rather than identity, healing or liberation. Further, the representation (or lack thereof) of queer participants in trials of psychedelic-assisted therapies is uncertain, due to lack of standardised recording of this demographic.
Bartlett and colleagues (2024) set out to explore what the “meaningful, non-pathologising” inclusion of queer voices could look like, in psychedelics research. Their review asked:
- How have queer experiences of psychedelics been represented in the literature?
- Who is being studied, what motivates queer psychedelics use, and what outcomes are described?
This review aimed to highlight gaps and point the way forward for psychedelics research, which better includes and represents queer communities.
Methods
The authors searched seven major databases, using a wide range of psychedelic- and queer-related terms. There were no restrictions on publication date. They screened more than 74,000 records, which included qualitative studies, case reports, commentary pieces and some clinical trials.
The authors identify a purposive selection approach:
Part of the approach taken in this scoping review was to maintain a healthy skepticism of the heteronormative approach to research, including questioning the dominant research ideological framework and methodology, both historically and in modern research.
To be included, studies had to explore psychedelic use in ways that centred queer perspectives, identities and community, and avoided further stigmatisation. Publications that mentioned queer people only in passing, or framed psychedelic use solely in negative terms, were excluded – to yield a total of 18 studies spanning from the late 1960s to 2022, covering substances such as MDMA, LSD, psilocybin and ayahuasca.
Questioning conventional research narratives – the study included 18 papers spanning the late 1960s to 2022, chronicling queer experiences of psychedelic use.
Results
Looking at the definition of ‘psychedelics’ across the 18 included studies, one study covered ‘psychedelics’ as a class of substances, while others specifically referred to MDMA (7), and less commonly LSD (4), psilocybin (3) and ayahuasca (2). In-keeping with the Nixonian social policies that influenced both its use and its later control as a scheduled drug: all but one LSD-focused articles were written on queer experiences in the 1960s – two discussing psychedelic conversion therapy. The remainder of the extracted publications were written within the last 20 years, moving to a non-LSD psychedelic focus.
In terms of the population cohort, the authors remark:
A defining strength of the queer community is the diverse, ever evolving, and ever-expanding possibilities of self-identity with which one can align and express. Unfortunately, this heterogeneity and richness is not reflected in the queer psychedelic literature
Most of the literature reviewed, identified a focus on the psychedelic use of gay and cisgender men, often white and English-speaking. Queer women, trans and non-binary people remained largely absent in research, but a small number of studies offered some rich insights, as identity categorisation was often less rigid than ‘gay’, ‘bisexual’ etc, but more flexibly ‘Queer’ or ‘non-Queer’ (Bryant, 2016; Jadali 2022), rather than breakdowns by gender identity and sexuality.
Intersectional individual and collective identities (such as race, class, and disability), experiences and practices (such as those linked to religion or spirituality) were rarely explored – but Jadali’s 2022 study on how non-binary Islamic youth concceptualised and related to God through psychedelic use, was commended in this regard. Overall, given geographical and community spread, with some studies identifying non-western divergent gender and sexual identities as well (Stauffer et al; 2022 (Tumtum); Bryant, 2016 (Two-spirit)), demographic reporting standards were variable.
The literature identifies that motivations for psychedelic use and research have shifted over time. While naturalistic use of psychedelics has been a part of queer identity integration, in Indigenous communities (Stephen, 2002) throughout history, in the mid-20th century, psychedelics were sometimes proposed for use in attempts to suppress queer identity, with LSD and mescaline administered in so-called “psychic shock” conversion therapies (Dubus, 2020).
On the other hand, more recent accounts are beginning to re-frame both naturalistic and therapeutic psychedelic use. Settings ranged from clinical trials and ceremonial rituals to raves and private gatherings. The context often shaped the outcome: for some, a supportive group space fostered healing, while for others, solitary use in nature prompted profound spiritual insights. This is in keeping with the commonly cited ‘set and setting’ paradigm of psychedelics research.
The one included experimental clinical trial (Anderson et al., 2020) on psilocybin-assisted therapy for long-term HIV survivors, reported reduced demoralisation, PTSD symptoms and complicated grief. Both psilocybin (Agin-Liebes et al., 2021, in a clinical trial) and MDMA (Ching, 2020, as autoethnography) were identified to offer queer participants a route to self-acceptance, identity exploration, community connection and spiritual growth.
In some studies, participants described psychedelics as helping them process minority stress, confront internalised stigma, and build resilience. Importantly, both classical and non-classical psychedelics such as Ayahuasca (Cavnar, 2011; Cavnar, 2014), and MDMA in even larger studies (Coveney, 2005; McElrath, 2005) were specifically identified in qualitative studies as enhancers of sexual experience, and a way for people to explore their non-heterosexuality and normalise their journey of ‘coming out’ as queer, suggesting potential to research a bidirectional relationship between the use of psychedelics and queerness.
Love, Sex and Dreams: although most studies captured the experiences of gay cisgendered men, the wide range of study designs captured the ‘becoming’ of queer persons into their identities, the exploration and acceptance of their gender and sexuality, and also how they related to their dreams and spirituality.
Conclusions
Bartlett and colleagues show that queer voices in psychedelic research are still rare – and that when present, they are too often filtered through a narrow lens.
The studies that do centre queer perspectives suggest these substances can play a powerful role in self-discovery, healing and connection. This is broadly inkeeping with perspectives on the purpose of naturalistic psychedelic use, but may have particular community significance in the “set and setting” of queer communities and lived experience.
To further realise the potential of psychedelic use in experimental research and therapeutics – researchers need to go back to the drawing board, and draw on the rich experience of queer culture and history, in co-producing studies directly with queer communities, using inclusive and intersectional methods, and reporting demographic data transparently and robustly.
Queer culture offers vital lessons for more inclusive psychedelic research and therapy.
Strengths and limitations
A major strength of this review is its broad search strategy and clear, affirming inclusion criteria, which avoid perpetuating stigma. The authors also bring lived experience to their analysis, allowing for critical reflection on possible heteronormative bias in the field.
Critically, one newer literature review, by Haft et al. in 2025, has tried to cover “participant diversity in psychedelic-assisted psychotherapy trials” more broadly, Bartlett’s study is more unique and impactful in developing an inclusive search strategy – proactively uplifting under-represented queer voices and their experiences of psychedelics, with strong experiential accounts in academic autoethnographies and case studies, placed alongside findings of larger structured qualitative research or experimental trials. This allows for a more robust exploration of naturalistic psychedelic use and queer experiences, which should provide new avenues for researchers seeking to support queer communities, led by the community’s own priorities.
One possible limitation is that the research question itself may have been biased by choosing to focus exclusively on positive experiences of psychedelics, as this may overlook the possibility of there being specific negative effects that queer people experience in isolation, or disproportionately.
For example, post-psychedelic integration and the importance of safeguarding for vulnerable groups are a focus of discourse in psychedelic research spaces. The review may have been enriched by also considering these factors, although the authors do explicitly state their aim was to forgo including literature that further perpetuates negative stereotypes or stigmatization of psychedelic use and queer individuals. The pool of included studies was also small, making it difficult to generalise findings.
This study paved new ground by amplifying self-led first- and second-person case studies and autoethnographies on queer persons’ naturalistic use of psychedelics, alongside formalistic research and experimental trials on their therapeutic use with queer participants.
Implications for practice
For clinicians, the message is that psychedelic experiences can be deeply meaningful for queer people, but this must be recognised and respected in therapeutic settings. For researchers, there is an urgent need to broaden the range of identities represented and to take intersectionality seriously. Funders and policy-makers should support work that moves beyond risk and diagnosis to explore identity, community and pleasure.
This review suggests there is more to be done to treat queer people who use drugs as active partners in psychedelics research. For practice and future studies, the first step is to move away from an “outsider looking in” model. That may mean shifting from recruitment that relies on convenience samples and broad advertising towards in-reach strategies that embed researchers in the spaces where queer communities already gather – and may also mean increasing representativeness in teams who develop and lead research, beyond participants. Ways to facilitate this, include collaborating in research development with trusted community organisations, queer-led harm reduction services, and peer networks, and ensuring they are resourced to co-develop recruitment materials and protocols.
Addressing the absence of queer women, trans, non-binary, and marginalised intersecting participants requires intentional oversampling and targeted outreach. This could involve forming advisory groups made up of underrepresented sub-communities before the study starts, and then tailoring recruitment to their needs and spaces. For example, work with QTIPOC (Queer, Trans, Intersex People of Colour) networks, disabled queer collectives, and faith-based LGBTQIA+ groups can reach individuals whose voices are usually missing from research. Researchers should also budget for practical supports such as travel vouchers, childcare, and translation services, which can make participation feasible for people facing economic or accessibility barriers. It is important to note also that the NIHR now requires health equity to be a consideration actively made when submitting funding applications.
There are examples outside psychedelics worth emulating. The Trans PULSE Canada survey used a national network of community-based organisations to reach over 2,800 trans, non-binary participants, many from racially minoritised backgrounds. In HIV and sexual health, the Positive Voices study in England has demonstrated how partnership with grassroots organisations can deliver large, diverse samples that reflect community realities. Similar collaborative frameworks could underpin future psychedelic research, ensuring that those most marginalised are central to the study design.
Ultimately, practice in this area should adopt a “nothing about us without us” stance: queer communities must be actively involved in deciding the research questions concerning their community, shaping methods, interpreting findings, and sharing results back in accessible formats. This is not just about representation, but about generating evidence that is credible, relevant, and genuinely useful to those it aims to serve.
The door to exploration may be open – but queer communities cannot be doorstops for external psychedelics researchers, to decide intra-community research designs and priorities.
Statement of interests
Stephen has also completed a briefing for the UK Parliament focussed on psychedelic-assisted therapy for mental health conditions. Stephen also researches substance use in gay and bisexual men, specifically focussing on chemsex.
Shubhangi has worked as a public science communicator in Ireland, giving talks on the historical and political landscape and pressures on the scheduling of psychedelics, and the exclusion of marginalised groups in psychedelics research.
Reflexivity: Stephen identifies as a cisgender pansexual man, with lived experience of the topic being researched. Shubhangi identifies as QTIPOC, with lived experience of the topic being researched.
References
Primary paper
Bartlett A, Christ C, Martins B, Saxberg K, Ching THW. The library is open: a scoping review on queer representation in psychedelic research. Front Public Health. 2024;12:1472559. doi:10.3389/fpubh.2024.1472559
