What kinds of health care do trans and queer communities need in order to flourish? What obstacles are in the way? What seeds for life-affirming futures are beginning to sprout? These are just some of the provocative, expansive and open-ended questions that editor Zena Sharman takes up in “The Care We Dream Of: Liberatory and Transformative Approaches to LGBTQ+ Health.”
The book is made up of essays by Sharman and other contributors, as well as interviews Sharman conducted with people who work in what she broadly defines as queer and trans health care. While the book contains more questions than answers, it insists from the beginning that queer and trans people deserve every kind of health and every kind of well-being, on terms that we are allowed to define for ourselves. There’s a huge realm of topics covered, from “Thoughts on an Anarchist Response to Hepatitis C and HIV” by Alexander McClelland and Zoë Dodd, to “Dreaming Bigger: Body Liberation and Weight Inclusivity in Health Care” by Sand C. Chang, to “Borrowed Wisdom: Using Lessons from Queer History and Community in Suicide Intervention” by Carly Boyce. If you’re looking to push your thinking in multiple directions, this book could definitely do the trick.
The first piece that really grabbed me was “Pleasure as the Baseline,” an interview Sharman conducted with Dawn Serra, a sex and relationship coach. Serra laments the mainstream notion that the overall goal of health care is to eliminate pain. Instead, Serra prods us to ask: what if we designed health care around increasing pleasure? “Pleasure,” she says, “is truly being with the sensations, questions, and opportunities our bodies are offering us.” She suggests that health care practitioners start asking their patients questions like, “What can we do that increases your pleasure or gets you to a place where pleasure becomes possible?” These invitations sound so unfamiliar and outlandish to me that they helped me reconsider my own perspectives on what I expect health care to feel like.
The following essay is “Cripping Healing” by renowned disability/transformative justice worker Leah Lakshmi Piepzna-Samarasinha. Their piece introduces disability justice concepts and frameworks to the book: “not everyone wants to be cured or healthy, or can be.” The essay speaks to the rage, grief, inventiveness and legacies of sick and disabled people’s organizing for healing and self-determination.
Piepzna-Samarasinha invokes groups like Sins Invalid and disability justice organizers like Patty Berne and Aurora Levins Morales, while also sharing examples of more local concrete, radical experiments in access and healing. In Tumwater, just south of Olympia, the public library has introduced a “Library of Things,” which loans adaptive devices for free to people who want to try them. Piepzna-Samarasinha writes about how this program “creates a more playful, curious, and flexible space to explore disability and changing access needs.”
But Piepzna-Samarasinha’s essay also outlines the suffering, violence and harm experienced by disabled people. They directly name ways that the current medical-industrial complex harms queer and trans people. Specifically, Piepzna-Samarasinha lifts up the memory of Lucia Leandro “LL” Gimeno, a trans Afro Latinx femme community organizer, artist and healer who was a beloved part of Seattle queer and trans spaces. Gimeno died while awaiting a kidney transplant and experiencing medical neglect, fatphobia and violence.
Piepzna-Samarasinha is clear that our current “health” system is to blame for Gimeno’s death. They write, “We need nothing less than a total remaking of the medical industrial complex into a health care and healing system where disabled bodies, minds, and lives are seen as valuable and perfect.” The essay is intense, painful and important. Every queer and trans person in Seattle should make time to read Piepzna-Samarasinha’s words to uplift Gimeno’s memory and to be guided toward justice and the changes that are desperately needed.
Another piece that resonated powerfully with me was “the seven sacred ways of healing” by jaye simpson. It begins with a poem about a healing ceremony where Indigenous women scream together as a collective unleashing of trauma. The poem is followed by a short reflection that provides context about the ceremony, as well as simpson’s journey returning to their homelands as an Indigenous trans woman. simpson writes of the ceremony, “It was the most radical and affirming healing I had ever participated in.” Their writing offers us reminders that “no one can heal alone,” which feels like an anchoring sentiment for the book as a whole.
Unfortunately, the divergent strands of this book did start to feel like a downside over time. Some of the jumps in content were jarring and hard to process; for instance, a piece about how therapists could better serve sex workers leads directly into a piece about queer suicide prevention. Each chapter could have deserved its own book; alternatively, this book would have benefited from having multiple pieces reflecting on fatphobia or suicidality and community care.
I also didn’t really enjoy most of the interviews; since they are not directly related to other pieces in the book, I didn’t feel like there was enough context about the specific work the interviewees did or why each was chosen. By the end of “The Care We Dream Of,” I had the sense that the book was somewhat insular and reflected Sharman’s conversations with her friends and comrades. The book could have been made more well-rounded by casting a wider net for contributors.
Though I have critiques, I found this collection of essays and interviews a really inspiring read that often had me tearing up and imagining a more hopeful, joyful and healing world for all queer and trans people. “The Care We Dream Of” feels like finding a door; my dream is that on the other side of the door are fierce, abundant communities where queer and trans people create what we need in order to truly thrive.
Jed Walsh is a writer living on occupied Duwamish land.
Update: This story has been updated to reflect that jaye simpson's pronouns are they/them.
Read more of the Jun 1-7, 2022 issue.