The Care We Dream Of: Liberatory and Transformative Approaches to LGBTQ+ Health

by Zena Sharman

What if you could trust in getting the health care you need in ways that felt good and helped you thrive? What if the health system honored and valued queer and trans people's lives, bodies and expertise? What if LGBTQ+ communities led and organized our own health care as a form of mutual aid? What if every aspect of our health care was rooted in a commitment to our healing, pleasure and liberation?
LGBTQ+ health care doesn't look like this today, but it could. This is the care we dream of.
Through a series of essays (by the author and others) and interviews, this book by the editor of the Lambda Literary Award-winning anthology The Remedy offers possibilities--grounded in historical examples, present-day experiments, and dreams of the future - for more liberatory and transformative approaches to LGBTQ+ health and healing. It challenges readers to think differently about LGBTQ+ health and asks what it would look if our health care was rooted in a commitment to the flourishing and liberation of all LGBTQ+ people. This book is a calling out, a calling in and a call to action. It is a spell of healing and transformation, rooted in love.

Genres: Nonfiction, Queer, Disability, LGBT, Health, Social Justice, Essays

373 pages, Kindle Edition

First published October 5, 2021

Reviews

[zaynab · Rating 4 out of 5]

This anthology vacillated from enthralling to confounding. I greatly enjoyed the essays by practitioners working at the intersections of healthcare and migrant justice, disability justice, intersex justice, fat liberation, and trans liberation. I enjoyed hearing their first-person perspectives on what it would take to actually have healthcare that is liberatory and leaves no one behind.

What detracted from this anthology was the sheer number of Sharman's essays throughout the entire volume. It's one thing for an editor to write the introduction and an essay of their own. It's another thing for an editor to have 6 essays in an anthology they're editing. It lacks hubris, and quite frankly the subjects Sharman's essays cover could have been written by literally anyone else. It's almost contradictory to name how discussions of LGBTQ healthcare are dominated by cis white people of certain class privileges, and then be an editor of relatively the same composition that then occupies so much discursive space in an anthology. All six of Sharman's essays make reference to various scholars and activists who inform her thinking. Any one of those people could have written a contributing essay to take the place of one of Sharman's extra essays.

If other multiply marginalized people didn't want to submit essays to her anthology, maybe that says something about the potential reluctance of people to trust a cis white woman who is perpetually trying to drive more radical conversations on LGBTQ healthcare while centering her own voice.

Moreover, one that that stood out to me as missing was a perspective on madness and healthcare. I know Leah Lakshmi Piepzna-Samarasinha's was supposed to be the de-facto "crip/mad" essay. But, for lack of a better term, it's just getting lazy at this point for editors to continually default to them, to the exclusion of other voices who have something to say about disability justice and/or madness. There is a whole world of mad studies thinkers, and a whole world of mad movements where LGBTQ are holding it down. Include their voices alongside Leah's. There's more than enough room.

I was also surprised to see things like asexuality mentioned in Sharman's essay, but never actually given the scope of articulating what asexual justice or asexual affirming healthcare could look like via an essay by an asexual person. I'm not asexual, but I want to understand what it's like to navigate a healthcare system where sexual normativity is pervasive.

I know the common excuse for anthology editing is that "everything can't be included", but it sure can't when the editor takes up 6 essays worth of space for themselves.

If Sharman really feels the need to write 6 essays in an anthology, she should just write a stand-alone book that doesn't solicit other submissions. That would be more intellectually honest than the organization of this anthology.

[River · Rating 1 out of 5]

DNF. Maybe I’ll give it another go at some point, and maybe I’m too jaded, but as a radical queer going into healthcare I really wanted to love this book. I found it beautifully imaginative, but without many real examples of how we can make healthcare work better for us. I found it rambly and unrealistic, throwing in all the buzzwords to make it pass as a radical queer book. No shade, but I feel like the herbalists I know would love this book, but the people working in healthcare in a larger sense (I’m going to be a nurse) will be frustrated with this read.

[zoe k · Rating 4 out of 5]

After reading a lot of feminist literature written by white women, lack of perspective can get exhausting. When discussing world issues it’s very easy for white authors to write only what pertains to and affects them, or, in the rare instance they do discuss overlap in issues (issues for queer and/or disabled women of colour) they will act as if their knowledge is their own, refusing to credit theories that come from black and indigenous feminism.

Zena Sharman does the exact opposite of this. It is such a breath of fresh air to have a white author and editor use their platform to credit people of various backgrounds with different qualifications in a series of diverse subjects she touches upon in her book. Through her interviews or essays with other people she is able to fully capture the experience of being queer and fat, queer and disabled, queer and a person of colour, etc. As a health researcher and strategist I found she really knew what she was talking about, but her inclusion of other peoples stories makes the book all that more rich.

I think I’m going to be talking about this book for weeks, like I’m obsessed with it and I’ve told all my friends to read it and you should too!

[Stephanie · Rating 3 out of 5]

The best part of this volume was the number of different perspectives and interviews from experts in their respective fields. I learned a lot and now see healthcare in a new light (which is what I wanted from this!)

The segments written by the editor, on the other hand, were too numerous. Especially given the unique voices from the practitioners in the other sections. I found myself wanting more variety in her sections because of this.

Overall a very important and worthwhile read though!

[altate · Rating 5 out of 5]

Necessary read for all those who work in care professions or just people who care about others (hopefully most of us!!). It took me a while to get through but I’m glad I took my time with this read. Also bring your tissues for the beautiful writings on death—but also be prepared to feel hope for what our futures may hold. Loved it!!!

[Mica Doria · Rating 5 out of 5]

If you work in Queer healthcare or someone who has a radical social justice mindset, you must read this book. I learned so many new amazing things I had yet to know. Very racial, disability, fat justice accessible and diverse. Really opened my eyes in my approach to my work.

[Alexa]

Had to DNF this after reading approximately half of it; it's brilliant and I'm glad it exists, but it was going too slowly for me in part because it's written at a higher/more academic level than I currently have the mental capacity for.

[Amy · Rating 4 out of 5]

I enjoyed the variety of pieces and topics included (essays, interviews, poems...). Lots of dreaming to do. Lots of community work and collaboration to do (which I find is hard to get into!) but one thing this helps with is to be knowledgeable and sensitive to these topics to better support others.

[Mahala · Rating 5 out of 5]

One of my new very favorite books. So fucking beautiful

[Emily · Rating 2 out of 5]

I really wanted to like this. And while the majority of the concepts and stances this book argues for I agree with, it felt exhausting to read. Ironically it felt rather one-dimensional and whiny, which I know is not what is intended. I was offput by the number of essays Zena had included of their own, and it felt rather arrogant and out of touch, again, ironically. I feel that we can try to be so inclusive that it actuallt loses cohesion and focus. I wanted higher quality content. I am perhaps personally offended by the discussion of social work on oage 140, as Zena leaves no room for discussion that the field itself has worked immensely to overcome the stigma attached to the term; as a social worker, majority of my peers are qualified mental health professionals and not just because they are well-intended, but because they are intelligent and challenge the system in the spaces where their clients interact. Most social workers wish social work didn't even need to exist, which is abolitionist thinking, but the author offered no introspection into this, which takes me back to the same argument of this is wildly one-dimensional, despite the plea for readers to question everything. Which we should do, constantly--I just wanted better from this book, and it left me questioning the book content rather than the system. I do think people should read this, and topics similar, but with other viewpoints to add onto the ones inside the binding of just this particular book.

[Kora Dzbinski · Rating 5 out of 5]

i keep referring to various collections as "sacred" this year, but The Care We Dream Of its a holy book in it's own right. nothing is more motivating and sustaining than the reminder your body & your loved ones' bodies matter, & that another world is more than possible - the work has already been started by BIPOC & disabled & poor siblings.

[Jacob · Rating 4 out of 5]

This was a solid collection of essays around visioning futures for 2SLGBTQ+ health care curated by Canadian writer Zena Sharman. Although half of the essays are written by Sharman, she diversifies the collection with additional voices (essays and interviews) talking about both what is hoped for the future, and what folks have created now in terms of mutual aid, to fill the gaps where health systems fail our communities.

I appreciated its radical vision, wanting to go to the roots of the problems, for example, seeing the health futures of Indigenous peoples as inseparable from land rematriation, or fundamentally reframing the way we see 2SLGBTQ+ health, not in terms of risk or checkboxes, but holistically, in terms of what is possible. Sharman wants to reclaim the "perversion" claim that has been thrust upon our communities, calling upon us to pervert the status quo of health and health care. The book is rooted in disability justice, and a vision of no one left behind, including folks who cannot fit in with a respectability politics version of queer (e.g. including racialized people, people who use drugs, people who do sex work, chronically ill and disabled people etc.).

If we actually shaped the system using the values and practices in this book, everyone would benefit, and not just 2SLGBTQIA+ folks. As an EDI worker in the mental health system, I know all too well that it's getting policy makers and privileged health care providers to read things like this and to implement change that is the real challenge. I suspect it will be mostly queer and trans folks working in the system that read this book, and we're not as much the ones who need to. I hope I'm wrong. But even if it's just us - heck, I have cited this book in the work I do. We'll keep pushing from within and without these systems.

My personal favourite piece was Sharman's essay on queering death as I find many queers I know have a hard time envisioning the future, so they also don't envision or plan for death, or even old age. I hope we can build a world where all of us have that luxury to dream of a good death long in the future.

[Leah Coppola · Rating 2 out of 5]

I didn't finish it. I wanted to like this book a lot, I really did - the project of transforming healthcare to liberate queer people is inspiring and important. But the execution of this actual book was hard to read. The prose of many of the essays is stodgy, full of overqualified half-claims with no direct evidence to sink your teeth into. While I understand why Sharman introduces all of the queer identities and ethnicities and nationalities of any author she cites, it slows down the prose immensely and rarely adds to the point she is making.

Really though, my main complaint is this: While some chapters, such as the one on HIV/AIDS care, offer practical solutions, most (up until the halfway point, where I gave up out of exhaustion) stay largely theoretical and focused on a broad vision of transformative healthcare. That's great, of course, but I was hoping for some details.

I also was disappointed that there isn't much (in what I read, at least) about transforming trans healthcare. To be frank, if there is one part of the healthcare system that oppresses queer people, it is the shocking and awful ways transgender people have been gatekept by psychiatry and medicine. Most trans people know much more about our own healthcare than our medical providers, which is. You know. Garbage. When I picked up this book, I hoped I would hear a lot - a LOT - about how to make trans healthcare less of a dumpster fire - but alas.

It is possible there were some good nuggets that I missed from the later chapters, and if so, I'm sorry for misrepresenting the book. Still, I give it some kudos for having a vision and interest in justice. Though I can't agree with the execution, I do think the message is important.

[Anna · Rating 4 out of 5]

Highlights of this book for me:
- a vast array of different perspectives from within the US & Canadian queer communities inclusive of many multiply-marginalized identities
- discussions of queer ritual in context of physical and mental health
- discussion at length regarding frequently left out components of elder queer care
- history of HIV/AIDS and it's impacts on queer health care

Things I didn't like as much:
-- a lot of establishing and re-establishing the problems as they exist - which while important to provide context, are taking up a lot of space and become repetitive. As someone who has read the Remedy, and is queer myself, felt a bit excessive given the context of this book being presented as an answer to this
- something missing that would have been interesting to see would be more from queer healthcare providers thoughts on what we can do to transform the system to better serve our communities - there is some of this, but I'd have liked to see more

Highly recommend especially the last 1/3 of this book.

[Mary · Rating 5 out of 5]

This was such a beautiful and transformative book. I truly did not anticipate how seen & held I would feel by it, and how much it would account for feelings that I have had but never been able to put into words.

It took me almost a year to read because when I started, I had recently become disabled by Long COVID and the ideas here of embodied, community based, queer focused care were so far from my everyday lived experience at that time that they were too raw to touch.

Even now, while this book is a wonderful celebration of possibility, it is also a painful reminder of how the pandemic has severed me from queer community, and the kind of care that I desperately need, and my friends desperately want to offer.

I already know I will revisit this so many times - for encouragement, for comfort, for fire and rage. For all of it.

[Laura · Rating 5 out of 5]

Exactly what i needed to read at the closing of this year, full of covid and my own personal burn out. This booked helped to reconnect me with the ideas that brought me to this work. Although i have no concrete plans or changes I feel revived. It reminds me that although the systems I work within are broken that I hope for something better. For my community, my clients and for myself as a care giver. I am reminded to dream and to call myself to transformation.

[Mahima · Rating 5 out of 5]

A beautifully written book with reflections, essays, and calls for action in LGBTQ+ healthcare and creating community. The Care We Dream Of offered me a much needed space for reflection that is worth revisiting and continuing to expand on over time.

[Queena · Rating 4 out of 5]

A slower read for me but so good! So thought provoking, creative & imaginative. Also Carrie’s quite the variety & something for everyone: interviews, poems, personal essays & anecdotes, policy analysis and so much more. Everyone should read this radical re-imagining

[Karen San Andres · Rating 5 out of 5]

An important read, especially if you are in the health care field. I found myself saying YES! While reading the introduction. Let’s all work to do better for our LGBTQ2s+ communities, to make them feel respected, safe, seen and heard as the humans that they are.

[Jehnie · Rating 4 out of 5]

Uneven but worth a read. If you're open to abolitionist activism, this book looks at a variety of intersectional topics related to queerness and how to rethink systems.

[Mari C.L. Murphy · Rating 5 out of 5]

One of the most important books I’ve ever read

[Stephanie · Rating 5 out of 5]

This book was so phenomenal, I feel I’ve learned so much. Every person working in healthcare in anyway should 100% read this, I can’t recommend it more.

[Zain · Rating 5 out of 5]

Amazing

[Alex! · Rating 5 out of 5]

maybe cried a bit, leave me alone

[Lena · Rating 3 out of 5]

3.5

[Jonathan · Rating 5 out of 5]

Didn't agree with everything but that's okay.

[Laura Harrison · Rating 4 out of 5]

I will be using essays from this book in my Health, Wealth, and Power class and Feminist Activism and Social Justice

[Alex · Rating 5 out of 5]

I loved the story's and essays and esspecially how the author was able to give us a history of Queer rituals in Death and talk about her personal experiences.

[Adrian Shanker · Rating 5 out of 5]

In this book, Sharman dreams up a future where queer and trans people can access care for our bodies that feels truly affirming and even exciting. She goes so far to ask what it might look like if LGBTQ+ people "loved going to the doctor." At one point, she writes "the truth is that there is a big gap between the care I dream of and the care we have now." There is perhaps no truer statement about the reality of healthcare in the U.S!

[Tristan · Rating 5 out of 5]

This collection of anthologies provides hopeful and desire-based approaches for reimagining healthcare and book lit a fire in my heart for creating better systems. Every healthcare worker should read it.