“Gay gender” and identity suffering: the slam phenomenon (2014)

Gay gender and identity suffering: the slam phenomenon

Nouvelle Revue de Psychosociologie, 2014/1, No. 17, p. 109-120.

Chemsex. A new phenomenon emerged about six years ago under the name of “slam.” This English term, known for naming an art of verbal jousting, now refers to the practice of intravenous drug injection in a sexual context. It involves the consumption of psychoactive products from the cathinone family 1. The ecstasy-like 2 effects of these molecules available on the internet are valued for their ability to amplify physical and mental pleasure. This drug use practice appeared within the gay community (around 2004-2005). Originating notably from the festive space of clubbing and its recreational drug use, the use of certain molecules has gradually become a specific feature of the sexual life of a portion of the gay community. The effects of these products are appreciated for several reasons: for relational aspects, as they facilitate encounters and disinhibit users; for technical aspects, because they facilitate certain hard, extreme, or more intense practices than those usually practiced by users; and

for the pleasure and enjoyment that can be multiplied as a result. Suffering linked to identity (or the difficulties caused by sexual and social inhibition)—needs for recognition, relational tensions—and the means to alleviate them are at the heart of this phenomenon, blending both sexual identity and gender identity according to variations we propose to study. A gender approach applied to gay identity 3 allows us to uncover some underlying stakes regarding social, psychic, and sexual needs and contingencies. Let us see what clinical experience reveals and what maneuvers gender allows us to perform to understand them, but also to intervene clinically, from the position of a psychoanalyst, on the psychic level and while taking social and cultural aspects into account.

CLINICAL OBSERVATIONS

 

Slam brings together intra-psychic, relational, social, sexual, and cultural dimensions in a striking way. Indeed, slam emerges in social spaces—clubs, parties. It does not first appear in the bedroom, although its practice then leads to a change of scene from the public recreational space to the private space of an apartment. Jérémie, 32, explains: “At first, I used GHB 4 in clubs, like everyone else, and then when I saw that it helped me sexually to take more pleasure, I started using it during hookups at home too. That’s where one day someone offered me meph 5; I tried it and since then I only use that.”

The practice of slam causes psychic and physical damage from the very beginning of consumption. The practice of intravenous injection requires technical knowledge and habits that slam enthusiasts do not have at the time of their initiation, nor does the gay scene possess much in comparison to other communities—free-parties, squats—where recommendations for harm reduction injection practices have been circulating for many years 6. There are therefore immediate risks of infection, of conta-

mination by HIV or hepatitis (C, in particular), but also somatic damage to the venous system 7, and side effects of the injection on the respiratory or cardiac systems 8. Almost as quickly as the somatic risks, psychic effects appear during the “comedown,” which often proves painful for inexperienced users and even sometimes for regulars. Patients describe moments of “paranoia,” of

“depression” following, on the negative side, the positive effects previously felt, such as “unprecedented enjoyment and communion with the partner,” or a “pushing of boundaries.”

The real-time discovery that patients make in these experiences, which are still poorly understood by specialists, requires the clinician to perform work in cataloging and providing information on practices, effects, and problems encountered, which must be problematized and shared among all possible partners: addictologists, psychiatrists, expert users, sociologists, etc.

In the longer term, the practice of slam unfortunately causes almost as much damage as crack use—to which it is often compared to evoke its short, medium, and long-term consequences. Immediate physical and psychic damage worsens over time: mood disorders take hold outside of consumption periods with their relational, social, and professional consequences; weight loss can be very significant and rapid (several kilos, up to ten in a few months); infections and contaminations can multiply. When patients come to ask for help, they are almost always in an emergency situation, seeking a place to talk and begin an assessment of their situation, or even rapid hospitalization to alleviate often acute psychic fatigue. Jean, 45, asks: “You have to help me, I can’t take it anymore, I’m using at home in the evening all alone when before it was only for sex. I’ve missed work several times and I’m going to end up losing my job. I’m no longer taking my treatments. I’ve had syphilis three times this year, and also hepatitis C which I didn’t have before… I only had HIV. I’ve argued with everyone. As soon as a guy sends me a text to tell me he has meph, I can’t help myself from going. On the internet, I’m only offered chem 9 hookups.”

AIDS continues to divide

 

The professionals concerned (psychologists, addictologists, infectiologists, psychiatrists) are few in number to have specialized in this phenomenon. This constitutes a marginal clinical practice, which also frightens some health professionals insofar as such specialization may seem to induce a kind of exclusion, echoing that which the consumption of these specific products entails among gay men. Indeed, in a community with strong identity claims, the very constitution of the “slam phenomenon” must be observed as the symptom of another underlying exclusion, that of HIV-positive gay men among gay men. Indeed, the majority of gay men practicing slam are HIV-positive and, although there are no scientific data on this point, all stakeholders recognize this as a main characteristic of slam. Slam tells us something about the AIDS epidemic among gay men; this is, in any case, the hypothesis we have formulated since our first meeting with these patients about five years ago.

Firstly, with nearly 20% being HIV-positive, one cannot say that the gay community in Paris is discovering HIV, or HIV-positive people, in 2014—the prevalence reaches 12% among gay men or MSM (men who have sex with men) at the national level 10. There have therefore never been as many gay men carrying the virus as there are today. And since cases of contamination remain steady each year, this number will continue to grow thanks to treatments that increase life expectancy and guarantee the chronicity of the viral infection. Curiously, at the same time, HIV-positive gay men have, it seems, never experienced so much difficulty living with their HIV status within their own community, in emotional or sexual encounters, or even at work. Medical progress has not eradicated the fears that persist, even when this progress allows them to be reasoned with. This is what patients complain about when they consult, and what community media testify to more and more often: there is talk of “increased serophobia 11,” which is paradoxical from a certain point of view. The imaginary effects of AIDS reflected in the persistent fear of

contamination are maintained despite the existence of prevention methods, such as condoms, and despite the real reduction in contamination risks—treated individuals can become more or less non-infectious 12 even in the case of unprotected sexual intercourse, which is not always a matter of reckless risk-taking (life as a couple, individual choice, taking preventive treatment).

In clinical work with patients involved in slam, belonging to the gay community is addressed very quickly; it is identity in its broadest sense of sexual identity that appears. Hermann, 24, says: “I am gay, I did everything to be gay and not just homosexual. Homosexual is medical. Gay is gay. But since I’ve been HIV-positive, if I say it, guys don’t want to fuck with me anymore, the beginnings of relationships stop as soon as I talk about it. Yet I am undetectable, and at worst we can keep using condoms, I don’t care.” Gay identity designates more than sexual orientation, Hermann expresses here. Beyond the genital factor or a sexual preference, Hermann clearly exposes the social scope of sex, which we can understand as an expression of gender. He also tells us that this identity is the result of work—he “did everything to” achieve it—a construction that can go as far as performance. We believe this is a gender performance. Beyond his sexual identity—being male or female—gay identity here seems to account for this learning, this becoming gay that we parallel with becoming a man or becoming a woman as a gender identity 13. This production from and beyond biological sex testifies, in our view, to what Joan W. Scott expresses here about gender: “a constitutive element of social relationships based on perceived differences between the sexes, and […] a primary way of signifying relationships of power” (Scott, 1986, p. 186). Being gay, for Hermann and others, stems from the need to signify relationships of power and exclusion (heterosexuality/homosexuality, HIV-positive gay men/HIV-negative gay men), to admit their scope, and to identify oneself based on them in social relationships (professional, emotional, sexual, familial, community).

Gay identity, a gender identity rather than a sexual identity

 

Gay identity deserves, in our view, to be thought of henceforth as a gender identity insofar as it accounts for the social and cultural dimensions of sexual life. Gay proves to be not just an identity promise welcoming a sexual preference, but a sexual preference with identity consequences exceeding the single dimension of sex. This encourages us to define, in order to think about the slam phenomenon, what we designate from here on as “gay gender.” For if gender is not content to be the social expression of biological sex, but indeed accounts for the processes of construction and deconstruction at work in what sexual life imposes on the subject, then we need it to think about phenomena such as slam, and to envision through it an intervention in these processes.

Based on our clinical experience, gay gender thus allows us to distinguish what in gay identity is not content to give a visible representation to the subject’s identifications, but also gives form to the less visible, unconscious, and yet determining elements of psychic life. “Undoing the gay,” as others have “undone gender,” can be a way of translating the clinical option we propose in the face of this phenomenon. This is, moreover, what those who come to consult implicitly ask for, such as Pierre: “I don’t understand, I have a top job, I go out in the scene, I’m comfortable with my homosexuality, I have no difficulties in sexual practices, I fuck who I want when I want, I came to live in Paris for that, I have everything I wanted to have, everything I needed to be gay. And now, nothing is right anymore, I’m HIV-positive, which is almost ‘normal’ for a gay man, and I’m injecting drugs, no one wants to have sex with me normally anymore and neither do I for that matter, I’m exhausted, what did I do all this for?” How can we not follow and extend this questioning by turning its content around to open the questioning of this construction of gay identity itself in the light of gender?

IDENTITY ADVENT AND COMMUNITY PERIL

 

We are tempted to question “gay” with Pat Califia, who said as early as 1983: “[…] within the [gay] movement, people insist on a form of purity that has little to do with tenderness, sexual desire, or even political commitment. Being gay becomes a state of sexual grace, comparable to virginity. Fanatical proselytizing in favor of one hundred percent […] gay behavior often makes me think of a superstitious fear of contamination or pollution” (Califia, 1983, p. 71-82). At the time Califia gave this lecture, the AIDS epidemic was only beginning; it had not yet marked the homosexual community, which had just begun to

flourish in the open under its “gAy” banner (an acronym for Good as you) which had become its identity spearhead. Rereading these sentences today, in the era of slam and the elements we have just covered, is troubling. It seems that something obscure has been maintained in the foundations of the performance on which gay identity relied to establish itself, aided by AIDS, which did not remain foreign to it as it even seems to have introduced itself where a place was waiting for it.

The “purity” Califia speaks of brings to mind essentialism, that is, a “nature” of man or woman, for example. It also makes us think of the identity imperative that weighs on women and that feminists can sometimes assert, as Joan W. Scott deplores (Scott, 2011, p. 45-67). Indeed, the figures championed by a movement of recognition and identity affirmation—women or gay men, for example—sometimes harbor imaginary and unconscious constructions that weigh heavily on the freedom of individuals seeking to identify, tempted to commit to them to guarantee their fulfillment or survival, sometimes at the risk of ultimately compromising them. The identities “woman” and “gay” are integrated into discourses and circulate in such a way that they are no longer discussed. These identities must therefore, as Scott indicates to us regarding the

“woman” identity and which can be applied to the “gay” identity, be the subject of a meticulous, historical, and phantasmatic deconstruction to release the unconscious and sometimes deleterious stakes that these hoped-for emancipatory figures hide at their heart. This deconstruction can be carried out on the model of the deconstruction of gender.

It is indeed these stakes—of unconscious identification—which, by being ignored, place a burden, for example on gay men—confirmed or in the making—to have to prove in every possible way that the vanguard of sexualities belongs to them, and at any price. This is our working hypothesis. Whether this is proven by AIDS, drugs, or other signs invites us to welcome them as symptoms, not to manufacture identity pathologies, but to set back in motion the psychic and social processes concerned. By dissecting in clinical work the articulations of individual and collective stakes, as gender allows us to do, we can reopen the closed doors of identity discourses to renew their subversive and liberating power, and thus their therapeutic power for the subject. Thus, the dimensions of community, identity, the social, the individual, and the collective are all necessarily put to work simultaneously, thanks to the intersection of a resolutely clinical and psychosociological approach.

We have seen what history allows us to think with Joan W. Scott; let us see how philosophy and anthropology can help us. In 1975, Claude Lévi-Strauss concluded the seminar on identity with these words: “[…] identity is a kind of virtual focus to which it

is indispensable for us to refer to explain a certain number of things, but without it ever having a real existence. […] a limit to which in reality no experience corresponds” (Lévi-Strauss, 2000,

1. 332). We understand with him that the social representation offered by identity requires and supports the psychic and physical investment of the person who recognizes themselves in the figure it proposes. By extension, we can say that gay identity offers the subjects concerned, like any identity, meaning for real existence, for concrete life. And this is where the risk of stasis that identity imposes can be addressed by working with the gender tool as a “useful category of critical analysis” (Scott, 1986), so that the imaginary grip necessary for the subject is not frozen, but maintained in a creative perspective.

In another order of ideas, Jean-Luc Nancy also joins some elements exposed in Pat Califia’s remarks about identity and community. In The Inoperative Community, Nancy writes:

“Bataille knew better than anyone [he was the only one to pave the way for such knowledge] what forms more than a connection between ecstasy and community, what makes each the place of the other, or even that by which, according to an atopic topology, the circumscription of a community, or better its areality (its nature as an area, a formed space), is not a territory, but forms the areality of an ecstasy just as, conversely, the form of an ecstasy is that of a community” (Nancy, 1986,

1. 53). Is not the “state of sexual grace” Califia speaks of the project of an absolute of the gay community, which we can read with what Bataille designates as “ecstasy”? But these authors also argue that “ecstasy” and “community” limit each other, generating the ecstasy of the community and allowing the appearance of “being-in-common” which Nancy designates as a work of death and fusion. Califia’s words seem to follow in those footsteps. The reduction of the identity common denominator—moving from gay to HIV-positive gay, then to HIV-positive gay slam enthusiast—echoes this common work that can risk death as a community work, where the individual disappears in favor of said community—or its remains.

At the intersection of the identity-based and the unconscious

 

Failing to have recourse to gender to question the identity in which they can recognize themselves, HIV-positive gay men are today seizing upon slam as a new sexual practice and simultaneously questioning their identity. Having become HIV-positive is part of subjective history. And even though medical discourse and even prevention discourse can both rely on technical success and the progress of treatments, the physiological history of the virus, which is sometimes very quiet, does not systematically guarantee subjective peace. Being rejected by a lover, a friend, or a colleague is a consequence of the virus,

although without any organic justification. The psychic impacts of HIV status are today minimized by the surrounding identity and scientific discourse. Taking into account the needs of HIV-positive people very often no longer goes beyond the strict renewal of biannual prescriptions. The trauma of HIV status is largely denied today, as if biological survival should erase all the psychic, emotional, social, or cultural consequences that being infected nevertheless still induces today. Some consequences are no longer the same as at the beginning of the epidemic, but chronicity has brought others: if the fear of imminent death has partly dissipated, the long-term effects of treatments prevent certain commitments (in projects, in a family life). The social representation of the AIDS epidemic in a country like France is currently that of a disease to be repressed, to be ignored. Clinical experience teaches us this convincingly. Many patients, after years of being HIV-positive, no longer find—or sometimes have never found—someone with whom to share their experience, neither their friends, nor their doctor, nor their partner.

Under these conditions, HIV-positive gay men find themselves in an unprecedented situation. They are increasingly numerous and must at the same time be undetectable in the social, relational, and emotional field, just as their viral load must remain invisible to techniques for detecting virions in the blood. On the unconscious level, these elements feed great tensions and psychic conflicts making the identity stability necessary for everyone difficult. Identity, even gender identity, no longer offers the support it is supposed to give. The fundamental flickering that this maintains implies sooner or later employing some effective remedies to dissolve these pathogenic knots. In the absence of therapeutic or analytical speech, recourse to a practice such as intravenous drug injection within the framework of sexual practices—which therefore constitutes a sexual practice in itself—aims very directly at sexual identity and its construction, maintenance, or repair: this recourse becomes a concrete effective means of alleviating difficulties and repairing the failing identity. The positive psychoactive effects of the product reinforce this promise by reactivating desire, improving self-perception and the confidence linked to this image, and increasing the physical enjoyment of those who may otherwise live through negative experiences of rejection.

CLINICAL PERSPECTIVES

Would it not be simpler to deconstruct gay identity—with gay gender on the model of gender theory—rather than having recourse to potentially dangerous practices? The slam phenomenon highlights, from our point of view, this imperative of identity questioning and

deconstruction which can free certain gay men, very often HIV-positive, from morbid constraints. The urgency to get out of this situation, of this knot of unconscious, conscious, and social motives, is indeed what the visible but unspoken objective of slam fulfills. Recourse to slam compensates for and achieves on an unconscious level what “undoing gay identity” using gender as a tool for deconstruction and critical analysis allows to be achieved on a conscious level in therapeutic work. This is, moreover, what clinical and therapeutic experience demonstrates, when the use of gay gender in psychoanalytic work opens perspectives for transformation and change in the psychic processes at work on the conscious and unconscious levels. These can be untangled and offered to a new arrangement where social determinants dialogue differently with psychic determinants.

Gay gender at the end of this journey allows for the renewal of gay identity and the identifications that constitute it. Gender in the clinic is proposed, as we observe, as an imaginary object, which allows us to anchor our intervention in Claude Lévi-Strauss’s proposal on identity as a “virtual focus” so that the ghosts and sometimes deleterious motivations that community expectation carries with it, despite itself, and which weigh on the individual, are reflected there. And since it is an imaginary object, we then see it functioning as a symbolic process. This is what these two patients suggested to us, for example: “When I walk down Rue des Archives and I see them all in front of the Cox 14, I tell myself that I don’t look like that, I’m not the gender of those guys, with their jackets, their muscles, they look manly… anyway, I’m not their type,” “I like it when people tell me I look gay, that it shows… not necessarily effeminate or all that, but gay, you know! No need to explain it, it shows, it’s others who say it, not me.” We clearly distinguish, articulated with each other, gender as an imaginary object and a symbolic process. What can they serve us for in this form?

We maintain, supported by our experience, that gender and sex function together; without being complementary, they are nevertheless tied: we define them as two unknowns in an equation of the sexual that is impossible to solve, just as the enigma of the sexual formulated by Freud is. By handling gender, sex is displaced and questioned. This is an important maneuver in clinical work, because it offers access to identifications, infantile theories, beliefs, and all sorts of supposed truths about sex deposited in subjective and unconscious history.

We consider that by accessing sex through gender we can make our way to sexuation and uncover the subject’s deep identifications, their positioning regarding the phallic function, regarding

enjoyment. Of course, none of this is immediate or easy, and even less systematic. But in summary, it is the therapeutic and clinical option we propose. What is it for? For what effects? The first of these is the indictment of sex as a symbolic instance and the enumeration of the symbolic consequences of this reigning instance, which most patients have never had the opportunity to question before, before coming to consult. With gender, sex is urgently called into question, when we propose, for example: “You tell me you are gay, but how do you know? Is it linked to your sex?” The strangeness of the question has the merit of confronting sex with gender. This can be expressed in return in the following response:

“But that has nothing to do with it, you know nothing about it then.” To which we do not fail to respond, to encourage: “Tell me then, explain to me what ‘your’ gay is made of, and how your sex is useful in that…” Because beyond sexual practices, so vividly brought into play in slam—itself having become a sexual practice in its own right—sex becomes, or becomes again, this identificatory, imaginary process, where the image of oneself, caught in the gaze of the other, reappears and reveals its cracks, its defects that therapeutic effort can tackle. It becomes so again on the condition of going to look for it, in a certain way, of flushing it out where it hides, stubborn with certainties and frozen with habits. Organizing its hunt and welcoming its flight feeds the clinical perspective. For when we question “the gay,” in our example, it is the “gay gender” tied to sex that we are addressing, and not only gay identity as a supposed sexual identity.

conclusion

In a context of identity suffering, we have seen the ways in which recourse to gender, as a critical tool and deconstruction perspective, allows for the setting back in motion of what sometimes becomes pathologically frozen. Slam especially invites us to question gay identity often thought of as sexual identity, but for which we have demonstrated the interest of a gender approach capable of reopening the dead ends encountered to transform them into therapeutic perspectives. More generally, gender allows identity to be approached as a true pole of narcissistic attraction from which the identifications that found it can be reconsidered, rewritten, or rebuilt in psychoanalytic clinical work.

BIBLIOGRAPHY

 

CALIFIA, P. [1983] 2000. “Gays, lesbians, and sex: all together,” Sexe et utopie, Paris, La Musardine.

LÉVI-STRAUSS, C. [1975] 2000. L’identité, Paris, Puf.

 

 

NANCY, J.-L. 1986. La communauté désœuvrée, Paris, Christian Bourgeois.

SCOTT, J.W. 1986 [1988]. “Gender: A Useful Category of Historical Analysis,”

Les Cahiers du GRIF, No. 37-38.

SCOTT, J.W. 2011. The Fantasy of Feminist History, Durham and London, Duke University Press.

VINCENT BOURSEUL, Gay Gender and identity suffering:

The slam phenomenon

abstract

Slam—intravenous drug use in a sexual setting—has appeared in the gay community. The manifest identity stakes associated with this new sexual and drug use practice invite us to think about clinical experience through a gender approach. The article proposes to observe and question identity suffering and its social, unconscious, political, and historical determinants through what the author defines as “gay gender.” At the limit of individual needs for identity construction, the collective stakes of the community come into opposition, sometimes making the individual pay the heavy price of an identity conquest. The unconscious determination of the subject intersects at identity with the individual’s social and cultural stakes, which must be examined in their divergences and overlaps to enlighten the understanding of a phenomenon as spectacular as slam and to uncover some clinical and therapeutic perspectives.

keywords

Gay, gender, slam, identity, community.

 

VINCENT BOURSEUL, Gay Gender and identity suffering: the slam

 

ABSTRACT

The slam – consumption of drugs by intravenous way in a sexual context – appeared in the gay community. The obvious identical stakes associated to this new sexual practice and of use of drugs, invite us to think of the clinical experiment by an approach of gender. We can then progress in our investigation of the identity suffering and its social, unconscious, political and historic determiners with what we can define as « gay gender ». On the verge of the individual necessities of the construction of the identity come to oppose the collective stakes in the community, sometimes making wear to the individual heavy tribe of an identity conquest. The unconscious determination of the subject crosses in the identity the social and cultural stakes in the individual, which it is necessary to examine in their differences and their overlappings to enlighten the understanding of a phenomenon so spectacular as the slam, and to release some clinical and therapeutic perspectives.

Keywords

Gay, gender, slam, identity, community.