Sick of It: Medicine, Margins, & the Struggle to Be Understood
Well, yes! Another zine! For me, they’ve been a constant source of fascination since my middle school emo days, when I first read The Perks of Being a Wallflower. It felt like finding a secret language — a way to express myself outside the mainstream. Back then (and still now), I was obsessed with The Rocky Horror Picture Show and alternative music, and discovering that zines could blend both worlds was mind-blowing. Zines make complex, emotional, and nuanced topics easier to digest — especially in spaces like medicine, where the language can feel cold and clinical, and the stakes are deeply personal.
So why this topic, and why now? Well, the western world doesn’t usually think of medicine as a space for ambiguity, emotion, or cultural critique—but I believe we should. As someone going into the medical field, I’ve been grappling with how often care gets reduced to checklists, diagnoses, and prescriptions — especially when it comes to mental health. This topic is personal, too: as a queer person, I’ve seen how systems like the DSM have historically pathologized queerness and continue to enforce narrow ideas of what’s “normal.” Why are we so quick to label everyday human struggles as disorders? How did we end up treating things like loneliness, grief, or shyness with medication? And what happens when we bring in philosophy, queer theory, and other humanities to rethink what “health” even means?
By unpacking the history of the DSM, the medicalization of life, and our cultural discomfort with uncertainty, I aim to describe a future where medicine is less about control and more about care—where doctors are allowed to sit with the unknown, and where being human doesn’t have to mean being sick. This project is an homage to the queer and alternative voices that came before me—but it’s also for everyone. Everyone should have the right to timely, effective, and personal medical care.
Mental illnesses are real, valid, and can be incredibly debilitating—trust me, I know. This zine is in no way intended to delegitimize the reality of mental health struggles or the life-changing benefits that therapy, medication, and diagnosis can offer. For many people, these tools are essential, even lifesaving. This work is not a rejection of medicine, but a critique of how modern (and not-so-distant past) medical systems have sometimes failed to account for nuance, culture, and the full complexity of being human. My hope is to open up space for conversation, reflection, and alternative ways of thinking about care — not to close the door on any particular path to healing.
The American Psychiatric Association's DSM has been thought to be the science-informed, authoritative guide to diagnosing mental illness in the United States (and only in the United States) for decades. Yet its history is about more than simply an expanding knowledge base concerning mental health — it is about deeply ingrained cultural concerns about normativity, identity, and control. [x] From a queer theoretical perspective, the DSM is not merely a clinical instrument, but is equally an apparatus of regulation marking the limits of normative subjectivity.
Presented for the first time in 1952, the DSM has been revised six times, ever more pathologizing increasingly wide swaths of human behavior. With the DSM-III (1980), widely regarded as a revolution in psychiatry, there was an effort made to standardize diagnoses by moving toward its biomedical and symptom-focused model. This shift was couched as scientific advancement, but it reaffrimed the authority of psychiatry at the moment it was losing its legitimacy in culture [DSM: A history of psychiatry’s Bible].
This move may be understood as part of a larger biopolitics — a type of power which governs and specifies life through medicalizing so-called deviancy. Historically, queerness has itself been medicalized within the DSM: homosexuality was categorized as a disorder until 1973, and gender nonconformity is still couched in medical discourse through the diagnoses of "gender dysphoria.” [x] Despite the rewriting of language, the power relations remain. The DSM's categorizations do not merely categorize mental states — they create and impose norms about what sorts of lives are understandable, healthy, and valuable.
The DSM's trajectory from its initial editions to the current DSM-5-TR illustrates a trend toward expanding diagnostic categories. This expansion has been both appreciated for increasing recognition of mental health issues and critiqued for potentially over-pathologizing normal variations in human behavior.
This broadening of diagnoses has significant implications. On one hand, it can lead to greater access to care for individuals experiencing distress. On the other, it risks labeling individuals unnecessarily, leading to stigma and the potential for overmedication. The DSM's influence extends beyond clinical settings, affecting insurance coverage, educational accommodations, and legal decisions, ultimately embedding its classifications deeply into societal structures.
Oddly enough, where there is queer theory, there is Marxist theory. The way the DSM deals with capitalist institutions — especially the pharmaceutical industry — has been the central target of such criticism (go figure!). The proliferation of diagnostic categories strongly correlates with the commercial development of many new drugs, leaving one to wonder about the motives of some of the inclusions in the manual. Critics say such a relationship can foster the medicalization of normality, in which natural experiences are recast as disorders that must be addressed with drugs.
I think Peter Conrad puts it very well: “The impact of medicine and medical concepts has expanded enormously in the past fifty years... the jurisdiction of medicine has grown to include new problems that previously were not deemed to fall within the medical sphere.” [The Medicalization of Society...] The money that pharmaceutical companies make off these substances is genuinely disgusting. Discovering new disorders open markets for medications, and the sanction of the DSM confers legitimacy on these conditions. It’s this dynamic that has led to favoring medication over other types of therapy, such as psychotherapy or community-based interventions, which may be more beneficial for some people (but don't make the big companies as much money).
The DSM has come under fire for conflicts of interest in the creation of diagnostic criteria and selection of disorders for inclusion. Research from Cosgrove et al. informs that a majority of members of DSM panels had money links to drug firms. [x] This is cause for serious concern about the role of profit motives in determining what gets designated as a mental illness—especially given that new diagnoses typically spur demand for new medications.
Think about the medicalization of the everyday: shyness as social anxiety disorder, bereavement as major depressive disorder, moodiness in adolescents as intermittent explosive disorder—and all these changes result in a new wave of prescriptions for SSRIs and other psychotropics. The financial incentives to pathologize behavior not only shape the approaches to treatment but also the definitions of illness itself.
This expanding scope of medical prerogative has redefined the limits of what was once thought to be “treatable," reinforcing the notion that all types of distress or deviation must be remedied through therapeutic channels. As was mentioned earlier, the DSM defined homosexuality as a mental illness—what gets pathologized usually mirrors not scientific agreement but social bias. Although that designation was rescinded more than 50 years ago, the taint of pathologization often still clings to non-normative identity in more insidious forms.
The DSM becomes a site in which capitalist and clinical interests intersect, producing “treatable” subjects and driving the commercialization of mental illness. According to Horwitz, diagnoses have not only evolved to serve as tools for treatment but also as tools for the construction of identity, access to treatment, and institutionalization [DSM: A history of psychiatry’s Bible]. For a few, diagnosis offers language for suffering and a path to support. However, queer theorists warn against the comfortable allure of legibility in a system that has historically pathologized and erased non-normative being. Thus, while diagnosis might provide solace in the form of legitimation, communality, and access, it also exacts a frame that threatens to reduce multifaceted lives to lists. For queer and raced communities, this might be a lifeline and a straitjacket—a means of being noticed but only within a frame that has exerted efforts to eliminate them.
So, here in a world in which queer lives tend to get misunderstood or overlooked, diagnosis of mental illness can provide a kind of epistemic acknowledgment. Epi-what-now?! In simple terms, epistemology is a branch of philosophy that deals with the nature, origin, boundaries, and value of knowledge. It deals with the core questions: What does it mean to understand something? How do we separate belief and truth? In medical and psychiatric fields, epistemology assists us in analyzing how a certain type of knowledge—such as diagnostic criteria or clinician expertise—is made, validated, and used, sometimes laying bare the cultural, political, and institutional power structures that determine what we think of as "capital ‘T’ truth" about the human body and mind.
Being diagnosed can authenticate that a real process is occurring—when the cause of distress is structural in nature, e.g., homophobia, racism, family rejection. In cyberspace in particular, communities tend to congregate in respect to diagnosis—ADHD, BPD, autism, CPTSD. For queer people in some cases, these conditions may grant more cultural visibility than queerness does on its own, providing a legible cultural model through which to explain their difference.
In his journal, Michel Foucault’s asserts that "medical language does not merely describe reality—it aids in the construction of reality."
Diagnoses do not merely name disorder; instead, they aid in the formation of the way individuals perceive themselves and are perceived by others. Neurodivergent conceptualizations appeal to many queer individuals because they upend normative timelines, ways of expressing themselves, and modes of relationship. In this sense, requesting a diagnosis isn't always a matter of fixing the self but rather a matter of resisting assimilation into cishetero-normative and neurotypical forms. It is a survival and articulation tactic in a hostile world. This holds particularly for the diagnosis of gender dysphoria, which it’s possible to reclaim as a means of negotiating healthcare systems while resisting their normative enforcement.
At the same time, we need to make space for paradox. Medical gaslighting—where women, queer individuals, and people of color have their symptoms disregarded—is an ongoing and damaging practice that exists. [x] But so does the pathologization of marginalized identity. A queer patient may be invalidated when complaining about pain but also rapidly diagnosed with a psychiatric condition that locates their distress within personal pathology instead of as a reaction to structural violence.
In The Epistemology of the Closet, Eve Kosofsky Sedgwick critiques the rigid binaries that dominate Western thought—healthy or sick, treatable or untreatable, known or unknown—and reveals how those dichotomies oversimplify the richness of human experience. Her metaphor of “the closet” is not limited to sexuality; it serves as an epistemological structure that organizes what is speakable and unspeakable, what is acknowledged and what is disavowed. Sedgwick observes that “the relations of the closet—the relations of the known and the unknown, the explicit and the inexplicit… have the potential for being peculiarly revealing, even paradigmatic, for the understanding of other kinds of epistemological structures.” This insight resonates deeply within psychiatry, a field where uncertainty is often met not with curiosity but with suspicion—and all too often, with diagnosis [The Epistemology of the Closet]. The DSM's relentless push to label and classify emotional distress speaks volumes about a larger cultural tendency to sidestep the discomfort of the unknown. Increasingly, medical practitioners—especially physicians—are expected to respond not only to physical illness but also to deeper, less tangible forms of suffering: loneliness, grief, disconnection, and the weight of systemic harm. When care becomes a process of regulation—when every ache must be labeled, coded, and treated—we risk erasing the profoundly human potential that lies within what medicine can’t yet name.
This call for a more humane approach echoes in modern critiques of clinical practice. Hilty et al. argues for a reimagining of medical education—one grounded in interdisciplinary learning and human-focused care. [x] Similarly, Amsterlaw et al. point out a troubling gap between reality and expectation: while patients often crave certainty and doctors strive to deliver it, certainty rarely captures the messy, fluid truth of human health. [x] That mismatch—between lived experience and rigid diagnostic structures—can lead to overmedication, fractured trust, and a sense of alienation that no prescription can fix.
So, in short, the DSM is not a neutral document. It is shaped by political, cultural, and economic forces—which, in turn, shapes us. So I offer this: what if naming is not always liberating? What if diagnosis sometimes deepens the exclusions it aims to heal?
Moving Toward a New Philosophy of Care
So, what can be done? It is not just practice but also philosophy that must change in medicine. We need systems that reward relationships, not solely diagnosis: longer visits, integrative teams, community-based care. Physicians should be taught to hear stories, not just checklists. The humanities in general, and queer theory in particular, supply critical tools: We challenge the binaries, derive worth from the inarticulate, and practice compassion for what can’t be cured.
What if practitioners were trained to say, “I don’t know — but I’m here with you”? What if healing was about more than just an absence of symptoms? This isn’t naive—it’s a demand for structural and cultural change. The medicine of the future is one that is permeated with slowness, multiplicity and uncertainty; not because these are failings, but because they are constitutive of caring itself.
Rethinking caring is not just a matter of philosophy—it is a matter of action. Are the reform efforts centered on access? Without the line to the doctor, the person who is listening and the shoulder to lean on, the vision stays silhouetted. Broad-case providers — PAs, NPs, DOs, MDs — are lifelines in low-access areas. But they are frequently overwhelmed, underpaid and asked to not only heal illness, but also grief, poverty and alienation. This is where reform needs to start. Increase access through mobile clinics, multilingual care and community-centered services. Invest in primary care as the foundation of health — not just as a gateway to specialists, but as a milieu for relational healing as well. Include humanities and critical theory in medical education. Dismantle silos between fields. Fund time, not efficiency. And restructure our pharmaceutical systems to prioritize ethics over profit (I’m so done with these drug ads!).
Finally, it’s not only a matter of fixing what’s broken. It’s about redefining what we mean by health—and who gets to define it.
