In this article I draw on recent work regarding disabilities that are not readily apparent to analyze the experiences of lesbian, gay, bisexual, queer, and/or trans (LGBQT) mad people in the workplace. Based on interviews with LGBQT people about madness and everyday life, I use an intersectional approach to examine participants' work lives. I argue that decisions about disclosure of mental health related information are particularly pressing and high risk at work, given the economic stakes and the effects on health and well-being. As is the case for others with invisible disabilities, notions of authenticity shape processes of disclosure and access to accommodations for LGBQT mad people in the workplace. An intersectional analysis shows how madness cannot be considered the only salient aspect of my participants' subject positions and how multiple identities operate together to shape their experiences.

In this article I draw on recent work regarding disabilities that are not readily apparent to analyze the experiences of lesbian, gay, bisexual, queer, and/or trans (LGBQT) mad people in the workplace. Based on interviews with LGBQT people about madness and everyday life, I use an intersectional approach to examine participants' work lives. I argue that decisions about disclosure of mental health related information are particularly pressing and high risk at work, given the economic stakes and the effects on health and well-being. As is the case for others with invisible disabilities, notions of authenticity shape processes of disclosure and access to accommodations for LGBQT mad people in the workplace. An intersectional analysis shows how madness cannot be considered the only salient aspect of my participants' subject positions and how multiple identities operate together to shape their experiences.

Research Study

My contribution to the scholarly discussions about invisible disabilities is based on 36 semi-structured qualitative interviews conducted between August 2010 and August 2011 in two Canadian cities, Winnipeg, Manitoba, and Toronto, Ontario. Participants were between the ages of 20 and 49 and were a diverse group in terms of racial and ethnic identities and class backgrounds. All identified as lesbian, gay, bisexual, queer and/or trans. 1

I conducted these interviews as part of a larger project that explores the impact of current understandings of madness and mental health on LGBQT people. LGBQT people have been defined as 'mentally ill' based on their sexualities and gender identities. 2 This longstanding and ongoing pathologizing of LGBQT people means that they have a particularly complicated relationship to concepts of madness and mental health. My project aims to elucidate that relationship, while resisting the denigration of madness and allowing for the possibility of mad pride. The experiences of LGBQT mad people are underrepresented in the literature about madness as well as in sexuality studies and trans studies. My project begins to address some of these gaps by exploring the ways in which LGBQT mad people navigate the material realities created by contemporary understandings of mental health. The semi-structured, face-to-face interviews covered a range of topics regarding madness and everyday life, focusing on processes of identity formation, involvement in identity-based communities, experiences with health care professionals, and issues of employment. This article draws on the data concerning employment and the workplace.


Interviewees used a large variety of terms to refer to their identities in terms of mental health, including various psychiatric diagnoses, 'crazy,' 'mad,' 'psychiatric service user,' 'psychiatric survivor,' 'consumer,' 'mentally ill,' and more. This range of terms is significant, as labelling and naming has been an important part of the struggle for self-determination for those deemed 'mentally ill' (Reaume, 2002). As Reaume (2002) argues, nomenclature regarding 'mental illness' has changed significantly since the 1970s, largely due to the activism of those who have been psychiatrized. Those with psychiatric histories have challenged the power of medical authorities to define them through the rejection of some terms and the (re)claiming of others. The choice of terminology for self-definition can therefore be seen as an indication of ideological positions on "public policy on mental health care, as well as personal experiences and expectations of mental health treatment" (p. 425). Indeed, in most cases participants offered detailed rationales for their (dis)identification with various labels that demonstrated their range of approaches to conceptualizing madness or mental health. Some participants rejected the medicalization of their experiences and eschewed medical labels such as 'mentally ill,' 'sick,' and 'patient.' These participants often rejected labels altogether, or chose terms that have been politicized by those with psychiatric histories, such as 'psychiatric survivor,' 'consumer,' 'mad,' and 'crazy.' Many used medicalized language strategically, for example to make themselves intelligible in certain contexts such as in healthcare facilities and the workplace. A few embraced medicalized language and employed the term 'mentally ill' unequivocally.

Throughout this article I use the term 'madness' to indicate my own conceptual approach. Though there is no definitive consensus on what 'madness' necessarily refers to, the term has been politicized by psychiatric survivor activists who resist the pathologizing inherent in terms such as 'mental illness' (Harper, 2005). 'Madness' is a term that has been used by activists seeking to challenge the stigma associated with 'mental illness' and create pride and solidarity amongst those who have been psychiatrized (see for example, annual Mad Pride celebrations in Toronto and internationally). As Price (2011) argues, the term madness has a "long history of positive and person-centered discourses" and "achieves a broad historical sweep" that acknowledges historical approaches pre-dating psychiatry (p. 10). 'Madness' therefore encompasses more than the currently dominant understanding of 'mental illness' as a biological condition that can be scientifically evidenced and universally applied (Price, 2011; Reaume, 2006). I thereby employ 'madness' as an anti-pathologizing term that acknowledges the historically and culturally specific character of societal attitudes and knowledge production about minds deemed non-normative.

I also make use of the term 'mental health,' as it is currently a commonly used term that has been institutionalized as an umbrella term to describe mental well-being as well as various states of mind, or what are often understood as 'disorders' (for example, by the Canadian Mental Health Association, and the Mental Health Commission of Canada). I use this term as an acknowledgement of the current context in which madness is understood (i.e. in terms of health) and thus the ways in which participants are positioned and the predominant framework available to them to make sense of themselves.

The Importance of Intersectionality

In considering the experiences of mad LGBQT people, it is important to keep the intersectional character of identity and experience at the forefront. The concept of intersectionality was originally developed by feminist legal scholar Crenshaw (1989) to analyze the ways in which antidiscrimination laws in the United States erase the specific experiences of black women through the treatment of "race and gender as mutually exclusive categories of experience and analysis" (p. 57). Feminists have since used intersectionality to theorize how race, class, gender, sexuality, and disability operate together to shape identity, experience, and power relations on both individual and institutional levels (Anzaldúa, 1991; Garland-Thomson, 2002; Hill Collins, 1990; Valentine, 2007; Yuval-Davis, 2006). As Valentine (2007) argues, intersectionality recognizes that "it is not possible to separate out the categories of gender, race, class, and sexuality, nor to explain inequalities through a single framework" (p.12). An intersectional approach is therefore crucial to my study because madness cannot be considered on its own; to do so implies that it can somehow be isolated in understanding mad lives and experiences. Intersectionality considers the relevance of multiple identities, as well as the ways in which identities are defined and experienced 'through' one another; in other words, how they are mutually constitutive. As one participant, Travis, 3 said,

It's like people think either you're gay or you're Aboriginal, and it's this weird perception that people have about how you're more oppressed. Are you more oppressed because you're gay, or are you more oppressed because you're Aboriginal? Which is completely ridiculous. Like, how do you choose, right, like how do you… [trails off].

Though Travis is referring here to sexuality and race rather than madness, his comments indicate that his identities cannot be considered mutually exclusive in understanding his experiences of oppression. In other words, being gay and Aboriginal creates a different experience than being (for example) gay and white, or Aboriginal and heterosexual. Similarly, Viki described the importance of considering the combination of all of her identities in understanding her experiences:

I have an interesting relationship between mental health and physical health because some of my mental health diagnoses came out of physical ones…I'm also learning the complexities of being a queer, gender minority, person of colour. And I don't think I could pick one, I think it's that combo that is really salient. It's the fact that all of those things are parts of my identity that have made it an interesting experience.

Viki articulates a complex interplay of mental health, physical health, sexuality, gender identity, and race, drawing attention to the ways in which identity is mutually constitutive. For Viki, like other participants, madness is inextricably bound up with other aspects of identity. As will be discussed more below, this is an important consideration for making sense of participants' experiences in the workplace.

Madness: An Invisible Disability?

Scholars and activists continue to debate whether madness should be considered a disability, and whether insights from disability theory should be used to conceptualize madness (Anderson, Sapey & Spandler, 2011; Beresford & Wallcraft, 1997; Beresford, 2000; Lester & Tritter, 2005; Mulvaney, 2000; Plumb, 1994). These debates indicate that there is something contentious about the potential connections between disability and madness. Though this is not my central focus, I make mention of these debates in order to acknowledge that some of the assumptions I make are not incontrovertible and are part of larger debates about the place of madness in disability studies. Namely, I refer to my positioning of madness as an invisible disability and as a necessary subject for consideration for disability studies. Though I see madness studies as an emerging field in its own right, I am also convinced by arguments about its inextricable ties to disability and disability studies (Beresford, 2000). Though I do not engage this debate directly, I believe that disability studies can be meaningfully enhanced by analyses of madness and see my work as part of this effort.

Within the last decade, there have been calls for disability studies to become more inclusive of 'invisible,' 'nonvisible,' or 'hidden' disabilities. Scholars have pointed to the relentless focus on the ways in which identity is constructed through the interpretation of visible bodily markers and the gaze that 'others' and marginalizes. Samuels (2003) argues that this focus on visibility has restricted our very understanding of what disability is, marginalizing invisible disabilities and perpetuating visibility as a central organizing tenet for understanding identity and accessing social recognition.

Invisibility is thus becoming an important concept for theorizing identity in disability studies, expanding the boundaries of disability discourse. Disability studies scholars have begun to consider the difficulties faced by those who have disabilities that are not always readily apparent, including struggles with social recognition, access to accommodations, decisions regarding disclosure, and problems in being considered 'authentically' disabled by self and others (Caldwell, 2010; Kooistra, 2008; Lingsom, 2008; Samuels, 2003; Tierney, 2002; Valeras, 2010).

Analyses of invisible disabilities are helpful for understanding madness. The prevailing assumption governing everyday interactions is that visual cues tell the 'truth' about the body and that disability can therefore always be seen (Kooistra, 2008; Lingsom, 2008; Samuels, 2003). As Robinson (1994) claims, "the visible is never easily or simply a guarantor of truth," yet the assumption that identity can be assessed by looking persists (p. 719). Madness is no exception to this; given the lack of visual signs to make madness immediately 'readable' off the body, participants in my study were commonly assumed not to be mad.

I therefore position madness as 'invisible,' though I do not employ this term in a strictly dichotomous sense. 'Visible' and 'invisible' are not mutually exclusive, discrete categories; whether or not any identity is visible depends on many factors, including context, circumstance, audience, and interpretation. As Valeras (2010) argues about the visibility of disability, it can vary according to "symptomology, medication, time of day, clothing, or activity requirements." This insight is applicable to madness. Many participants indicated that while their madness was for the most part not readily apparent to others, there were a few circumstances when it was. For example, Viki said the following about the visibility of what she called her chronic mental health problems:

I do have scars that become visible often…So it's almost like I'm already wearing it in a certain way, I don't want to wear it any more…Like just scars from cutting. I have a hard time on subways, holding on to poles because I prefer not to wear sleeves, I tend to roll them up.

Viki told me that she experienced judgment and stigma based on her scars and felt that she 'wore' her mental health status whether she wanted to or not. Madness was 'readable' from the scars on her body that were sometimes visible, depending on her clothing and activity. Madness is thus not always strictly invisible or visible. However, for most participants, madness was not usually readily apparent through visual signifiers and they were therefore often assumed not to be mad. For example, another interviewee, Mike, described the relationship between madness and visibility in the following way:

I think it's more of an invisible disability because it's not as obvious as a physical disability. If you're in a wheelchair or something like that, then you automatically read someone as disabled. I mean, yeah, I think for the most part I pass as not being disabled because it is my brain, you can't really see that. But I don't think it's any less of a disability even though it is mostly invisible.

Mike draws attention to the importance of what can be seen in defining who is disabled in daily interaction. For Mike, like most participants, madness was most often invisible.

Invisible Identity and Processes of Disclosure at Work

Those with identities that are not readily apparent must employ discursive strategies to make their identities known (Kooistra, 2008) and face complicated decisions about disclosure or 'coming out' (Lingsom, 2008; Valeras, 2010). Navigating invisible identities means that disclosure can sometimes be optional, resulting in the need for complex decisions about when, where, and how much to disclose. It is sometimes assumed that those with invisible identities benefit from being able to 'pass themselves off' as members of dominant, privileged groups, and indeed, the oppression and danger that can accompany being immediately visible as a member of marginalized groups should not be minimized. However, as Samuels points out, "passing deliberately" and "passing by default" are often conflated (p. 240). Widespread assumptions about the visibility of identity mean that those with invisible identities are often assumed to be members of the dominant group, regardless of their intention.

This created difficulties for the participants, who indicated that the workplace is a space where these kinds of assumptions and decisions about disclosure regarding madness were intensified. Many of the participants expressed frustration with the assumptions that were often made about their identities and experienced high levels of stress about what, how often, and when to disclose. This is in part because the assumption and expectation that everybody is able-bodied is tightly tied to evaluations of job performance. Participants were often measured against able-bodied standards and the invisible nature of much of the distress they experienced often meant they were facing suspicion and disbelief, something characteristic of the experiences of those with invisible disabilities (Lingsom, 2008). One interviewee, A.P., described this as follows,

People don't really get the whole concept of disability in general. It's like, if someone is young and appears healthy then they don't understand why someone might need a lot of appointments or might not be able to do particular things that they think they should be able to do, and so on.

Another interviewee, Sonja, described the difficulties of being measured against able-bodied standards and the ways in which her symptoms of anxiety were easily dismissed at work:

Sometimes I'll say, 'okay, I've had chest pains for four hours now because of the level of stress. I'm going to have to take a break now.' And I'm afraid people will roll their eyes or be disappointed and talk about how incapable I am of dealing, you know. I do worry about having to express my needs if they're not in line with someone who's not anxious.

Like Sonja, many participants feared that being measured against able-bodied standards would result in negative repercussions and pushed themselves to continue working, often increasing their distress.

As Sonja's comments also indicate, mad people are at risk of being perceived as incapable of adequate job performance. Indeed, as Lapsley, Waimarie, & Black (2002) argue, the association of madness with "unreason, excess, incapacity and unreliability are historically entrenched attitudes in Western societies" (p. 4). This had an impact on whether or not participants felt like they could disclose their mental health status at work. As one participant, Michelle, said, she avoids talking about her mental health at work because she is "afraid of how that would affect your coworkers' or your boss's perception of you and your ability. That's just scary how someone could then think of you as less of an employee. So I've never brought that up with anyone." As Esther also told me, she is "picky about which workplaces" she discusses her anxiety in, because she fears "being seen as incapable, or unreliable, and unpredictable." This common concern led many participants to avoid disclosing mental health related information unless absolutely necessary.

Disclosure, Authenticity and Access to Accommodations

The need to access accommodations was often something that required participants to disclose. However, the invisible character of madness made it difficult for the participants to be perceived as 'authentically' or 'truly' disabled and therefore entitled to access accommodations. People with invisible disabilities are often thought to be making fraudulent claims to a disabled identity and are seen as less legitimate candidates for disability accommodations (Lingsom, 2008; Valeras, 2010). This is particularly relevant to madness as an invisible identity because of the prevalence of ableist ideologies that position madness as a form of personal weakness that can be easily overcome if one would simply 'buckle down and pull up one's socks.' Many participants had encountered this kind of attitude, which made it difficult to be seen as 'authentically' disabled and in need of accommodations. Barry described the difficulties of having depression taken seriously in the workplace. He told me that if he were to tell his employers, "I'm really depressed, I really need to talk to someone," he would be told to "suck it up and get back to work." Similarly, Betty told me that having a panic attack would not be seen as a legitimate reason to miss work:

At my most recent job, I would never have called in crazy to work. Ever. I'm not sure if that would be seen as a legitimate reason to take a day off work, you know. Even though it's way more legitimate than that I have a cold. Because I'm sick. If you have an hour long panic attack where your heart's beating way faster than it should be beating, you need to take a break after that.

Likewise, another participant, Lisa, expressed frustration about not being able to access necessary accommodations because mental health was not seen as an adequate reason. She described losing several jobs because she was refused time off to attend mental health related appointments. She also described how mental and physical disabilities are treated differently in her workplace:

If I have an appointment because I have dialysis every week, work will actually let me go. If I have an appointment for therapy which is my well-being, which means that I could go to work every day, which is just as important as dialysis, work will not let me go. It is not okay to miss work for a therapy appointment but it is okay to miss work for dialysis.

Barry, Betty, and Lisa articulated a common concern amongst participants; mental health concerns that are not necessarily visible are perceived as 'no big deal' and participants were seen as simply slacking off and making unnecessary or fraudulent requests for accommodations.

Unfortunately, when madness is 'taken seriously,' it is often associated with violence and lack of control. Common stereotypes position mad people as dangerous, threatening, volatile, and even murderous (Beresford, 2002; Holland, 2012; Steadman et al., 1998; Tierney, 2002). Participants were concerned that these kinds of commonly held oppressive beliefs about mad people would affect their work lives if they were to disclose. Barry told me that he downplays or "glosses over" discussions of depression in the workplace because,

When you say you're depressed people kinda get this idea that you were a secret cutter or you were like trying to drown your baby in a bathtub, [they] think of like the worst case scenarios and not the shades of grey that are in the middle.

Barry feared that prevalent stereotypes about mad people as violent and murderous would govern his coworkers and employer's perception of him. Notably, in Barry's example, it is when one's mental state becomes visible on the body through cutting that it is taken 'seriously.' Another participant, A.P., explained the ways in which she is seen as threatening, volatile, and incapable of doing an adequate job:

Depending on how well I'm hiding it or whatever at that particular workplace, people either see me as a threat, like someone who could suddenly flip out on them for no apparent reasons, or someone who has to be sort of sheltered, like not be allowed to take on too much.

Similarly, Jen told me she hesitates to disclose madness in the workplace for the following reasons:

There's a perception that if you have mental health, you're deranged and you're gonna fly off the handle, and you're one step away from, you know, going nuts. Or that you have a defect in some way. And I think that with something like social anxiety or depression it's seen as a character flaw instead of a mental health issue. And that's bad, too, because people say, 'well why don't you just get over it' and that's not helpful either.

Barry, Betty, Lisa, A.P., and Jen's comments exemplify the double bind that was common for participants; being perceived as 'not crazy enough' and complaining about nothing or being perceived as 'too crazy' and therefore potentially violent and out of control. Either way, participants were perceived as incapable of adequate job performance. This double bind acted as a powerful barrier to disclosure, resulting in difficulties with gaining access to necessary workplace accommodations.

This often meant that the participants suffered negative consequences in terms of their health and financial well-being. Some described making difficult decisions about whether to sacrifice their health or their finances. As Rob said:

There comes a balance of taking care of myself but also being able to provide for myself financially. And so there are times when I may have made a choice that wasn't in the best interest of my mental health but rather in the best interest of my financial well-being.

Similarly, Angela missed important mental-health related appointments rather than disclosing the reasons why she needed time off to her employer:

I've been with this company a month and I haven't gone to my psychiatrist appointments because I'm scared to leave work. I'm scared to, you know, 'why is she going to these doctor appointments?' I also turned down a group that starts at four-thirty through the psychiatric services because, again, I can't, I'm scared to leave and ask for time right now.

Other participants described quitting their jobs rather than disclosing mental health related information. As Michelle told me:

I've had to quit jobs before because of times in my life where I haven't been able to work, I would just flat out quit instead of saying I need time off for whatever. I guess out of fear, or just not feeling comfortable enough to bring that up.

Likewise, A.P. described troubles maintaining work, stating that she was only "able to keep a job for at most a year before it all goes to hell and I have to quit for my own health." The comments of Rob, Angela, Michelle, and A.P. indicate that there are serious consequences to not being able to access accommodations including negative effects on health, and economic hardship.

Notably, working class participants were affected differently than middle class participants. Workplaces vary in terms of what (if any) accommodations are available to employees. Many working class participants described workplaces with minimal or no accommodations, and some struggled to even find employment. Participants who held jobs in workplaces with disability services, those in unionized workplaces, those with flexible jobs and paid sick days, and those under less financial pressure were in a better position to navigate the circumstances described above. Such conditions were experienced more often by middle class participants.

Intersectional Oppression in the Workplace

As aforementioned, madness cannot be considered the only salient aspect of participants' identities. An intersectional perspective paints a more holistic picture of the participants' experiences at work. The participants' work lives were shaped by a confluence of factors based on their subject positions. A Canadian poll conducted by Angus Reid in 2011 showed that "one in 10 LGBT workers still find coworkers and employers intolerant of their sexual orientation, and between one third to half of respondents had experienced some form of discrimination throughout their professional lives" (QMI Agency, 2011). Likewise, a survey of trans people in Ontario the found that they face "unhealthy and unsafe working conditions" due to "the lack of trans-positive attitudes as well as trans-inclusive policies within workplaces" (Trans PULSE, 2011, p.2). Many participants encountered homophobia and/or transphobia at work. For example, Barry shared the following experience with me:

At my old job they weren't going to hire this individual because he was gay. That made me that much less comfortable with myself at work. The guy handed in his resume, and when he left one of [my coworkers] walks over and says, 'don't hire him he's fucking gay. It's disgusting.' And then the manager just kind of nodded and tucked it under the till and kept working. At that point there were a couple people who knew [I am gay], so they were like 'are you okay?' and I'm like, 'no. I want to go home.'

Another participant, Brayden, told me that he had to quit his job because of transphobic discrimination:

As soon as they found out I was transgender, they didn't like it… There was two people that were fine with it but the rest, everybody was just like, 'don't touch me you've got a disease' type thing…That's why I quit, because of that.

For those already experiencing homophobia and/or transphobia, there was a reluctance to disclose something that could lead to more judgement or oppression from coworkers and employers. As Andrea told me about her former workplace:

Well a lot of the ladies [at work], like after I came out as queer they were less friendly and I'm like, if I tell you that I'm queer and crazy you're totally just not even going to talk to me. So. Yeah [laughs].

Andrea, like other participants already experiencing oppression in the workplace, hesitated to share something that could potentially lead to more discrimination.

Additionally, some participants feared being positioned as 'mentally ill' and pathologized on the basis of sexuality and gender identity because of the links that are often made between 'mental illness' and LGBQT identities. As Jen told me, she refrains from disclosing her mental health status at work because "being queer is kind of getting more mainstream, but it's not really a mainstream identity. And I don't want that to be connected to the fact that I have had mental health issues." Similarly, Devon described how being trans is sometimes pathologized as sexually perverse and the impact of this transphobic belief on his work life. He described a job where he was particularly concerned about this because he was working with children:

When it comes to dealing with kids and certain things that are seen as sexual, sexuality and pathology, it gets really sticky. So I was worried about that coming to an ugly end somehow or something happening. But I also wasn't the only trans person who was a part of the instructor staff. And we were always a little bit on edge.

Devon articulated a common concern amongst trans participants that they may be pathologized on the basis of gender identity. 4

Racialized participants in particular described work environments that were hostile and discriminatory in several ways. 5 Racialized people face systemic racism and discrimination in the Canadian labour market (Khan, 2006; Li, 2008). A study of racist discrimination in the Canadian workforce shows that racialized people experience racism through various means such as, "a chilly or hostile climate, by limiting access to information or participation in work-related social interaction, or by introducing bias into decision-making regarding performance appraisal, promotion, developmental activities, job assignment, compensation or other areas" (Agocs & Jain, 2001, p. 5). Racialized participants, like Aaron, described multiple forms of discrimination at work. He said,

The manager of the first store that I worked at used to be a security guard [at a place where] the bathrooms were a big hook-up spot for gay men. So my manager would describe how fun it was to go in and scare the fags and how he missed that job and how it's a lot harder now because he has to be more responsible or whatever. And another experience that I had was one of my later jobs, my manager joked around that they only gave me the job because I was black and there were too many people working at that store who were white or not racialized enough.

The prevalence of racism also means that racialized mad people are already facing increased scrutiny and discriminatory evaluation of their job performance. As Marcus told me,

If I am not doing my work it's much more noticeable than my white counterparts who aren't doing work and who are walking around and talking — and that's fine — and if I do the same thing it's, 'what are you doing, you suck.' But if I'm next to the [white] person who's not doing the work, then it becomes apparent that that person is not doing work, but it's not apparent unless that contrast is there. That made me realize, it looks like the person of colour drops the ball — and it takes that much to bring it back up — whereas I feel like there's a lot more forgiveness with [white] folks.

Marcus describes the double standard for racialized people in the workplace, who are evaluated more strictly than white people. One of the most common fears amongst participants was that the disclosure of madness would mean being seen as incompetent in the workplace. For racialized participants facing the racist double standard described by Marcus, there was an increased risk associated with disclosing information about mental health or madness.

In this article I employed insights from disability studies about invisible disabilities in order to analyze the work lives of the participants in my study. LGBQT mad people face powerful barriers to disclosing mental health related information at work, which affects access to accommodations and their financial and mental well-being. LGBQT mad people face specific challenges in the workplace, yet their struggles also resonate with what has been documented about those with other forms of invisible disabilities. My analysis therefore contributes to scholarly conversations troubling one of the central tropes of disability studies, that of visibility. While it is important for madness studies to become established as a field in its own right, analyses of madness can continue to expand the confines of disability studies, enhancing understandings of concepts such as invisible disabilities. My research also shows the importance of intersectional analyses. As madness studies emerges as a field, it can learn from critiques of disability studies that point to the importance of taking up issues of race and the mutually constitutive character of identity and experience (Bell, 2006; Bell, 2011; Bolaki, 2011; Broeck & Davis, 2011; Jarman, 2011; Mollow, 2006). As I have shown, madness works in tandem with other aspects of identity to shape the experiences of mad people. I believe madness studies can be most useful when it also considers gender identity, race, sexuality, disability, and class.

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  1. See Appendix A for a more detailed description.
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  2. For example, through the inclusion of diagnoses such as Homosexuality in the first (1952) and second (1968) versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), Ego-Dystonic Homosexuality in DSM-III (1980), and Gender Identity Disorder in DSM-III, DSM-IV (1994), and the forthcoming DSM-V (2013).
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  3. Interviewees chose whether or not they wanted to use a pseudonym. The names used to refer to the interviewees in this article respect the choice they made on the interview consent forms.
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  4. There is more to be said about the in/visibility of sexuality and gender identity and the participants' decisions about disclosing LGBQT identities at work, however this is beyond the scope of this article.
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  5. The term 'racialized' positions race as a social construct that carries significant material and social consequences. It acknowledges that the psysiological and social attributes that constitute 'race' change across time and culture. While the same could be said about whiteness, the term 'racialized' is used to refer to groups who experience racism in order to acknowledge the power relations that structure the process through which people are categorized into racial groups For a more in-depth discussion of the term, see Agnew, 2007; Henry & Tator, 2002; Miles, 1989; Small, 1999.
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Appendix A


20s: 51%

30s: 35%

40s: 14%


female: 49% (32% non-trans, 17% trans i)

male: 38% (50% non-trans, 50% trans.)

neither male nor female: 5%


queer: 62%

gay: 22%

lesbian: 13%

bisexual: 8%

pansexual: 5%

heterosexual: 3%


white: 59%

racialized: 41%


working class: 51%

middle class: 49%


physical or mental disability: 51%

able-bodied: 49%

Explanation: The research participants were between the ages of 20 and 49, with 51% in their 20s, 35% in their 30s, and 14% in their 40s. In terms of gender, 49% of participants identified as female and 38% identified as male. Of the female participants, 17% also identified as trans and/or genderqueer, as did 50% of the male participants. The remaining 5% of participants did not specify either male or female, identifying simply as trans and/or genderqueer. Many participants used more than one term to describe their sexuality; 62% identified as queer, 22% as gay, 13% as lesbian, 8% as bisexual, 5% as pansexual/omnisexual, and 3% as heterosexual. The participants also used many terms to describe their race and ethnicity, but broadly speaking, 59% of participants identified as white, and 41% identified as racialized. In addition to identifying as white, 5% identified as French Canadian, 5% as Eastern European, 3% as Western European, 3% as Scottish, and 3% as Jewish. Of the participants who are racialized, 11% identified as black, 11% as Métis, 11% as mixed race/biracial, 5% as Aboriginal, 3% as brown, 3% as Korean, 3% as East Asian, 3% as South Asian, 3% as Middle Eastern, 3% as Indonesian, and 3% as Muslim. Just over half of the participants (51%) identified as working class, and the remaining 49% identified as middle class. In terms of disability, 51% of participants identified as having one or more physical and/or mental disabilities. It is important to note that the percentages for sexuality and race do not add up to 100 because many participants identified with more than one term.


  1. I use the term 'trans' as an umbrella term that includes trans, transgender, transsexual, and genderqueer people.
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