Jennifer Marie J. Yang, MD

From data collection and analysis in 2017, to poster presentation in 2018 and oral presentation in 2023 at the Performing Arts Medicine Association (PAMA) Annual International Symposium… our paper on health issues in drag queens is finally published! What a long and winding road, but here we are. And a webinar is in the works too, so keep an eye out for that!

Grateful for the opportunity to collaborate with an interdisciplinary and international team. My fellow physiatrist Dr. Kathleen Davenport first presented the findings of her small study in 2018 in a research poster at PAMA. She wrote it up as a manuscript in 2019 but journal peer reviewers said something like, “This has great potential but you need to discuss more about the rest of drag queen health, and not just the musculoskeletal stuff.” The COVID-19 pandemic got in the way and that project was placed on the back burner.

As you may already know, I was in Australia as a full-time student during the pandemic. Sometime in 2021 I was having a coffee catch-up with John, whom I knew from the Australian National University Filipino Association (ANUFA). He had taken a drag class recently and we talked about the health hazards from being a queen. This morphed into an oral paper presentation we co-authored and I presented at PAMA’s New York meeting in 2023.

We assembled an interdisciplinary team to create a comprehensive, holistic view of drag queen health – Esteban Padilla approached me after the 2023 presentation to offer a mental health perspective, and I met dermatologist Winlove Mojica during the University of the Philippines Medical Alumni Society Grand Scientific Symposium in Cebu later that year. While our intended expert opinion paper was a good idea, pairing it with Kathleen’s pilot study was even better – it was more likely to be accepted for publication. Her paper needed a more robust discussion which our expert opinions were able to provide. The new hybrid paper was rejected twice (one journal said “we are not accepting new articles at this time” and another said “we are not interested”), but finally accepted with very minor revisions and published relatively quickly soon after that.

The article is open access (no paywall, thanks to the generosity of donors from Kathleen’s hospital), so everyone can read about our queens’ health as they slay and sashay away.

We have a webinar in the works! Stay tuned for that blog post.

Here’s a layman’s summary of the academic article, created with the help of Claude.ai. This summary has been reviewed by one of the authors (me) and has been vetted to be accurate. I take responsibility for the content in this summary.

Health Study of Drag Queen Performers

Scientists wanted to learn more about the health of drag queens. Drag queens are people (usually men) who dress up as women and perform on stage. They dance, sing, and act in shows, often wearing fancy dresses, high heels, and lots of makeup. Even though drag queens are becoming more popular on TV shows and in clubs around the world, doctors don’t know much about their health problems.

What the Scientists Did

The researchers found 7 drag queens who agreed to participate in their study. The performers were between 22 and 56 years old. The scientists gave them the same health tests that professional dancers usually take. They checked their hearts by having them step up and down for 3 minutes. They tested how strong their muscles were and how well they could move and stretch. They also asked lots of questions about their personal health, like whether they had health insurance, went to the doctor regularly, and how they felt emotionally.

What They Found About Physical Health

The drag queens had several muscle and movement problems:

• Almost all of them (5 out of 6) had very tight hip muscles, which can make it hard to move and cause pain
• All of them had trouble rotating their hips inward
• Their stomach muscles and the muscles in their bottoms were weak
• The right side of their body was stronger than the left side for most muscle groups
• 4 out of 7 had been injured while performing, especially hurting their feet, ankles, shoulders, and lower backs

When they tested how fit the drag queens were, the results were mixed. 3 had excellent fitness, but the others had poor or very poor fitness levels.

Healthcare and Insurance Problems

Many drag queens couldn’t get proper medical care:

• Only 3 out of 7 had health insurance (compared to most Americans who have insurance)
• 4 hadn’t seen a regular doctor in over 2 years
• The ones without insurance were the same ones who couldn’t see doctors
• Most had seen a dentist recently, but only if they had insurance

Mental Health and Emotional Concerns

The drag queens faced several emotional challenges:

• 4 felt they would benefit from talking to a counselor or therapist
• 2 felt sad, depressed, or hopeless in the past month
• 3 felt more tired than other performers
• 2 had trouble sleeping
• Some had experienced losses in their lives recently

Risky Behaviors and Lifestyle Issues

The study found some concerning behaviors:

• 4 drank 5 or more alcoholic drinks in one day at least 3 times in the past year
• 2 currently smoked cigarettes
• Some used recreational drugs, though many didn’t want to answer this question
• The performers said that drinking alcohol was considered normal and expected in drag culture
• They worried about performing dangerous moves while drunk

Why These Health Problems Happen

Drag queens face unique challenges that can hurt their health:

Performance Dangers: They do risky moves like the “death drop,” where they quickly throw themselves to the ground. They also do splits, cartwheels, and dance in high heels, which can cause injuries to their backs, legs, and feet.

Costume and Makeup Problems: They wear heavy costumes, tight corsets, and layers of clothing that can cause skin problems. They use tape to change how their bodies look, which can damage their skin when removed. Sharing makeup can spread infections.

Work Environment: Most drag queens work at night in bars and clubs. These places are often very loud, which can damage hearing. The air quality might be poor. Free drinks are common, which encourages drinking too much.

Social Challenges: Some drag queens face discrimination from family, friends, or romantic partners. This stress can affect their mental health. They might also face harassment from audience members who touch them without permission.

Financial Problems: Many drag queens work part-time or don’t have steady jobs, so they can’t afford good health insurance or regular medical care.

What Doctors Recommend

The scientists suggested several ways to help drag queens stay healthier:

• Do specific exercises to strengthen weak stomach and hip muscles
• Stretch tight hip muscles regularly
• Be more careful about alcohol use
• Find affordable ways to get regular medical checkups
• Create safe spaces where drag queens can talk about mental health without being judged
• Develop new health tests specifically designed for drag performers instead of using tests made for ballet dancers

Why This Study Matters

This research is important because it’s one of the first times scientists have seriously looked at drag queen health. The researchers want to help drag queens stay safe while doing what they love. They also noted that drag shows can be very positive for performers and communities, bringing people together and allowing creative self-expression.

The scientists said more research is needed to fully understand drag queen health and find better ways to prevent injuries and support their overall well-being.