Combining historical and ethnographic research, this article analyzes changing logics of control shaping addiction care for sexual minorities at a drug treatment facility in the US. While 30 years ago stigma and exclusion were viewed by staff members as fundamental causes of addiction among sexual minorities, this perspective faded as truth-eliciting confessionals declined and confidence in brain-targeting medicine increased. In this process, paradoxically, sexual stigma was no longer regarded as a barrier to fight and overcome, but instead is redeployed as part of practitioners’ toolkits as they work to regulate what they see as patients’ “addictive personalities”. While a biomedical model may imply that the facility has achieved a post-disciplinary treatment strategy, in that it no longer seeks to produce an identity but fragments it into governable components, staff members in fact continue to target sexual identity by translating this identity into pharmacological pathways and responses.
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