Gendering ketamine use: Emerging research and harm reduction recommendations

This paper explores ketamine use with a gender lens to show how ketamine social and biological variance across genders begs a tailored harm reduction approach. Ketamine provides dissociative anaesthesia and analgesia, now also used in the treatment of depression. The dissociation is particularly specific to ketamine and explains its medical and recreational utility. While there are some robust generic sources of information on ketamine and harm reduction, WHRIN and TalkingDrugs have identified a critical gap: the experiences of women and gender-diverse people are notably absent in much of the existing harm reduction guidance. While broad harm reduction advice and strategies exist around ketamine, the majority are provided with no consideration of gender-based differences. This oversight is concerning given identified differences in how ketamine affects individuals across gender spectrums and associated, distinct implications for harm reduction messaging.

Much of the existing research (of varied rigour and reliability) is pinned to predominantly male human subjects and/or rodent studies. While our quest is to identify gendered difference in recreational ketamine experience, much of the data comes from clinical administration rather than recreational use contexts. It is also important to note at the outset that within the scientific research on ketamine, where it acknowledges gendered differences at all, these are almost exclusively expressed through a binary understanding of sex. Testing is done on female and male rats, for example, with little consideration as to how this binary may or may not apply to human beings and the diversity of genders and sex 1characteristics contained within. Exploring ketamine use with a feminist and trans-inclusive lens means acknowledging the limitations of this perspective – because of the existence of intersex people; because of the variations in hormone levels within each assigned sex; and because drug use for all genders is shaped by patriarchy together with the gendered impact of drug policy and cannot be understood solely through biological mechanisms. While we rely on this research, we understand that it is hinged on understandings of sex and gender that are incomplete at best and that this will impact both the findings themselves and the types of questions that currently remain unasked.