Background Public health research on the topic of Androgenic-Anabolic Steroid (AAS) use has primarily focused on the general male population with an emphasis on risk, pathologies, and the discrete and drug subculture that this practice. The same emphasis exists in AAS research with 2Spirit, Gay, Bisexual and Queer (2SGBQ+) men, however none has explored the “how” and “why” of this practice.

Objectives This study addressed the following research question: How is Anabolic/Androgenic Steroid (AAS) use implicated in the production of subjectivities among 2SGBQ+ men in Manitoba, and what are health implications that result? This study addressed the following research objectives: 1) Describe the practice of AAS use in general; 2) Identify the intrinsic and extrinsic motivators that drive AAS use; 3) Explore the effects of dominant social discourses in shaping the sociality surrounding AAS use; 4) Understand the sources of information consulted by AAS users; 5) Identify processes of subjectification that relate to AAS use among 2SGBQ+ men; and 6) Articulate the public health implications for supporting the health of 2SGBQ+ men who choose to use AASs.

Methodology A Foucauldian Discourse Analysis methodology was employed to collect, analyze and interpret data. Semi-structured interviews were conducted with 17 participants. A three-stage analysis technique was employed that involved open, axial and theoretical coding using MAXQDA.

Results This study revealed the discursive regimes that produce subjectivities in 2SGBQ+ men in response to social and cultural forces that dominate and oppress this community. Sources of information about AASs were predominantly user-generated. Intrinsic motivations for using AAS included a desire to achieve a certain physique, increase social and sexual capital, and mitigate the effects of sexuality-related stigma and racialized violence. Extrinsic motivators included discourses produced through social and sexual media.

Discussion and Recommendations This study revealed that AASs are used by 2SGBQ+ men as a protective “technology of the self” to mitigate the harms of discursive regimes that privilege white, masculine gay men. Public health systems need to consider a harm reduction approach to in health programs and services, which may create new entry points for 2SGBQ+ men to connect to care.