In 2017, I left the conservative church long after I should have, pulling up roots that had formed the foundation of my identity. One of the catalysts for this uprooting was my growing misalignment with the church’s beliefs about, and treatment of, queer people. As a straight cis woman, my departure was less a benevolent act of allyship and more the result of an inevitable logical conclusion: If the church could be this stupid about sexuality and gender, what else were they wrong about?
Unaccustomed to idle Sunday mornings, I began attending a progressive church with a rainbow flag on the lawn and a nonbinary pastor in the pulpit. With a shaved head and cuffed blazer revealing a sleeve of tattoos, the pastor preached James H. Cone’s Black liberation theology, which described God not only as the creator of the world but as the liberator of the oppressed. After the sermon, a worship leader wearing a “God is Trans” T-shirt led us in song. I smiled at the cheeky nod to scriptural truth: The bible describes God as male, female, and neither. I thought, If the folks at my old church could see this, they’d think I’d lost my faith—along with my mind.
Spanish philosopher Paul B. Preciado’s latest book, Dysphoria Mundi (Graywolf, 2025), begins with the words, “I had to declare myself insane.” He is referring to the process of obtaining a medical diagnosis of “dysphoria” so he could receive gender-affirming healthcare. Preciado rejects the classification of dysphoria as a mental illness, despite its inclusion in the DSM (Diagnostic and Statistical Manual of Mental Disorders), the guide referenced by drug developers, insurance companies, researchers, and policymakers. The manual’s past entries include hysteria and homosexuality, setting a historical precedent for pathologizing liberation. Preciado describes dysphoria instead as an internal longing for change, both personal and political, that anyone—cis or trans—can experience. “Your dysphoria is your resistance to the norm,” he writes. “In it lies the power to transform the present.” If we reframe dysphoria as discontent with the status quo, then many of us have long been dysphoric.
Preciado pinpoints, as a locus for this decade’s spread of dysphoria, the Covid-19 pandemic. He writes, “Most years begin on 1 January and end on 31 December. 2020 was not one of them.” Each chapter header in this second and largest section of the book points to an element of global dysphoria drawn into stark relief by Covid-19: “Labour Is Out of Joint;” “The Border Is Out of Joint;” “Breath Is Out of Joint.” Preciado recalls how, as fear of infection intensified in early 2020, privileged classes bunkered inside their homes and continued production via digital means, while “essential workers” risked their lives to deliver toilet paper, food, and sourdough hobby supplies. The media took up the language of invader to describe the virus—a scientifically inaccurate metaphor fueling xenophobic border anxieties. (Remember “China virus”?) Later, anti-trans activists would co-opt the term “epidemic” to incite panic surrounding rising rates of transgender people claiming their identities.
Dysphoria Mundi, described on the cover as “a diary of planetary transition,” travels the globe identifying sites of dysphoria. There’s “Foxconn City,” a massive factory in which China’s peasant class manufactures two thirds of the world’s iPhones, in working conditions unimaginable to most Americans. Preciado observes, “The take-off of the digital economy would not have been possible without huge numbers of impoverished workers in the micro-electronics industry.” These workers both labor and live in employer-owned buildings, under constant surveillance and forbidden from communicating with one another during their twelve-hour shifts. Perhaps unsurprisingly, Foxconn has made headlines for the high suicide rate of its workers, people who self-identify as “i-slaves.” Were these now-dead factory workers mentally ill? Or were they dysphoric?
Preciado also finds dysphoria in the Catholic Church, amid rampant sexual abuse. Referencing the Church’s longstanding opposition to abortion and LGBTQ+ rights, he writes, “What threatens the integrity of childhood is not homosexuality, trans identity, or homosexual marriage, but the hierarchical power structures of the Church.” He continues: “Priests rape . . . and they do it not because some of them are isolated monsters, or deviant, but because the patriarchal regime that underpins the Church and the heterosexual family gives them the right and power to do so. . . . Sexual criminality is not an accident but the very architecture of power of the ecclesiastical institution.” Here we see dysphoria’s root: not an internal mental imbalance but external injustice and material harm caused by systems of hierarchy and domination.
Dysphoria is everywhere, once you know how to spot it: the melting glaciers; the dismembered arm of a child in Gaza; and now, Elon Musk’s self-parodying DOGE eliminating entire functions of government and unleashing mass chaos in the name of “efficiency.” As Preciado’s American publication date arrives and Dysphoria Mundi washes up on the shores of the United States, the project of global gaslighting, too, has touched even the world’s most privileged.
From nuclear war to data harvesting to the science of infection, the breadth of topics touched upon by Dysphoria Mundi could easily feel like a scattershot of ideas, were they not so well structured. Preciado describes the text’s form as “nonbinary;” it shape-shifts between poetry, narrative nonfiction, and philosophy. While the book is four hundred pages, the short chapters dip into topics then tie them neatly back to Preciado’s central exploration, adding depth rather than superfluous details. The poems provide welcome pauses amidst prose that otherwise could feel dense. One caveat for first-time Preciado readers (like me) is he introduces invented words such as “petrosexoracial” and “pharmacopornographic” without defining them until later. Anyone overwhelmed by the first and most dense section could skip it and still glean much from the work.
Preciado’s preponderance of subjects demonstrates how the dysphorias he names all intersect. “Gaza is everywhere,” he writes. “We all live in Hiroshima.” I took this to mean the violence we enact or permit against our siblings across the world will boomerang back. Contained in this solidaristic argument is an implicit and oftentimes explicit critique of liberalism’s failure to create systems benefitting all. For example, Preciado writes, “Climate action that is not at the same time a project of depatriarchalization and institutional and social decolonization can only increase class, sexual, gender and racial oppression. The bicycle paths in the center of Paris, New York, or London can perfectly coexist with domestic sexual violence, with the institutional confinement of racialized minorities and with trans-bashing. . . . Racism can also be green.”
While the book has been out in Europe since 2022, it seemed to anticipate our current political moment, as many of us grasp for ways we can resist the rise of fascism in the United States. Preciado advises, “Don’t expect messiahs or heroes. On the contrary, messiahs and heroes have been our fundamental historical problems. . . . Don’t expect anything from institutions either.” To illustrate the futility of seeking help from institutions, “funeral prayers” appear throughout the book, in which the narrator pleads for mercy from the entities to which we have given our power: “Our Lady of Chemical Weapons, pray for us”; “Our Lady of ExxonMobil, pray for us”; “Our Lady of Facial Recognition, pray for us”; “Our Lady of Instagram, pray for us”; . . . “You who produce our pain and invest in our death, have mercy on us.” I am reminded of well-meaning friends at my conservative church who tried in vain to address church injustices by pleading with the pastors. As Audre Lorde said, “The master’s tools will never dismantle the master’s house.”
What, then, can we do about all this dysphoria? Preciado says we must begin by reclaiming our desires from capitalism and colonialism. Then, we must join a global transition that is already underway. “This mutation in progress,” he writes, “could ultimately catalyse a shift from an anthropocentric society and a petrosexoracial regime, where a fraction of the global human community authorizes itself to exercise a politics of universal extractivist predation, to a society that is capable of redistributing energy and sovereignty—from a society of fossil energies to one of symbiotic energies.” Knowing most elected Democrats rejected plans to phase out fossil fuels—despite their elimination being essential to averting climate catastrophe—Preciado’s very reasonable plan for saving the world feels, in 2025, impossibly ambitious.
And yet, he includes a pair of anecdotes that renews my hope—if not in leaders and institutions, then in my fellow humans with whom I share the planet. First, Preciado recalls watching television with his parents as a young dysphoric child and seeing a news story spotlighting dying AIDS patients. In other words, the first time queerness becomes visible to him it is synonymous with disease and death. And yet, he later writes that during early trials for the anti-AIDS drug AZT, patients cracked open their pills to determine whether they’d gotten the placebo or the real thing; those who had the drug would then split their dose with someone who had the blank. Forty years ago, these dying men showed us how to care for one another when their leaders failed to. Our survival, the story suggests, depends on both our solidarity, and our defiance.
Conservatives have long used the slippery slope argument to block queer people from obtaining rights. This argument is obviously offensive and in bad faith. However, perhaps it contains a kernel of truth, in that exposing the artifice of gender exposes all false constructs—race, class, ability/disability—that the powerful use to keep us in line. “‘Gender,’” Preciado writes, “is to the heteropatriarchal and the binary management of national reproduction what ‘climate’ is to the capitalist management of production: the word that embodies a critical awareness and a possibility of deconstructing the norm.” My church didn’t pathologize and oppress queerness because they hated queer people—although certainly they may have hated them—rather, heteronormativity and gender essentialism were key ingredients in the authority they held over each member of the congregation, queer and straight alike.
Only after I recognized the people most harmed by the church were my firmest allies was I able to extricate myself from the church’s grasp. This required I acknowledge I’d sunk years into a corrupt institution, aiding its victimization of others. The realization was incredibly painful. “Dysphoria is bad,” Preciado affirms. “It is our misery. It is demanding. It is painful. It destroys us. . . . But it is also our truth. . . . The intuition that allows us to know what needs to be changed.” When I finally looked directly at my own dysphoria, I was able to understand that of others. Making eye contact across the church aisle, our faces spoke wordlessly to one another: You’re not crazy, they are. And in that moment of connection, we knew that together, we could free ourselves.
