queer appalachia


How a queer Instagram is helping fight the opioid epidemic in Appalachia

It's a new way to tackle a real epidemic.


Emily Anna Keith

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Posted on Jul 21, 2019   Updated on Aug 31, 2020, 12:22 pm CDT

If you are a queer person in a rural part of the eastern United States, you might be familiar with Queer Appalachia, a collective fronted by an Instagram account with a radical message—full of colorful photos, in-your-face jokes, and cheeky innuendos—representing LGBTQ life in the region’s hills and hollers. 

Since its inception in 2016, the page has become a key way to distribute anarchist, leftist, and radical information, like about the ongoing tree-sitters movement in southern West Virginia. There, organizers have been camped out in trees for months, protesting the proposed Mountain Valley Pipeline. 

Queer Appalachia also draw attention to the plights of individual queer people in the region, particularly transgender people in need of shelter or money, by posting the person’s Venmo or Paypal information on Instagram and asking for donations to help them. 

The account’s main goals right now, though, are two-fold: celebrate and cultivate love for Appalachia while engaging in radical queer activism to battle the opioid crisis gripping the region.  

Born from addiction, grief, and love, Queer Appalachia started as a handmade zine project called Electric Dirt. The social media accounts, like Instagram, were established to draw submissions to the zine, but they grew into an internet phenomenon that currently boasts a quarter of a million followers.. 

Gina Mamone, one of the founders and Queer Appalachia’s media curator, who goes colloquially by their last name and uses they/them pronouns, said that when the artists laying the groundwork for the Electric Dirt zine, they envisioned it being a small project.

“I’m a first-generation Riot Grrrl,” Mamone said, referring to the 1990s underground feminist punk movement that is seen as having launched third-wave feminism. “And to me zines are made with loose paper and glue sticks.” 

But by the time the group closed down pre-orders for Electric Dirt, it had over $30,000 at its disposal. “We ended up being able to have two hundred professionally printed pages,” Mamone told me, “and that was a game-changer for us.” 

Queer Appalachia’s Instagram account proved an invaluable asset. The number of responses to their call for Electric Dirt submissions was so overwhelming that they quickly realized the region’s queer community needed them to be more than a zine. As Mamone explained, “We saw that the Instagram could be sort of social passport to what the community created and needed,” a way to bring awareness to what’s really going on in the mountains and hollers. 

And what’s happening right now is an epidemic of opioid abuse and widespread harm.

According to a report released by the Commonwealth Fund on June 12, West Virginia had the highest death rate from drug overdoses in 2017, a majority of which stemmed directly from opioid abuse. But prescription painkillers are not solely responsible; neither is heroin. The study found that fentanyl, a synthetic opioid similar to heroin but much more potent, along with other artificial drugs, is becoming more common in drugs like cocaine, exposing unaware users to deadly toxicity levels.

Queer Appalachia’s efforts to fight these overdoses center around harm reduction in the region. The aim is to educate the population not only on drug use reduction but on how to safely use drugs in manners that reduce risks. Recent Instagram posts, for example, detail bodily injection sites with colored graphics of least-to-most-safe areas. 

Mamone said they have led harm reduction training during various speaking engagements, which detail topics from safe injection to proper use of drugs that counteract overdoses, like Naloxone and Narcan. This June, Queer Appalachia said they held its first harm reduction pop-up clinic in Charleston, West Virginia, where members handed out Narcan and drug testing strips in addition to clean needles.  

Their efforts doubled down on harm reduction efforts happening elsewhere in the state. The only safe needle exchange program is located in Morgantown, an eight-hour drive from the southern coalfields. Many people, as Mamone pointed out, will not take a road trip to get clean needles, “because when you’re poor, a tank of gas means a lot.”

With the goal of holding more clinics and training sessions in the future, Queer Appalachia also works to mail out home HIV testing kits to queer people who feel unsafe coming out. While queer people are disproportionately affected by the opioid epidemic, they are also more likely to contract diseases like HIV from unclean needles and not seek help out of fear of being outed. 

“You can write to us, and we’ll send them [the kits] very discreetly,” Mamone told me. When the group first advertised that service on Instagram, the reaction was intense. Requests poured in, and in a matter of minutes, the group’s entire supply had been claimed. The demand is so high largely due to the stigma of getting tested in a small town. 

“When you grow up with one of your primary care physician’s office personnel, HIPAA don’t mean shit,” Mamone explained, referring to federal laws restricting the release of medical information. “Because everyone talks in a small town, the result is that people don’t get tested. Even just getting tested is kind of a red flag in small towns.” 

What’s worse, AIDS treatment is currently out of reach for the most impoverished victims. 

“It’s because they don’t feel comfortable getting treatment and they often can’t. Poor people can’t afford the [treatment] cocktail every month. Even with insurance, it’s $450 bucks. Buying that at a small pharmacy really outs you…  There really is this underground AIDS epidemic in Appalachia that’s not getting any press,” Mamone told me. 

Geographically, Appalachia stretches from northern West Virginia and the southwestern tips of Pennsylvania to the ridges of the Great Smoky Mountains. It’s known for coal mining and bluegrass music, but there are other phenomena specific to the region, like being raised to leave it. Arteries that come in and out of the region are known as hillbilly highways, though they typically flow more steadily in the outward direction. 

It can be hard to stay in touch with the mountains once you leave them, and Queer Appalachia’s Instagram account is a way for the people of the Appalachia diaspora to access their roots when doing so is difficult, and at times, unsafe.   

Queer Appalachians, Mamone pointed out, are almost an oxymoron to what people generally see when they picture Appalachia. Queerness doesn’t coincide with traditionally gendered images of coal miners and country folks, which can prove dangerous for people who don’t fit that mold. 

A large social media presence especially comes with complications. The Queer Appalachia Instagram account receives roughly 800 messages a day, and when a platform gets that much traffic, some of it is bound to be negative. 

The organization said it has been beset by cyberbullying in recent months from individuals involved in some of West Virginia’s most powerful nonprofits, according to Mamone. Specifically, Appalshop, which aims to preserve “the lasting traditions of Appalachia,” and The Stay Project, which works to keep Appalachian youth in their home communities. 

Queer Appalachia says they are suffering the effects of a sort of moral lens that ostracizes people with addiction histories. People in the West Virginia queer community who are involved with Appalshop and The Stay Project, Mamone told me, have taken to social media to disparage Queer Appalachia’s name and the work they do. 

“Shit posting,” as Mamone put it, has gotten increasingly harsh over the last few months, and in such a small community, more and more unbearable for the people it targets. The Appalshop community, in particular, “is very very small, and it doesn’t matter that the posts aren’t coming from the Appalshop [social media] pages when they come from the personal accounts of the people who run these things,” they said. 

But things have gone beyond defamatory posts and cyberbullying. Recently, Mamone said, the people targeting Queer Appalachia have threatened to publish what they say is the truth about the collective.

Mamone did not provide evidence of the cyberbullying they received.

While it isn’t clear where their information is coming from, or if their threats are valid at all, Mamone said they are feeling the weight of what’s being thrown against them.

“The way journalists come at us is crazy,” Mamone told me. “I’ve never seen journalism like this… the journalist supposedly working with this group of people sends emails, cold calling nonprofits in the region asking if they’ve worked with us… they’re looking for dirt. They want to shame and humiliate us so everyone knows what a piece of shit we are.”  

A lot of what they have to say is about Mamone specifically. When they first moved home, they had a brief romantic relationship with another person in the queer community that did not end well, which Queer Appalachia sees as the starting point for the discord. “I hurt their friend and I understand that,” Mamone said, “but I also know that The Stay Project and Appalshop, and the leadership there, is trying to villainize my addictive past and use it against me.”

They later added in an email, “we can’t handle it getting worse,” emphasizing they are trying to make peace and wave a white flag over the conflict. 

“They’re all good people,” Mamone added. “They are good organizations.”

Neither Appalshop nor The Stay Project returned requests for comment. 

A possible upside of social turmoil, though, is that it empowers people to enact change. In Queer Appalachia’s case, they’re working to rise above what Mamone terms “petty personal problems becoming part of organizations’ agendas.”

After experiencing the community isolation that comes with navigating addiction and recovery and discovering how that cycle connects to infection rates, the collective took the first data collection of addiction rates among queer people in Appalachia. 

The friction is costing mountain communities resources they desperately need. Mamone said several Queer Appalachia members have walked away from the collective in recent months because of the stress. However, Mamone did not provide evidence of the size of Queer Appalachia’s collective, nor numbers involved. 

A possible upside of social turmoil, though, is that it empowers people to enact change. In Queer Appalachia’s case, the organization is working to rise above what Mamone terms “petty personal problems becoming part of organizations’ agendas.”

After experiencing the community isolation that comes with navigating addiction and recovery and discovering how that cycle connects to infection rates, the collective recorded the very first data of addiction rates among LGBTQ people in Appalachia.

The numbers are alarming. It is often impossible to tell if an individual died by suicide or overdose because the rates of addiction and death are so high. 

“What we found through the survey,” Mamone told me, “is that all the resources in Appalachia do not work for queer people… in fact, if you are outside the binary in any way, it is not safe for you to seek help… Your family likely isn’t there for you… Nonprofits aren’t available to you, even though it’s probably the only free thing in the region, and the queer community will do everything in its power to alienate, isolate, and ostracize you… If you are addicted and queer in Appalachia, that is the very definition of you against the world. The community is not there… I mean, even straight people have the option of embracing Jesus to be accepted back into their community. But queer people don’t have a version of that; we don’t have anything equivalent. We’re just done.” 

Their data collection Mamone said, would be published by West Virginia University Press next year in a book titled Opioid Aesthetics.

The West Virginia University Press confirmed Mamone has an essay in Opioid Aesthetics, but said the book does not have a release date and is still under peer review. 

The collective is also working to hold more Narcan training and safe needle exchanges and send out more HIV home testing kits. 

The events and resources are part of what keeps Queer Appalachia on social media, too. In a time and place when many queer people don’t feel safe reaching out to conventional agencies, platforms like Instagram are vital for communication and resource distribution. 

It’s also through social media that the group hopes to gather a larger following and information for their efforts. Their longer-term goals include writing grants to receive state funding and establishing a mobile harm reduction unit that can travel to out-of-the-way locations.

More than anything right now, though, Mamone wants the social media attacks on Queer Appalachia to stop, not only because it is detrimental to their work and hurtful to their members but because the posts are harmful to the Appalachian queer community as a whole. As Mamone said, there is a cognitive dissonance between the larger queer community and addiction, and that gap needs to get narrower before things can get better. 

Update 11:52am CT, Aug. 31: A Washington Post report this month raised concerns about the distribution of funds and items that were raised by the Queer Appalachia and its Instagram account, noting they were unable to get in contact with people on the receiving end of Queer Appalachia’s charity efforts. The report also questioned Queer Appalachia’s use of the term “collective,” as they were unable to find proof anyone aside from Mahomes was involved in the organization’s decision making.

After the Post article was published, Queer Appalachia challenged some of the accusations made in the piece before eventually pledging transparency. The Instagram account for the organization was also taken over by activists. It has not posted since Aug. 7.


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This post has been updated.

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*First Published: Jul 21, 2019, 6:30 am CDT