The Communist Pleasure Activism That’s Helping Erase Medical Debt in Appalachia

Editor’s Note (September 2020): When we published this article on November 9, 2019 we believed Mutual Aid Lube when they described both their collective organization structure and what they were doing with the funds they raised. On August 3, 2020 Emma Copley Eisenberg wrote an investigative piece in The Washington Post Magazine titled “The Tale of Queer Appalachia,” bringing into question how the organization is run and where the money they have raised over the years really goes. We are leaving this article up, but urge readers to check out Eisenberg’s piece and to stop giving money to Mutual Aid Lubeuntil they provide clarity and confirmation about where the funds are going and who they are really supporting.

Dispatches from the Country Culture War is a monthly column that explores queer country music and art, and examines how it informs broader community opinions about rural queers. 

Mutual Aid Lube, a “vegan plant-based lube made by queers for queers,” started off as “a crazy idea I had alone on a mountaintop daydreaming,” according to the organization’s founder, Chelsea. A queer resident of the mountains of West Virginia, Chelsea’s project — tagline: “a fistin’ lube for lovers and others” — partners with RIP Medical Debt, an organization committed to buying up and forgiving medical debt all across the country. RIP Medical Debt has a specific project for Appalachia because the need is so great. With healthcare being a major issue in the nation at the moment, and discussions of the opioid crisis and student loan debt dominating major political debates, Chelsea wanted to create something that dealt directly with medical debt in a funny and queer way.

The results of the 2016 election have put more attention on rural America as a means to better understand the perceived group of people who put Donald Trump in office — working class white people living in remote and small town communities. This political narrative has been proven false, but in anticipation of the 2020 election there’s continued observation of the large portions of the country considered “rural.” I asked Chelsea what they considered the difference between “rural” and “country,” considering the terms are used fairly interchangeably and provoke very specific images for different people.

“I use rural for a more clinical context,” they told me.” When I describe institutional systems and trends I use the term ‘rural.’ I’m more likely to use the term rural if I’m talking to folks in an urban area. Country has more romance, I use it when describing cultural setting, landscapes, and feelings.”

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We had a great time at @queencityzinefest Thanks to all the friends who stopped by! We’ve been getting some great feedback about the lube and want to encourage more! Let us know what is working for you, and what can be improved! We aim to make a product folks will love while also erasing Appalachian medical debt 🥰. The shipping cost killed us and going forward we are gonna add a few bucks to the price so we don’t take a hit financially. To make this project sustainable it needs to pay for itself. Thank y’all for understanding and supporting us in this wild ‘n wonderful endeavor! Feel free to email us at mutualaidlube @ 😘😘 #mutualaidlube #ripmedicaldebt #queersex #abolishdebt #pleasureactivism #feminism #betterorgasms

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Chelsea’s is an unusual story in that they moved from a metropolitan area to the Mountains. Most narratives on rural queer life revolve around small towns and small minds forcing their queer citizens to flee to the bastions of major cities, specifically coastal ones like New York, San Francisco, or Los Angeles. But Chelsea moved from the Washington DC area to several parts of Appalachia before settling in West Virginia. An interdisciplinary artist specializing in multimedia work, including textiles and sculpture and furniture design, Chelsea experienced their own medical debt specter after going to the hospital for a concussion and ending up with a multi thousand dollar bill.

“A couple thousand dollars to someone who lives on less than, like, ten thousand a year can be pretty intense so I have a lot of compassion for people who experience those problems.”

They couldn’t pay it, and the experience affected their credit and relationships in their personal life. “I have a special soft spot for medical debt,” they told me,

The name of the lube, for those who didn’t have communist pamphlets under their bed as a teen, comes from the concept of Mutual Aid — a voluntary exchange of resources for mutual benefit designed to not operate as charity, but as greater community building. Chelsea rented an allergy and pet-free kitchen, and is learning as they go. “I want to be as considerate as possible in how I go about doing this.”

The idea of Mutual Aid Lube might have begun as a dream on a mountaintop, but it’s certainly popular now that it’s in the world. Inspired by adrienne maree brown’s book, Pleasure Activism, Chelsea began making lube solutions because store bought products didn’t work for them, and decided to put some humor into the work. Since promoting on Instagram, preorders are open, previous orders have shipped out, and customers have the option to purchase additional medical debt as part of their order. So far, Chelsea’s been able to help forgive $55,000 of medical debt in Appalachia.

Chelsea’s doing most of the work themselves, from promotion to manufacturing to design, and was surprised and excited at how interested people were in the product. “I did a lot of research first, and it’s been a slow and steady march to getting the ingredients together to testing things to talking to sexual educators about what concerns I would need to look out for.” Chelsea is also excited about getting attention from harm reduction groups and sexual advocacy “rooted in a field of other activists who are working on important projects who are in the same family of helping people helping each other… Coming from an arts background, people get really competitive with each other and it can be exhausting. A byproduct of capitalism is this idea that we’re all competing with each other which is obviously so unnecessary. It’s been truly wonderful to see the support from people who just want to put in an order for lube and be part of a DIY project that popped up on the internet a few weeks ago.”

Chelsea was living in the Mountains during the 2016 election, and got to watch first hand how the political climate as shaped the area: “Lives were changed as far as health, Medicaid, and benefits slowly being taken away from folks. I want to say it’s been like a slow crushing of people’s livelihood.”

It’s easy to dismiss Southern Appalachia and West Virginia as being backward or being more bigoted that urban epicenters, but Chelsea says that kind of thinking, “erases all the groups that are here and doing exciting things [for their communities].”

However, being a rural queer is not without very specific challenges. According to the Where We Call Home: LGBT in Rural America, a report by MAP, the largest struggles for rural queers are their visibility, fewer resources, and the ripple effects of rejection. With resources diminishing overall in rural areas, the reduction of access is even greater for the upwards of three million rural queers where healthcare can be religiously motivated, and communities are more likely to take advantage of the lack of state and federal protections for queer people.

“It’s a different existence. There are certain shirts I don’t wear out of the house. When I’m in more rural areas I have to think about safety a lot more, and sometimes that looks like being really specific about what bathrooms you stop at on long drives. Sometimes it’s remembering which waitresses or what gas stations don’t want to serve you at, and avoiding those.”

Yet, Chelsea feels just as exhausted wading through the microaggressions of urbanites when they find out they live in West Virginia. Not all rural communities are created equal, “I try to be careful to not speak for someone who was raised here or grew up here, because I understand that’s a completely different experience.” Chelsea has also lived in rural upstate New York (the part with confederate flags) and notes that not all rural experiences are the same. Appalachia is more of a healthcare desert, Chelsea says, “Sometimes It feels very jobless here”

In the wake of the discussions about debt, there’s a lot of conversation about education, but medical debt affects 25% of Americans, and more than half of medical debt carriers have no other forms of debt. It can prevent access to housing, lead to bankruptcy, and facilitate generational and systemic poverty. And then there’s the opioid epidemic. Pharmaceutical companies targeted West Virginia with painkillers, specifically coal country, and created a deadly plague that’s resulted in thousands of deaths.

“There’s no time for you to take off and recover from your injuries, especially as people get older. You gotta sorta suck it up and take your pills so you can go to work and bring home some money.” Chelsea sees a direct connection of the trap of medical debt and the resource extraction that’s been a long problem in West Virginia. Where the state is valuable for its timber, coal, and natural gas, the money from those industries has never really matriculated into the local economies and results in very hard lives for residents. “What I’m trying to do is approach the problem from the level of praxis and reach people where they’re at.”

Chelsea’s queer sexuality has always been present in their work, and while attending graduate school, they managed the student run gallery and curated a collection called Queering the Mountains. With this project, Chelsea’s main goal isn’t to make money — “this would be a terrible business model” — but to cover expenses and get people to talk about medical debt and demonstrate that “you can mix your praxis and the way you find your light.”

You can learn more about Mutual Aid Lube here.

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Lauren Parker

Lauren Parker is a writer based in Oakland. A graduate of Hiram College's Creative Writing program, she has written for the Toast, the Tusk, Ravishly, The Bold Italic, Harlot Magazine, Hoodline, and plain china. She's the winner of the Summer of Love essay contest in the Daily Californian, the Vachel Lindsay poetry prize, and a was featured in Bennington College's Best Undergraduate Writing series in 2012. She is a producer on the monthly literary series Cliterary Salon, and the author of the zine My Side of Our Story. Follow her on Twitter: @laurenink.

Lauren has written 11 articles for us.


  1. Thank you for featuring this! I follow this and a number of other queer Appalachian pages on Instagram. Like Chelsea. I too moved from the DC area to Appalachia, though most of my ancestors are from the hills. It has been 8 years, but I still feel torn daily on staying or going. I feel a strong pull to these mountains, and there is so much work to be done, but it is also exhausting as a bi, chronically ill, polyamorous, woman with a disabled child. But queer Appalachian culture exists and it is beautiful! Mutal aid and solidarity forever!!!

    • I would love to hear more about the other IG accounts you follow!

      I moved to Appalachia after growing up in the urban Midwest, and it’s been so disconcernting to hear people from home express worry about me here. I only ever lived there in the closet, and I’ve been out since before moving here.

      I’m trying to learn more about what’s genuinely necessary precaution here and what’s stereotype, but I also need straight folks back home to understand that they’re not living in a queer paradise, either.

  2. Yessss rural queer pioneers forging new ways to sell things and make things and change lives! I joke sometimes that small queer businesses are usually not nonprofit, but not NOT nonprofit.

  3. This is really neat and I’m glad it exists! Sideeyeing the headline calling any business “communist,” though…

  4. Are Mutual Aid and Queer Appalachia the same? Seems like different people and different organizations.

Comments are closed.