Book excerpt: This book urges those invested in social justice for 2SLGBTQ people to interrogate the biomedical model of mental illness beyond the diagnoses that specifically target gender and sexual dissidence. In this first comprehensive application of Mad Studies to queer and trans experiences of mental distress, Pilling advances a broad critique of the biomedical model of mental illness as it pertains to 2SLGBTQ people, arguing that Mad Studies is especially amenable to making sense of queer and trans madness. Based on empirical data from two qualitative research studies, this book includes analyses of inpatient chart documentation from a psychiatric hospital and interviews with those who have experienced distress. Using an intersectional lens, Pilling critically examines what constitutes mental health treatment and the impacts of medical strategies on mad queer and trans people. Ultimately, Queer and Trans Madness: Struggles for Social Justice explores the emancipatory promise of queer and trans madness, advocating for more resources to respond to crisis and distress in ways that are non-coercive, non-carceral, and honour autonomy as well as interdependence within 2SLGBTQ communities.