La Trobe
Connoisseurship accepted version.docx (78.5 kB)

Is another relationship possible? Connoisseurship and the doctor–patient relationship for men who consume performance and image-enhancing drugs

Download (78.5 kB)
journal contribution
posted on 04.03.2021, 03:59 by Suzanne Fraser, Renae Fomiatti, David Moore, Kathryn Seear, C Aitken
© 2019 Elsevier Ltd

Consumption of steroids and other performance and image-enhancing drugs (PIEDs) is thought to be on the rise in Australia. Along with the benefits experienced by consumers come a range of health risks. This article draws on interviews conducted for an Australian research project on men who inject PIEDs to consider the ways in which information about managing these risks can be provided, the sources of information men use and value, and the professional relationships most effective for securing the best outcomes for them. As we will show, the men in our project expressed a very strong desire for reliable, credible information about risks and how to manage them, but also described often having to rely on information gleaned from sources of questionable reliability such as online forums and friends and acquaintances. Among the sources of information, advice and monitoring they expressed a desire to access were general medical practitioners (GPs), but high-quality interactions with GPs were, they argued, rarely possible. Using the recent work of Isabelle Stengers, particularly the notions of connoisseurship and symbiosis, we argue that new modes of engagement need to be developed that might allow men who consume PIEDs to access the information and support they need, including through their GPs. Following Stengers, we characterise the men in our project as ‘connoisseurs’ of PIEDs, and we consider what might be at stake and made possible were GPs and PIED connoisseurs to enter into more collaborative relationships to manage PIED-related health issues. In conducting our analysis, we argue for greater recognition of the complexities GPs face when encountering people engaged in illegal forms of consumption and call for new symbiotic models of engagement beyond both zero tolerance-style refusals to help and narrowly focused harm reduction approaches.


This research was conducted with the support of an Australian Research Council Discovery Grant (DP170100302).


Publication Date



Social Science and Medicine



Article Number

ARTN 112720







Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.