Ayahuasca has been found in some research to have positive long-term effects on mental states and a particularly strong positive effect on perceptions of identity. The research in this chapter examines these findings in relationship to the experience of gay people, who are often taught by their culture and religion that their lifestyles, values, and sexual orientation are unacceptable. A qualitative study examined the open-ended responses of 17 self-identified gay and lesbian participants who had drunk ayahuasca in a ceremonial context within the past three years, regarding their self-perceptions and integration of group beliefs. Participants drank either in shamanic or Santo Daime ceremonies or, in the case of one participant, with an Afro-Brazilian group that used ayahuasca. All participants reported affirmation of their sexual orientation, and no participants reported negative effects on perception of identity. Additional positive effects in other areas of their lives, which they attributed to ayahuasca sessions, contributed to the overall positive outcomes that were reported by this group as a result of their ayahuasca ingestion.