He helped found one of the earliest gay community centers in the United States, edited two newsletters devoted to sexual health, and served as editor of The Advocate in 1975.
Preston was an outspoken advocate of the artistic and social worth of erotic writings, delivering a lecture at Harvard University entitled My Life as a Pornographer.
Testimony regarding the literary merit of his novel I Once Had a Master helped a Vancouver LGBT bookstore, Little Sister's Book and Art Emporium, to partially win a case against Canada Customs in the Canadian Supreme Court in 2000.
He wrote a long feature about the local monopoly newspaper, the Portland Press Herald, as well as many food articles, movie reviews, and other writing.
These books, which included "Sweet Dreams," "Golden Years," and "Deadly Lies," combined action-story plots with an exploration of issues such as the problems facing gay youth.
[17] Some of his last essays, found in his nonfiction anthologies and in his posthumous collection Winter's Light, describe his struggle to come emotionally to terms with a disease that had already killed many of his friends and fellow writers.