Two people excitedly fight for healthcare in America. In Capitalist Realism, the social critic Mark Fisher said the focus on discussing mental health in purely biochemical terms works hand-in-hand with its depoliticization.
Most people who experience mental health problems will find the discussion of mental health in purely biochemical terms familiar, and it can be helpful in de-stigmatizing mental health; “I’m not choosing to be depressed, the chemicals in my brain make me depressed.”
But, I have an issue with this that I’d like to talk about in this blog:
Most people who experience mental health problems will find the discussion of mental health in purely biochemical terms familiar, and it can be helpful in de-stigmatizing mental health; “I’m not choosing to be depressed, the chemicals in my brain make me depressed.”
But, I have an issue with this that I’d like to talk about in this blog:
Only talking about mental health in medical terms can be harmful to the LGBTQ+ community.
Social and political conversations get closed off when we speak about mental health biologically because the “problem” becomes isolated to the individual’s brain chemistry. And in the process, we ignore the social and political realities those conditions are a part of.
Mental Illness in the Queer Community
According to the National Alliance on Mental Illness (NAMI);
Minority stress is a kind of constant anxiety that minorities feel due to constant awareness of their actions. Are they drawing too much attention to themselves? Are they representing their community? Do they have reliable social support?
Are they in danger?
Constant minority stress (obviously) leads to worse mental health issues.
Progress has been made to reduce minority stress, but constant diagnosis’ of the LGBT+ community ignores the nature of LGBT+ people’s environmental stresses. In other words, the discussion of mental health as a biological issue has built a stigma that has been used in turn, as a tactic by LGBTQ+ rights opponents to remove power from our identities.
- Members of the LGBTQ+ community are 3 times more likely to experience mental health issues, such as depression and generalized anxiety disorder than straight people.
- LGBTQ+ youth are 3 times more likely to commit suicide and engage in self-harm. Somewhere between 38%-65% of trans individuals experience suicidal ideation.
- Between 20-30% of the LGBTQ+ community abuse hard drugs, compared 9% of the general population. 25% of the LGBTQ+ community abuses alcohol, - double the general public’s 5-10%.
Minority stress is a kind of constant anxiety that minorities feel due to constant awareness of their actions. Are they drawing too much attention to themselves? Are they representing their community? Do they have reliable social support?
Are they in danger?
Constant minority stress (obviously) leads to worse mental health issues.
Progress has been made to reduce minority stress, but constant diagnosis’ of the LGBT+ community ignores the nature of LGBT+ people’s environmental stresses. In other words, the discussion of mental health as a biological issue has built a stigma that has been used in turn, as a tactic by LGBTQ+ rights opponents to remove power from our identities.
Politics and Mental Health
So we’ve been talking pretty up-in-the-air here, but let’s get real:
The diagnosis and treatment of mental health issues carry undeniable political impact for the minority people who are diagnosed.
While being diagnosed on its own is overall an empowering thing for an individual, there is a power-exchange between the prescribing doctor and the patient, in the diagnosis.
It is fundamentally a political act to determine whether certain behaviors are acceptable or in the bounds of illness and whether people should be allowed to live freely given that condition.
To declare someone “mad” is to remove agency from their life. Leveraging mental health diagnosis’ has been a longstanding tactic of maintaining the status quo, and the strategy has become more potent with the medicalization of mental health in the early 20th century.
Feminists and civil rights activists have been famously institutionalized for their political activity, but in the case of the LGBTQ+ community, the focus has been on declaring someone to have a mental disorder— not for acting a certain way, but for being a certain way.
For a long time, having a “gender dysphoria” diagnosis preemptively closed off the possibility of political action because it was a mental health condition.
Until 1973, being gay, lesbian, or bisexual was officially considered a mental illness. It was only in 2013 that the term gender dysphoria came to replace the term Gender Identity Disorder in the DSM, which was done to help align psychiatric practices with the aim of helping trans folk with their mental health rather than treating being trans in itself as a mental disorder.
Being queer was forcibly depoliticized which made it appear politically neutral.
2 examples
A current example of this forced neutralization can be seen in the conversation around transgender bathroom rights. Opponents of these rights often close trans folk out of the discussion entirely by attributing their trans status to a dangerous or contagious disorder or sexual deviancy.
We also see this issue in conversion therapy. While it’s not recognized as a legitimate psychiatric practice, the message inherent to conversion therapy is that “being gay needs to be fixed rather than understood as an identity.”
In each case, psychiatric practice is used to transform a social issue into an individual one and then as a clear “problem” to be solved with that person.
And because LGBTQ+ youth are much more susceptible to this loss of power and identity the risk is magnified horrifically.
If this occurs, the political and social realities leading to widespread anxiety in young minorities would be closed off to the conversation. They would lose their voice and with it any hope of a political solution.
They would lose any platform for managing their own identities.
The diagnosis and treatment of mental health issues carry undeniable political impact for the minority people who are diagnosed.
While being diagnosed on its own is overall an empowering thing for an individual, there is a power-exchange between the prescribing doctor and the patient, in the diagnosis.
It is fundamentally a political act to determine whether certain behaviors are acceptable or in the bounds of illness and whether people should be allowed to live freely given that condition.
To declare someone “mad” is to remove agency from their life. Leveraging mental health diagnosis’ has been a longstanding tactic of maintaining the status quo, and the strategy has become more potent with the medicalization of mental health in the early 20th century.
Feminists and civil rights activists have been famously institutionalized for their political activity, but in the case of the LGBTQ+ community, the focus has been on declaring someone to have a mental disorder— not for acting a certain way, but for being a certain way.
For a long time, having a “gender dysphoria” diagnosis preemptively closed off the possibility of political action because it was a mental health condition.
Until 1973, being gay, lesbian, or bisexual was officially considered a mental illness. It was only in 2013 that the term gender dysphoria came to replace the term Gender Identity Disorder in the DSM, which was done to help align psychiatric practices with the aim of helping trans folk with their mental health rather than treating being trans in itself as a mental disorder.
Being queer was forcibly depoliticized which made it appear politically neutral.
2 examples
A current example of this forced neutralization can be seen in the conversation around transgender bathroom rights. Opponents of these rights often close trans folk out of the discussion entirely by attributing their trans status to a dangerous or contagious disorder or sexual deviancy.
We also see this issue in conversion therapy. While it’s not recognized as a legitimate psychiatric practice, the message inherent to conversion therapy is that “being gay needs to be fixed rather than understood as an identity.”
In each case, psychiatric practice is used to transform a social issue into an individual one and then as a clear “problem” to be solved with that person.
And because LGBTQ+ youth are much more susceptible to this loss of power and identity the risk is magnified horrifically.
If this occurs, the political and social realities leading to widespread anxiety in young minorities would be closed off to the conversation. They would lose their voice and with it any hope of a political solution.
They would lose any platform for managing their own identities.
Politicizing LGBTQ+ Mental Health
When the prevalence of mental health issues for members of the LGBTQ+ community and the messy political history of psychiatry, are taken together it shows a clear need for a more forward political discussion.
Now again, the biochemical discussion of mental health is useful for helping members of the LGBTQ+ community individually. We need a proper medical vocabulary to help diagnose what problems exist within one’s brain chemistry and prescribe treatments for the symptoms.
BUT
If the discussion ends there we are left with a system that atomizes mental health, closes off the possibility for political change doesn’t approach minority stress, and renders the LGBTQ+ community captives to pharmaceutical solutions.
Politicizing the constant anxiety and depression associated with being queer is a necessary step in queer liberation. These collective illnesses demand collective action.
Maintaining a purely scientific, biochemical discussion of mental health silences this collective action. We must treat medicalization as a political tool for reforming the social needs of marginalized communities instead of repressing them.
Now again, the biochemical discussion of mental health is useful for helping members of the LGBTQ+ community individually. We need a proper medical vocabulary to help diagnose what problems exist within one’s brain chemistry and prescribe treatments for the symptoms.
BUT
If the discussion ends there we are left with a system that atomizes mental health, closes off the possibility for political change doesn’t approach minority stress, and renders the LGBTQ+ community captives to pharmaceutical solutions.
Politicizing the constant anxiety and depression associated with being queer is a necessary step in queer liberation. These collective illnesses demand collective action.
Maintaining a purely scientific, biochemical discussion of mental health silences this collective action. We must treat medicalization as a political tool for reforming the social needs of marginalized communities instead of repressing them.
Dylan T. Clark
Writer and editor for Rescqu.net. Mostly sparkles.
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