An Anarchist Perspective on Treating PTSD and Achieving Trans Liberation
December 9, 2011 4 Comments
I haven’t posted anything new in a long time because my life is still incredibly hectic — I’m living in two cities (Brooklyn and D.C.), working part-time, doing tons of organizing with Occupy and writing for OccupyWallSt.org, while also navigating my own basic needs like housing, mental health, stability, relationships, etc. Hopefully I’ll be able to come back to the other projects soon. But for now, I decided to post some musings that came out of a conversation I had with my partner Zoe about PTSD and trans oppression , and how the anarchist idea of balancing the individual and social can help us understand how to help people affected by them. I hope you like it!
An Anarchist Perspective on PTSD and Trans Politics
In mainstream discourse, post-traumatic stress disorder (PTSD) is mainly considered a psychological and/or biological condition. While not denying the validity of those ideas, in order to truly account for our lived experiences as people with PTSD, it must also be understood as a social condition. Without a holistic analysis, we cannot offer a useful strategy for helping us deal with PTSD as individuals or as a society.
PTSD is not purely a socially-constructed or culturally-produced experience. Research indicates that a certain percentage (depending on the study and the population observed, I’ve seen anywhere between 8% and 30%) of people have a genetic or neurological predisposition to it. For example, let’s say (for the sake of argument) out of 100 soldiers who experience more-or-less the exact same traumatic event, 30 will probably develop PTSD. If 100 queers get gay bashed, 30 will end up with PTSD.
This is obviously a drastic simplification of a complex phenomenon. Certain populations have a higher chance of PTSD compared to the general population, and the level of trauma involved also has a role in whether someone develops PTSD. Also, lacking the predisposition doesn’t mean one can’t get PTSD. It just means it is less likely. But while none of this necessarily implies causation, it still suggests that there is a biological component. And, as I can attest to personally, medications acting on biological mechanisms in my body can help treat PTSD (even though I still have never found anything that is completely effective except during small periods of time).
However, this doesn’t mean we should conclude (as many doctors, therapists, researchers, bureaucrats, service-providers, and even social justice activists do) that PTSD is a purely biological condition that solely needs to be defined medically or treated individually. Most trauma is rooted in socially-produced systems: rape, war, poverty, bigotry, oppression. If those social realities were replaced with non-hierarchical, liberatory structures, the majority of people with a biological predisposition would never develop PTSD at all. Most obviously, none of those soldiers would have gone to fight imperialist, capitalist wars if we didn’t live in an imperialist, capitalist culture. None of those queers would be gay-bashed in a society that respected sexual and gender diversity.
Additionally, much of how PTSD is understood and experienced is shaped by social/cultural forces like how we are labeled, medicalized, perceived by others, oppressed by ableism/neurocentrism, etc. People who develop PTSD are faced with a world that stigmatizes us and makes it extremely difficult for us to recover. In an economy that demands a narrowly-defined form of productivity and punishes anyone who cannot function within a normative work environment, PTSD is a serious disability and can be a huge barrier to keeping a stable job.
When I worked in a coffee shop and was triggered on the job, I wasn’t allowed to take a break. I had to keep working and I literally couldn’t handle it — emotionally or physically. (It’s hard to steam milk when you’re hyperventilating and your hands are trembling.) I had no time to deal with my panic attacks or practice self-care. I eventually got fired for being late all the time and for being “unproductive.” Having a panic attack that prevents me from making lattes is not profitable for the company, and bosses care more about money than the health needs of their employees. That’s how capitalism works.
So I ended up homeless and broke (again), which meant that I was even more likely to be in unsafe, triggering situations and it was even harder to obtain the resources I needed to stay healthy. Without a job, I couldn’t afford the medications I needed… because the medical industry cares more about money than the health needs of their patients. Capitalism again.
Individual treatments like medicine and therapy alone will not solve these problems. Treatment for PTSD must not be thought of in purely biological/psychological/medical terms, nor only social ones. Because the ways in which we experience PTSD are both personal and social, any liberatory strategy must account for both. The coin must always be two-sided: we must have individualized responses (support as survivors and access to adequate treatment, including within a medical/biological framework such as medication) and collective liberation (an end to the social systems that place us in traumatic/triggering situations in the first place and social/economic conditions that constantly re-traumatize us and prevent us from meeting our basic needs).
The ability to find support and be treated individually is not complete without fundamentally changing the way our society operates so that: (1) we prevent as many people as possible from ever having to experience PTSD, and (2) people who do have PTSD are not constantly put back into triggering situations and are able to meet their basic needs and manage their illness.
As I was talking about this stuff with my partner, we both realized how much of this can also be applied directly to trans experiences. In mainstream discourse, trans identities/experiences are considered a psychological condition, and increasingly a biological one — either way, it is still located within the individual. Thus, their focus on “treating” the “condition” of being trans is surgery, hormone replacement, etc. While not denying the validity of these ideas either, being trans, like PTSD, must also be understood as a social position in order to accurately account for the entirety of our lived experiences as trans people. Just as for PTSD, without a holistic analysis, we cannot offer a useful strategy for bringing about individual gender self-determination and collective trans liberation.
Again, trans identity is not purely culturally specific. Though we don’t know why, most existing research seems to show that trans female neurology is more similar to cis female than cis male neurology. I don’t pay much attention to these studies, because I don’t feel I need science to validate who I am — but people in the trans community circulate them all the time, so I’m well aware they exist. Though the identity “trans” is contextually specific to the modern/post-modern eras, I agree that experiences and identities we would now define as gender-variant or gender non-conforming have been present in nearly all known cultures. The ways in which such experiences are defined, lived, and related to have varied greatly, but this still suggests there may be some biological component to the experiences we presently call trans. Even in a world without gendered social systems, people would probably still transition using whatever technologies they desire and communicate their identity using whatever language available.
However, even granted all that, this doesn’t mean that trans identity is a purely biological condition that needs to be defined medically or treated individually either. Gender identity is rooted in systemic social structures: the gender binary, patriarchy, heteronormativity. If those social realities were replaced with non-hierarchical, liberatory structures, the term “trans” would have no meaning. Transgender means living/identifying/presenting as a gender other than the gender you were assigned-at-birth. If no one were assigned a gender, no one would be “trans.” And just as the parameters for what it means to be female or a woman have changed over time and space, so too has the definition of “trans” varied across cultures.
Even if some trans people have a particular neurological variance, this probably does not account for why all trans people are trans. Many people choose to be trans for a lot of (all totally valid) reasons — for a lover, to escape oppression, for a kink, to entertain (drag performers), to make money (especially in the context of sex work), because of a biological intersex condition, boredom, to make a political statement. To sum all of these up as genetic or neurological differentiation is to ignore the complex social forces that structure our experiences and the many complex, diverse, messy reasons people live, present, or identify as a gender other than the one they were assigned at birth.
How trans identities are understood and experienced is also shaped by cultural forces like how we are medicalized, perceived by others, oppressed by transphobia/cis-centrism, etc. I shouldn’t even need to explain the consequences of living in a cis supremacist culture. Trans people experience twice the rate of unemployment, near universal job harassment, 1-in-12 chance of dying violently (for women), high rates of homelessness, incarceration, mental illness, lack of family/community support, low self-esteem due to constant harassment and stimga, and on and on. There’s nothing “biological” about any of that. And while these things like a psychological impact on us, this oppression is not a figment of our psyches.
Whether we’re trans because we choose to be or we were born that way, we still face the same oppressions. We share the same (marginalized) position within society. The only thing that really makes us trans is our identification with the term (whether chosen by ourselves or assigned by others) and our active participation in the construction of trans identity within the present world. All of this could, word for word, also be said about what it means to be female/a woman. As many people have said before, that doesn’t make “trans” or “woman” any less real or valid as ways to describe ourselves.
The idea that biology/neurology can entirely explain trans identity is particularly alarming to me as a trans liberation activist. Biological essentialism would merely replace the current oppressive system with another. Right now, trans people’s identities can only be legally/socially recognized through psychiatric analysis. Our access to desired technologies is controlled by psychological standards. A system under which trans people’s identities would only be validated by neurological examination and our access to desired technologies controlled by medical standards wouldn’t be any better. Either way, we still lack the right to self-determine our own identities/bodies and name our own experiences. New boss, same as the old boss.
If biological definitions became the dominant lens through which we understood trans identity, what would stop doctors from requiring a brain scan in order to grant access to hormones, under the assumption that only people with that brain structure are “really” trans? As long as we continue assigning gender, whether based on genitalia or presentation or neurology, some trans people will still be oppressed. Whether policed by psychiatry or neurology, gender policing is always coercive. This is why it is so detrimental when some trans people argue for rights using the justification that they have a biological condition that makes them trans. To claim authenticity using any “objective” standard inherently appeals to an authoritarian ideology that denies our subjective understanding of our own bodies and lived experiences.
Once again, individual solutions like medical interventions or therapy cannot fix all of the problems that come with being trans in this world. Because the ways in which we experience trans identity are both individual (biology, psychology) and social, any liberatory strategy must account for both. The coin must always be two-sided: we must have both individual solutions (gender self-determination, access to desired medical treatments, and autonomous control of our bodies) and collective liberation (abolition of coercively-assigned gender roles, etc).
Although this was not at all what my partner and I set out to do with this discussion, we realized we were essentially presenting a case for using anarchist principles to approach both PTSD and trans politics. I am an anarchist because I desire both individual freedom from systems based on violent control like the State and collective liberation from exploitative social structures like capitalism (and all other forms of hierarchy and oppression). I believe we can’t have one without the other. This is one reason I still like the ‘classical’ description of anarchists as “libertarian socialists.”
Capitalism and Statist “democracy” both present a false liberty. The ability to choose which products we buy within a system that is inherently classist, exploitative, hierarchical, coercive and unsustainable is not really choice. The freedom to elect a figurehead leader from governing parties that are all ultimately ruled by whoever has the most money is not real freedom. You can’t solve the world’s problems by focusing only on personal liberty and autonomy (as the right-wing libertarians do), because free choice within an inherently exploitative/oppressive social system is not freedom. On the other hand, using hierarchical structures like the State to get rid of oppressive social systems like capitalism without emphasizing individual autonomy leads to authoritarianism.
The same can be said for trans politics: The ability to self-determine one’s identity within an inherently limiting, objectively/outwardly-determined system (whether determined by biology or psychology) is not really freedom; we must both be able to self-determine our identities, and be able to do so within an equitable cultural system that respects our autonomy. And to PTSD: The ability to access health care within a culture that is discriminatory and violent toward people with mental illnesses is not really healing; we must both be able to survive and manage our illnesses and do so within a society that respects and supports us by limiting our exposure to trauma.
In a sick society, no one can really be free. Without liberty, no one can really heal. Real liberty — and thus, health — can only exist when:
- (1) Our basic individual needs — including our need for (gender) self-determination, (bodily) autonomy, respect, love, shelter, food, and comfort — are met.
- (2) The cultural systems that govern our world are transformed through collective liberation and social change.
It must be both, or else the solution won’t really solve anything.