On "Gender Insanity"

their method to our madness (cw mental health, politics)

1. I first started talk therapy during my senior year of high school with self-reported anxiety and depression. My symptoms dated back to the start of puberty. My therapist took a cognitive-behavioral approach, and I enjoyed memorizing the cognitive distortions as if I was preparing for a test. But, my mood didn’t improve, so I was soon referred to a psychiatrist who prescribed the selective serotonin reuptake inhibitor (SSRI) Zoloft.

Looking back, I wasn’t able to articulate the true cause of my symptoms (gender dysphoria). So, the therapy was only mildly successful at addressing my poor emotional state. If anything, it deteriorated further.

An aspiring neuroscience and behavior major, I became obsessed with the biological bases of mental illness. As I learned more about my very special interest, I convinced myself that I was developing a serious psychotic condition. So, I made a secret rendezvous with my psychiatrist and came home with a low dose antipsychotic (Ripserdal) - which I had to explain to my parents when I got home.

In retrospect, this too missed the true issue. Years later, I realized that the feelings that I thought were signs of a serious illness were simply the result of a crush I developed on another boy. It was easier to assign blame to a neuropsychiatric condition than face my queer sexuality.

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The English word “mad” has two definitions that emerged around the same time: ca. 1300, according to the Oxford English Dictionary. One definition evokes aggression and the other insanity or hysteria. Given these distinct definitions, it’s impossible to ignore the way our society genders and racializes “madness.”

Hysteria is coded as a feminine illness, while aggression is a valorized masculine behavior. Cis men simply feel an emotion (anger) while every else merits a pathology. ForHers first sold anxiety and depression treatments, while ForHims started by selling generic Viagra. Some men even resist seeking out psychotherapy because of perceived dissonances between attending counseling and a masculine identity.

People of color, on the other hand, are consistently perceived as more aggressive and threatening than White people, regardless of their gender presentation. Yet in these cases, aggression is stripped of its masculine virtue. Instead, the two definitions of “mad” are combined as unhinged aggression. In reality, the only bit of insanity is this racist stereotype.

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2. Risperdal helped level me out which assuaged my parents’ fears about me starting college away from home. But before I even got to campus, I scheduled an intake with the university counseling center at my parents’ reasonable request. I went to a few sessions but ended during my first semester by reporting that my mood was improved. Soon after, I worked with my psychiatrist to end the Risperdal prescription.

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On October 13, former American president Donald Trump told Fox News host Maria Bartiromo: “We have some very bad people, some sick people, radical-left lunatics.” Three days later, he threw a town hall to court cis women in Georgia. There, he promised to issue executive orders targeting “left-wing gender insanity.”

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3. I slowly began spiraling, and I found myself back in talk therapy 2 years later - but not of my own volition. I was required to attend in order to remain enrolled in my university after I was found with weed in my room. The therapy itself utilized shame, pairing nicely with the amorphous shame I had felt since puberty. During this period, I began a four year long struggle with alcohol abuse.

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Wellness capitalism is everywhere. Companies are mass producing health and happiness on the backs of workers. You can get some, too - for a price. In 2022, the total value of the wellness economy was $5.6 trillion, up 14% from 2019. Ironically, capitalism creates our unhappiness. On top of global genocides, capitalist modes of production require workers to reproduce their physical and emotional state - so that they can come into work the next day. Those who have a hard time doing so struggle to stay afloat in our economic system.

In Empire of Normality: Neurodivergence and Capitalism, Dr. Robert Chapman traces how monied interests have co-opted the idea of a “normal mind.” In this paradigm, individuals’ bodies and brains are judged as normal (or abnormal) relative to their economic productivity. Neurodivergence, then, not only represents genuine differences in lived experience but is also manufactured by constantly intensifying capitalist production.

According to Chapman, this dynamic serves the needs of capital by creating a surplus class - a cohort of unemployed or underemployed people. This class of potential laborers is needed as a ready and waiting workforce in case of a new productive innovation or a labor shortage. In other words, the cruelty is the point.

The surplus class often includes disabled and neurodivergent folks but is not solely restricted to these groups. During the HIV/AIDS epidemic, new jobs serving queer patients became available to trans women of color who had previously worked as sex workers outside of the sanctioned capitalist marketplace.

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4. As a grad student, I returned to therapy - five years after drug counseling. I had decided that remaining in the closet was no longer tenable for me, so I made an appointment with the queer health center on campus. That year (2022), I planned to begin my medical and social transitions and wanted therapeutic accompaniment. I used talk therapy as a way to process those early social transition milestones like coming out at work and to family. After nine months, the process was more or less complete.

My family was the last to hear the news. I returned from a visit with my parents still processing all that was said, but my therapist had something else in mind. She said I had accomplished the “therapeutic goal” I had set for myself. I needed to articulate a new therapeutic goal if I wanted to continue using the space. Unprepared and unable to do so, that session was our last.

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It was a cold day in San Francisco - the kind that reminds me of Ohio in fall. I was exhausted from chronic stress and decided to wander around Golden Gate Park to clear my head. I made my way to Haight Street, made famous by hippies and mythologized by Didion. Lured by the covers in the front window, I darted into The Booksmith. One of the staff picks was “How to Relax” by Zen Buddhist monk Thích Nhất Hạnh. It’s not the type of book I’d normally pick up. But it spoke to my sense of burnout, so I bought it.

It took me months to find the energy to sit down and read it. Once I did, one metaphor in particular caught my attention: “breath is a bridge” between body and mind. It reminded me of a theory of brain organization that I had always viewed as oversimple. In this theory, the “lizard brain” is the core component of the vertebrate brain which controls vital functions like breathing. The “mammalian brain” was built on top of the lizard brain and processes emotion. Last, the “primate brain” sits above the others and permits reason and consciousness.

If breath is a bridge, then perhaps being attuned to our vital capacities align our lizard, mammalian, and primate brains? Maybe long-term internal misalignment contributes to stress and exhaustion? If so, who benefits from scrambling our brains?

Or, am I a mad scientist?

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5. My current stretch of therapy began in January. I am trying to combat burnout by listening to my body more often. I’ve come a long way since January, and my last appointment is scheduled for the end of the month.

It’s not that I’m “cured.” I still take Zoloft, for example. Often I come home and contemplate ordering dinner because I have no energy to prepare a meal. Some days, I drink too much. I require a lot of rest, and loneliness creeps in the background.

I’m confident that my future will contain a few more stints in therapy. I’d like to think it means that I’m continuing to grow and evolve. But also, many problems lie outside of my control. My energy is best spent supporting my communities and preserving my peace.