In this post I want to share some thoughts about the learnings that I believe are important, in both directions, between mental health activism and sexuality/gender activism. I also want to explore the separation that we make between these two areas and whether that might be part of the problem.

Separating out mental health and gender/sexuality

The first thing we were asked to do on the panel was to introduce ourselves, including our own gender and sexuality – given the focus of the panel – and our lived experience of mental health struggles.

The answer I would usually give to this question nowadays – for example in the interview that I did for mental health podcast So Many Wings – would be something like this: 

‘My gender is trans, my sexuality is queer, and my mental health situation is that I’m a survivor of developmental and relational trauma who experiences themselves as plural.’

So I could be diagnosed with post traumatic stress and dissociative identity disorders if using those psychiatric categories. If you wanted to add a question in there about my spiritual/therapeutic stance then something like somatic- and social justice-informed Buddhist mindfulness might get close to that.

As I considered this answer though, I realised that a deeper truth is that it really doesn’t make much sense to me, any more, to distinguish my gender, my sexuality, my mental health status, and my spirituality in this way. The answer to all of these questions – gender, sexuality, mental health, and spirituality – could be trans, they could all be queer, they could all be plural, traumatised, and mindful. They are all of them.

So the main point I want to make in this piece is that I think we should question the very separation between mental health activism and LGBTQIA+ activism. The reasons for this is not just because – as Black feminists have rightly pointed out – we have to fight all forms of injustice – whether or not they impact us directly – in order to be truly free. It’s also not just because so many queers are also survivors due to the traumatising nature of marginalisation and stigmatisation. It’s because the very separation of these aspects of our experience may well be part of the problem which leads to both the oppression of queer people and to the distress of survivors. 

I’ll return to this theme in more depth shortly. First, let’s consider what each form of activism might learn from the other, if we did regard them as separable. For each I’ll make a couple of key suggestions although there are many more we could consider.

What can mental health activism learn from LGBTQIA+ activism?

My answers to this question are both things which more radical mental health activism has already learnt from queer activism, but which could definitely do with filtering through more fully to mainstream mental health activism.

First, LGBTQIA+ activism – whether the more mainstream or radical version – has generally located the problem of queer experience out there in the heteronormative, homophobic, biphobic, transphobic, acephobic, etc. culture, rather than in queer people themselves. This is a shift that began a long time ago, in the moves towards decriminalisation and depathologisation of homosexuality. It has continued as each new addition to the LGBTQIA+ acronym has eventually argued that their experience should not be understood as a problem within the individual, but an issue with wider normative society. 

Within more mainstream mental health activism there is still often a sense of mental health struggles as something which are located within the individual, which require fixing, rather than as signs of a toxic culture, unjust social structures, or systemic problems within a family or workplace, for example. 

Some mental health struggles simply wouldn’t be struggles within a culture which accepted diverse experience rather than insisting that people follow certain rigid norms of behaviour and experience, and pathologised and stigmatised those who don’t. Many other struggles are the result of forms of traumatic experiences such as marginalisation and non-consensual treatment, which are individualised in the person who is struggling, rather than recognised as being structural and systemic problems. 

Survivor-led and mad pride movements have moved towards a more similar understanding to queer activism: that the problem is out there rather than in here, and that one important form of resistance is that of visibly taking pride in our difference, rather than accepting the shame and stigma of the wider world. For example we might question those who can can manage to fit into the category of ‘sane’ in such an ‘insane’ world. We might celebrate the ‘creatively maladjusted misfits and changemakers’ that we are, as So Many Wings does.

What can LGBTQIA+ activism learn from mental health activism?

My answers to this question are about what LGBTQIA+ activism could learn from the more radical and critical versions of mental health activism. I wrote more about this in this paper on why bi communities, in particular, could do with a more critical understanding of mental health.

One thing that’s always surprised me in queer communities is the way people who are very critical about normative ways of understanding gender and sexuality, often seem to accept mainstream medical models of mental health. Folks who think carefully and queerly about the labels and categories that are imposed on our genders and sexualities, where those come from and who benefits from them, often seem comfortable labelling their mental health struggles with psychiatric categories, and accepting that those make them a certain kind of – disordered – person. 

Also, many in the queer world challenge the binaries and hierarchies that are imposed on gender and sexuality, without applying this to mental health. So the main thing I’d like to see from a dialogue between queer and mental health activism, would be a more critical perspective on mental health among queers which questions binary divisions between normal and abnormal, mad and sane, functional and dysfunctional, healthy and unhealthy, rational and emotional, and so on. Just as with the binaries of man/woman, gay/straight, cis/trans, etc. we can ask who is served by such divisions, and whether they stand up to scrutiny. Alex Iantaffi and I explore these questions more in our book Life Isn’t Binary.

Secondly, mental health activism is – it seems to me – increasingly informed by somatic understandings of trauma and the way it operates in the body. Queer activism could certainly do with learning from such trauma-informed perspectives. My experience of LGBTQIA+ and sex positive spaces is that they are often unaware of this. For example, there’s often little awareness in party and con spaces of the potential triggers of trauma, how these show up in the body, how to know that you – or somebody else – is in a trauma response, and the implications of this in for our sexual practices and relationships. 

In more conscious sexuality and kink spaces, there can often be a sense that people should be pushed to their edges, or confronted with challenging activities as a form of catharsis, without an awareness of the potentially retraumatising impact of putting somebody through a similar situation to one which was traumatising in early life. Online call-out and cancel culture, which is prevalent in some queer communities, similarly lacks an awarenes of the potentially retraumatising impact of public shaming, and the traumatised places in ourselves that such impulses can come from.

Mental health activism is LGBTQIA+ activism and vice versa

When I worked as a therapist, one thing that struck me was that gender and sexuality were almost always deeply relevant to clients’ mental health struggles. This was true whether they were somebody whose gender and/or sexuality was marginalised, or somebody who was more normative in their presentation of their gender and/or sexuality. 

LGBTQIA+ people’s mental health struggles are clearly related to their experiences of marginalisation, stigma, invisibility, discrimination, bullying, and so on. For more normative folks, it is often the attempt to adhere to rigid ideals of masculinity, femininity, and heteronormativity that is the problem. 

For example, in relation to gender, we know that high rates of suicide and addiction in men is highly linked to toxic masculinity and rules against expressing vulnerability or emotion, and seeking help or support from others. We also know that high rates of depression, anxiety, and body shame in women is highly linked to the way femininity is defined in relation to others, and women’s worth is wrapped up in their relationships and desirability. 

In relation to sexuality, many people experience distress because the very limited ideas about the kind of sex that they should have, and the relationship contexts they should be having it in, bear little relation to their internal erotic landscapes. This mismatch plays out regularly in a vulnerable and embodied way during sex, which takes a great toll on mental health. It could be seen as a form of everyday non-consent enacted against the bodies of ourselves and/or of others.

So, whether we are marginalised in relation to our gender and sexuality or not, normative understandings of gender and sexuality traumatise us. For this reason, our mental health struggles, genders, and sexualities cannot easily be disentangled, in fact should be explored together.

Bringing mental health and gender/sexuality back together

It strikes me that many cultures around the world do not separate out gender, sexuality, spirituality, and mental health at all. In many places the most spiritual people have also been those who were gender creative and erotically expansive. Language has developed in such contexts which captures that whole state rather than separating out gender, sexuality, and spirituality. In many faiths and communities, experiences which we might label mental health struggles are seen as sacred experiences, or paths to enlightenment, and people going through them are honoured and supported.

The separation of gender, sexuality, mental health, and spirituality could be seen as a toxic aspect of racial capitalism, required to ensure docile subjects who are too busy policing themselves, and each other, around their ‘normality’ or otherwise to critically consider what is being done to them, or its impact. 

Certainly we can see the roots of the current form of the binary gender model and heteronormativity in forms of capitalism which required women to work unpaid in the home supporting and reproducing the workforce. In many ways this has ramped up under neoliberal capitalism with its pressure to present a successful, productive singular self who is performing gender, sex, and mental well-being perfectly, while paying little attention to spirituality beyond the individualised kind of care required to keep them functional and productive.

Perhaps one of the reasons we see such high rates of distress in neoliberal capitalist cultures is this very severing of gender, sexuality, mental health, and spirituality, within such an unjust race and class system. This could, itself, be seen as a form of historical and intergenerational trauma, as authors such as Alex Iantaffi have suggested. 

The work of Audre Lorde – and many Black feminists who’ve followed her – calls into question such separation. They suggest instead that we could understand ‘the erotic’ as a powerful resource relating to how we feel when we’re most alive and mentally well which incorporates and transcends the sexual and the spiritual. If liberated such a resource would reveal and challenge all of the destructive forces we’re operating under, and require something very different.

My trans, queer, plural, traumatised, mindful self

You might find it useful – like me – to play with whether the labels you use to describe one aspect of your experience or identity are actually helpful to apply to other aspects. Perhaps this can be helpful in breaking down the divisions between gender, sexuality, mental health status, and spirituality.

I find trans a useful word to apply to all of these areas because my experience of all of them is different to what they were assumed to be when I was born, not just my gender. Also we can understand trans as signalling transition, or change over time, and I consider all these aspects of me as in a state of becoming, rather than being fixed.

The word queer can signal being outside of normativity of all kinds, and that certainly applies to gender, sexuality, mental health, and spirituality for me. Queer also involves questioning binaries, and the power structures they serve, which is something I’m keen to do, whether those binaries be man/woman or cis/trans, gay/straight or sexual/non-sexual, mad/sane or normal/abnormal, spiritual/non-spiritual or Buddhist/secular.

In addition to transition, plurality is a word which captures my experience of selfhood better than most. Again this applies across all these aspects of being. My plural parts have different genders, they have different sexualities and erotic desires, they express trauma in different ways and fall into different survival strategies, and they certainly come down in different places on a spectrum from secular to spiritual, or ‘rational’ to ‘woo’.

Finally trauma and mindful are both words which are useful across all aspects of myself. I have certainly been traumatised by normative understandings of gender, sexuality, mental health, and spirituality which have been passed down through the generations to me. These are also all sites of trauma for me as I’ve experienced gender-related bullying and discrimination; sexual assault and harrassment; gaslighting and stigma around my mental health struggles; and traumatic experiences in spiritual and conscious sexuality communities – both personally and in relation to the wider #MeToo moments that such communities have gone through.

Somatic and social justice forms of Buddhist mindfulness have been important for me, in addressing all these forms of trauma, and in coming to understand my self (or selves, or no self) better in relation to gender, sexuality, mental health, spirituality, and the ways these are all woven together.

Further resources

• You can read a dialogue between me and Helen Spandler on what queer studies and mad studies can learn from each other here.
• This resource that I wrote for the BACP explains in more detail why gender and sexuality are themes that need to be explored with all clients in relation to their mental health struggles, along with race, class, disability and other key intersections.
• This article I wrote about mental health as depression and oppression in relation to bi communities also deals with these themes.

• You can find more of my resources about trauma on my trauma work page.
• Patreon link: If you found this useful, please feel free to support my Patreon.

The post Queer Activism and Mental Health Activism: The Need For Dialogue appeared first on Rewriting The Rules.

There has been a great deal of discussion lately on the topic of trigger warnings. First a spate of articles appeared in the press describing situations in which students had asked teachers to provide warnings about the content of materials on their courses. These warnings aimed to provide people with information about any topics that they might find personally difficult, due to connections with events that had occurred in their own lives. Many of the newspaper articles ridiculed the idea of putting warnings on great literature, for example, and portrayed such requests as entitled and over-sensitive, and as a form of censorship. Following this, a number of online authors wrote defences of trigger warnings, portraying them instead as a means for people to have some control over what they are exposed to, often in the context of wider discriminations.

I’ve been struck that most of the articles and blog posts that I have seen on this topic have taken a stance for or against trigger warnings, often presenting an impassioned argument in favour of providing trigger warnings or virulent opposition to the practice.

As readers of this blog will know, I’ve been attempting to take a different kind of approach in my thinking about this kind of thing, despite the ongoing magnetic pull towards binaries of right and wrong, good and bad. I’m trying to avoid polarisation, but instead to ask the following questions (for example, in relation to pornography, sex advice media, monogamy, or mental health diagnoses).

1. One thing or many?

What are we really talking about here? Is it one unitary thing, or might it be many things collapsed together, meaning that the ‘pro’ and ‘anti’ people are often referring to slightly – or totally – different things (we see this, for example, when anti porn feminists focus on the most aggressive examples of mainstream porn, and sex positive feminists focus on alternative and/or ethical porn)

2. Opening up and closing down

Given that whatever we are talking about is probably an umbrella term covering many things rather than a singular thing, and given that people seem to have such strong feelings about it in both directions, it seems unlikely that it can be determined to be either entirely positive or entirely negative. So instead it is helpful to ask ourselves what it has the potential to open up, and what it risks closing down. We might helpfully consider this question on multiple levels, i.e. what it opens up and closes down for the individuals concerned, for communities in which they are embedded, for achieving their aims, and for wider culture.

3. Moving from what to how

Working through these questions often leads to different kind of conclusions. Instead of focusing on what to do (e.g. whether to use trigger warnings or not, whether to censor porn or not), we might focus instead on how we engage with whatever-it-is.

For the rest of this blog I’ll work through these points providing some of my own thoughts on trigger warnings. You might well have ideas to add in each place from your own reflections and from the other writing that already exists on the topic. Hopefully this will also provide a wider model for the way in which other topics might be engaged with from the ‘opening up/closing down’ perspective.

What are triggers?

First let’s think about what we mean by triggers. Some of the concern about trigger warnings stems from the different ways in which this term is being used. The word ‘trigger’ can be employed in a narrow sense to mean something which sparks a flashback in a person who is suffering from post-traumatic stress disorder (PTSD), or it can be used in a much wider sense to mean anything that anyone finds uncomfortable in any way. Some writers have criticised those requesting trigger warnings for claiming trauma for minor stressors in way that insults those with genuine experiences of trauma.

As with many debates around mental health diagnoses this gets us into tricky territory. What counts as ‘real’ trauma and what doesn’t? Where do we draw the line on the continuum from everyday stress to traumatic experience? And who gets to decide what counts as trauma or trigger? This line-drawing gets even more complex when we remember how dependent such things are on personal meaning: what traumatises one person is not what traumatises another.

One friend is triggered by a classroom activity involving blindfolds, decades after their experience of imprisonment as a refugee. Another is triggered when jokingly called a word that was used repeatedly against them in school to let them know that they weren’t accepted or acceptable. A third is triggered by watching a scene of conflict only a week after a painful breakup. A final friend feels triggered when told (in a debate about trigger warnings) that they don’t understand trauma, despite having undergone a life-threatening situation some months ago which is not something they feel comfortable speaking about publicly. One of these people responds angrily, using all their power to cut the offending person down to size. Another immediately leaves the situation to go home, curl up in a ball and rock themselves until the bad memories stop racing through their head. Another becomes very quiet and focuses intently on other things. The last bursts into tears and then berates themselves for getting so upset over something so trivial compared to other peoples’ struggles.

As with other such debates, those on the ‘pro’ side often focus on what seem to be incontrovertibly traumatic triggers such as sexual assault, child abuse, and violent discrimination, whilst those on the ‘anti’ side often mention seemingly trifling things like name-calling, unusual phobias, or personal slights. Perhaps it would be useful if all authors on the topic applied their argument to the entire spectrum of potential traumas to consider whether what they’re saying works across the range or is limited to a certain section. As with the wider use of a terms like ‘depression’ and ‘anxiety’, those who are pro trigger warnings might consider what it is like for somebody who struggles daily with flashbacks and panic attacks to hear others claiming trauma, whilst those who are anti trigger warnings might reflect on what they are doing when they make claims about what counts as trauma and what doesn’t.

Some have suggested the phrase ‘content warnings’ as being less loaded than ‘trigger warnings’ and this might well be a helpful move. However, the idea of being triggered is something that we can all relate to and is, I think, a useful broad concept. One of my favourite authors, Pema Chodron, uses the term to refer to those times when something happens, or somebody says something, and – due to resonances with things that have happened in our past – we find ourselves quickly responding in old habitual ways: perhaps trying to escape, or lashing out at whoever triggered us. We become very blinkered and unable to see the whole situation, and our defences go up as we try desperately to protect ourselves, feeling under threat.

In this sense, the joke that some authors have made about the trigger warning debate potentially triggering people is not far off the mark! For many on the ‘pro’ side, the ‘anti’ articles remind them of all the other times when their pain has been dismissed. Often those articles feel like yet another occasion when the particular oppressions that their group experiences are being erased or ignored by those in more privileged positions. For many on the ‘anti’ side, the ‘pro’ articles read like yet more whining from people who seem to think they deserve special treatment. Perhaps it feels like a dismissal of their own pain, which nobody has ever taken that seriously. Or, through their lens on the situation, they see a bunch of relatively privileged people asking for others to take responsibility for their emotions in an individualistic way which leaves the structural features of oppression unchallenged.

What do trigger warnings open up and close down?

Perhaps the main point of trigger warnings is to open up the possibility for people to determine what they engage with, when and how. The idea is that, if we provide people with a brief overview of the kinds of topics and issues they are going to be confronted with (in a novel, a movie, a lecture, or a workshop, for example), then they can make an informed decision about whether they wish to engage with it or not. Advocates of trigger warnings regard this as a form of consensual practice, and a good way of modelling, and enabling, a more consensual culture than we currently have. It is also a potential way of recognising the structural constraints around agency. Not all people are as free as others, and one key limit on our freedom are the scars left by experiences of discrimination and oppression. Trigger warnings are one way of giving people greater agency within the structural limits on this. Perhaps they also have the potential to somewhat flatten the hierarchy between those in a position of power (giving the message) and those in a less powerful position (receiving it). For example, a teacher providing trigger warnings to their class is potentially recognising the less privileged positions of many students (who may have experienced the kinds of things the lecture covers in ways that the teacher has not), and also flattening the hierarchy between teacher and student so that students can make choices about whether and how they engage with the materials.

However, there is also the potential – of course – for this approach to close down possibilities as well as opening them up. One risk is that, if taken too rigidly, we start to divide the world in binary ways between the powerful people who get to give trigger warnings, and the powerless victims who require them. This ‘us and them’ scenario serves nobody. The ‘powerless’ can become further disempowered by the assumption that they require looking after and can’t take responsibility for their own experience. The ‘powerful’ can find that their own vulnerabilities are dismissed or ignored by others – and by themselves if they invest in this position. This potential alerts us again to the risks in line-drawing between traumatised and non-traumatised, oppressed and non-oppressed. Perhaps instead it points us towards recognising the inevitability of traumatic experience during a person’s life, and the complex net of intersecting oppressions in which each person is located.

Critics of trigger warnings have pointed out another way in which trigger warnings can close things down for individuals. There is a risk that trigger warnings reinforce the common cultural perception that we should avoid the situations that trigger us. There is a pretty compelling consensus, amongst researchers and practitioners, that fear and anxiety are generally exacerbated by avoidance, and ameliorated by engaging with them in some way (the ‘feel the fear and do it anyway’ approach). There is certainly a real danger if we teach people that anything they find painful is to be avoided: this is a path to greater suffering, not less, as people’s worlds can end up constricting to smaller and smaller zones of perceived safety.

Advocates of trigger warnings, however, point out that the aim is not to avoid people confronting frightening or painful material, but rather to provide them with greater control over how and when they do this. No therapist I know would advocate randomly plunging a client into a situation they find highly traumatic without warning, rather most take a gradual approach, helping clients to learn to sit with their fear for brief periods at first (rather than trying to escape or avoid it) in a context where they can prepare themselves before it happens. Whilst obviously real life is sometimes going to confront us with unexpected triggers, it seems cruel to use that as justification to ignore the strong possibility of triggering somebody in the particularly exposing context of a lecture hall or other public venue if our material contains likely triggers.

Turning from the individual to wider communities, an important set of criticisms of trigger warnings in social justice movements is that they feed into a culture which is prevalent at the moment. In this there is a focus on ‘calling out’ bad behaviour within communities, often with many people jumping on the bandwagon when this happens and criticising the perceived ‘bad’ person in order to shore up their own position as a great activist or ally. Things disintegrate into a kind of ‘oppression olympics’ or ‘tragedy top-trumps’ to determine who is most marginalised and therefore has most right to call out anybody else. This often results in newer members of communities feeling unable to speak up and in people withdrawing from movements from fear of this happening to them. Critics have pointed out the risk of movements imploding or fragmenting in ways that render them impotent and which allow the systems and structures that they were attempting to change to continue. There is a danger that a focus on blaming individuals for causing personal trauma takes our attention away from social and cultural dynamics of oppression, and that our movements may be ridiculed by outsiders who observe this ‘infighting’ occurring.

There is certainly a risk that trigger warnings play into this culture if the onus is on everyone to avoid triggering anybody else, and if great shame and guilt are attached to having triggered somebody. The phrase ‘hurt people hurt people’ is a useful one for capturing the ways in which we so often bump up against each other when we ourselves are struggling, in ways that bruise others and leave them more defensive and prone to bumping into others too. Perhaps an answer here is to weave together a culture of trigger warnings with a culture of recognising the inevitability of making mistakes. We are surrounded by wider cultures in which it is not deemed acceptable to own up to having been wrong. That is a message that our communities could helpfully resist by helping people to admit to mistakes, and to acknowledge when they have hurt others, without being berated or excluded for it.

Finally it is important to think carefully about this risk of ‘fragmentation’ in communities. At the same time that there are important dialogues to be had about how to avoid communities collapsing into in-fighting, the fear of ‘fragmentation’ has historically been used to erase difference within movements in ways which privilege those who already have the most power. For example, black feminists were shouted down for ‘fragmenting’ communities when they pointed out the emphasis on issues that only impacted white women. Bisexual and trans activists are often shouted down for ‘fragmenting’ LGBT movements when pointing out their relative invisibility, or questioning whether issues like same-sex marriage should be the priority.

Moving from what we do to how we do it

I feel like I have only covered some of the many, many issues that are relevant when we start to think about trigger warnings. Perhaps this is why it has become such a hot topic of late, as it enables people to start talking about a whole load of issues that have been bubbling under the surface in many communities for a long time now, and which people have felt scared to speak out about for fear of being called-out and piled-upon for doing so. Maybe some of the rage in the anti trigger warning articles comes from a sense of having been silent for too long about something that has caused great distress. Trigger warnings are something that people can somehow legitimately target, in a similar way to the way in which it is easier to call-out an individual than it is to address the wider problematic cultures in which they are embedded. However there is a risk here that collapsing several different things together under ‘trigger warnings’ results in muddled messages which only add fuel to the fire as people polarise into ‘us and them’ positions for a pointless and exhausting battle.

As I’ve tried to suggest, an alternative approach involves not trying to determine which side you are on, or whether trigger warnings are a good or bad thing. Rather we could consider how we engage with the possibility of trigger/content warnings in ways which most enable their potential to open things up, whilst also being mindful of their potential to close things down (and also recognising that whatever we do will not be perfect, and some closing down is probably inevitable – it is an ongoing process, not a once-and-for-all choice).

Suggestions that I would make here include the following:

• Making clear that content/trigger warnings are about giving people the opportunity to consider when and how they engage with material, rather than encouraging them to avoid anything potentially painful or difficult.
• Recognising that it is impossible to predict all possible triggers and perhaps engaging groups in also thinking about what individuals and communities can do when people are triggered.
• Acknowledging both that everybody has triggers and traumas and that there are differences in experiences, particularly depending on how we are located within intersecting oppressions (not all trauma is equal)
• Making trigger/content warnings part of a wider move towards cultures of consent, and acknowledgement of imperfection and vulnerability, rather than seeing them as any kind of singular quick fix solution.

As with many such debates I think there is a good deal to be gained from listening with empathy to the other ‘side’ rather than looking for more reasons to dismiss them. As I’ve said elsewhere, in our communities we have generally all had times when we’ve been abused or oppressed by others, as well as times when we – ourselves – have been accused of abuse or oppression. It can be incredibly useful, before we engage, to remember the times we were on the other side of those dynamics, how that felt, and how we responded.

Further Reading

I explore the process I’ve applied here more in my book The Psychology of Sex, and will build on it in my forthcoming book with Alex Iantaffi for Jessica Kingsley: Life Isn’t Binary.

Julia Serano’s latest book, Excluded, is a very interesting reflection on these kinds of issues in social justice movements, particularly feminist and LGBT communities. Julia has also commented on the trigger warning debate specifically here:

Regarding “Generation Wars”

A couple of thought-provoking and useful blog posts about trigger warnings, which I drew upon here, are:

Jack Halberstam: You are triggering me! The neo-Liberal rhetoric of harm, danger and trauma

and

Scott Alexander: The wonderful thing about triggers

The post Trigger warning: Trigger warnings (towards a different approach) appeared first on Rewriting The Rules.