Substantive equality – bold and cowardly versions

Reading Catharine MacKinnon on substantive equality in feminist law, I am struck by the difference between her use of that concept and the use to which it has been put in some disability law contexts.

For MacKinnon, substantive equality means that social hierarchy, social inequality, is taken into account when making and interpreting legal standards. Instead of the Aristotelian approach to equality, treating like as like and unlike, which as she righty points out is meaningless as a tool because it can give opposite results depending on what aspect of a situation are being considered, substantive equality looks at how a group, or class of people, is situated in society and what needs to be done to remedy systemic disadvantages, inequalities of power and resources, subordination, subjugation, oppression, exploitation. Substantive equality in MacKinnon’s approach is revolutionary for women, because it means going deeper than the question, ‘are men and women being treated the same in respect of a particular rule’ when men might not be a comparator class e.g. in discrimination related to pregnancy which only affects women, or in crimes of sexual aggression and exploitation where not only is there a disproportionate impact on women in numbers, the ideology of those crimes and their systemic character affects all women as a class and individual victims in ways that underscore and emblematize their sex-based oppression as women.

Formal equality as applied to women had meant that if men don’t suffer certain kind of disadvantage or if men believed it was trivial or inconsequential, it was legally non-cognizable as a violation of rights. Substantive equality meant looking deeper, acknowledging that women’s situation in relation to society as a whole was as a class being subordinated to and by men as a class, and looking for remedies for injustices related to this social inequality.

In the disability context, substantive equality has returned to Aristotelianism. The idea is promoted that, in order to treat people with disabilities as substantively equal to people without disabilities certain compensatory measures are necessary to bring them up to the required level. In other words, because of the ways that people with disabilities are unlike people without disabilities, treating unlike as unlike is required. That is not substantive equality in the MacKinnon sense! It is not equality at all but discrimination that is masking as a good deed, i.e. paternalism.

In the disability context,* the paternalistic facet of substantive equality is particularly directed against people whose actual or alleged disabilities lie in the realm considered to affect their mental capacity or decision-making. Reasonable accommodation and accessibility are compensatory measures not for impairment, not to compensate deficiencies of the individual, but to remedy and correct social failures to take account of how a subset of the population will use services or facilities, excluding them by deliberate or inadvertent policy. These measures properly understood are substantive equality in the revolutionary sense, dignifying disabled people as rights holders and not charity seekers. Yet perhaps because of lingering charity model attitudes about disability, policymakers sometimes wrongly invoke the concept of reasonable accommodation, or more often substantive equality, to claim that coercive measures for paternalistic purposes against individuals who are believed to lack good judgment about their own needs are necessary to bring the person to a point where they are (accepted by self-styled judges of good decision-making as) capable of exercising legal capacity.

This approach to substantive equality as paternalism was evident in Michael Bach’s advocacy on Article 12 in the Day of General Discussion several years ago, which posited three tiers of decision-making – independent, supported and substituted (called facilitated in his framework), into which individuals would be sorted by some entity acting as the invisible hand of god and unquestioned as to its own capabilities or right to make such classifications. My own contribution that day consisted of an equality-based approach starting with formal equality (absence of facial discrimination in the law or of any purposeful discrimination masked by facially neutral terminology), universally-designed protocol and legal doctrine, systemic accessibility, reasonable accommodation and personalized support to move from the most generalized levels to the most personalized. I believe that this is the way to ensure change in policy and attitudes so that the onus is not on individuals to conform to systems that systemically discriminate against them by acts of omission or commision – by deliberate exclusion or systematic failure to take their circumstances and perspectives into account at the levels of policy and design and legal norms.

(The capabilities framework of Amartya Sen and Martha Nussbaum is commonly offered to elide the differences between a revolutionary approach to substantive equality and a paternalistic one. Without discussing that further here, I note it as a topic for further research and elaboration.)

Thus I would be more aligned with substantive equality in MacKinnon’s sense. MacKinnon is not opposed to facial equality, to eliminating laws that were made deliberately to subjugate women or based on paternalistic and oppressive stereotypes that disadvantage women and single them out for adverse treatment. Her substantive equality means going deeper into the meaning of equality and rejeting the Aristotelian rule that serves to perpetuate the status quo or to make whatever changes the status quo might deem allowable without actually changing the structure of power. What the misuse of substantive equality in the disabilities context means, is a denial or lack of understanding that the relations between non-disabled people and disabled people are relations of power: the power to exclude and to subject to intolerable conditions of life, the power to dominate social institutions and political discourse, the power to ignore, the power to exploit as surplus labor or subjects of experimentation and victims of a destructive service industry with its own institutional financial and professional interests, the power to suppress populations via the threat of the madhouse and mental illness accusations – both populations as a whole and women, people of color and political dissidents of any stripe whom society finds inconvenient, including survivor of psychiatric abuse activists, the power to incarcerate populations in institutions rather than equalize wealth and the genocidal implications and potential of such incarceration.

Militant disability rights advocacy for all was what unified us in the CRPD drafting and negotiations, isn’t it time that returned? I am challenging all human rights defenders, all academics in the disability and human rights field, NGOs, all those who claim in good faith to uphold the CRPD to respond to this call.

*Actually, discrimination as harm to oppressed group in the absence of a comparator class was a feature of the US case Olmstead v LC on right to live in the ‘most integrated setting’.  However, the term ‘substantive equality’ does not appear in the decision and paternalism is present in the qualifier that only ‘unnecessary’ institutionalization as determined by ‘the state’s treating professionals’ constitutes discrimination.

Tina Minkowitz (c) 2018

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Vision of the world we want to achieve when we abolish forced psychiatry

 

Since the work on CRPD began part of the challenge re abolition of forced psychiatry has been ‘what is the positive, you can’t just be negative, against something.’  To me that made no sense, there have been plenty of abolitionist movements in history that are viewed unreservedly as positive.
Still – on legal capacity we made a clear distinction that allowed us to parse good from bad motivations in the impulse to reach out to someone who seems to be struggling.  We said that support in exercising legal capacity is a good thing, so long as it does not amount to substituting or negating the person’s own will and preferences.  That helped a lot to give people something to hold onto and envision.  People in the CRPD negotiations all kind of got the idea and started seeing supported decision-making everywhere in their everyday lives.
Abolition of forced psychiatry was itself a midway position that our movement developed to encompass people who want psychiatry and other mental health services, and people who want no part of that system.  ‘Have whatever you want so long as it’s not forced on me.’  But this doesn’t satisfy those who hear the critiques of the mental health system beyond force and want to imagine something that might be an unmitigated good and not only a grudging compromise.
I suppose many of us have been thinking and visioning all this time, and I’ve been listening and formulating also.
What I came up with, that has resonated with many people so far, is this:
-The vision is a world where we are all mutually accommodating each other’s craziness, and offering support, not control when needed-
I want
– a world, not a service or support (living in the community not as managed policy of inclusion but as mutual acceptance of diversity)
– mutual accommodation, not falsely objective ‘reasonable accommodation’ (reasonable accommodation makes sense in contexts that are hierarchical but not in communities)
– acknowledgement that we all have something to put up with in other people, and everyone has to put up with something to be around ourselves
– not said but for me implied in mutual accommodation, is that we might fight, we might conflict, but we don’t use mental illness accusations to win these conflicts
– also not said but implied is that we set limits, need to be secure enough in our world to set limits that reflect our actual needs
– this can be a learning process to keep discovering our actual needs, we are complicated
– if ‘it takes a village’ and it’s not managerial, we are going to be open to each other and care about what others in this interactive world are needing and how they are suffering
– this can’t be a demand that we appease, that’s not mutual – we do get to set limits
– but if we are offering support it’s support and not control
– control is not support
– people have a lot of love and warmth and kindness to give, and also some of us want a more forbearing approach – need to be sensitive to how to how your attempt to support is responded to
– it’s not about ‘support’ alone, it’s always about how we deal with conflicts + how we are responding to an actual need for connection and support of any kind
– restorative justice is related and linked, but for now seems a little bit separate, or else may be part of what i’m thinking is ‘implied in mutual accommodation’
*
In further discussion, there were two aspects of ‘restorative justice’ that were clarified:  one is reparations for victims of forced psychiatric interventions, and the other is a policy for changing how we think about crime and accountability.
For me reparations is the best framework to get us to the world where that vision actually exists, where we can all live in that way.
So, three components to an agenda for change:
-Abolition (of forced psychiatry, segregation and discriminatory detention, coercive paternalistic state interventions)
-Positive vision of a world we want to live in
-Reparations as the process to make it happen
This agenda is itself a vision since there is the question of which governments, when and how will put it into practice.  We are always looking for countries that might be close to something really changing, that could take that big step of the real ‘paradigm shift’.
*
When I mentioned restorative justice I was thinking of a different aspect, though they are linked – an approach to the way that society responds to acts of violence or culpable harm to any member of the community.  It’s nice to make the linkage with reparations for forced psychiatry, and we are actually going to be rather lenient on them all considered.  Even if we have some process of accountability we cannot possibly prosecute and punish everyone who has ever done forced psychiatric interventions.
And a contribution on restorative justice in the usual criminal context was provided by Fleur Beaupert, which I accept with thanks:
Fostering restorative justice principles in criminal matters in line with mutual accommodation in providing support across our lives, including by:
  • Dealing with conflict and ensuring responsibility is assumed for harm caused, but also moving away as far as possible from punitive responses which replicate and exacerbate societal inequalities and oppressions.
  • Making equal and non-discriminatory adjustments delinked from mental illness or incompetency determinations for anyone who can be considered as not having intended to commit an offence or having a justification for their actions.
(c) Tina Minkowitz 2018

Sexism on the left, 2

The failure of intersectionality, insofar as it fails us, is not primarily a failure of feminism.  Rather it is elevated expectations of feminism (or stricter standards applied to women’s behavior), and lowered expectations of all the other movements (or more permissive standards applied to men), that create the biggest problems.

Kimberlé Crenshaw took note of the disparate reactions by her students to similar questions of intersectionality in feminist and anti-racist movements in her article ‘Close Encounters of Three Kinds: On Teaching Dominance Feminism and Intersectionality.’  Recently I observed an example of a generic call for coalition-building issued by a white male leftist in the name of intersectionality, which completely failed to grasp the nature of intersectionality as actually illuminating what each movement misses because it ignores the issues faced by a significant part of its own constituency.  Thus, in a Counterpunch article Anthony DiMaggio fails to connect the dots that make #metoo a workers’ rights movement – surely elimination of sexual harassment would raise the status and bargaining power of women as workers! – and similarly fails to relate Black Lives Matter and similar protests against racially motivated police violence to class struggle – surely this repression, and the accompanying criminalization, is connected to maintaining a large segment of African Americans as a super-exploitable underclass.

Everyone seems to point a finger at other movements that should be intersectional – actually with the exception of feminism, which has taken on its own struggles internally now for decades, and in many spaces as a result of this painstaking work achieved some real success.

The problem becomes most acute for women now because the transgender movement has misused intersectionality so that it becomes not a call for inclusion but a demand to re-set the entire table of feminism on its own terms.  These terms are, like most other movements not led by women, dictated by men – by trans-identified-males who refer to themselves as trans women and refer to women, or females who do not identify as trans men, as cis women.  This is an extraordinary reversal of the polarities of dominant and subordinated classes, most extraordinary in that it is so widely and popularly accepted in left circles and the liberal mainstream.

A friend asked me yesterday, what was a TERF and how to understand where trans ideology comes from, why it has become such a conflagration?

I thought about it for a long time after the conversation, and these are some of the pieces:

After same-sex marriage equality was established in the US by the Supreme Court’s Obergefell decision – a huge milestone – there was a vacuum in the lesbian/gay movement’s advocacy.  Although many lesbians in particular were politically and personally unenthusiastic about marriage, an institution that as we knew it enslaved women and privileged upper classes, I don’t think that anything else would have enshrined in law and public consciousness the honor and dignity of our relationships, and by extension our sexuality.  In a society where marriage remains the only way to create family between equal adult partners, and it rests on a sexual relationship, marriage equality stands in for, and opens public space for, our sexual and romantic relations to be acknowledged openly and celebrated.  We don’t all have to be married, and we can live marriage as we choose if we do marry.  We can be sexual outlaws or nonconformists, if that’s still who we are.  Marriage, I think, still creates more space for us as lesbians, gay men and bisexual women and men.

There is a connection between sexuality and personal expression, and in particular between homosexual orientation and rejection or divergence from the roles and expectations prescribed for one’s sex.  Homosexual and heterosexual are binary orientations, even bisexuality is binary in that we are dealing with two sexes.  Similarly gender is binary if we understand gender to be the sociocultural constructs related to the two sexes.  Cultural symbolism around sex does not need to be patriarchal; think of women’s autonomous spiritual practices and productions.  (I will refrain from including generally ‘goddess symbolism’ here as it can be subordinated or created through a male gaze, to serve men.)  We cannot escape the need for cultural signifiers relating to sex – there are knowledge bases available and relevant to women and not men, about our female bodies and their development and capabilities and powers, our cycles, our sexuality, our center of gravity and our energy.  Our motherhood or inability to become mothers or rejection of motherhood.  We need our language and our connections to each other around these experiences that are binary in nature within the context of society, as they are unique to women.  If we are homosexual we are these amazing female beings who bring this entire being to another female.  Men, including gay men, will have whatever binary experience they have on their side that is not necessarily about dominating or exploiting women or about entitlement to enact violence and sexual aggression (i.e. patriarchy).  Lesbians and gay men have a unique vantage point on the roles and expectations for our sex, respectively, necessarily because our sexuality is qualitatively different from heterosexuality, and we are a different kind of woman and a different kind of man.  But it goes deeper than that also; many lesbians grow up rejecting femininity and become proud butches, many gay men grow up being told they are sissies and come out to their beautiful selves.  In this gender nonconformity is the connection between lesbian/gay politics and the issue of gender expression and identity.

Transgender people who choose to express themselves in ways that violate gender binary expectations, or to live in an identity different than their sex, which may include body modification that creates a quasi-intersex body type and experience, have the right to enjoy all their human rights and not be excluded from society.  But if we really want to talk intersectionality, the gender identity movement needs to start by addressing anti-sexism, and the differential impact of gender identity and transgender identities on men and women, including those who are equally gender nonconforming and do not identify as transgender but as butch lesbians or the equivalent for gay men.  That movement needs to deal with the feminist analysis of gender as the vehicle for maintaining male supremacy and patriarchy, an analysis to which numerous lesbians contributed, and which leads women identifying with feminism to understand themselves, and all women, as by definition gender non-conforming because they resist the subservience demanded of women as part of femininity.   (Which is why we reject the name ‘cis’.)  Feminists also maintain that the distinction between transgender and non-transgender is a false binary as no one is a walking stereotype.  Even non-feminist women heft babies and diaper bags and strollers, mow the lawn and stack wood, for example.

Women are pushing back against the new political orthodoxy demanded of us in left circles and in a new male-led transgender-focused feminism.  In the UK feminists are getting mainstream airtime and media (for example, here, and news roundup with link here)  in their fight to prevent legal changes that would allow a male to receive a gender recognition certificate as a woman purely on his self-declaration.  Australian leftist journalist Caity Johnstone took note of the transgender movement’s policing of language as part of a liberal identity politics that masks authoritarianism.  In the US, we are impeded by the right-wing’s capture of the pushback against gender identity as a return to manly men and womanly women; attempts at coalition-building between feminists and right-wing women while potentially interesting are doomed to fail so long as feminists put feminism in the back seat.

Let’s have some rules for intersectionality.

  1. Intersections have to go both ways.  I build bridges between lesbian/feminism and the psychiatric survivor movement.  That means I work in both of them, bringing out issues, experiences and perspectives that pertain to lesbians and other women who are survivors.  I have to say at present it is highly risky to bring lesbian/feminist ideas to the survivor movement, because of capture by transgender identity politics.  And for the moment lesbian/feminism is more open.  But in principle there has to be mutuality of engagement with the issues of a segment of each movement’s constituency that the movement is not paying attention to.
  2. Intersectionality cannot require reversal of the polarities of an existing movement or cannibalizing it out of existence.  That is what the gender identity movement is doing to feminism.  We, lesbians, midwives and other feminists who are backed into a corner or simply have the chutzpah to stand up for ourselves, aren’t allowing ourselves to be eaten.

What else can you think of?

Sexism on the left

There isn’t much difference between the current transgender ideology that bullies women and ejects us from our own home ground, and ordinary sexism that has always existed in the left, in all the movements ranging from anti-war to the one I’m most familiar with, the survivors of psychiatric oppression movement.  The only difference is that anti-feminist men and women have found a way to obliterate the political existence of women as a dogma of leftist politics.  In order to be a bona fide, acceptable speaker, organizer, thinker in these movements, now, one has to agree that there is no such thing as sexism defined as systemic, institutionalized male supremacy over females.  Sex is said to have no political meaning, to assert such a meaning is considered tantamount to the bigotry that feminists lead the fight against – the biological essentialism of patriarchal society, particularly fundamentalist Christians, who believe that females must serve males and that both must stay in pre-defined roles.

Transgender ideology takes up part of the feminist agenda, which I welcome – the part that says we can all be ourselves, look how we want, dress and speak how we want, we don’t have to fit the roles that patriarchy assigned to our sex, we can cross over or do our own thing outside the box.  Marlo Thomas sang it in ‘Free to Be You and Me’ and it’s still what feminists believe.

But feminism has always been a movement that 1) fights against institutionalized male supremacy over females, and 2) pays attention to the body and particularly to women’s subjectivity as embodied female human beings.  So much of male supremacy happens by men asserting not just control over or imposed access to women’s bodies, but the negation of women’s subjectivity.  If she says no to sex, she can’t mean it, she really means yes.  If she doesn’t respond to you, she’s a whore.  Men impose their meaning on women and their meaning is a servile body.  It’s not entirely an object, not the same as a plastic doll, they want the subordination of women’s reason and conscience to their own, enacted in many ways but focused on sexual, emotional, reproductive, and caregiving service.  (Carole Pateman, The Sexual Contract, points out that women were not excluded entirely from the realm of contract, they were required to make one contract, that of marriage, which secured their inferior status.)

Women taking back our subjectivity meant our embodied subjectivity.  Not just in personal life and in heterosexual relationships, but as a matter of cultural archetype and policy claiming that our form was as much ‘in the image of God’ as that of males – or more, since it is females who birth males and females both, not the other way around – and that the world should be run from the standpoint of women, including our bodily experiences of menstruation, fertility, childbearing, menopause, our kinds of physical strength and endurance, our physical configuration and energy, our physical vulnerabilities and protections – as distinct from the socially imposed ones or the reaction to predatory male violence.  We got some changes made for some of the most obvious aspects of policy, like providing for pregnancy leave and prohibiting workplace discrimination including sexual harassment – though we know these measures are insufficient and don’t change the actual power relations much; as I write this the #metoo campaign is for the first time in memory succeeding in toppling the careers of sexual predators, not because of law but because of women rising up.

Lesbians are outside much of the focal points for male supremacy, we aren’t in a position of fighting for sexual equality in our intimate relationships or generally of dealing with unwanted pregnancy.  Having relations with other females, we are doubly negated in the patriarchy and our subjectivity is simply of no importance to anyone but ourselves.

Until it comes time for a male-bodied person who is heterosexual to declare himself a lesbian – then our subjectivity is derided and reviled if we cast him out, call him a man and deny him a place in our sisterhood.

The same way, all women’s subjectivity as women to define our own boundaries collectively, as well as individually, is derided and reviled and silenced when we assert that our movement is a movement of females to end male supremacy, and that males who want an identity other than that of men as it has been assigned to them need to create their own movement, with a separate identity, and not parasitize ours – not attack and feed off our political labor as men have done in every other sphere of life.

If our movements cannot fight sexism – cannot embrace as a core political principle the abolition of male supremacy over females, and the primacy of female people as the political agents of this struggle, then they are more than bullshit, they are another face of oppression.

Health, women, and autonomy

The feminist women’s health movement wasn’t just about abortion and self-examination with speculums.  It was about taking the knowledge and power of health into our own hands, in all aspects of our health.  Herbal knowledge from parts of the world our ancestors came from and where we are now, other kinds of healing traditions both energetic and manipulative.  Some of us learned deeply and trained and became practitioners to treat others, some of us learned enough to apply it to ourselves, more or less well.  Not so different from the knowledge any of our mothers and grandmothers had, to be able to take care of a sick child or elder or anyone the best they knew how.  We also asserted ourselves with doctors who were mostly male and rejected the idea that they knew best because their white coat and stethoscope and degree conferred knowledge stamped with patriarchal institutional authority.  We created, or tried to create, relationships with doctors based on equality, tried to be on first-name basis or otherwise to be on formal basis equally, to be Mary and Jane/Bob, or Ms/Dr/Rev/etc. X and Dr Y, not Mary and Dr Y.  We learned about diagnostic procedures and treatments, pros and cons, and decided for ourselves, sometimes rejected western medicine for holistic medicine of some kind, other times did a combination.

Somewhere along the way things changed.  More women became doctors, and even those who were alternative practitioners – like chiropractors – wanted to be addressed as Dr Y and took on the unequal relationship calling us Mary.  Alternative practitioners created elaborate consent forms that listed everything under the sun that could conceivably go wrong with the treatment so that we absolved them preemptively of any kind of malpractice claims.  Managed care came in and even doctors who wanted to practice the art of medicine were pressured to be assembly-line workers running rote protocols according to the popular evidence-based statistical recommendations of the day.  Population-based medicine is the real meaning of evidence-based; you get what the statistics say is the best overall outcome for a whole population, however large or small that population is defined, and the doctor isn’t expected to really think much about you as a whole person; if she wants to she doesn’t really have the time.  (If she is really extraordinary, wants to serve her patients individually and keeps taking insurance because she isn’t only for rich folks, she has to work serious overtime without pay to keep up.)

The proposal for single payer health care in New York State will not do anything to eliminate these serious structural problems that plague our health care system in addition to the simple lack of access without money.  In fact that proposal if enacted will continue the prioritization of money over people, only as a public system run by the government as cheaply as possible, using the same principles as managed care to treat health as a problem at the level of populations as a whole rather than meeting individual needs.  Paying a ‘capitation rate’ to serve a certain number of patients rather than paying for the services actually used encourages statistical management of the health of the population of patients as a group – achieving a certain statistical outcome for the health center or hospital or geographical region as a whole.  It also encourages manipulative practices to steer patients towards health care decisions that the system deems desirable in prevention or screening or treatment, and the dumbing-down of informed consent practices which are also seriously undermined by their use to avoid malpractice claims which is placed above the patient’s right and need to make well-informed decisions.

The NY single payer proposal brings in an additional requirement that comes directly from managed care, the figure of a care coordinator, who is supposed to ensure that medically necessary services are made available to, and are effectively utilized by, the members.  This is at best a busybody whose calls you can ignore or whom you can direct to leave you alone if you don’t want their attention; at worst, since it would be a requirement to be enrolled with a care coordinator to receive services under the plan, it creates the infrastructure for more aggressive forms of coercion, incentive and disincentive, manipulative opt-out scenarios, being marked down as a troublemaker.

We have already lost our privacy rights thanks to HIPAA, the voluminous federal law on health care privacy that advocates long warned was anti-privacy.  It is hard to get our own records, especially the medical notes that doctors share with each other but prefer to keep hidden from patients lest we dare to read and think about their conclusions for ourselves.  We don’t know what else they keep hidden from us.

The culture of compliance, which some of us know all too well from experience or advocacy in the mental health context, is nauseatingly present and permeating health care today.  I hear of doctors who refuse to treat a patient unless she takes a certain medication that they prescribe (e.g. for high cholesterol), forcing her to lie if she wants to continue receiving treatment that she wants.  The pressure to accept flu shots and other vaccinations is strong.  Screenings and questionnaires sometimes are inordinately interested in personal behavior including such matters as ‘use of illegal drugs,’ alcohol and tobacco use, body mass index, and the ubiquitous depression screening and dementia screening that are designed to capture unsuspecting folks to be initiated into the world of prescribed and enforced psychotropic drugging, and labeled with the kinds of disabilities for which one can have their rights and freedoms taken away.

The NY single payer bill also specifically preserves the existing medicaid managed care plans, including mental health managed care which is required for people covered by medicaid who ‘receive chronic mental health services’ or are labeled as ‘severely and persistently mentally ill’.  I have tried unsuccessfully to get information from reliable sources about how this has worked in practice, but recall that at the time it was enacted there was resistance from the survivor community to this classification and its implications for keeping people tied to a service system that is managerial and essentially institutional even within the community.  (See CRPD Committee’s General Comment 5 on Article 19 and OHCHR study on living independently and being included in the community, both addressing obligations to eliminate institutional forms of care both large and small-scale.)

As I grow older – I will be 59 and eligible to join OLOC on my upcoming birthday – I worry not only about needing health care for the inevitable breakdown of my physical body.  I worry also about the risks to which our society exposes older people of having my legal capacity taken away if someone thinks I am not making good decisions.  I am an ornery and quirky person, I have a great memory for some things and a terrible memory for others, and I don’t want any of the screenings.  Who’s going to stand with me?

 

Female autonomy

My introduction to feminism was women’s liberation.  ‘Do you agree with women’s liberation?’ a friend asked me, in junior high school in 1970 or 71.  I asked what it was and she explained that it meant a woman can do anything a man can do.  I thought about it a few seconds, and said yes.  It changed my life, to have the possibility of living as a full person in the world and not being required to be ‘a wife and a mother and…”

A slogan that I embraced and still remember from that time was, ‘A woman without a man is like a fish without a bicycle.’  It says that, contrary to the ideology that told me I had to be a wife and mother no matter what else I might become, I exist in myself and have no need of a man to be complete and for my existence to make sense.  The ideology that paired up boys and girls in elementary school, that insisted on a ‘smartest boy’ and ‘smartest girl’ in my first grade class, I could overthrow as authority once it was ridiculed as absurd.

As it turned out, the premise of female autonomy expressed in the slogan appealed to me as a lesbian – on the sexual level as well as other aspects of life.  But the premise of existential female autonomy is important for heterosexual women as well, to know themselves as existing in and for themselves, before any relationship they may have with a male partner.  On the species level, as we know, both female and male are necessary for sexual reproduction, with distinct reproductive contributions and the female partner contributing the vast majority of labor and physical substance.  Yet this fact implies nothing about the political relationship between females and males, if anything it suggests the greater dependence of males on females.  Men’s subjugation of women is not natural, it is not implied or made necessary by any biological imperative, and to attempt such justification suggests a fear of lesbianism, or at least a fear that heterosexuality is not appealing enough in itself to sufficient numbers of women for the species to continue.

If the species dies out because women are free and do not desire men or pregnancy (or because men stop desiring women or lose their potency), maybe it means that the species does not need to exist any more.  Species existence depends also on many other factors, such as climate and war, in addition to reproduction.  It is immoral to enslave any individual or group of individuals to the aim of continuation of the species.

At the individual level, everywhere we look, we do not see heterosexuality dying out, or an end to women choosing to become mothers.  Women’s bodies are powerful in birth and the choice to risk one’s own life and health to birth another human should be honored with gratitude while not obligating any woman who is not so moved.

As a girl faced with coerced heterosexuality as the only option, I learned to deny and suppress not only sexual feelings for other females but a sense of myself as autonomous with respect to the world at large.  Not being ‘naturally’ as I was expected to be, and not being free to be me, the paradigm of female service to others allowed me a kind of space to fit within a gender role.  I didn’t have to serve men; serving humanity, or anyone in need, especially women or other girls whom I was naturally drawn to, was safe.

I don’t know if all the ways I felt ‘different’ as a child and have known myself as ‘different’ throughout my life can be explained by being a lesbian.  I don’t feel fully at home in lesbian community or in any community.  I don’t accept my difference as impairment either, though I have been disabled by being treated as such.  My difference feels more than anything else, like a sense of my actual autonomous being in a way that connects me deeply to a sense of harmony with the whole.  While I need connection it is much less than I have been taught to believe is natural, either for ‘women’ or for anyone.  The connection I need is often not with other humans, it is something else.  When I need connection may be the time when I most need to be alone.

Female autonomy as a principle encompasses all these levels.  Each one of us is an actual autonomous being, and can know ourselves as such.  Sexually, we have a right to come to know ourselves and to be free to connect deeply with other females without hindrance, and/or to connect deeply with males on one’s own terms.  Socially, familially, we also have a right to choose to connect with other females without hindrance, with males on our own terms, and in mixed spaces.  I could equally say we have a right to connect with anyone we choose, without hindrance and on our own terms – as a friend commented to me – but there is a reason to differentiate as I have.

Patriarchy, the system by which males extract resources from females, hinders us from relating to other females to the exclusion of males – whether on a sexual, social, familial, organizational or political level.  And the same system deprives us of the power and freedom to control the terms on which we relate to males.  We still live under this patriarchal system despite same-sex marriage equality and limited rights to use contraception and terminate a pregnancy, limited criminalization of rape.  The smashing of female-only identities (such as lesbian, mother), spaces (festivals, showers, shelters, health care, sports, etc.), and political movements (feminism/women’s liberation) tells us it’s time to wake up again.  The second wave didn’t free us, we didn’t free ourselves, patriarchy is enmeshed with racism, colonialism, militarism, capitalism.  Individualist freedom-seeking – ok, I did not have to become a ‘wife and mother and…’ – meets its limits not only in the glass-ceiling for any kind of achievement within a public arena, in the unrelenting march of male violence of all kinds – rape, police killing, war, psychiatric assault, in the failure to create possibilities for women as public actors outside the idea of middle class careers, inaccessible to large numbers of us, and I’m sure we can go on and on.

The ultimate collective level of female autonomy would be large-scale political organization.  There are and have been in the past societies where women and men are separate halves of the political structure, where collective decision-making and responsibility are separated based on sex (e.g. see Barbara A. Mann, Iroquoian Women: The Gantowisas) or where women have a separate military structure within communal, egalitarian democracy (e.g. Kurdish women as described here).  How do we get there, and is it enough?  Do we want instead to envision something like the stories of ancient Amazons who lived entirely apart from men except for times when they would meet with a counterpart male society for trade and (for heterosexuals among them) sexual relations?  Do we want lesbian-only societies that adopt girls to raise?  In any case there is a need for cooperative and respectful men if we are to live in peace and stability, whether in mutual harmony or at least free from aggression.  I think it is worthwhile to think about the implications of a principle of female autonomy for large-scale political organization, especially in light of contemporary and past societies where this structural feature seems to foster not only women’s autonomy, authority and integrity but also men’s respect for the same.

The concept and experience of autonomy is different in a cooperative economic and social context, than in a competitive and exploitative one.  When we have competition and exploitation (as modern capitalist colonialist patriarchy) those in the subjugated classes are expected to submerge their autonomy for the good of the whole, while on the contrary the individual drive of the dominant ones is lauded and even deified as an engine of dynamism and creativity.  When we flag this and call for autonomy, separatism, self-love and self-determination, the dominant groups and their acolytes try to shame us back into our place, first by appealing to cooperation as two halves of a whole, then by elevating the altruistic values they have projected onto us as a superficial ethic for everyone without changing the structure of exploitation/subjugation.

I think that this holds true for economic classes, sex classes, and race classes.  You can consider what you know of recent history and see if you agree.

What I read and observe about autonomy in a cooperative economic and social context, and what I experience in small constrained contexts within capitalist patriarchy, is freedom to be oneself while remaining connected to a whole.  A sense of place, of relationship and responsibility to others that doesn’t preclude fights and sorrows, heartbreak and rejection.  I don’t want to live in any of the lesbian or women-only communities I know of, but I am a lesbian, married, at home in my own house and land that becomes center of the four directions for my world.

I’d like to fight for and work on cooperative economics and politics in my local area but am stymied by centrist politics stifling the possibility of even a radical naming of the problems (such as calling the Democrats a corporate party, or calling attention to the different material interests of health care providers vs people taking control of our own health care and autonomy).

Forced psychiatry is the antithesis of any kind of autonomy, reaching into the body to disrupt the brain and psyche, the sense of self-organization and possibility of wholeness. Being cracked and broken one can then know oneself as wholly outside what they can do to break us, but it has othering implications, and if I can’t relate to male-defined/mixed-sex generic madness discussions or to the view of madness itself as a thing rather than the content of what we are sad about or turning ourselves inside out on, well there aren’t many places to go.  The male-violence aspect of forced psychiatry helped me to know I’m a lesbian but also chilled my relationship to all social, economic and political institutions with the fear of being prey, building and reinforcing my Jewish heritage instincts and my  caginess to appease the abusers of my childhood.  Female betrayal put me into the hands of psychiatry and kept me there until they were done with me.  This is a feminist issue and an issue that could only be talked about among women, yet even then there are no words most of the time, no ground for it to be fully heard.  No place for the twisted ugliness of abuse to be surrendered and healed, it has nowhere to go.

It’s also far in the past now.  I am not a ‘person with a psychosocial disability’ in my daily life unless my ordinary craziness is diagnosable as it is, and I care to frame my life in this way.  I’m tired and don’t need or want the identity except as a link to survivorship, ex-mental-patienthood that will never escape me and that I don’t want to hide or dismiss.  Other communities won’t fully hold me or embrace me, and neither will this one now, because of the gender identity witch-hunts finally reaching us, in the end that becomes decisive beyond any other dyke-baiting, dragon woman force of nature misogynies.

I don’t think we necessarily need separate political structures in a formal sense in order for female autonomy to be put into practice and respected.  Separate political structures can be another Noah’s Ark scenario, male leaders and female leaders as ‘smartest boy’ and ‘smartest girl’, created as an arbitrary demarcation without a consciousness of ‘women’s business’ or women’s political autonomy and liberation from men as a principle and purpose.  Respect for female autonomy can start anywhere by consciousness-raising and practice where we claim public space, public roles for the power and space we take in the world by being single mothers, business owners and skilled tradespeople, teachers, anywhere we are acting from strength and not performance, standing in our courage and linking in solidarity with other women whenever we choose to for pleasure, for resistance to male expectations and entitlement, for nurturing ourselves and each other and building our strengths.  And with men learning to back off when we bar the door, or simply prioritize women, instead of treating it as a challenge or a joke.

I’m thinking of Kate Millett, who died during the time I have been writing this blog post.  Reading Flying which I had bought from Kate and never read before, thinking of Kate’s art and her open lesbian desire in art and writing, her erudition and plain speech, how her life and charm and needs and insight touched everyone who came to know her in person or through her work, and her life like mine and any of ours an open puzzle, not solved and worked with all we have at any moment in our full hearts.

I can’t answer the questions posed by my work and advocacy about how we should ‘deal with’ each other’s pain and violence to self and the pain and violence we cause to others, all these frustrations and concerns when we are too far away in our own lives to reach each other and give everything that our sister needs.  I know that life is hard for all of us whether we identify as mad or mentally ill or not, and while my mind does shut off to some of my sisters’ pains, that’s my limitation and not an excuse to have them locked up and tortured.  I am an abolitionist, bearing witness to what I survived and trying to make reparations possible.

Cooperation is needed between women.  Maybe some things work best with a focus, like Mary Lou Singleton’s wonderful interview calling for reproductive sovereignty – ‘abortion on demand with no apology’ – and women taking back control over abortions and birth control, learning again together to do these things for ourselves outside the medical/pharmaceutical industries.  What else can we do politically, cooperatively and collectively as women to take back our sovereignty over everything that is ours?

Can we cultivate female solidarity against male violence and harassment in public places?  Not posses or roving teams, just women learning to make eye contact with other women in public, to defend each other verbally or physically – similarly to how the left is now promoting for white allies to defend people of color against racists.  I don’t want to involve men in this for now – I want it to start with women connecting with each other to name the aggression, let each other know we see, it’s real, we have each other’s backs.

To take back our sovereignty over being in public space in our female bodies, to not be objects of protection by the state or individual males.  Take back the night marches were part of this but at least in the US reportedly came to be associated with calls for better policing, which is double-edged especially for communities of color, and for crazy and disabled women.

Political class solidarity among women is different than creating women-only communities that try to be all things to all women, or at least all things to a small group of women.  For me intentional communities raise way too many red flags about trying to meet expectations, worse than marriage since no fundamental emotional connection and potentially intrusive interpretations of ‘the personal is political’ as ‘everything in your life is up for political discussion by anyone who disapproves of it.’

To link it back with some other points, I think political class solidarity may be better suited to the way we live now in modern non-indigenous communities, rather than trying to create or re-create ways of living that imitate our heritage past or contemporary indigenous people as functioning societies with internal political, economic, and cultural self-sufficiency.  For those of us who easily get ostracized if we’re not the ones in control (looking at many of us), whether as crazy or as ‘not our kind’ in one way or another, maybe having our own homes is a priority and (re-)creating the political solidarity movement of women, i.e. the women’s liberation movement, from where we are.  In-person in cities, in small towns, online.  Why not?

seamless community and healing

Intro and context (dry stuff at the beginning, skip if not interested)

I have chosen to review the WHO Quality Rights training modules, based on my understanding that the Mental Health Policy and Service Development team (Michelle Funk and Nathalie Drew) officially and publicly upholds the CRPD standard that requires abolition of involuntary treatment and involuntary detention (i.e. involuntary admission/retention) in mental health services.

This is a major step for WHO, as they are the health agency associated with the United Nations (though technically separate), and have a considerable influence in the health policy of countries throughout the world.  A number of activists/advocates in the users and survivors of psychiatry/people with psychosocial disabilities movement have been involved with writing and reviewing the modules to date, as well as UN experts who contributed to the CRPD standards.  Also there are psychiatrists involved.  It has been a large and diverse group.

An obstacle to more activists taking part in the review is the large amount of time needed for the volume of material, without remuneration.  I will describe why, for me, it has been worthwhile – not necessarily to encourage others to do the same, but to start a conversation among ourselves, raising the same underlying question and related ones:

  • What is mental health policy following CRPD?
  • What is the place of mental health policy within the overall goal of implementing the rights of people with psychosocial disabilities under CRPD?
  • What are the possibilities for CRPD-coherent ways of understanding not just alternatives to conventional mental health practices, but alternatives to mental health treatments/services and their underlying perspective?

In particular, I am interested in exploring alternative forms of support that do not conceptually separate people or any of their experiences from the community and its ways of working with emotions, spiritual dimensions, and mental states.

Lesbian feminist community, healing, and capabilities of communities

In this post I am going to talk about lesbian feminist community, about healing, and about what it has to do (or not) with concepts of ‘recovery’ and ‘mental health’.

In my life there have been different threads that come together, diverge, come together again, in larger and larger groups of coherence.  (Think of it as joining strands into a thin rope, and then joining the ropes together to make a thicker and stronger one, etc.)

Lesbian feminist community, coming out as a lesbian, female autonomous spirituality, have been threads that diverged and came back together perhaps more than once, with deeper understanding.

Spirituality and healing began as separate threads and then converged.  I can’t recall how this even felt when they began as separate, but I recall marking the change when they converged.

Healing began for me as healing from psychiatric assault, then deepened into wider aspects of my life that needed to be healed.  At first it was healing from identifiable trauma but it has also become healing of anything that is hurting, any way that my life is in pain.

Healing the psyche began as separate from physical healing, but that too is converging.  As I get older, there is always a greater sense of physical vulnerability and mortality, and awareness that my body isn’t and never will be very well explained by conventional western medicine.  I haven’t gotten to explore other systems of healing in depth, or found practitioners who have worked any miracles with me.  Instead I find myself faced with more choices about conventional medicine and its risks, and also am attuned to psychic aspects of my body and its healing.

Lesbian feminist community has always been a space where women found healing.  Just being free of the constraints of the male gaze, knowing we had to do it all for ourselves and finding strength we didn’t know we had, connecting with each other on deep levels that let us know we are not alone.  There is a great joy to this connection, and to throwing off shackles, and we find we still have our core flame when we come back into the ordinary world where we need to be more armored to deal with men, with patriarchy, with everything that patriarchy feeds as barriers between people: racism, anti-semitism, ableism, capitalism, and more.

Is this healing something that lifts us out of any idea of our craziness?  For me, it has been.  Craziness is unworthiness in some sense, it is only a part of me that ever has separated out and judged, ‘that’s crazy.’  It’s a part of me that is defined by fear of crossing over a line that other people define in some way.  It’s an alliance with others’ judgment, against myself.  It feels like a kind of self-preservation and it is at bottom a kind of instrumental self-hatred, that may or may not help you to fight your way through a situation that is life-endangering (being institutionalized) but that is harmful in the long term.

It seems to me that many people find their way to this point (I am not crazy), from a number of different paths.  It seems like it is the product of a journey, and retroactively defines the journey.  Even if you know it intellectually, it is the emotional feeling of connection that makes you know it for real, come home to yourself in a way that cannot be undone.

Another thread that may be relevant here, a conversation I had with a good long-time friend, who articulated what happens when ‘long-term goals are so important, you are afraid of fucking it up, so in the short term you avoid it.’  I have had that fear, and I love how my friend put it so non-judgmentally.  I have that fear now, that saying the connection, and not-craziness, ‘cannot be undone,’ will undo it.  But my mind goes there, and I cannot help but take the step, and rely on my faith and trust in the thing itself, which got me here.

Can the healing I’m talking about be relevant to anyone, at any stage of their journey?  It took me so long to be able to receive it, in the way I describe.  I was working on my healing for a long time, and when I didn’t even say I was working on it anymore, this came.

Does it make sense to talk about valued communities of any kind, as holding the space for all of us, including those who don’t feel it?  I used to hate it when people told me that they would hold open friendship for me to come back to, as their way of announcing the friendship was over, or that they loved me while I knew they were deliberately excluding me from collaborations in which I had an interest.  This is still a rejection, clothed in sanctimony and self-interest.  In some rejections, there is an underlying affirmation, a willingness to keep exploring our own boundaries and each others’; despite the potential for this to be misread as an endorsement of misogynist rape culture ‘no may be yes’ it is something that happens.  We don’t have to be rapists, we can be attentive and care whether there is ever a yes and whether it is real or just a belief in the need to appease.

And, not everybody who is eligible will find their way to a particular community or feel it as home.  Not the psychiatric survivor or peer community, not the lesbian feminist community, not the Jewish community.  But can these communities in themselves, defined by shared values and beliefs, as well as shared experiences, history and traditions to a greater or lesser extent, foster and contain within themselves the ability to keep space and keep faith with all of their members, in good times and in bad?  Can healing be the same as reconciliation, or as finding home for the first time in a society where so many of us are effectively rootless?

This may be the same vision as the Beloved Community that Martin Luther King envisioned not only for activists but as transformation of the world.  Yet we can’t be naive or vague about what it means to create healing, to open the door to healing, to create space for healing, to invite healing.  Healing is messy, loud, it comes with conflict.  It doesn’t need to go somewhere else to happen – it doesn’t taint the space.

Maybe sometimes healing is trying to happen without asking, and may or may not be what’s happening when someone annoys you and persists in doing so.  How can we deal with that?  How can we get on with our agendas, if we need to, and not get derailed while also allowing this other thing to happen?

‘Recovery’ and ‘mental health’

And finally, what if anything does this have to do with ‘recovery’ and with ‘mental health’?

Like some other survivor activists, I dislike the term recovery and do not use it for myself.  I feel also a kind of judgment and shame in not doing so, does this mean I am not  ‘recovered’, that I am ‘still mentally ill’?  Well, no.  I reject the idea of ‘mental illness’ because it takes ‘craziness’ a step farther and says ‘there is something wrong with you’.  There is a pseudoscience and a set of experts and a way to fix that thing, and it is inside  you and you have to be taken apart to get it out.

I’ve talked about my definition of mental health.  I don’t actively use that concept in my life, it was an exercise in how I can connect to an idea that I can understand as a value, but that ultimately is too commodified to be coherent with my own values and beliefs.  I don’t pursue mental health, I live my life and try to feel good in my whole self and to be in harmony with creation.  To say this is not to define it as a goal or objective of any kind, rather a description of what I gravitate towards as plants gravitate towards light.

I am also committed to making coherent discussions between my point of view, and what it means for people to understand themselves as dealing with mental illness or working on recovery, or taking a recovery approach (in relation to themselves).  Our experiences don’t have to be the same, and I want to understand the nature of the differences: to what extent is it a difference in beliefs and values, to what extent a difference in the kinds of challenges we have faced?

WHO uses the ‘recovery’ framework in their materials, drawing extensively on work done by or in collaboration with users and survivors of psychiatry.  The understanding of recovery is not a simplistic one as ‘recovery from mental illness,’ rather it is (from Module 10):

  • ‘a lifelong journey of growing and learning, gaining resilience, managing setbacks and celebrating successes’;
  • ‘happening when people can live well in the presence or absence of a condition, diagnosis or symptoms’;
  • ‘about regaining control of their identity and life, having hope for their life and living a life that has meaning for them whether that be through work, relationships, community engagement or some or all of these’.

There’s a lot to value there despite the criticisms I am making in the review process, where, like in this post, I am looking through two sets of eyes – one my own experience as someone who has no use for the mental health system (literally, I simply have no use for it, the same as, being a lesbian, I have no use for men as sexual partners), and the other my awareness that the mental health system is the social institution in modern societies that responds and takes responsibility for needs that I describe as healing and reconciliation.  Maybe this is what is happening: the mental health system is the way that modern society calls people back to itself, to its values and belonging, and it is the underlying beliefs and values of that society itself, reflected in the mental health system, that require self-hatred and alienation, separation and classification rather than creation and contribution from within.

Or maybe there is always a need to see with two sets of eyes, one that sees separation and another that sees the whole and calls it back to itself.

What I like about the recovery approach is building the person up rather than tearing them down (‘building on the person’s strengths and assets’).  The recovery approach could be an expression of emerging values in modern society that are turning back towards cooperation and respect for nature, including human bodies and inner knowing.  Our own innate capacity to heal and the creativity inherent in our movement and choices at every moment and throughout life.  (This is said to be related to Hannah Arendt’s concept of natality, which I have been meaning to research.)

WHO also assumes the necessity to challenge a person’s ideas and keep these challenges in balance with support.  I would reframe to say that it can be valuable to offer a different perspective that occurs to you, that the other person may not be considering and that balances and complements the strengths they’ve been leaning hard on.  It may be something you have been thinking and then in a conversation the words come and the person can hear.  This is not ego and it is not a recipe or a practice.  If you go around challenging everybody, listening for holes and trying to fill them, you will be a smart-ass or a bully.  It’s part of building the person up, building on their strengths, and not a contradiction; not ‘here’s what you’re missing,’ but ‘consider this too.’

Back again to the experience of avoiding in the short term, something you deeply desire in the long-term because you are afraid of fucking it up.  This relates to what the recovery approach calls, ‘taking positive risks’.  But again it can’t be a recipe, and it can’t be ‘risk management’ where life is a negotiation between you and your therapist.  It’s ok if you mess up.  When you mess up is when you need to focus again on building yourself up and not tearing yourself down.

Implications for policy

Mental health systems should continue to learn from natural communities and supports – without trying to become them or to enfold them into its own structures, bring them under its governance (through regulation, funding or theory) or treat them as assets to be exploited in working towards a person’s recovery.  Mental health needs to keep its hands off my community and my healing, acknowledge its power, acknowledge that some people who use their services also have access to other spaces that do some of the same things and may do them better.

The dialogue and cross- fertilization can be useful – assuming we are taking CRPD absolute prohibition of coercive practices as a starting point – if both sides are recognized as being on equal terms, and imbalances in resources and institutional power and hegemony are acknowledged and compensated for.  The aim might be, to narrow the gap  so that eventually the public service functions related to healing and reconciliation are no longer separated from natural communities and natural communities have the strength and capabilities – and the power and freedom – to deal with all aspects of life for ourselves, not as an extraordinary time or isolated place but permeating and assuming the technologies and responsibilities needed everywhere.