The Roots of the Left’s Gender Madness
By David Allison
“The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.” — George Orwell, 1984.
The New York Times refers to the hulking, trans-identified suspect in the Minneapolis school shooting as “she”. A clickbait headline informs us that a “fourth British man has given birth”.
This is the language of left-leaning media, both gaslighting and infuriating to the rational public. It is, in a word, “madness,” and it is now closely tied to the political left. Have they lost touch with reality? It appears so. Many on the left now seem to believe that men can be women, with horrific consequences: “female-identifying” male rapists are being placed in women’s prisons. Toddlers are encouraged to challenge their biological sex. But how many truly believe it’s possible to change sex when it comes down to it? And how is it possible to rationalize policies like self-ID that allow men into women’s spaces?
The reason is that the left has already exonerated itself by deciding that madness itself is a socially constructed instrument of social control. Madness doesn’t truly exist. Or so it was claimed during the heyday of the countercultural 1960s and 1970s.
The Anti-Psychiatric Movement
In his 1982 critique of mental health theory and practice, PsychoPolitics, psychologist and educator Peter Sedgewick, once described by Christopher Hitchens as a “noble remnant of the libertarian left” recounts an extraordinary discovery:
“As an active partisan of many left-wing causes and movements, I was amazed (as the expansion of radical or revolutionary groupings gathered force in the late sixties and the seventies) to discover that on the left the most popular attitude towards the mental illnesses was to deny their very existence.”.1
What Sedgewick refers to here is “anti-psychiatry”: a diffuse set of contradictory ideas associated with celebrated figures like R.D. Laing, Thomas Szasz, Michel Foucault, and Erving Goffman. What these very different writers shared was their critique of institutional psychiatry, specifically the treatment of schizophrenia.
These writers rightly criticized the worst abuses of the 1960s and 1970s: overuse of compulsory admissions, inhumane management of psychiatric hospitals, coercion of patients into high doses of neuroleptic drugs, and routine use of convulsive and psychosurgical procedures. Their critiques effectively propelled reform, including a rapid move away from institutionalization and efforts to improve the codification and reliability of psychiatric categories and diagnostic practices.
But the anti-psychiatry movement aspired to be more than a voice for reform. Foucault2 argued that, partly through the power of socially constructed “labels” assigned to psychological phenomena, psychiatry was deeply implicated in coercive social control. Thomas Szasz believed the classification of mental disorder was a fiction perpetrated by psychiatry on behalf of an authoritarian state eager to exclude nonconformists and pathologize the political resistance of dissidents.3 Laing claimed to discern sense in the apparently absurd articulations of the insane.
Schizophrenia as Authenticity
Schizophrenic speech, Laing argued, was intelligible on its own terms. Under capitalism, normality negated the true self. A schizophrenia diagnosis, he believed, was a prime example of social control aimed at suppressing authenticity. These control theories supported the claim that mental illness was a myth, an “attempt by oppressive social structures to stifle the revolutionary power of desire and deviance”. Madness and desire, it was thought, could play a key role in a broader liberation effort to dismantle capitalist oppression.
R.D. Laing became a pop star among college students of the time. His ideas found fertile ground in a counterculture eager to embrace the strange and unconventional. Sedgewick, skeptical of Laing’s claims about the supposedly normal and life-enhancing qualities of schizophrenic frenzy, observed with astonishment that:
“Virtually the entire left and an enormous proportion of the liberal-arts and social-studies reading public were convinced that R.D. Laing and his band of colleagues had produced novel and essentially accurate renderings of what psychotic experience truly signified. Seldom can a vanguard minority of researchers, opposed to the main orthodoxies of a dominant applied science, have achieved in so short a span of years a cultural and even political dominance of their own among progressive circles of the public with a pretension to discrimination in the matter of ideas.”
This “ideological capture” will be familiar to those astonished by the rapid rise of Judith Butler’s Gender Trouble. However, the societal effects of this newer movement are far deeper, and the strategy of transgender advocates has been more refined.
But first, what became of the anti-psychiatry fad?
Gone, But Not Forgotten
The notion of mental illness as a fiction appealed to ascendant neoliberal thinkers and politicians. Sedgewick argued that anti-psychiatrists betrayed the left’s goal of improving psychiatric services. The mentally ill proved ineffective as foot soldiers for the socialist revolution and were soon abandoned by the left in favor of more promising revolutionary groups, such as racial minorities, women, and gay people. Meanwhile, the deinstitutionalization advocated by social control theorists quickly degenerated into a policy of cost-cutting neglect. Inadequate funding for community-based mental health services led to chronically ill people flooding the streets of major cities like London, San Francisco, and Frankfurt.
Mainstream psychiatry has since moved on. The “biopsychosocial model” is now the dominant paradigm for treatment and diagnosis. It considers how social factors, psychological development, and genetics interact, aiming to address the whole person and take patients’ personal problems seriously. This approach is also advocated by Genspect for individuals distressed by their gender.
While anti-psychiatry, though not entirely gone, is largely seen as an embarrassing episode from the 1970s, psychiatry and political activism remain deeply interwoven into current transgender ideology. Thus, the belief that one’s true gender is at odds with their biological sex (gender incongruence) is no longer classified as a mental disorder by the World Health Organization. This is surely a late triumph for anti-psychiatry. While it’s undeniable that transgender people face disproportionate mental health challenges, these are attributed to “minority stress”: the “stigma, prejudice, and violence” they experience due to marginalization of their identity by a heteronormative society. The narrative holds that transgender people seek only to live as their authentic selves but are prevented by an oppressive, transphobic society. This echoes the social control argument all over again.
Ironically, while gender-critical voices oppose unnecessary medical (pharmaceutical and surgical) interventions and emphasize “the importance of psychological and social support”, so-called anti-conversion therapy laws promoted by transgender activists threaten to make talk therapies nearly inaccessible to those questioning their gender identity.
Madness as a Human Right
In a sharp departure from Laing’s rejection of drugs and surgery, trans activists now view access to puberty blockers, cross-sex hormones, and surgical removal of breasts or penises as inviolable human rights. The pharmaceutical industry has shifted from being a corporate adversary to a “trans ally.” The consumerist strain in contemporary critical psychiatry has turned the profession into a self-service provider of medical interventions: the psychiatrist’s role in “treating” gender-confused individuals is reduced to affirming their ideation and prescribing endocrinological goodies. Anti-psychiatrists used labeling theory to counter the stigma of mental disorder; transgender activism embraces labels (a myriad of queer identities) as badges of honor, proudly displaying the marks of gender nonconformity across their breasts, groins, and ravaged tissue-harvested forearms. If transgender people are not mentally ill, many still seem to require medical and surgical interventions to become their “true selves.”
Diagnostic overshadowing, where all healthcare issues except “gender identity” are overlooked in patients questioning their gender, suggests that those seeking help are ill-served by professionals. Like anti-psychiatry before it, trans-affirmative medicine resembles a movement in which the needs of patients are secondary to its political project.
A Twisted Legacy
The imperative to depathologize has made it impossible to address the real needs of those questioning their gender identity. Anti-psychiatrists refused to work for better social services; trans-affirmative practitioners now deny patients the psychosocial support they need, whether through psychotherapy, watchful waiting, or fostering self-acceptance and emotional maturity.
Diagnostic labeling in psychiatry is likely to remain an inexact science, influenced by social beliefs. Yet psychiatry has always considered beliefs wholly at odds with objective reality as pathological. Delusion exists. If an anorexic young woman believes she is obese, or someone hears nonexistent voices, we are justified in calling these delusions or hallucinations. Social media recounts stories of people who believe one of their legs doesn’t “belong” to them and seek amputation, or who pour drain cleaner into their eyes because they believe they “should have been blind from birth”. In such cases, it is reasonable to speak of a disorder of perception or delusion. Stigma or not, that way madness lies. Believing you were “born in the wrong body” with the “wrong” sex falls into the same category.
Transgender activists have captured institutions far more effectively than anti-psychiatrists ever did. Through effective campaigning and often surreptitious behind-the-scenes lobbying, transgender affirmation is now firmly entrenched across the political spectrum. Yet it remains the brainchild of the left.
Anti-psychiatry was synonymous with the spirit of 1968, a year of apparent victories for the New Left but of defeats for those focused on material economic goals. The period from 1968 to 1979 marked the mainstream left’s abandonment of class politics, ushering in the identity politics of the 21st century. This both stemmed from and contributed to a “loss of faith in the human capacity to act rationally, morally, and collectively to transform the world” 4. Instead, the left turned inward to “remake humanity”—embracing madness in the process. This is why it is now possible to argue seriously for the impossible and unethical: the trans identity of young children and the moral imperative of surgically altering their bodies. As Genspect’s Mia Hughes puts it, “The transgender child is the most harmful, destructive concept psychiatry has ever unleashed. It’s the result of political, cultural, and medical threads converging at one catastrophic moment, causing society to go collectively mad”. But the harbinger of this disaster was not psychiatry itself, but its adversary: anti-psychiatry.
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1 Peter Sedgewick, Psychopolitics, Pluto Press, 1982
2 Michel Foucault, Madness and Civilization, Routledge, 1989 (first published Libraire Plon, 1961)
3 Thomas Szasz, The Myth of Mental Illness, HarperCollins, 1961
4 Kenan Malik, The Quest For A Moral Compass, Atlantic Books, 2014