Interview in Culture, Medicine, and Psychiatry journal
This is a re-publication of an interview with PhD student Wren A. Gould and Kinnon R. MacKinnon, which gives a short run-down of an article led by Wren Gould
Wren Ariel Gould is a PhD student at the Dalla Lana School of Public Health at the University of Toronto. They leverage critical theory, political economy, and critical psychiatry in considering LGBT mental health, with their research addressing this vital intersection (e.g., trans mental healthcare, anti-trans health legislation).
Kinnon Ross MacKinnon is an Assistant Professor in the School of Social Work at York University. His research examines the socio-political dimensions of gender-affirming healthcare delivery and how sexual and gender minority (LGBTQ+) individuals have experienced this care.
The paper we discuss in the interview is titled “Detransition narratives trouble the simple attribution of madness in transantagonistic contexts: A qualitative analysis of 16 canadians’ experiences.”
It was published in the critical psychiatry/critical mental health journal called Culture, Medicine, and Psychiatry.
The abstract of the paper is posted below, following the interview.
The interview was published on July 29, 2024.
Summary of the paper
This article is about how accusations of “mental illness” are often used to undermine marginalized peoples, especially transgender, nonbinary, and gender-nonconforming people. One way accusations of mental illness can be leveraged against gender minority people is through stories about how trans/nonbinary identities are not “real” because they are rooted in mental illness, and that some people detransition when they “realize” their transition was motivated by a mental illness.
Our paper interviewed individuals whose personal stories reflects insights into this trajectory, highlighting that at the center of their narratives was resistance to the idea that mental illness made any part of their life story (or former trans identities) any less real or valid. These individuals sometimes reflected that earlier gender dysphoria was real, even if they have come to understand dysphoria as intersecting with mental illness or neurodivergence.
Ultimately, these stories suggest that neurodivergence or mental health challenges are no reason to invalidate others, and that providers of gender-affirming healthcare may look to develop approaches to care that are trauma-informed and can better attend to madness.
Tell us a little bit about yourself and your research interests
Wren: I’m interested in LGBT mental health viewed from a few critical perspectives, especially critical political economy. On the one hand, that means I’m interested in how states are trying to assume control over trans healthcare, especially from the perspective of a thorny political context in the U.S. But I’m also interested a broader U.S. political context and what it means for LGBT mental health, mainly U.S. divisions between rural and urban spaces.
I’m particularly interested in ideas about how urban spaces are (relatively) safe for LGBT people, especially because I wonder if that holds for everyone. I grew up in a small town in the U.S., and at least my experience was a bit more complicated than that. I’m curious if those ideas are complicated for other people and what implications that holds for the U.S. political landscape.
What drew you to this project?
Wren: I was drawn to the project because I actually have a lived experience of detransition and also years of experience as a mental health provider (informed by recovery and critical psychiatry).
My experience was that my story was really different from stories in the media that depict detransition as a unilateral failure and as negative, and I wanted to know what others’ perspectives were.
I also try to think about “mental illness” outside of psychiatric frames, as part of human neurodiversity, so I was especially curious about how neurodiversity informed detransition and how that story may not be categorically negative and could look really differently from what I saw in the news.
Kinnon: I was the principal investigator of the Re/DeTrans Canada study that provided the qualitative data for this paper. The trajectory of my scholarship for the past decade has consistently included attention to the needs of sexual and gender minority people on the margins of society.
Detransition is an experience that is becoming increasingly visibilized in society, yet it remains highly stigmatized, misunderstood, and a politicized experience. In the current socio-political context, there is extreme polarization and rigid ideas surrounding what it means to be transgender or detransitioned.
As a trans scholar who transitioned 15 years ago, and who has supported friends to transition and to detransition, I am curious about these phenomena and the narratives relating to both experiences, especially pertaining to mental health discourse.
What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)
Wren: I’m currently reading Lent, by Jo Walton, an historical fantasy novel about the “mad” monk Girolamo Savonarola in Renaissance Italy, and somewhere between re-watching Legion (about an X-men character with multiple personalities) and The Owl House (about learning how to be a witch in the Boiling Isles and how to embrace being a weirdo).
If there was one takeaway or action point you hope people will get from your work, what would it be?
When neurodivergent people speak, they deserve to be heard.
Here is a description of the article led by Wren Gould. It’s in the disciplinary realm of critical mental health/mad studies.
Abstract
Emerging evidence suggests that transgender individuals are more likely than cisgender peers to receive a diagnosis with a primary mental disorder. Attributions of madness, though, may serve the social function of dismissing and discrediting transgender individual’s self-perceptions. The narratives of individuals who stop or reverse an initial gender transition who also identify as living with mental health conditions can sometimes amplify these socio-political discourses about transgender people.
Through a critical mental health lens, this article presents a qualitative analysis of 16 individuals who stopped or reversed a gender transition and who also reported a primary mental health condition.
Semi-structured, virtual interviews were conducted with people living in Canada. Applying constructivist grounded theory methodology, and following an iterative, inductive approach to analysis, we used the constant comparative method to analyse these 16 in-depth interviews.
Results show rich complexity such that participants narrated madness in nuanced and complex ways while disrupting biased attitudes that madness discredited their thoughts and feelings, including prior gender dysphoria. Instead, participants incorporated madness into expanding self-awareness and narrated their thoughts and feelings as valid and worthy.
Future research must consider providers’ perspectives, though, in treating mad individuals who detransitioned, since alternate gender-affirming care models may better support the identification and wellness of care-seeking individuals who may be identified (in the past, present, or future) as mad.
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