The medicalisation of conservative nightmares

It must be hard to be a certain type of conservative in today’s world. Maybe it always was. But today things seem to be changing pretty fast and it must be agonising if you are one of those conservatives who would prefer the illusion of cast iron certainties, and for the world either to stand still or to move backwards.

The latest source of agony from Grassroots Conservatives is the government’s proposal to make it easier for individuals to access gender reassignment surgery.

People who want to change their gender are suffering from a mental illness, the group claims. This is reminiscent of homosexuality having, in the past, been classified as both crime and mental illness.

The psychiatrists’ bible of (DSM-5), has an entry for Gender Dysphoria – 

“a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify.” 

The medical profession should be, and most often is, careful about what it includes in its catalogue of recognised mental illness. We have had too long a history of the medicalisation of that which is simply outside mainstream social norms, only to be reversed at a later date.

But many of these classifications are driven by two factors. First is the seemingly insatiable scientist’s compulsion to describe, order, classify and name. The second is that compulsion’s Siamese twin – bureaucracy. The need to have an accepted, classified and numbered medical diagnosis before one is entitled to receive treatment.

Through these mechanisms, we create illness out of thin air and medicalise people, often unnecessarily. It is this medicalisation, driven by the scientific-bureaucratic complex, that the government is, to its credit, trying, in this case, to eliminate.

For the activist, the system is a gift. Simply to translate such situations into ‘mental illness’ with its attendant conscious and sub-conscious layers of interpretation among the lay public is abusive. It is the language of prejudice and activism that routinely – and usually willfully – mis-interprets and exploits technical terminology.

Activist abuse of medical terminology has a long and disreputable history. From the well known classification of political dissidents as mentally ill in many autocratic countries to the much less evil, but still potentially damaging, coining of the term ‘nature deficit disorder’ by environmental activists.

Once a situation is medicalised and neatly classified, the bureaucracy permits treatment. For ‘gender dysphoria’, treatment options “include counseling, cross-sex hormones, puberty suppression and gender reassignment surgery” according to the American Psychiatric Association – a set of interventions that usually work together rather than being mutually exclusive.

Mary Douglas of Grassroots Conservatives has this to say

“I think many people have really profound concerns about this. If somebody thinks they have a mismatch between how they think and the way their body is, the question is: ‘Which should be changed?’” 

That is a fair question. But Ms Douglas fails to ask the follow up: Who should be deciding the answer to that question? The government or the individual concerned? Or maybe Grassroots Conservative members?

This episode also highlights the difficulties political parties face in being a big tent encompassing many different views. All parties face these issues. The Liberal Democrats have been politically mutilated because of a clash between the leaders and activists about tuition fees. Labour is currently having its issues and it is not clear whether Corbyn has any intention of keeping the tent big or purging it into a hard socialist monoculture.

It is to consecutive Conservative governments’ credit that they pushed through single-sex marriage legislation and are now tackling gender reassignment in the face of opposition from a section of their grassroots.

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Radix is the radical centre think tank. We welcome all contributions which promote system change, challenge established notions and re-imagine our societies. The views expressed here are those of the individual contributor and not necessarily shared by Radix.

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