As noted in a previous blog entry (Disordering Bodies for Disordered Minds), there is a robust social psychology in the discipline where I hold advanced degrees. George Herbert Mead, a principal founder of the perspective Herbert Blumer tagged “symbolic interactionism,” describes his own views as “social behaviorism.” Erving Goffman writes powerfully on mental life, as you will see below, as does Peter Berger and Thomas Luckmann (social constructionism). Howard Becker and his cohort pioneered labeling theory. There is also a robust tradition in sociology of critical examination of the institution and practice of medicine, including psychiatry, while clarifying and deepening understandings of the latter. This essay is yet another instantiation of that tradition, leveraged here to throw some light on the controversy over Texas examining the practice of “gender-affirming care” (see also A Fact-Proof Screen: Black Lives Matter and Hoffer’s True Believer and Living at the Borderline—You are Free to Repeat After Me).
Executive and legislative action in Texas concerning medical interventions for minors suffering from gender dysphoria is rooted in state law that prevents the sterilization (surgical and chemical) of minors. A person in Texas must be 21 years of age to consent to sterilization. Surgical procedures and cross-sex hormones used in “gender-affirming care” can and do result in sterilization. Thus, the question of whether such procedures constitute child abuse is a reasonable one. These procedures must be examined to see if they square with state law.
One needs to understand history to understand why such laws are in place and the establishment media is doing a very poor job of helping the public understand history. The United States has a long and storied past of those in authority, aided and often pushed by medical authorities, who profit from their participation, altering the reproductive capacity of both females and males to reduce social problems and shape demographic patterns reducing subpopulation numbers. For more than a century, progressives pushed an ideology of eugenics that used medical interventions to disrupt reproduction for the purpose of social engineering.
You may have missed my blogs on this (the principle ones: The principle that sustains compulsory vaccination is broad enough to cover cutting the fallopian tubes; On the Ethics of Compulsory Vaccination; Biden’s Biofascist Regime), but an early version of the mandatory vaccination law (smallpox) that progressives are keen on seeing instituted everywhere, a desire that includes requiring shots in arms for children, was cited by the Supreme Court back in the 1920s to justify state laws mandating tubal ligation and, by extension, other procedures, such as hysterectomy, partial and total. This decision was made even though the precedent established by the previous court sharply limited the ruling to one vaccine and, moreover, to the question of state not federal power.
It was after the Nazi medical experiments in which bodies were altered in various ways by doctors interested in various things that the horror of allowing the medical-industrial complex to “treat” those who cannot consent to “treatment” shook the world, however unevenly. This led to states passing laws (not quickly nor broadly enough) that not only eliminated mandatory sterilization programs (nearly thirty states had such laws at one point, as did Canada, Great Britain, Sweden, and many other European countries), but passed laws recognizing the special vulnerability of those under the ages of 18-21, thereby forbidding medical authorities, including psychiatrists and clinical psychologists, as well as the social engineers, from taking advantage of immaturity to obtain “consent” for unnecessary or questionable medical interventions. (For a discussion of Nuremberg see above links as well as The Immorality of Vaccine Passports and the Demands of Nuremberg.)
With respect to minors, in order to make medical decisions for them, the question turns on whether a medical intervention is necessary and reasonable (safe and effective) to prevent or treat a legitimate physiological illness or a severe psychological malady that roots in physiology. Psychiatric interventions that involve pharmaceuticals and surgery are troubling given the problems with the validity of diagnostic categories in this field. I have examined the Diagnostic and Statistical Manual of Mental Disorders (the DSM) across its many editions and what cannot escape such an exercise if one is critical is how categories change over time, as well as come and go, and the overarching drive to medicalize what are, as Thomas Szasz in The Myth of Mental Illness described as “problems in living” and “indirect forms of communication.” (Szasz went on to document the horrors of psychiatry in The Manufacture of Madness, after taking up the question of ethics in, among other works, Law, Liberty, and Psychiatry.) It may be one thing for a consenting adult to agree to radical body modification (this is not itself a settled question), but the rules must be different for those who cannot reasonably be considered capable of consenting to life-altering chemical and surgical interventions. Consent in medical treatment is essential to human rights, and consent requires the capacity to reason—and an objective ad verifiable reason for putting a person in such a situation.
It is an easy matter to find out what moved Szasz to criticize his own profession. The conscientious student of history will find alongside the horrors of eugenics the horror of chemical and surgical interventions in the realm of psychiatry. I will spare readers the details of psychic surgery (the above image should serve the purpose of horrifying you). But I do need to emphasize the long-standing association supposed among medical professionals between the reproductive parts of human beings and emotional and psychological function. It is no accident that the terms “hysterectomy” and “hysteria” both find their root in the Greek word for uterus: hystera. Theories of the association continue into the twenty-first century.
The medical-industrial establishment has a long history of altering brains and uteruses to remedy emotional and psychological maladies. It could be expected that doctors would move to altering other parts of bodies to achieve these ends. Surgeons have moved well beyond facelifts, rhinoplasty, and breast augmentation to radically altering human bodies to fit the delusions and desires of their patients (see Disordering Bodies for Disordered Minds). And where doctors won’t go, tattooists and piercers will—ear-pointing, injecting dye in eyes, tongue splitting, subdermal and transdermal implants, whatever, it seems. It’s only a matter of time before doctors get in on all the action. There’s money to be made and they have the power to declare such modifications the domain of their profession. And why not? If complete removal of a person’s genitalia is not the paradigm of extreme, it is hard to imagine what else could be. The arm is an appendage, too.
The law in this area needs to be sorted out. It is understood that, as a general rule, body modification is illegal without informed consent, and that would necessarily make it illegal to modify the body of a minor without an objective and verifiable medical reason, the intervention necessarily reasonable, who cannot consent to such a procedure. Even then it is a tricky matter. We should not suppose that a mother suffering from Munchausen syndrome by proxy should be allowed to have her daughter surgically altered for the mother’s esteem and reputation. We certainly would not think it okay for a mother to mutilate the genitalia of her daughter for cultural or religious reasons. Do we? (Yet we allow the father to mutilate his son in the same way.) Other areas of the law are murkier. Consent alone doesn’t necessarily make a procedure legal. As this article on FindLaw notes, for example, “sadomasochism that results in bodily harm” is “recognized as neither socially useful nor morally acceptable, and therefore cannot be legalized by consent, even if the person is an adult.” (Given what one can see for free on Pornhub, this must not be the rule in every state.) With respect to the moves Texas is making, the point of the exercise seems to be to shed some light on some of the murkier areas of the law.
As I suggested in my previous blog entry, beyond sorting out the law, what the world needs is not only a healthy dose of anti-psychiatry (which is not to say there isn’t madness, Munchausen by proxy being an instantiate of such), but more broadly a healthy skepticism of the promethean confidence of the medical profession. In the age of technocracy, the study of the world of things has moved beyond science into scientism. The nightmares of Mary Shelley are upon us. One must therefore consider the sociology of all this (even if my discipline has gone to the dogs, the sociological is real). The desire to transcend one’s physical body may be a manifestation of the trans-humanism that seems all to eager to ushering out of the theater of man his human right to bodily integrity. Progressives notions of consent are a jumble. Sometimes the world needs to take a deep breath. As it should have before it let Walter Jackson Freeman drive his icepick into the brains of his patients.