psychiatry

Palliative Care Isn’t Enough: Antidepressants, Dependency, and Revolution

When I came to Europe, I wasn’t sure how long I would stay. I brought enough medication to last three months (the most I could). By the time it ran out, I was already making plans to return to Turtle Island and figured I could get free refills if I waited. I have been waiting a long time now. Emergencies keep coming up that prevent me from having enough money to leave.

I was able to borrow other prescriptions, but the one thing I couldn’t find was my SSRIs (selective serotonin re-uptake inhibitors — a common genre of antidepressants), specifically citalopram (celexa). I had previously considered discontinuing them anyway, but I knew it was dangerous, especially when my situation and my (mental) health are already so precarious. There was always some life-threatening crisis, constant brushes with death, and crushing poverty, so it never seemed like the right time to add another potential hazard. Plus, I had more pressing chemical dependencies to deal with first.

So when I started to run out of them, I figured it was as good a time as any to go off them. I knew the risks when I started taking my SSRIs years ago. So before I quit, I read as much as I could. I tapered my doses downward over a period of months. It has now been several weeks since I stopped taking them entirely and I feel like shit.

I didn’t immediately recognize the creeping, inexplicable (and therefore terrifying) symptoms as SSRI withdrawal. When I first realized it was connected, I was a bit relieved because it seemed to show it was a transitory chemical readjustment. But it kept getting worse and worse and I started to fear something was very wrong, that it must be something else. But the more I looked into it, I found that the scary truth seems to be that this kind of suffering is a relatively normal thing during SSRI withdrawal.

(more…)

Advertisements

Toward Participatory Gender: Trans Self-Determination and Movements for Social Justice

A friend asked to see my thesis, so I found a copy. I spent over a year and a half writing this in 2008-2010. Some of the writing was taken from pieces even older than that. This is the first time I’ve looked at it in a year or two, and I’m surprisingly still pretty fond of it! It’s especially kind of fascinating in light of my involvement in the Occupy Wall Street movement, and linking that back to my work with the DC Trans Coalition and trans-centric organizing more broadly.

I decided to share some of it, since only a couple people have read it so far (and I’ve promised to share it with a lot of folks but never followed up). Given that it’s a thesis, it’s slightly more academic than my usual writing, but I tried to write as accessibly as I could. Here’s the Abstract, and the Introduction and Overview (the first 20ish pages of the entire thesis, which contains a summary of most of the rest) are below the cut. The whole thing is around 250 pages. Perhaps I will eventually get around to sharing the rest someday! As I do, I will post links on the Table of Contents below. :)

Toward Participatory Gender: Trans Self-Determination and Movements for Social Justice

Goddard College
June 2010

Abstract

This paper explores notions of identity, gender, and social justice by delving into the histories and politics of trans communities in north america. The author explores how trans people have actively built communities around shared experiences, and how these communities both contribute to and benefit from engaging in struggles for social and economic justice. She urges broader progressive, radical, and feminist movements not to ignore how forces such as cis supremacy and transphobia situate oppression, and thus how we organize resistance to it. She passionately develops her own vision for a movement that is both capable of realizing a participatory gender system and grounded in a shared ethics of total liberation.

The author argues that academic studies of trans people have largely neglected trans people’s own agency in shaping our identities and communities. She claims that medical, psychiatric, feminist, and queer accounts of trans issues have all so far failed to critically examine the material conditions of trans people’s lives or recognize the diverse strategies we have created to transform those conditions. She reexamines these histories, with a focus on the participation of poor trans women of color and other marginalized voices, in order to give context to her own experiences of embodiment and political action.

The project also discusses how trans liberation activists will fail if they focus only on fighting “transphobia” without analyzing the ways in which other institutions and systems – such as the state and white supremacy – also shape trans experiences. The author argues that trans praxis must be grounded in our everyday lived experiences, and thus must also account for the ways in which differing privileges and oppressions intersect in our selves. She does this with detailed accounts of trans people’s interactions with policing and incarceration, the politics of hate crime legislation, her own engagement with doctors and government bureaucracies, the stigma of mental illness and sex work, and much more. Throughout the work, she blends personal narrative, theory, and research to explore the ethics of gender self-determination, her own identity as a genderqueer transsexual woman, and her involvement in organizing for collective empowerment in trans communities.

(more…)

Defending Addiction and Madness: On Psychiatric Disabilities and Choice

Before I posted my newest story (What’s Left When Coping is Killing Me?), I spent days editing it. I had to vividly relive the experiences I was writing about. Also, it was extremely hard to share those parts of my life — especially my recent drug use. Until that post, that was one of the few remaining things I wasn’t “out” about. On top of stress about housing, finances, and the continued spike in violence against trans women in D.C., my anxiety was off-the-charts.

I give off confident vibes, and I share most aspects of my identity/history freely. However, being so visible and exposed is extremely draining and occasionally terrifying. People recognize me on the metro. I’ve received death threats on my cell phone. I don’t live in a protected, academic bubble — I’m a crazy, low-income tranny punk and a sex worker. Being out has serious consequences.

Recently, when I admitted to my therapist that I had lost the desire to live, I was nearly hospitalized. It was a brutal wake-up call — both to how bad off I was, and how I am not immune to the constant threat of medical surveillance and even incarceration. After sharing my story about this, I mostly received praise and support. But a few folks recommended various ways to “get rid of my anxiety” or “cure my depression/addictions/etc.” I think it’s worth unpacking their assumptions.

Most neurotypical people assume I want to or should change those aspects of myself. This ends up reinforcing much of the ableist ideologies that contributed to my being in that situation to begin with. A lot of this also had to do with judgement (outright or subtle) around the use of ‘hard’ drugs. I want to clarify/reinforce some of the things I was trying to say, and why I said them. So I decided to write about what publishing that story felt like. It evolved into a meditation about how I experience my mental illness — personally and politically — as a disability, and growing into my identity as a proudly mad, disabled person. I’m not necessarily glad to be so crazy; it makes my life very hard and has led to untold suffering. But there is a different between being glad and being proud.

I look at how ableism divides the world into “normal” and “disabled” people by making much of life inaccessible for people with physical and/or psychiatric impairments. I also explore the problem of countering false narrative of personal responsibility (“drug addiction is a choice”) with the need to value autonomous decision-making. Finally, I look at ways that being crazy can be a gift and a weapon that, when re-directed away from our selves, can destroy the social conditions which keep us from healing.
(more…)

Silences Such as These (A Coming Out Story)

This is an old one! I wrote it years ago at my beloved hippie college. I was challenged by my advisory to write a personal narrative, so I wrote about starting hormones. I reflect on my life up until that point and attempt to answer the unanswerable question, which was demanded as a condition for being allowed to medically transition, “when did you first know you were meant to be a woman?” I’m still really proud of the result.

If you’re familiar with trans narratives, some of this might sound familiar. However, sadly, most trans autobiographies fail to contextualize the story within broader social histories. I wanted to talk about my identity as it both reflects and challenges a world where gender assignments are binary, naturalized, compulsory, and violently enforced. I also think about how my body interacts with the medical establishment that has been erected to maintain that very gender system.

I’m sharing my story because I haven’t posted much creative nonfiction here, and for all of the young trans folks who, like I once was, are pouring over the internet for empowering alternative ways to make sense of their desires outside of the prescribed Harry Benjamin-esque narratives of the medical-psychiatric institution.

Trigger warnings for mentions of violence and mental illness.
(more…)

Transphobic Violence and Complex PTSD

As someone who is diagnosed with post-traumatic stress disorder, I sometimes feel like there is an expectation that my symptoms can be easily traced to one cause. Unlike some “mental illnesses”, where biologically deterministic theories reign supreme, PTSD is most closely associated with particular life experiences. PTSD is what happens after a car bomb blows up part of your convoy, or an earthquake shatters your windows.

I’ve felt this pressure — from friends, psychiatrists, and myself — to explain my PTSD as something caused by a singular event. Most commonly, I point to the time I was jumped just outside of my house. That was not the first extremely violent situation that ever happened to me; the first time of many I was queer bashed was when I was 13. But because this is the most recent, and because I have to walk by where it happened almost every day, it’s this one time that I feel most often in flashbacks and that continues to haunt me most severely.

However, I don’t think this is a very helpful way of looking at PTSD, at least not for me. It’s really impossible for me to isolate one event from the entire context of my life and say “this is what caused it.” The concept of Complex PTSD is a proposed diagnostic category that begins to get at this – it would be used to describe trauma from prolonged situations, such as “chronic maltreatment by caregivers” (which I also experienced, and I believe most trans people who had transphobic parents could potentially be placed under this). C-PTSD is the result not of one traumatic event, but rather a pervasive state of powerlessness and abuse. It was first noted as occurring in prisoners of war, survivors of genocidal atrocities, and child sexual abuse survivors.

(more…)