(Note: A reoccurring issue I am having as a psychology student is that I feel as though nothing is inclusive enough. There is always a group of people being left out of the conversation or being invalidated. Last semester I wrote a piece for my queer studies course about the intersectionality and erasure of asexuality in psychology, however, it doesn’t stop there. I’ve noticed these issues within gender, disability, sexuality, race, religion, etc. Considering that this still applies, this essay outlines just the beginning of what needs to change in order to make our world a more inclusive place.)
Within science, there is a level of factuality and certainty. When someone goes to the doctor with a sore throat, they expect a clear diagnosis and a treatment plan. Within psychology, the first step of treatment is addressing the issue and how it affects or impairs the person’s everyday functioning. Next, most doctors will attempt a simpler course of therapy to address the issue. If that doesn’t work or if the issue is too large, therapy is continued and psychiatric drugs are introduced. Psychology is already considered a queerer aspect of medicine since the brain is very complex and treatment is not as straight forward as some treatments within the body. However, there are a few common issues within psychiatry such as depression or anxiety that are considered “the common cold” of psychology. This is because they are some of the most commonly seen psychiatric disorders. Just as with medicine, there are many disorders that are rare or less frequent but are still identified within the DSM (diagnostic and statistics manual). While psychology is a queerer form of science, it is still not queer enough. Up until 1987, homosexuality was still considered a mental disorder. While removing homosexuality was a huge stride in the right direction, there are still changes to be made. In the DSM 5 (the most updated version of the DSM), there is still a whole classification of sexual disorders that desperately needs to be revised. The psychology field likes to pride themselves on being ever-changing, and progressive therefore being queerer than some other forms of science. However, with the DSM still having certain sexual disorders, this can completely erase the validity of asexual individuals. This leads my discussion into not only the queerness of psychology but also how psychology needs to be changed in order to be as progressive as it claims to be. Furthermore, within the change of psychology, perhaps there will be a change within science overall to be more inclusive and progressive within the treatment of queer folk.
Within the textbook, “Essentials of Abnormal Psychology” by V. Mark Durand and David H. Barlow, there is a chapter which covers some basics of sexual dysfunction disorders within the DSM 5. These are seen as necessary disorders for anyone going into clinical psychology to know. As a psychology major, who also happens to fall on the asexual spectrum, I didn’t have a problem with the initial disorders the chapter discussed (such as erectile dysfunction). I did start to notice a problem as I continued on with the disorders I was reading about. An arousal disorder within the textbook defined for men is “male hypoactive sexual desire disorder” which has the definition of “apparent lack of interest in sexual activity or fantasy that would not be expected considering the person’s age and life situation”. As for women, there is a disorder that is called “female sexual interest/arousal disorder” which is defined as “the recurrent inability in some women to attain or maintain adequate lubrication and sexual excitement swelling responses until completion of sexual activity.” Overall, there is generalization title (“sexual dysfunction”) which is defined as “a sexual disorder in which the client finds it difficult to function adequately while having sex”. While these definitions are seemingly meaningless, they can actually be detrimental to anyone within the asexual community.
Sexual dysfunction can be a helpful term for psychiatrists (or doctors) to use if a client develops a change in sexual arousal or functioning with the changing of medications. However, a common theme within psychology is that in order for symptoms to be a disorder, there can’t be certain underlying issues that could be causing the symptoms instead. Therefore, with disorders such as male hypoactive sexual desire disorder or with female sexual interest/arousal disorder, they cannot be diagnosed if the client has another mental disorder (such as depression or anxiety) and/or is taking medication that could inhibit their sexual being. A valid way that these two particular disorders can be diagnosed that doesn’t necessarily block the way queer acts, is if the changes have a more sudden onset, doesn’t have an underlying condition, or is a change within a particular relationship. However, many times these conditions can be diagnosed when the client is having sexual dysfunction without change which is where the conflict between queer and psychology really comes into play.
The asexual spectrum flows anywhere between having no romantic or sexual attraction to anyone to having attraction with special specifications and everything in between. For me, being asexual means that I have no sexual attraction until I have a deep emotional connection with someone and I have limited romantic attraction often times until I have an emotional connection with someone. From a psychological standpoint, and the requirements of diagnosing mental disorders within the DSM, I could be considered to have a sexual disorder because my asexuality did cause me distress in my everyday life. However, also realizing that I was gay had an impact because I learned more about the LGBT+ community where I found a label that described me. In Robert McRuer’s essay “Compulsory Able-Bodiedness”, a quote that I directly relate to is “Compulsion is here produced and covered over, with the appearance of choice (sexual preference) mystifying a system in which there is actually no choice”. While this essay directly talks about the intersectionality between queer movements including LGBT+ movements and disability movements, this quote I felt really impacted the way I’ve lived my life. As young as I can remember, I haven’t had crushes or attraction to almost anyone. And when my friends would have crushes I would pretend to fit in. In health, when I was older and we learned about sex, I pretended to like it and I would force myself to think about it because I thought that was normal in our society. I obviously realized later in high school that what I was feeling wasn’t “normal”. I never learned about alternate titles for sexuality other than heterosexuality and I didn’t learn about any other type of sex besides straight sex. I didn’t know how queer I actually was until I started questioning my sexuality of being straight. As the quote says, I was trying to fit into a binary where I didn’t belong. All of this journey could be considered to be causing impairment of functioning in my life and yet it felt normal to me. Except my normal wasn’t normal enough compared to others.
It wasn’t until this past year of school where I realized the severity of why we need to change the DSM’s classification of sexual disorders. As I’ve come to terms with my own sexuality, I have realized that I am asexual and I am happy being that way. I have learned how to live like that just as I learned how to live being gay. However, taking an abnormal psychology course along with a queer studies course made me reevaluate a certain experience I had. I have a history of depression, anxiety, and OCD, however, I have been asexual since before I showed these symptoms. More recently, I have been taking antidepressants and trying to figure out which medications work. My psychiatrist asked me if I had any change in sexual functioning and/or sexual arousal. I explained to him that I was on the asexual spectrum and so therefore I’ve never been sexual and so there has been no change. He got very concerned and was asking me questions about my sexual functioning trying to diagnose me with a sexual disorder because of my asexuality. Another key part of asexuality is that if someone identifies as asexual regardless of situational factors or life changes etc., they are still validly an asexual individual. After this appointment with my psychiatrist, I really began to reflect queerly on psychology and how progressive and open-minded it really is.
In a study from 1991, Simon LeVay published a study he had done trying to create a correlation between hypothalamus size and gay men. His study found that a gay man’s hypothalamus size seemed to be nearly double that of a straight man’s. While there are many criticisms to LeVay’s study from a psychological point of view, there are even more questions that I was curious about from a queer studies point of view. While it is a very queer approach for science to try to study gay people and figure out the biological causes for sexuality, this study was anything but queer. Queer doesn’t like binaries and this study was trying to explain sexuality as a strictly biological cause. There is an age-old question of sexuality which asks if sexuality is biologically-based, environmentally-based, or both. As a queer studies scholar, I believe that sexuality is too complex to attribute simply one cause such as environment or biology to sexual preference. This directly relates to the asexuality issue because while homosexuality is removed from the DSM and LeVay’s study has been seen as less valid because of the critiques and strong variables it carries, this does not solve the problem of there not being a place for queer within a scientific setting.
A final example of a way that science disables the queer mindset is directly related to transgender individuals. In order for transgender people looking to start their transition, they have to go through a complicated process of meeting with doctors first, seeing therapists and psychiatrists to diagnose them with gender dysphoria and then after a certain amount of time they may be approved for the ability to start transitioning. This is yet another aspect of science that may be seen as queer since medicine is seemingly accepting of transgender individuals and yet it is extremely not queer. Forcing those to “prove” their identity to anyone especially medical professionals is directly what queer fights against. Not only does queer combat labels, but queer does not approve of forcing people into boxes based on their identity. Ideally, queer would like for labels to be completely erased, however, we as queer activists cannot let labels be erased before they are accepted. To an extent, there may be a necessity for transgender individuals to go through this process if, for example, their insurance needs proof that the surgery they’re looking to have done isn’t strictly cosmetic. However, even then, that is not a queer way of looking at such an issue.
As stated above, with medicine and psychology, part of the field can be very progressive. As new studies come out every day for cures and ideas of how to help people in one way or another. Medicine and psychology are expanding and creating breakthroughs that are necessary for our health and wellness. On the other hand, there are aspects of medicine and psychology that need to be picked apart with a pin in order to fix the deep issues we have created. Part of these issues within medicine and psychology run as deep as our roots. The stigma and norms we have created surrounding sexuality have created check boxes for gender to fall into rather than a fill-in-the-blank line. By continuing to break down gender and sexuality norms within our everyday society (media), through our health programs in our school districts, even to go as far as how we raise our children; we will not only be able to normalize queerness within gender and sexuality but we will also be able to support medicine and psychology through a queer transition as well.
To revise psychology, we need to look at the definitions and obligations that lie within mental disorders and figure out how to reassess them so that they have a queerer way of thinking. An example of this would be to not push an asexual being into a sexual disorder simply because they do not have sexual attraction within the “normal” range. Another example would be to stop putting transgender people through so much in order to get them the medical care that they need. While psychology is objective through the eyes of the psychology professional, it is also objective through the patient as well. The job of a mental health professional is not to put patients into a box so that they feel trapped but rather listen to and see what the individual is saying with the freedom of the boxed in walls down. The psychology field should be progressive and learning through individuals rather than having the mindset that the professional knows best. By liberating psychology from the anti-queer mindset, this will further help the medical field become queerer as well. If the medical field became queerer then the psychology field would definitely follow, however, the medical field seems to be more set in its ways than psychology. Therefore, by normalizing queerness within psychology, hopefully medicine will follow shortly behind.
A way to normalize queerness within science is a lot easier than by trying to change the entire course of medicine and psychology. As a society, if we start by destigmatizing psychology (especially mental health disorders) we can lessen the queerness of the psychology stigma. Secondly, by continuing to talk about mental health, psychology will become the less queer science than it previously has been seen to be and medical professionals will be able to follow psychology with less shame than previously done. Lastly, a main thing we can do to change the way medical and psychology professionals see not only asexuality but also transgender folks, is by normalizing queerness within our everyday lives. By being open and outright with our identities as queer people, whether that be with a disability, mental illness, sexuality, race, gender, etc.; we can erase the silence that surrounds these issues. I was not diagnosed with a sexual disorder because I stood my ground and was very confident in my sexuality and who I identified myself as. As a future mental health professional, I have made it my goal to stand up for queerness within the psychology field and to advocate for those who may not be able to advocate for themselves. While this issue wasn’t directly discussed within the readings from this past semester or in either one of my courses (abnormal psychology and queer studies) that doesn’t make this connection any less valid. Asexuality is not a mental disorder just as homosexuality isn’t a mental disorder. From a queer studies perspective, science needs to be queer. It cannot be masked as queer but rather needs to be shouting queer from the rooftops in order to really make a change.