#demedicalization

[disabledunitypunk]

A Conversation About Demedicalization and Disorders

Let's talk about demedicalization. What is demedicalization? The Open Education Sociology Dictionary defines demedicalization as "The process by which a behavior or condition, once labeled 'sick', becomes defined as natural or normal." It is the process of normalizing a trait of the body or brain or behavior as a normal variance of human existence, rather than a pathological variance in need of treatment or correction.

Put simply, it is no longer looking at something as a sickness in need of treatment, but rather just another way of existing.

Some background info that is needed: the social and medical models of disability.

The medical model posits that the existence of disability is predicated on inherent pathological differences in the bodymind, that it is active physical limitations, some of which can be treated or "corrected", that make a person disabled.

The social model, on the other hand, states that is is a societal lack of access and accommodations that disables a person, and that a person would no longer be functionally disabled were these access barriers to be removed. Keep in mind that this does not mean they believe that people would not still have "impairments" that affect how they are able to function, but that it defines disability as the disadvantages caused by an ableist society treating impairments as needing to be "fixed" rather than accommodated. I defines being abled as being able to participate in society to the full extent an impaired individual wishes to.

I believe in a mixed social-medical model. I believe that some conditions are inherently disabling and that seeking medical treatment for them, while it should be up to disabled individuals, is helpful and good. My ADHD, for example, will still limit my participation in society to the extent I want to, without medication. You could consider medication an accommodation, but there's also the example of my chronic pain and fatigue and POTS that often keeps me housebound or bedbound. There may not be a treatment for that, and I cannot fully participate in the world around me because of that.

"Ultimately, the social model of disability proposes that a disability is only disabling when it prevents someone from doing what they want or need to do."

I am actively prevented from doing what I want or need to do by an inherent feature of my body that no amount of accommodation can allow for. However, some of my conditions would not be disabling with proper accommodation - my autism, for example, I don't generally consider disabling because the people and structures around me DO accommodate for it.

So why is demedicalization helpful or necessary, and how is is applied?

Well, three psychological examples: autism, psychosis, and schizophrenia.

Autism is currently, in the DSM, called autism spectrum disorder. However, autism is a neurotype, and many autistic people do not feel that autism inherently causes them distress or dysfunction, and is therefore not disordered. That is why many of us call ourselves autistic people or say we have autism, rather than ASD. There has been a push for years for the diagnosis itself to be changed to not contain the word "disorder", and to allow for informed self-diagnosis.

Informed self-diagnosis is also an important part of demedicalization, especially of neurodivergence. It says "someone doesn't need a doctorate to know themselves and their own experiences well enough to categorize and classify them. Good research and introspection is enough to trust a person to make the call, and labeling oneself as a specific kind of neurodivergence is harmless, even if they later find out they were wrong.

Psychosis is the next example. There is a growing movement that I've talked about before: the pro-delusion movement. Not everybody experiences distressing delusions, and even when they are distressing, this movement says that only the individual experiencing them has the right to decide whether they should be encouraged or discouraged. It states that it is a violation of autonomy to nonconsensually reality check (tell someone their delusions are not reality) someone, and that as long as a person is not harming others, they can do as they like with their delusions.

This is an example of demedicalization. Treating delusions as something not to be suppressed with medication or ignored or "treated" or "fixed", but as simply another, morally and "healthily neutral" way of existing outside homogenous neurotypical norms.

Finally plurality. Now what's key here is that demedicalization does not mean saying a thing can NEVER be disordered. In fact, that's why I made this post. I saw someone the other day say that they felt their aromantic identity was disordered. Initially, I balked, thinking they were internally arophobic, but I listened to what they had to say. Essentially, they expressed that the identity was never inherently disordered, but that it caused them distress and dysfunction and so they experienced it as such, and crucially, that wasn't a morally bad thing or something they felt they had to correct.

Because here's I think what gets left out of discussions on demedicalization: demedicalization also means no longer treating disorders as something that inherently have to be treated or fixed, that disorders can simply exist as they are if the person with a disorder so chooses; and that anything can be labeled a disorder if it causes distress and dysfunction without being inherently disordered AND without needing to be treated.

And conversely, this means that if you experience something as disordered, demedicalizing it means that you do not have to meet an arbitrary categorical set of requirements to seek treatment, but can do so based on self-reported symptoms. Treatment cannot be gatekept behind a diagnosis that only a "qualified professional" can assign you.

This means if someone wants to, they can label their autism as disordered, but it is never forced on anyone. If someone feels ANY identity - neurodivergent, disabled, queer, alterhuman, paraphilia, whatever - is disordered, they can label it as such, but they also don't have to. There are no requirements to follow through with "treating" anything you label a disorde, either. No strings attached, just the right to self-determination and the right to autonomy hand in hand,

So, back to plurality. You essentially end up with three aspects of demedicalization. You have nondisordered plurality being normalized, you have dissociative disorders that systems can choose not to pursue treatment for without judgment or coercion, and you have disordered systems that can pursue treatment for dissociative symptoms without receiving a difficult-to-access diagnosis. Based on their experiences, they can choose to label themselves as having DID, OSDD, UDD, or related disorders, or to forgo the label and simply seek treatment for whatever distress or dysfunction the disorder is causing.

"But without a specific diagnosis, what if they pursue the wrong treatment and it harms them?"

This is where the importance of recognizing self-reported symptoms as valid comes in. If an OSDD-1b system that hasn't labeled themselves or receives a diagnosis reports that they don't experience amnesia, they won't receive treatment for amnesia.

And since symptoms can mask, if a DID system reports not experiencing amnesia, they simply do not become aware of it or receive treatment for it before they are ready, which is a good thing because recognizing certain symptoms before you are ready to deal with them can be destabilizing and dangerous. More awareness of dissociative disorders will also make it easier for systems to adequately recognize those symptoms, and this isn't saying that someone else can't suggest it to the system experiencing it. It's simply saying the person experiencing a disorder takes the lead and is centered as the most important perspective.

I consider myself to have several disorders and several forms of nondisordered neurodivergence. My BPD is disordered but I am not treating it because I have healthy coping skills already. Same with my schizophrenia. My narcissism, on the other hand, is simply a neurotype. My plurality is both - the plurality itself isn't disordered, but I do have DID on top of it.

A last example, this one physical, of demedicalization: intersex variations. The intersex community has been pushing to recognize that intersex variations are natural variations in human sex, and not medical conditions that need corrected. This doesn't mean that any unpleasant symptoms related to an intersex variation can't ever be treated - in fact, it's important to the community to have that bodily autonomy to access whatever reproductive healthcare is needed - but it does mean treating our sexes as inherently normal and NOT trying to coercively "correct" them.

So in summary, demedicalization is fundamentally about autonomy. It is about considering natural human variations as such, rather than as sickness to be cured, about letting people determine for themselves whether any aspect of themselves is disordered, and the decision on whether or not to pursue treatment for anything being theirs alone. It is about trusting people to be reliable witnesses and narrators of their own subjective internal experiences, and about never forcing anyone to change any aspects of themselves, disordered or not, that aren't harming others. In short, it is about putting power back into the hands of disabled people. And that is what this blog is all about.

[cambriancrew]

Listen. Endogenic systems (with or without DID/OSDD-1) and nondisordered traumagenic systems and supporters thereof, by a very large majority, are not calling for DID/OSDD-1 to be demedicalized. We want those to stay disorders so that people who actually do need the help and support and treatment and accommodations can get it.

We want plurality to be demedicalized. It already is, anyway - that's why there's nondisordered plural systems in the first place. We want more people to recognize that it's possible to be many in one head and not have DID or OSDD-1 or any other disorder - just like the ICD-11 says is possible. Like Dr. Eric Yarbrough's book Transgender Mental Health says in its chapter on plurality. Like what two of the authors of the theory of structural dissociation of the personality said. Just like we plurals have been saying for decades.

So please stop saying that we want DID/OSDD-1 to be demedicalized. We don't. That's a strawman.

[sysmedsaresexist]

How do you politely say, "bro, you're being kind of ableist and sanist right now"?

Like, you're doing the complete opposite of what you think you're doing

And it's very painful to watch and read, and the number of people you're hurting with your disdain for the mentally ill is more obvious than you realize

[vitruvianmanbara]

the way so many ppl on here react to trans women just like loving themselves their bodies & sexuality with this inherent suspicion is so sick tbh it's like some of you are living in the 1950s...I really think everyone should learn a thing or two about the history of the medicalization of transness. so you 1) can see how unfair it is that the medical world doesn't bat an eye at how a cis woman's sense of gender can factor into her sense of sexuality in a way that's enjoyable & hot to her, but trans women who expresses the same is literally still considered to have a mental disorder by the medical establishment in 2023. and to 2) also be more mindful of how this transmisogynistic, medicalized way of thinking about trans sexuality & gender affects how you treat trans women 😶

[strawberrymilksystem]

I’m crawling through pluralpedia for ya’ll and I’m so so tired.

-B0ffy

[folkgender]

on: endogenic and traumagenic shared spaces

endogens and traumagens cannot and should not share spaces online.

these states of being are entirely different. i was speaking to another traumagen system about this, and we came to the consensus that traumagens and endogens are actually completely different.

“but planetary,” you say, “both -genics have alters!”

yes. we both do. however, endogenic collectives are alter based. being endogen is not a disorder (and i’ve got another ramble on that just you wait) and generally, being endogen is about headmates and having different people in your brain.

that is never, ever what didosdd will be fully completely and wholly about.

didosdd are trauma disorders. in every traumagen system, you will see the progression of trauma in early childhood to dissociation to the sense of self never fully integrating, creating alters. every. single. time.

traumagen systems are about dissociation, trauma, not having a sense of identity, and amnesia— endogen collectives can dissociate and have trauma but if your collective did NOT come from a traumatic origin, you probably shouldn’t be sharing a space with cptsd survivors.

[thestarseersystem]

Sysmed is not a slur, but it's used to insult and degrade people that say dissociative disorders should stay disorders.

Like idk why y'all think people are upset.

Sysmed as a term is incredibly offensive, we just don't want complex dissociative disorders to be demedicalized.

People calling us names and insulting us is like they want to call us slurs. But it's not a slur, it's just a shitty term with a shitty origin.

So like? Just call us anti-endos instead. Or something. Just stop using "sysmed" because it's transphobic, you asshole.

[coffeecandy]

just saw someone say sysmeds are """"ableist"""" i think we need to bring back public executions im so serious

[syscoursehell]

got pinged on a post and instead of rb’ing it here i’m gonna just tell you guys my thoughts.

the reason i state that the endo community has the goal of trying to demedicalize DID/OSDD/UDD is because that has been their goal from the very start of the community. astraeas web and the “empowered multiples” movement shows that very clearly. the history of the endo community out of that environment is one of demedicalization of a trauma disorder, for which people need long-term and extensive therapy to even begin healing with (whatever the goal of that system may be), and if this disorder were to be demedicalized, that would mean dozens of systems would no longer have their treatment covered by insurance or by the means that it is usually covered where they live. it’s nearly impossible to find a dissociative specialist in some places, and if it were completely removed from the DSM or ICD, the damage would be immense.

anyways. demedicalizing DID/OSDD/UDD is deeply harmful, thanks for coming to my ted talk

[woman-respecter]

tmi but i am functionally asexual bc of depression and taking ssris from a young age but i will never id that way for multiple reasons one of which being the fact that asexuals on here can be quite uh cringe. the other reasons being obvious. can you imagine how fucked up it would be to gloss over those issues just to use the asexual label

[endonp-no-d]

the demedicalization of disorders is going to kill people.

Anon, tell me, what made you jump to such an extreme conclusion and feel the need to drop the unlikely into the inbox of a person just trying to exist peacefully in their own space?

What is making you act out in these ways, to someone who has explained their points and beliefs already?

The de-medicalization of things such as personality based and system based disorders won't kill people. Same with autism or adhd.

Yes, there are limits to what can and cannot be de-medicalized, that might have severe problems if it was tried. Yeah, duh. But how about you go back and re-read our posts about us and how we live life.

Also, it's clear you ran out of argument points because you resorted to a very extreme situation to try and win the battle you're losing.

[karmaphone]

and just so it's final, I don't believe in endogenics, and I will block you if you try to start syscourse over it. every single piece of research on dissociative disorders (especially parts-related complex dissociative disorders) indicates that they are caused exclusively by repetitive childhood trauma - usually sexual trauma but other repetitive traumas can also be a causative factor. saying you're a system or are plural and that you don't have trauma plays right into the social stigma of the disorders, especially considering what contributes a lot of time to the formation of systems is trauma that is denied and explained away as normal - especially problems like incest. I've seen far too many posts by former endogenics explaining explicitly how that community has harmed them, especially as it relates to the idea that you shouldn't have to unpack your trauma and work on your trauma responses - because hey, we don't have to be traumatized to be like this, right? don't worry about that - let's focus on how cool this is and what we can do with it - isn't it cool how you can make your own friends?

I've also seen far too many people appropriating tulpas in the endogenic community. you're not cute, it's cultural appropriation.

If you message me about syscourse or try to make a call out post I will simply block you and move on with my life. because *gasp* therapy works and I can mind my own fuckin business if someone online is mad at me or holds a different position ✌🏻

[permanently-sprained-ankle]

All disabled people are disabled, but some disabled people are more disabled than other disabled people.

All disabled people face ableism, but some types of disability will be more subject to ableism than others.

We can accept both facts: there is unity among disabled people in the oppression that we face and the identity we share, and also that there is a wide range of experiences and privileges within the spectrum of disability.

Edit: I made a blog @cripplepunk-archives for this kind of thing so go check it out if you liked this post ig

[Image ID: White text in a Galaxy background reads If you: Derail my posts; are an “aspie”; run a sh/ed blog; are under 16; are a TERF; think cripplepunk is for mental disabilities; think that autism isn’t a disorder; are pro-transabled, trace, transage, etc; are pro-map or pro-zoo; are a transmed; want to completely demedicalize autism, I will probably block or mock you. End ID]

[detrasystem]

for the love of god can "sysmeds" stop ruining everything for TWO SECONDS!!!!!!!!!!!!!!!!!!!!!!!

[trans-axolotl]

decided to try to go back on testosterone again. i got my prescription at planned parenthood on sunday and am going to try to pick it up today. have been off t for about a year and was doing diy before that. i really like being on testosterone and really like how it makes me feel and really like the changes it brings but the past trauma from being forced on estrogen makes it SO hard for me to actually stay on it. i start to get so fucked up just about taking any hormones at all and sometimes get paranoid and delusional that they are secretly giving me estrogen instead of testosterone and it's so so hard to stay on it. also really hard to convince myself to willingly go see an endocrinologist. forever so mad at how intersexism caused me this type of medical trauma that STILL fucks up my ability to transition. like i want to be on testosterone so fucking bad but so far the longest i've been able to stay on it without getting delusional is about 8 months. i hate that the medical abuse is still creating barriers for something i want to do 8 years later.

but. we're trying. got a bunch of axolotl stickers to cover my sharps bin + testosterone containers in to try to demedicalize it as much as possible. got a lot of extra needles so that needles access isn't a barrier. also in a much better place than the last time i was on testosterone and am going to try to stop my habit of reusing needles. also think im going to try to stockpile hrt a tiny bit so that i can overlap when i move and don't have to go months without t again. just. trying everything i can to make this as easy as possible bc it brings me so much joy to be on testosterone and i wish it were easier for me.

also if any intersex or schizo besties who have similar things going on and have any tips that have worked for them. pls let me know

[pluralcultureis]

hey this a friendly question not an accusation or anything i just wanna ask why it is you don’t support endos? im new to this community n just kinda learned what an endo is, and i understand why you might not want to interact with endos, but im confused as to why you’re anti-endo. ty for reading!

Endos spread a lot of harmful misinformation, especially the biggest one that systems can be formed without trauma, because they can't

DID/OSDD are traumagenic disorders in nature, and a lot of endos push for the de-medicalization of plurality. Getting a diagnosis as a system is already so insanely hard, and if it got demedicalized it would be even worse

On top of that, systems who enter Endo spaces when in early discovery often don't remember their trauma, or if they do they don't remember a lot of it. And while it's not good to push to remember what you aren't ready to, it's worse to become convinced it never happened. Because you can't heal if you never acknowledge that you were traumatized

We've also had endos try and convince us that what trauma we expirenced that gave us this disorder wasn't enough to be a traumagenic system, so we had to be endogenic or we weren't a system

What endos do and spread does so much damage to the healing of systems, and they push so many anti recovery rhetoric

Personally I'm not actually anti-endo, I just don't want them to interact with me. I believe they're systems, I just don't believe they formed how they think they did because the disorder is doing it's job and protecting them from it

I consider myself neutral, because at the end of the day if someone isn't spreading misinformation idgaf. But a majority of ppl who identify as endogenic spread so much misinformation it's genuinely scary

And again, as always when this topic comes up, please just do your own research. Read papers, look for articles, find information that's trustworthy and form your own opinion