Jem Tosh, a nonbinary psychologist focusing on gender and trauma, has sounded a call to action within the psychological community. They challenge practitioners to dig deeper than surface-level inclusivity and critically assess their biases and institutional systems that perpetuate harmful narratives and practices.
In a recent interview with Güler Cansu Ağören from Ankara Yildirim Beyazit University in Türkiye, Tosh unravels the complexity of performative allyship and the risk of complacency among professionals who may believe they’re doing enough by merely acknowledging the existence of marginalized communities. Citing examples from their own experience, Tosh notes instances where professionals in the field of feminist psychology preach the importance of inclusivity but simultaneously hold unfounded biases against the very communities they profess to support.
The discussion dives deep into the heart of psychology, probing the need for a fundamental “conceptual revolution” that acknowledges and dismantles oppressive systems from within.
“In these attempts to incorporate more critical perspectives… there has been less focus on the dismantling of oppressive structures (such as the colonial gender binary and gender’ norms’ produced by psychology) or the creation of alternative therapeutic/healing systems that exist outside of these structures,” Tosh explains.
“This is because the default in psychology is the dominant discourses and oppressive structures, like cishet normativity and white supremacy, which is due to the long history of mainstream psychology being predominantly defined by cisgender, straight, white men. A psychological revolution requires more than self-defining as ‘good’ or ‘inclusive’ to change that. Like the rainbow-washing of organizations that change their logos for Pride while enacting anti-2SLGBTQAI+ policies, so too can declarations of inclusivity without the action to back it up be a way for people to feel like it is not their responsibility to change.”
Their platform, Psygentra, uses critical approaches to psychology and psychiatry “based on the interaction of [client] experience and expertise” while generating and publishing research that focuses on “intersectionality in the fields of gender and trauma.” Tosh seeks to challenge these established norms and bridge the divide between theory and practice, ensuring the voices of the marginalized are not just included in psychological discourse but central to the conversation.
Jem Tosh discussed their experiences in the “psy fields,” encompassing the differences between “inclusivity” and “affirmation” and the concept of “performative allyship” practiced in the field of psychology. They also highlighted the need for a “conceptual revolution” in psychology to challenge and dissolve oppressive systems. The conversation went deeper into the examination of consent, particularly within sexuality and its extension to the psychiatric field. The dialogue concluded with details on Tosh’s new organization, Psygentra, and its intended purpose.
Performative Inclusion and Affirmation
“Stemming from the position that the individual is ‘good’ and therefore harmful or oppressive actions are incongruent with how they view themselves, there can be this disconnect between that self-perception and their engagement with problematic discourses, structures, and practices.”
Ağören inquired about Tosh’s perspective on the tension between critical approaches to psychology and mainstream psychology. Tosh’s initial point was about the challenge individuals face in reconciling their perceived “goodness” with critical critiques. This often leads psychologists to prioritize their personal image over confronting larger institutional issues.
For example, universities and healthcare companies with clinical departments will often boast about their inclusivity and openness and market their stance against transphobia, homophobia, and other forms of oppression (especially during Pride Month, with what is known as “Rainbow Capitalism”). However, these same departments will still teach “reparative therapies” for LGBTQIA+ people, continue sometimes destructive discussions around “brain diseases,” or place the effort needed for change onto the marginalized group that is being oppressed.
“Rather than introducing change to the organization or group (led by or in consultation with that marginalized community), what happens is that marginalized person enters an oppressive system that was designed to exclude them and may be hostile towards them, which can result in bullying, harassment, and violence, as well as trauma and distress.”
Tosh stresses that those considering themselves “good” should not just reflect on their individual morality but should actively challenge and dismantle oppressive systems. True affirmation for marginalized communities goes beyond merely demonstrating “the minimum necessary and political and ethical awareness.”
“…those smaller actions won’t change the oppressive system if the people think they are already ‘good’ and that if any further work needs to be done, it needs to be done by someone else.”
Psychology’s Need for a “Conceptual Revolution”
Tosh emphasizes that for psychology to be genuinely inclusive and transparent about its limitations, foundational shifts in its approach are essential. They discuss how “political concepts can become sanitized and individualized within psychology, as approaches that promote ‘objectivity’ (over transparency and reflexivity) attempt to single out the issue under study, such as to remove ‘confounding variables’ in positivistic discourse, but doing so can strip the phenomena from its social, historical, and cultural contexts and the complexity and interconnectedness of human experience and subjectivity.”
They point to the changes in social psychology that helped birth Ian Parker’s Critical Psychology and the removal of diagnoses in the DSM that specifically targeted queer people as attempts to change these oppressive structures. Yet, these attempts themselves have been marginalized or minimized.
In terms of the removed diagnoses, a “closed book” history emerges that ignores the history of those diagnoses, the research that still exists based on those diagnoses, and ignores that there are still people who look at non-heterosexuality and non-gender conformity as pathological and diagnosable mental illnesses.
Critical Psychology itself, while beginning in the realm of social psychology, has tried to branch into other areas of psychology, such as Cognitive Psychology. However, these critiques often remain on the outskirts or are only taken up philosophically and never introduced in praxis.
“The result is that the critical perspective is positioned on the fringe, as an ‘extra,’ or only relevant in specific settings, and the main focus of the training and the mainstream concepts remain relatively unchanged.”
For example, Tosh discusses a common experience they had while training on gender inclusivity. During these trainings, physicians often ask, “What do I call them?” regarding pronouns and gender identity. Their response was, “Ask them.” But simply making this request or asking these physicians to admit they did not immediately know something raised an important issue.
“This seemingly simple question [what are your preferred pronouns?] revealed a more fundamental problem that represented a greater structural hierarchy that needed addressing first – that the doctors felt the need to be the most knowledgeable person in the room. In their role, they were positioned as expert, and admitting to a patient that they did not know something as basic as their name, gender, or pronoun felt like a betrayal of the role required of them.”
This situation showed that the hierarchical and authoritarian power dynamic, even in an expressly inclusive setting, is alive and well. It is not as simple as including token representation or symbols of inclusion but asking questions about social relationships at their very core.
Sexual Violence and Consent
Ağören and Tosh, to better describe the issues in these social relationships in the clinical setting, discuss some of the problems that still exist within our social definitions of consent, especially in terms of embodied experience and sexuality. To better understand their position on consent, Dr. Tosh first describes the theory of intersectionality:
“Within this framework, individuals hold positions of relative power and oppression simultaneously, such as the privilege that comes from being a cisgender man in patriarchy, but also the marginalization of being a black man existing in a racist white supremacy, and/or a working-class man under capitalism. These positions shift and transform in fluid ways as the context and culture changes. When we also consider other axes of power and oppression, such as sexuality, disability, and sanism4 (i.e., the oppression of people who have been ‘psychiatrized’ or have a psychiatric diagnosis…), it becomes even more complex again.”
Just as an identity may hold privileges and oppression, consent and the power dynamic within consensual agreements become more fluid and dependent on definitions and conversations. In terms of sex, there may be initial consent, but any assertion of non-consent is enough for an encounter to become coercive. Yet, the presence of initial consent in today’s culture can lead to dismissals of claims of sexual assault.
“Many instances of resistance, such as saying ‘no,’ trying to leave, crying, or physically fighting off a perpetrator, are disregarded for any instance of consent, which then becomes used as ‘evidence’ that the entire interaction was ‘consensual.’ This erasure of resistance draws on a contractual form of consent and assumes that once consent is given, it can be applied retroactively and cannot be retracted.”
Reconceptualizing consent also affects psychiatry when medications and physical interventions are performed on the body. Full consent is needed for any possible interventions a physician may perform on a person. Yet, in the field of psychiatry, there are still gaps in terms of full disclosure around medications, including a recent example found on the Mad in America website where an antipsychotic was prescribed for acid reflux without the full disclosure of the drug’s side effects and possible changes to the brain, or around the long term effects of procedures such as Electroconvulsive Therapy (ECT).
Just as in the arena of sexuality and gender, changes to psychology to accept this definition of consent would include the understanding and then dismantling of systems that limit the voices of those affected by these power dynamics, leading to non-consensual or coercive experiences with psychiatric treatment, while also ensuring the voices of victims are heard and not limited by existing biases and power structures.
The purpose of Psygentra
The interview ends with Tosh describing their new organization, Psygentra, and how it attempts to move out of mainstream academia and clinical treatment to enact the changes Tosh sees as necessary for creating a truly non-oppressive psychology. Their goal is not to be simply inclusive, “where people are invited into an already existing space that is oppressive or exclusionary for them, in the hope that they will change that space and make it more inclusive by their presence,” but instead, Psygentra hopes to “build a community around [those excluded from mainstream psychological discourse].”
“This means that rather than have a constructed boundary between psychologists or psy professionals, and those who experience trauma and its long-lasting effects, [Psygentra positions] those who have experienced trauma as both survivors and experts… This subverts the standard hierarchy in pathologizing psychologies. We also include critical perspectives in our work around surviving and healing from sexual abuse (such as non-pathologizing and feminist work), as well as keeping a critical lens on the profession itself, such as addressing sexual abuse that happens within psychology.”
The interview with Jem Tosh spotlights a fundamental issue in modern psychology: the dissonance between declarative inclusivity and actual practice. Tosh’s insights underscore a pressing need to thoroughly reevaluate the foundational structures and biases ingrained within psychology and psychiatry, highlighting the gap between acknowledging marginalized communities and truly understanding, respecting, and integrating their experiences.
For those deeply invested in critical approaches to these fields, Tosh’s call to action underscores the profound significance of bridging theoretical acknowledgment with substantive change. As the discussion around performative allyship and institutional complacency intensifies, Tosh’s work serves as a clarion call, emphasizing the indispensability of intersectionality, consent, and authentic affirmation in transforming psychological discourse.
Ağören, G. C. (2023). From inclusivity to decentralization: An interview with Jem Tosh on imagining an alternative psychology in the context of othering, transphobia, and sexual consent. Journal of Psychology, Gender, & Trauma, 1. https://www.researchgate.net/publication/373652184_From_Inclusivity_to_Decentralization_An_Interview_with_Jem_Tosh_on_Imagining_an_Alternative_Psychology_in_the_Context_of_Othering_Transphobia_and_Sexual_Consent