Queerness x Neurodiversity I: Autistic Liberation and Queer and Trans Liberation Are Fundamentally Intertwined
by: Kay Salvatore (They/He) — autistic afro-realist, INTJ, 8w7w9, screenwriter sans representation.
If you are against gay and trans conversion therapy but you support applied behavior analysis (whether it’s called ABA, RDI (relationship development intervention), FloorTime, Occupational Therapy (for “autism”), or anything else that the notorious antiAutistic hate organization Autism Speaks supports), you literally support gay and trans conversion therapy.
If you didn’t know, here are some facts about the relationship between the autistic community and the LGBTQIA2+ community (which I will be referring to as the queer and trans community hereafter; and, yes, I know that not everyone who is part of the LGBTQIA2+ community identifies as queer, and that queer politics is fundamentally different from LGBT politics):
In the largest study to date on these topics, the team at the Autism Research Centre used an anonymous, self-report survey to study the sexual activity, sexual orientation, and sexual health of autistic adults. Overall, 1,183 autistic and 1,203 non-autistic adolescents and adults (aged 16–90 years) provided information about their sexual activity, sexual orientation, and medical history of STIs.
The results showed that the majority of autistic adults (70% of autistic males and 76% of autistic females) engage in sexual activity — although they do so to a lesser degree than their non-autistic peers (89% of both non-autistic males and females report engaging in sexual activity). In contrast to previous findings, the results also found that there were no differences in likelihood of ever contracting an STI, or the age at which participants first engaged in sexual activity, between autistic and non-autistic individuals.
In addition, the study found that autistic adults and adolescents are approximately eight times more likely to identify as asexual and ‘other’ sexuality than their non-autistic peers. And there were sex differences in sexual orientation: autistic males are 3.5 times more likely to identify as bisexual than non-autistic males, whereas autistic females are three times more likely to identify as homosexual than non-autistic females.
When comparing autistic females and males directly, autistic females were more likely to be sexually active; more likely to identify as asexual, bisexual, and ‘other’ sexuality; and were less likely to identify as heterosexual.
And:
People who do not identify with the sex they were assigned at birth are three to six times as likely to be autistic as cisgender people are, according to the largest study yet to examine the connection1. Gender-diverse people are also more likely to report autism traits and to suspect they have undiagnosed autism.
Interesting, right? So, if you’re part of the queer and trans community, either you know someone who is autistic or you are an autistic person. Part of the reason why that may be difficult to accept is:
An early and obvious extrapolation of the idea of the military industrial complex was the articulation of the analogous medical industrial complex (Ehrenreich & Ehrenreich, 1970), more recently further conceptually developed by Mia Mingus (2015). Mingus proposes a fluid and dynamic four-pronged interlocking web of sectors, comprising the sectors of science and medicine, health, access, and safety, further articulating corresponding and underlying motivations or drivers of these sectors: eugenics, desirability, charity and ableism, and population control. Within these overlapping sectors, and driven by these overlapping cultural ideologies, values, or motivators, Mingus articulates some of the major profit-generating components of the medical industrial complex, such as the pharmaceutical and mental health industries, medical schools, insurance companies, and the prison-industrial complex and nursing home industries. Mingus’s conceptual framework is at once complex and dynamic, and indicative of a rapidly evolving marketplace in relation to a relatively stable underlying economic and ideological architecture.
Another obvious extrapolation from the concept of the military industrial complex is that of the education industrial complex: Picciano and Spring (2012) outline a thesis detailing the rise of what they call “the great American education-industrial complex,” defining it as “networks of ideological, technophile, and for-profit entities that seek to promote their beliefs, ideas, products, and services in furtherance of their own goals and objectives. This complex is fueled by significant resources and advocacy provided by companies, foundations, and the media that want to shape American education policy to conform to their own ideals and that also stand to profit significantly from its development.” (p. 2)
Substitute “autism” for “education” in this definition and you have a cogent description of the aic. Picciano and Spring’s analytic is a much simpler heuristic than Mingus’s, comprising principally the tripartite intersecting components of ideology, technology, and profit. Central to Picciano and Spring’s heuristic is the intersections of networks of entities that seek not only to promote their products and services in order to generate profit, but that simultaneously seek to promote their ideas and beliefs (which is just as central to the ultimate goal of generating profit). Autism as a commodity is produced and consumed in part through the mobilization of both the medical- and education-industrial complexes, and the specific exploration of the aic has the potential to further explicate and illuminate how both underlying industrial complexes function. Without endeavoring to reconcile or collapse these two divergent conceptual frameworks into one, we will nevertheless note that in the case of the aic, multiple intersecting and networked sectors of the economy are implicated in the simultaneous production not only of technologies (products and services), but also of ideologies (concepts, values, beliefs, and cultural narratives), that are jointly marketed, produced, and distributed for consumption, all in the ultimate service of profit generation.
Indeed, Picciano and Spring (2012) point out the centrality of these networks to the economic operation of the educational industrial complex, noting that “it is not simply a single entity conspiring to influence education policy. In fact, it is made up of multiple networks that sometimes share agendas but frequently operate independently and compete with one another for contracts and sales of goods and services.” (p. 2)
As is the case with both the medical- and educational-industrial complexes, these networks of entities that comprise the aic are loose and overlapping, and in many ways have emerged over decades as an ad hoc apparatus that is distinctly different from a planned, coordinated, orchestrated monolithic entity. This paper does not afford the time or space necessary to fully outline each of the plutocratic players in the neoliberal networks of the aic, nor to fully outline and analyze the rhetorical and ideological evolution of the aic. Mapping the historical emergence and retrenchment of the aic is part of a larger (book-length) project. However, in lieu of that (Broderick, forthcoming) analysis, we offer here an abridged composite narrative of the emergence of several main “players” on the autism scene, coupled with brief illustrations of their emergence further solidifying the foundations of aic as described.
Among these overlapping and intersecting authorities operating in the aic marketplace are at least four different networks of players, each of which is intimately connected with the field of behaviorism, generally, and with the field of Applied Behavior Analysis (aba), more specifically. These include: (a) academic behaviorists (Ph.D.s in behavioral psychology, teaching at institutions of higher education and publishing studies and position papers in peer-reviewed scientific journals); (b) nonautistic parents of autistic children; ( c) the Behavior Analyst Certification Board (bacb) (a private, non-profit corporation established in 1999 that certifies behavior analysts [Board Certified Behavior Analysts, or BCBAs] at multiple levels); and (d) Autism Speaks (self-described as the world’s largest scientific and advocacy organization for autism; described here as a global, multi-platform, neoliberal media organization and corporate-style policy lobbyist). These players anchor a network of interrelated ventures, and together comprise the foundational plutocrats of the aic, each of which currently participates in some way in the commodification of autism, as well as the concurrent manufacture and branding of its market through producing interventionist logics for public consumption. In so doing, each of these component networks also participates in the commodification of autistic bodies and the production of autistic identities.
What does that mean? Well, in short, there is an intentional global effort on the part of mental health and medical professionals (psychologists and psychiatrists in particular, including “behavioral analysts” (some of whom are autistic as well, which is key in all of this)), politicians, notorious antiAutistic hate organization like Autism Speaks, etc. to spread misinformation and disinformation about autistic people because the existence of “autism” is profitable.
Here’s another relationship between the two communities that isn’t often talked about:
The “founding father” of ABA is generally considered to be Ivar Lovaas, a Norwegian-American psychologist and professor at the University of California, Los Angeles (UCLA). He believed that autistic children were not even people. As Lovaas once said, “You see, you start pretty much from scratch when you work with an autistic child. You have a person in the physical sense — they have hair, a nose and a mouth — but they are not people in the psychological sense. One way to look at the job of helping autistic kids is to see it as a matter of constructing a person. You have the raw materials, but you have to build the person.”
Lovaas developed what he believed to be a comprehensive way to “build the person” and called it Applied Behavioral Analysis. His recommendation was that autistic children receive 40 hours of ABA therapy a week. One of his most important goals was to shape and mold their behaviors so they would appear more like “typically-developing” children. Lovaas felt this was the only way autistic children would ever be able to learn anything, and he would often employ harsh aversive techniques such as withholding affection, withholding food, physical punishments, and even electric shocks.
The strong and punitive aversives Lovaas suggested may not be as widely used today, but the reliance on rewards and punishment continues in other “therapies” and “interventions” that use the principles of ABA, which I’ll discuss in a future article. Some therapists argue that the more “modern” forms of ABA are more humane approaches, but they are nonetheless still based in the idea that autistic ways of being in the world are unacceptable and must be eradicated.
So what’s the connection to gay conversion therapy?
Well, Lovaas was also substantially involved in the Feminine Boy Project, which has strong connections to what is today known as gay conversion therapy. Psychologist George Rekers, a key figure in the world of conversion therapy (and co-founder of the notoriously anti-gay Family Research Council), used Lovaas’s techniques to treat so-called “deviant sex-role behaviors” in male children.
And when you think about it, even if Lovaas had no connections at all to gay conversion therapy, ABA has enough similarities to gay conversion therapy that many autistics refer to it as “autistic conversion therapy”.
And what do we already know about gay conversion therapy and trans conversion therapy?
Speaking at the Human Rights Council where he presented his latest report, the UN Independent Expert on sexual orientation and gender identity, Victor Madrigal-Borloz, called on States to “work together to institute a global ban on practices of conversion therapy.”
The expert added that these practices are “inherently discriminatory, that they are cruel, inhuman and degrading treatment, and that depending on the severity or physical or mental pain and suffering inflicted to the victim, they may amount to torture.”
‘Conversion therapy’ describes interventions that purport to achieve a change in a person’s sexual orientation or gender identity, and thus claim to aim at changing people from gay, lesbian or bisexual to heterosexual, and from trans or gender diverse to cisgender — meaning whose gender identity corresponds to the sex they were assigned at birth.
“Practices of conversion therapy are rooted in the belief that persons of diverse sexual orientation and gender identity are somehow inferior, either morally, spiritually or physically because of their orientation or identity, and that they must modify that orientation or identity to remedy that inferiority,” Madrigal-Borloz said.
In his report to the Council, he identifies three main approaches in the practice of ‘conversion therapy’: psychotherapeutic interventions based on the belief that sexual or gender diversity steams from an abnormal upbringing or experience; medical practices rooted in the theory that sexual or gender diversity is an inherent biological dysfunction; and faith-based interventions that act on the premise that there is something inherently evil in diverse sexual orientations and gender identities.
Acts of physical, psychological and sexual abuse, electrocution and forced medication, isolation and confinement, verbal abuse and humiliation are all examples pointed out by Madrigal-Borloz of methods applied to attempt conversion.
A recurrent method used is aversion through which a person is subjected to a negative, painful or distressing sensation while being exposed to a stimulus connected to their sexual orientation.
Interventions can also rely on pharmaceutical approaches, such as medication or hormone or steroid therapy. The expert gives examples where individuals who inevitably fail at ‘converting’ their sexual orientation will often be pressured to undergo gender-affirming surgery, in the belief that it will neutralize their orientation.
A large, first-of-its-kind study has found that transgender people who reported receiving so-called conversion therapy were more than twice as likely to have attempted suicide during their lifetime than their peers who had engaged in other types of therapy, NBC News reports. And for those who were younger than age 10 when they underwent attempts by practitioners to align their gender identity with their sex assigned at birth, the relative risk of attempted suicide was more than four times as great. The study, based on a 2015 survey of nearly 28,000 transgender people, also found that conversion therapy survivors were 1.5 times more likely than peers who underwent other kinds of therapy to have experienced “severe psychological distress” in the month before the survey, researchers reported yesterday in JAMA Psychiatry. Another important finding: There was no significant difference in risk for people who reported receiving conversion therapy from religious advisers versus secular therapists.
2. What happens in conversion therapy?
Because conversion therapy is not a mainstream psychological treatment, there are no professional standards or guidelines for how it is conducted. Early treatments in the 1960s and 70s included aversion therapy, such as shocking patients or giving them nausea-inducing drugs while showing them same-sex erotica, according to a 2004 article in the British Medical Journal.
Other methods included psychoanalysis or talk therapy, estrogen treatments to reduce libido in men, and even electroconvulsive therapy, in which an electric shock is used to induce a seizure, with side effects such as memory loss. [7 Absolutely Evil Medical Experiments]
More recently, people who have been through conversion therapy report talk therapy that emphasizes pseudoscientific theories, such as the idea that an overbearing mother and a distant father make a child gay. In an April 2012 essay in The American Prospect, writer Gabriel Arana describes his “ex-gay” therapy experience. His therapist blamed his parents for Arana’s homosexuality, and urged him to distance himself from his female best friends.
Chaim Levin, one of the men suing Jonah for deceptive practices, says that he quit conversion therapy after his therapist had him strip down and touch himself to “reconnect with his masculinity,” according to the New York Times.
3. Why psychologists say conversion therapy doesn’t work
Homosexuality is not considered a mental disorder, so the American Psychological Association (APA) does not recommend “curing” same-sex attraction in any case. Instead, societal ignorance, prejudice and pressure to conform to heterosexual desires are the real dangers to gay people’s mental health, according to a 1997 statement on “conversion” or “reparative” therapy by the APA.
A 2009 APA task force found that conversion therapies, despite being touted by religious organizations, have little evidence to back them up. A review of studies from 1960 to 2007 found only 83 on the topic, the vast majority of which did not have the experimental muscle to show whether the therapies achieved their stated goals. (Many of the people studied in the early years were court-mandated to take the therapies, adding a coercive element to those outcomes.)
The best-quality studies were more recent and qualitative, the APA task force found, meaning they focused not on the statistical effectiveness of treatment, but of the subjective experience.
“These studies show that enduring change to an individual’s sexual orientation is uncommon,” the task force wrote in their 2009 report. The participants continued to report same-sex attractions after the conversion therapy, and were not significantly more attracted to the opposite gender.
These studies did find that conversion therapy could be harmful, however. Negative effects included “loss of sexual feeling, depression, suicidality and anxiety.” [. . .]
5. Okay, but what about that one study that found conversion therapies work?
Groups that promote conversion therapy often point to a single study to support their work. In 2003, famed psychiatrist Robert Spitzer, who spearheaded the removal of homosexuality from the American Psychiatric Association’s mental disorder list in 1973, reported in the journal Archives of Sexual Behavior that interviews with conversion therapy patients suggested that some people could change their sexual orientation.
The paper was incendiary and highly criticized, given that it relied on interviews with patients instead of measurable benchmarks of same-sex desires. Conservative groups were delighted to have support from Spitzer, who wasn’t tainted with religious bias or anti-gay ideology; gay organizations felt betrayed.
In the end, however, Spitzer came to agree with his critics. There was no way to confirm that what his interviewees said was true, he wrote in 2012 to the editor of the journal Archives of Sexual Behavior. The study, he said, was fatally flawed.
“I believe I owe the gay community an apology for my study making unproven claims of the efficacy of reparative therapy,” Spitzer wrote.
So, what does this mean?
It means that if you are against gay and trans conversion therapy, you must necessarily be against subjecting autistic people and allistic (non-autistic) people who are assumed to be autistic to applied behavior analysis (ABA). If you know and understand how fundamentally damaging queer and trans conversion therapies are for the queer and trans community, and you now know that ABA is literally the same thing as queer and trans conversion therapy for autistic people, and you support ABA (in any and every one of its forms (listen below; which, I would imagine, is not an exhaustive list of all forms of ABA (and this also includes the ways that we’ve been conditioned to treat introverts since all introverts are autistic; and, no, being an introvert is not synonymous with being quiet, “shy,” “antisocial,” “reserved,” etc. the same way that extrovert is not synonymous with being social and outgoing)) you literally also support queer and trans conversion therapy. And that makes you no better than the homophobes and transphobes you claim to be against.
There are a lot of people (including queer and trans autistic people) who work as behavioral analysts for these companies that claim to not do ABA or support notorious antiAutistic hate organization Autism Speaks (and “autism” organizations run mostly/only by allistic people), yet they all promote some form of ABA that is listed on Autism Speaks’ website including (but not limited to):
Early Start Denver Model (ESDM)
Pivotal Response Treatment (PRT)
Relationship Development Intervention (RDI)
Research in ABA continues to neglect the structure of the autistic brain, the overstimulation of the autistic brain, the trajectory of child development, or the complex nature of human psychology, as all of these factors were ignored in the response and are ignored in ABA practice itself. Providing a treatment that causes pain in exchange for no benefit, even if unknowingly, is tantamount to torture and violates the most basic requirement of any therapy, to do no harm.
So, where does this leave us?
If you are fighting for the liberation of queer and trans people but you are not also fighting for the liberation of autistic people, you are literally not fighting for the liberation of queer and trans people. In fact, you are literally fighting for the complete eradication of queer and trans people if you do not fight against ableism and to the end the practice of ABA and all its modern iterations because while ‘[s]ome therapists argue that the more “modern” forms of ABA are more humane approaches, [the fact remains that] they are nonetheless still based in the idea that autistic ways of being in the world are unacceptable and must be eradicated.’
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