The Body and Consent in Psychology, Psychiatry, and Medicine: A Therapeutic Rape Culture

Jemma Tosh (2020)

This groundbreaking text interrogates the constructed boundary between therapy and violence, by examining therapeutic practice and discourse through the lens of a psychologist and a survivor of sexual abuse. It asks, what happens when those we approach for help cause further harm? Can we identify coercive practices and stop sexual abuse in psychology, psychiatry, and medicine? Tosh explores these questions and more to illustrate that many of the therapies considered fundamental to clinical practice are deeply problematic when issues of consent and sexual abuse are considered. 

Psychology and Gender Dysphoria: Feminist and Transgender Perspectives

Jemma Tosh (2016)

Drawing on discursive psychology, this book traces the historical development of psychiatric constructions of ‘normal’ and ‘abnormal’ gender expression. It contextualises the recent reconstruction of gender through the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and its criteria for gender dysphoria. This latest diagnosis illustrates the continued disagreement and debate within the profession surrounding gender identity as ‘disordered’. It also provides an opportunity to reflect on the conflicted history between feminist and transgender communities in the changing context of a more trans-positive feminism, and the potential implications of the diagnoses for these distinct but linked communities.

Perverse Psychology

Jemma Tosh (2014)

Perverse Psychology examines psychiatric constructions of sexual violence and gender nonconformity from the 19th century until the latest DSM-5 diagnoses. It uses discourse analysis to interrogate the discursive boundaries between 'normal' and 'abnormal' rape, as well as the pathologization of gender and sexual diversity. The book illuminates for the first time the parallels between psychiatry's construction of gender diversity and sexual violence, and leads us to question whether it is the violence that the profession finds so intriguing, or the gender nonconformity it represents.

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Book Chapters

Sexual Abuse and Surviving with(in) Psychology

In '#MeToo: Counsellors and Psychotherapists Speak About Sexual Violence and Abuse'

Jemma Tosh with Fionnuala Dempsey (2020)

In this chapter Tosh describes their experiences as a queer and genderfluid survivor growing up in Northern Ireland, and how those experiences influenced their career as a psychologist who specialises in sexual abuse and violence. Tosh outlines the complex intersections of gender, sexuality, race, place, and historical context and shows why these intersections should be central to therapeutic approaches that aim to help survivors heal from sexual trauma.The chapter also has a discussion section where the authors talk about abuse, psychology, intersectionality and more.

A Critical Commentary on Follow-Up Studies and "Desistance" Theories about Transgender and Gender-Nonconforming Children

In 'Today's Transgender Youth: Health, Well-being and Opportunities for Resilence'

J. Temple Newhook, J. Pyne, K. Winters, S. Feder, C. Holmes, J. Tosh, M. Sinnott, A. Jamieson and S. Pickett (2019)

The tethering of childhood gender diversity to the framework of “desistance” or “persistence” has stifled advancements in our understanding of children's gender in all its complexity. These follow-up studies fall short in helping us understand what children need. As work begins on the 8th version of the Standards of Care by the World Professional Association for Transgender Health (WPATH), we call for a more inclusive conceptual framework that takes children's voices seriously. Listening to children's experiences will enable a more comprehensive understanding of the needs of gender-nonconforming children and provide guidance to scientific and lay communities.

Learning to Listen to Trans and Gender Diverse Children: A Response to Zucker (2018) and Steensma and Cohen-Kettenis (2018)

In 'Today's Transgender Youth: Health, Well-Being and Opportunities for Resilence'

K. Winters, J. Temple Newhook, J. Pyne, S. Feder, A. Jamieson, C. Holmes, M. Sinnott, S. Pickett, & J. Tosh (2019)

The authors answer recent responses by Steensma & Cohen-Kettenis (2018) and Zucker (2018) to our critical commentary on “desistance” stereotypes and their underlying research on trans and gender diverse children (Temple Newhook et al., 2018). We provide clarification in the following areas: (1) the scope of our paper; (2) our support of longitudinal studies; (3) consequences of harm to trans and gender diverse children; (4) clinical practice implications; (5) concerns about validity of research methodology; and (6) the importance of learning to listen to trans and gender diverse children.

Working Together for an Inclusive and Gender Creative Future: A Critical Lens on 'Gender Dysphoria'

In 'Supporting Transgender and Gender Creative Youth: Schools, Families, and Communities in Action'

Jemma Tosh (2014/2018)

This chapter reflects on the conflicted history of the diagnosis of 'gender dysphoria', as well as describe a collaborative project challenging its implementation. This project addressed the DSM-5 Chair of the Sexual and Gender Identity Disorders Section and involved contributions and support from lesbian, gay, bisexual, trans, intersex and feminist activists, academics and clinicians. The acceptance of diverse differences in relation to philosophical or political issues was nurtured through the commitment to a common goal: the condemnation of psychiatric intervention with young gender creative children. This politically engaged academic intervention illustrated the potential for creating awareness and intervening in professional discussions around psychiatric intervention when groups overcome differences and work together to develop extensive and valuable activist networks.

The Complex Impacts of Intensive Resource Extraction on Women, Children, and Aboriginal Peoples: Towards Contextually-Informed Approaches to Climate Change and Health

In 'Climate Change and Gender in Rich Countries: Work, Public Policy, and Action'

M. Gislason, C. Buse, S. Dolan, M. Parkes, J. Tosh, B. Woollard (2017)

It is now widely understood that human health and well-being is affected not only by the social and economic contexts and conditions within which people live, but also by ecological systems and services. Yet dramatic social and ecological challenges to people’s health and well-being, and their impacts in particular on vulnerable populations, are not always carefully studied. In this chapter, we consider a range of ways that Aboriginal and non-Aboriginal women and children living in northern British Columbia (BC) are impacted by intensive resource extraction (IRE), and how these complex, regional dynamics need to be taken into account when seeking to understand the dynamics of climate change and health. We focus on the interrelated pathways that make women and children vulnerable to short- term social and ecological changes as well as to their long-term consequences, and why these populations may serve as sentinels which illustrate how sustainably communities are being developed (Poland & Dooris 2010).  


In 'Mad or Bad? A Critical Approach to Counselling and Forensic Psychology'

Jemma Tosh (2017)

There is a long and complex history regarding clinical/counselling and forensic psychology's roles in defining sexual 'abnormality'. From 19th century studies of 'perversion' to current understandings of 'paraphilic disorders', there has been a wealth of debate, disagreement, and controversy. This chapter outlines several key diagnoses in the field, describing their history and criticisms from the inside and outside of the profession. It encourages critical reflexivity on the context and ethics of categorizing diverse sexualities as 'abnormal'. The chapter includes examples of pathologized sexualities in relation to sexual orientation, gender expression, and sexual consent. Psychology's portrayal of these concepts is examined, as are the tensions between clinical/counselling and forensic perspectives, particularly when sexual coercion is involved. 

Gender Nonconformity or Psychiatric Noncompliance? How Organized Noncompliance Can Offer a Future without Psychiatry

In 'Critical Inquiries for Social Justice in Mental Health'

Jemma Tosh (2017)

Gender nonconformity has been pathologized by psychiatry for well over a century, and critiques of this pathologization are numerous. I add to this body of analysis by drawing on feminist, transgender and critical psychology perspectives to critique current psychiatric diagnostic approaches to gender. I also foreground the role of power in psychiatry’s defining of gender normality by interweaving poststructuralist and intersectionality theory (Crenshaw, 1991; Foucault, 1977), including a discursive analysis of the criteria for “gender dysphoria” (Parker, 2003). In conducting this analysis, I illustrate how the diagnosis of gender dysphoria represents a form of psychiatric noncompliance, which is considered problematic by psychiatry but offers a useful way of resisting psychiatric power when organized.

No Body, No Crime? (Representations of) Sexual Violence Online

In 'Talking Bodies: Interdisciplinary Perspectives on Embodiment, Gender and Identity'

Jemma Tosh (2017)

Sexual violence is an ever-increasing feature of online culture, with rape the central aim of ‘stalking simulators’ as well as the infamous violence directed towards avatar sex workers in the Grand Theft Auto franchise (Martinez & Manolovitz, 2010, p. 68). This is in addition to the word ‘rape’ being commandeered and redefined by online gaming communities to refer to murder, humiliation and destruction (Hernandez, 2012) while simultaneously being ridiculed in online rape ‘jokes’ (Kramer, 2011). Using discourse analysis (Parker, 1992; 2003), this chapter examines discussions from online forums about the use of the word rape to refer to instances of sexual violence in online spaces. It interrogates the debate around whether these occurrences are forms of sexual violence, or representations of sexual violence based on the presence/absence of an embodied material experience. 

Kritische Feministische, Queer - & Trans-Psychologie: Zur Dekonstruktion von Gender und Sexualität

In 'Perspektiven kritischer Psychologie und qualitativer Forschung'

Jemma Tosh (2017)

In den Hauptströmungen der Psychologie und Psychiatrie gibt es eine lange Tradition von Definitionen und Festlegungen, was bezüglich Gender und Sexualität als 'abnormal' gilt. Diese und die mit ihnen assoziierten Theorien haben meist minorisierte Gender und Sexualitäten äußerst negativ dargestellt. Diejenigen, die sich als Frauen/weiblich, schwul, lesbisch, bisexuell oder transsexuell identifizieren oder diejenigen, denen die Legitimität ihrer Geschlechtsidentität abgesprochen wird (Ansara 2012), sind oft als geistig minderwertig, pathologisch oder deviant dargestellt worden (Foucault 1990; Lev 2005; Ussher 1991). Es gibt zahlreiche psychologische Theorien und Diagnosen die das verdeutlichen, z.B. „Hysterie“ (American Psychiatric Association [APA] 1952; 1968), „Homosexualität“ (APA 1952; 1968) und „Geschlechtsidentitätsstörung“ (APA 1980; 2000a). Diese werden als exemplarische Diagnosen in diesem Kapitel untersucht, das im Weiteren der Frage nachgeht, wie Queer-, Trans- und feministische Psychologien kritische Perspektiven und sozialen Aktivismus genutzt haben, um solche negativen Konstruktionen zu bekämpfen.

The Problem with 'Normal': Teaching and Learning about Gender and Trans Psychology

In 'Critical & Experiential: Dimensions in Gender & Sexual Diversity'

Jemma Tosh (2016)

General training in psychology, whether undergraduate or postgraduate, can contain little content on the issues and complexities regarding the psychology of gender. The problems I go on to discuss here, regarding psychology, can be applied across the psy-professions of psychiatry and psychotherapy. It is not the case that discussions of 'essential sex differences' and comparisons of men and women do not feature in these trainings, but that critical examinations of the psychology of gender, and of psychological approaches to gender identity and gender-related distress, are often absent. This lack of explicit discussion can lead to students being surprised when they discover the role psychology has had in how we think about gender, and how important the topic has been to psychology. 

The Caring Professions, Not So Caring? Bullying and Emotional Distress in the Academy

In 'Psychiatry Interrogated: An Institutional Ethnography Anthology'

Jemma Tosh (2016)

In this chapter we analyze two case studies of bullying in Unitied Kingdom (UK) universities, one involving a student of social work and another of a faculty member in a psychology department. The initial disjuncture in one case study occurred when a victim of bullying was labeled as "mentally ill," and the second was when someone was bullied because of a label of "mental illness." These two similar but opposing disjunctures offer an opportunity for comparative analysis. This includes an investigation of the process and discourses at play within the broader context of UK higher education and constructions of bullying and emotional distress.

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"Highly original, closely argued, and ingenious analysis."

—  Professor Erica Burman,

University of Manchester