by Dr. Jem Tosh
I'm no stranger to the topic of sexual abuse or the controversy and conflict that goes with writing about it. Having outlined the complex and contested diagnosis of 'paraphilic coercive disorder' in my historical and critical analysis of sexual violence in Perverse Psychology (Tosh, 2015), I'm soon to finish my new book on the body, consent, and violence within psychology, psychiatry, and medicine. It is broad in scope and draws together diverse and expansive topics in a discursive and intersectional analysis. Below I talk about where the idea came from and what readers can expect from this new work.
How I come up with my ideas:
I have an unusual habit where as soon as one book is finished, I get an idea for the next. After I finished Psychology and Gender Dysphoria, despite being exhausted, on the same day I wrote my proposal for The Body and Consent in Psychology, Psychiatry, and Medicine: A Therapeutic Rape Culture. It just came to me and it was incredibly clear. I needed to put it down on paper right there and then. That tends to be how my process works.
Writing a book about an emotive topic:
This is probably the most difficult piece of writing I have done in my career, for many reasons. I have spent much of my research and writing discussing difficult and emotive topics, most of it on sexual violence, but this book was more difficult because in addition to the violence described, there was the added aspect of the medical profession, and psychology and psychiatry, justifying or normalising it or discrediting victims in various ways. So, it was like having to immerse yourself in this double victimisation. It is also always very difficult for me to write, despite how much I love writing, because I'm a survivor of sexual abuse myself. I'm well aware of the topics I am writing about, not just because of my education and research, but because I have physically experienced it too. I think that was one of the reasons that I felt it was so important to include an analysis of the issue with the embodied experience front and centre of a predominantly discursive piece.
It is also always very difficult for me to write, despite how much I love writing, because I'm a survivor of sexual abuse myself. I'm well aware of the topics I am writing about, not just because of my education and research, but because I have physically experienced it too.
Why this book and why now:
I spent several years analysing different diagnoses related to sexual abuse, as well as the experiences of queer and trans individuals and sexual violence. The more I researched, and the more perspectives I included, the more connections and patterns I started to see across those diverse examples. I wanted to bring them together in one book, so that we could see the connections between, say intersex protests against non-consensual surgeries on infants, the gatekeeping of transgender individuals in accessing body modification procedures, and women pathologized for supposedly being 'too' sexual or 'not sexual enough' - and the context and situations that put these individuals at risk of violence or abuse due to the common issues of pathologization, medicalization, patriarchy, and medical authority.
As a queer and genderfluid survivor, who has been assaulted by men and women, I have often found writing on the topic of sexual abuse very binary and heteronormative.
What I'm most proud of:
The scope of the book. It is always difficult as an author to decide what makes the last cut - I'm always way over my word limit and it breaks my heart to choose what stays and what has to wait until the next publication. It's about finding that balance between breadth and depth in an analysis. I'm proud of the scope of this book in terms of gender, in that I have discussed experiences of sexual abuse in medical settings with chapters about intersex individuals, transgender and nonbinary people, as well as cisgender men and women. As a queer and genderfluid survivor, who has been assaulted by men and women, I have often found writing on the topic of sexual abuse very binary and heteronormative. It was helpful, and in a way cathartic, to be able to bring these other experiences to the forefront of the discussion.
The Body and Consent in Psychology, Psychiatry, and Medicine: A Therapeutic Rape Culture is available to buy now. Use promo code FLY21 for 20% discount when buying from routledge.com
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.
The book examines a range of situations where medical power and authority produces a context where the refusals and non-consent of oppressed groups are denied, dismissed, or ignored, arguing that key concepts and discourses have resulted in the production and standardisation of a therapeutic rape culture in the helping professions. Tosh uses critical intersectionality theory and discourse analysis to expertly highlight the complex interrelationships between race, class, gender, sexuality, and disability in our understanding of abuse and how we define survivors.
Drawing on a wide range of comprehensive examples, including experiences and perspectives from cisgender and transgender men and women, as well as nonbinary and intersex people, this is essential reading for students and researchers of critical and queer psychology, gender studies, as well as mental health practitioners and social workers.
Intersex youth: Non-consensual surgeries and nosocomial sexual abuse
Queer and trans youth: ‘Sexual rehearsal play’ and reparative therapies
‘Sex’ as treatment: Consent, coercion, and sex therapy
Penetration as ‘treatment’: Pathologizing sexual avoidance and pain
Phallometrics: Quantifying sexual violence and sexuality
Conclusions: a therapeutic rape culture
Dr. Jem Tosh is a Chartered Member of the British Psychological Society and a Full Member of the Canadian Psychological Association. They are the Founding Director of Psygentra, an organisation that specialises in the psychology of gender and trauma. Jem is also the author of Perverse Psychology (2014) and Psychology and Gender Dysphoria: Feminist and Transgender Perspectives (2016).
"Tosh offers a liberating way forward to those who refuse to be pathologised..." - Dan Oudshoorn