Call Me Crazy: Why Sanism Matters to Queer and Feminist Activists


“The worst thing to call somebody is “crazy”. It’s dismissive. I don’t understand this person, so they’re crazy. That’s bullshit! People are not crazy. They are strong people. Maybe the environment is a little sick.” –Dave Chappelle

1 in 5 Americans deals with some form of mental illness. Yet despite its relatively commonplace occurrence, those with mental illness face stigma and discrimination. Such discrimination is known as mentalism or sanism. From Wikipedia:

While mentalism and sanism are used interchangeably, sanism is becoming predominant in certain circles, such as academics, those who identify as mad and mad advocates and in a socio-political context where sanism is gaining ground as a movement.[1] The movement of sanism is an act of resistance among those who identify as mad, consumer survivors, and mental health advocates.

Because of this, a worldwide mad pride movement is starting to take form. Some of its advocates’ goals range from reclaiming words such as “madness” or “crazy”, to addressing the unique discrimination that those with mental illness face. Many are critical of the idea that “madness” is abnormal, and instead wish to celebrate it as another example of human diversity. (See also: The Hearing Voices Movement and The Icarus Project.) While some mad pride proponents are anti-psychiatry (or advocate “alternative” medicine), many wish to reform mental health services in general. Because of stigma, costs, or inaccessible health providers, many cannot access the care they need.

Sample Mad Pride flag
Sample Mad Pride flag

Mental illness should be treated like a physical illness. (After all, what are neural processes but physical, chemical reactions in the brain?) People with mental illnesses should be treated with dignity, respect, and caring, like anyone else.  But most popular portrayals of mental illness are misleading, inaccurate, or violent. Even the words “schizo” or “psycho” have negative connotations. Serial killers are often called “psychotic”, which leads many to believe psychosis is a violent outburst, and not a period of being out of touch with reality. The reality is that most often, those with mental illness are more likely to be the victims of violence rather than the perpetrators.

That all said, why is sanism an important issue for queer and feminist activists? Mental illness has a place in intersectionality. Historically and presently, oppressed groups have been labeled “crazy” or mentally inferior by their oppressors.

Many LGBT/Queer rights activists are aware of homosexuality being considered a sign of mental illness, prior to and throughout most of the 20th century. Indeed, some of the most common reasons for treatment in insane asylums in early medical history were “sexual perversion”, masturbation, and homosexual tendencies. Even today, attempts at “reparative therapy” are still used on gay or polysexual people to try and convert them to “normalcy” (i.e. heterosexuality). Also quite common (and yet to be entirely denounced) are therapies aimed at forcing trans and non-binary children into “accepting” their bodies/assigned genders.

“Gender Identity Disorder” was listed in the DSM until the 5th edition changed it to Gender Dysphoria in 2013. Sanism-based cissexism also manifests in gatekeeping, the efforts of the medical community to prevent trans people from receiving medical treatment. Except in cases of informed consent, trans patients still generally need a letter from a therapist before being able to medically transition. Standards of care and attitudes are changing. Yet many people still assume transgender and non-binary people are mentally ill, leading to discrimination from workplaces, child custody battles, and more.

Women (queer and otherwise) have also been treated poorly in psychiatric history. Indeed, PMS and “hysteria”, have historically been used against women to gaslight them and keep them “in their place”. Many people still believe “women are crazy”, and certain mental illnesses get diagnosed more in women than in men (histrionic personality disorder, for starters).

Stigma is maddening.

In fact, kyriarchal societal structures can aggravate mental health problems in marginalized groups. From the Wikipedia article on mentalism:

A spiral of oppression experienced by some groups in society has been identified. Firstly, oppressions occur on the basis of perceived or actual differences (which may be related to broad group stereotypes such as racism, sexism, classism, ageism, homophobia etc.). This can have negative physical, social, economic and psychological effects on individuals, including emotional distress and what might be considered mental health problems. Then, society’s response to such distress may be to treat it within a system of medical and social care rather than (also) understanding and challenging the oppressions that gave rise to it, thus reinforcing the problem with further oppressive attitudes and practices, which can lead to more distress, and so on in a vicious cycle. In addition, due to coming into contact with mental health services, people may become subject to the oppression of mentalism, since society (and mental health services themselves) have such negative attitudes towards people with a psychiatric diagnosis, thus further perpetuating oppression and discrimination.[35][36]

Misogyny, transmisogyny, heterosexism, and cissexism are all strengthened by sanist ideas about what constitutes as “normal”. It seems in our society if you are different, or behave in a misunderstood way, you are “crazy”.

Queer and feminist activists need to pay attention to mental health issues because of how interconnected sanism is with other –isms. But further than that, mental illness issues are human rights issues. Just because someone has a mental illness does not mean they are not intelligent, cannot love, cannot feel, or cannot lead productive lives. Allies need to start fighting for those with mental illness. Us mad people must be able to tell our stories without stigma or shame. Finally, we all need to be critical of sanist structures and attitudes, even within our own activist communities.

Call me crazy, but I think feminists and queer activists need to start paying attention to us mad folk. You all can be perceived to be mad. But what about those who are?

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