This essay is an exploration of the ways that queerness has been pathologized, and a condemnation of a kind of care that is contingent on profit, on status. At moments, it is a reproach of my family, who trusted these doctors to care for my cousin, still a child, in an institution that interfered with something fundamental about who she was.

There can be violence cloaked in the rhetoric of care. As a teenager, I attended church youth groups that made it clear they would not welcome an openly gay member. Their messages were bound up in the language of benevolence: we want you to be well, we want you to be saved.

I was lucky to find communities that would embrace me. Others I knew were faced with the choice to stay with their families, to attend therapy with dubiously-trained counselors who undermined their sense of self, or to lose their communities, their housing, their support networks.

I remember the fine line we walked as teenagers. It was a pivotal moment of self-definition – I started shaving my head with Bic razors, I wore crinolines and suspenders to school, I got high in City Park and snuck through the basement window of my girlfriend’s parents house. More than anything, I needed to rewrite myself, over and over again, to find who I was.

Years later, I worked for an outreach team supporting queer youth. Our clients had mostly lost their families, one way or another, often because of a stubborn divide between who they were, and who their families hoped they would become. They suffered for it, deeply, sometimes fatally. To treat an adolescent like a child is as much a violation as to treat them like an adult. We can no more expedite their growth than we can suppress it.

Ruth Simkin, a young patient at Chestnut Lodge who went on to become a doctor, wrote a memoir, many years after her treatment. Simkin had been placed at the facility for epilepsy, at the time considered a mental illness. During her first appointment with a therapist, she was diagnosed as “anti-social,” and denied the privilege of eating meals with the rest of the patients. She was reminded that she had to cooperate with her therapist, that he could have her locked up for life.

After some months in Chestnut Lodge, she told her therapist that she was a lesbian, which he denied. In her treatment at the facility, she experienced a kind of compounded medical gaslighting. The message she received was that her epilepsy, her queerness, and her anti-social behavior were problems of the mind that could be fixed, through talk therapy and willpower (100).* Any lack of success was considered a personal failure.

* Simkin, Ruth. The Jagged Years of Ruthie J. Ekstasis Editions, 2010.

At the end of her memoir, Simkin writes: “For all the decades that I was a physician, I never forgot my past. I love medicine and I love being a doctor, but being a physician meant one important thing to me in particular: it meant that I now had the power. I had the power and no one, no one, was ever going to lock me up again” (214).

In 1952, the first Diagnostic and Statistical Manual of Mental Disorders (DSM) was released by the American Psychiatric Association (Queer Diagnoses, 389). This was intended to be a comprehensive listing of psychiatric diagnoses, and in this original issue, homosexuality was listed as a sociopathic personality disturbance and sexual deviation. At this point, treatments for homosexuality had been incorporated into many psychiatric hospitals and treatment regimens. Grouped together with broader personality disorders, homosexuality was subjected to the larger “corrective” moral frameworks in the postwar years. In her book Private Practices, Naoko Wake writes:

Psychologists, sociologists and anthropologists shared an urgent sense of responsibility– that scientists must help the nation to use victory in the war to reestablish social order and create promises of a better future. In their discussion, the dissociation of families, changing gender relationships, and “immature” personalities were of central concern (195).

Chestnut Lodge 3

Dr. Ray Osheroff was treated for depression at Chestnut Lodge for a year, before being transferred to another facility that supported the use of antidepressants, the use of which marked a distinct improvement in Osheroff’s mental health.

In an article for The Guardian, Rachel Aviv describes his circumstances: “After half a year, Ray’s mother visited him at the Lodge and was alarmed by his deterioration. His hair had grown to his shoulders. He was using the belt of his bathrobe to hold up his trousers, because he had lost 18kg (almost three stone). Ray had once been a prodigious reader, but he had completely stopped. He was also a musician, and, although he had packed sheets of music in the suitcase he brought to the Lodge, he almost never looked at the pages. When a nurse called him Dr Osheroff, he corrected her: “Mr Osheroff.”

Many years later, Osheroff sued (and settled with) Chestnut Lodge for negligence and malpractice. His argument was that the Lodge denied him known medical treatments for depression, opting instead to teach patients that their happiness was a matter of willpower and responsibility. Osheroff had been emboldened by the writing of Gerald Klerman. Aviv writes: “Klerman had written disparagingly of what he called “pharmacological Calvinism” – the belief that “if a drug makes you feel good, it’s either somehow morally wrong, or you’re going to pay for it with dependence, liver damage, chromosomal change, or some other form of secular theological retribution”.

During his treatment at Chestnut Lodge, Osheroff asked his doctor how he might get out. His doctor responded: “When you stop using your shirt for a napkin, or when you run out of money.” (rayosheroff.org)

If this essay is a reproach of my family, it’s a confession of my own, too, an effort to trace what I have inherited. For some years, I worked at a drop-in center for at-risk youth. Our clients were unhoused, mostly, and rightly suspicious of me. But every once in a while I would work with someone who immediately opened up to me. They would tell me horror stories from their lives, tell me about the people at the shelters where they lived, about what they did for money, about the last time they spoke to their families.

I found it more uncomfortable when they opened up to me than I did when they iced me out, because I knew that I would be gone soon. My shifts were irregular, I had other jobs. I couldn’t offer them real safety – not a place to leave their boots, or take a bath, not a weekday curfew or someone to gripe about to their friends.

I think about Gaëtane’s bêtises, and that violence disguised as care. I have been a messy teenager, but I have been a social worker, too. I am as much of Dot as I am Gaëtane.