Open Thread: Stupid Treatments for Chronic Illness

Tags

disability

A few days ago I read Chronic Tension Headaches: a detailed self-help guide (I highly recommend his site for anyone struggling with chronic pain). In it, the author mentions that one cause of chronic headaches is wearing glasses that don’t fit your prescription.

Since I haven’t had an eye exam in five years, this instantly shot up my list of possible causes of chronic headache. And let me tell you, if I have had daily painful headaches for over a year because I’ve been wearing glasses that don’t fit, I will be overjoyed and will also feel like a complete moron.

I will also be extremely irritated at all my doctors, who saw I was wearing glasses and did not any point go “hey, did you have a recent eye exam? Out-of-date glasses prescriptions can cause daily chronic headache.”

This is not the first such stupid cause of chronic illness I’ve learned about. For example:

• If you have anxiety, and you drink a lot of coffee, the coffee might be causing your anxiety. It’s a stimulant and stimulants cause anxiety.
• If you are depressed and you live in a place that doesn’t get a lot of light part of the year, try sitting in front of a light box.
• If you are depressed and no antidepressant is working, ask politely if you’ve been screened for hypothyroidism, anemia, and vitamin deficiencies, all of which are known to cause depression.
  • If you’re depressed and you can’t see a doctor, and you are pale, weak, and tired, and experience the compulsion to eat ice or dirt or something else that isn’t food (pica), take an iron supplement and see if it helps.
  • Similarly, try taking a multivitamin and see if it helps.

So I thought this open thread might be a good idea. What are some stupid treatments for chronic illness? When I say “stupid treatments”, I mean:

• It is little-known and medical professionals might not tell you about it (so not medication, therapy for mental illness, etc).
• It is relatively easily testable (so not “try this extremely complicated routine for six months and if it doesn’t work it’s your fault for not adhering to it”).
• It is a treatment, not a thing you should have done three years ago to prevent your chronic illness.
• When you hear about it, it makes you slap yourself on the head and go “duh.”

Since this topic is particularly likely to attract pseudoscience, I would like to lay out the following commenting guidelines:

1. All suggested treatments must fit the definition of “stupid treatment” above.
2. Your suggested treatment can treat at most three things. I will delete all comments about how a particular supplement, diet, or Traditional Chinese Medicine practice can cure everything from low back pain to diabetes to hair loss to insufficiently attractive feet.
3. When talking about diets, all links should be to peer-reviewed scientific studies and not to websites of people advocating for the diet. If weight loss is recommended, you must provide a specific reason to believe that losing weight specifically will help, which is not “everyone knows that being fat is bad for you.”
4. Known pseudoscience and quackery will be deleted at my discretion, unless the commenter both (a) acknowledges that this is pseudoscience and (b) either:
   1. Provides a plausible biological mechanism based on what we know of how the human body works
   2. Links to a systemic review or meta-analysis from a reasonably reputable journal (not The Journal of Acupuncture and Meridian Studies or The Journal of Poetry Therapy) that suggests the treatment will work.

April Fools Post #5

Tags

disability

I am not, I see, the first dimensional traveler to exist in this body. But how can I make you understand the strangeness of your world to me?

Imagine, if you will, a world where everyone is illiterate. There are no books to read; TV shows do not have subtitles; if you want people to know the rules at your local pool, you have to hire a person to stand near the door and explain it to each of them individually. There are a few simple signs– a red octagon means STOP, a yellow triangle means YIELD– but it has never progressed beyond that stage.

But it is not that this world has not invented literacy. Indeed, there are many written languages. However, these are essentially only known by the mute, and those who work with them. Perhaps a child will learn to spell a few words as part of the disability acceptance unit at their school: their name, maybe “mother” and “father,” maybe their favorite color. But if you have the capacity to use speech, in this world, you do not read.

I speak, of course, of the fact that your world does not have sign.

“But we don’t need sign,” you might say. “We can speak.” Certainly! As long as you never go to a concert. Or want to talk during a movie. Or have dinner at a crowded restaurant. Or take care of a newborn who sleeps lightly and wakes up often. Or want to send a message to someone without other people overhearing. Or want to talk at the same time that another person is talking. Or have a migraine, or autism, or any of dozens of conditions that lead to a sensitivity to sound.

Since none of those things are true, in fact, you would benefit a good deal from sign. But inexplicably instead of learning it you all choose to yell at each other at bars. Why.

I can’t believe how rude people in this world are in public spaces. In my world, if you’re in a restaurant or coffeeshop or on a train or an airplane, you automatically switch to signing. That way, everyone can understand what other people are saying, and no one has to overhear random scraps of other people’s conversations, and if you prefer to focus on your book you can.

In my world, half of all people are deaf. There is an pandemic childhood disease– unfortunately, we have had no luck in developing a vaccine– that nearly everyone catches. It is quite harmless and mostly just gives you a few days off school, but a little more than half of all sufferers wind up losing their hearing.

We would never consider the deaf to be disabled. Deafness is an advantage in so many ways. You’d never hire a hearing person to work construction, or in a factory, or at a stadium in any position other than sound engineer: hearing people can’t focus when there are loud noises, and it can lead to hearing damage such as unpleasant ringing sounds. Deaf people have a huge advantage in focusing: they can simply turn off their cochlear implants and zone out. And deaf people can live in cities, where you can hear sounds of construction and cars and your neighbors upstairs. Hearing people find cities very stressful.

And even if there’s not a specific advantage to being deaf, deafness is just… normal. Sure, deaf people have to go to different concerts than hearing people. (At deaf concerts, the music is loud enough to make a hearing person go deaf, because they usually like the vibrations.) Sure, they have to buy TTY devices if they want to use the phone. I have to spend ten minutes looking for my glasses every morning and you wouldn’t call me disabled about it. Some things are genuinely disabling, like chronic pain or using a wheelchair. But you people take an ordinary part of human variation– one that, as many variations do, has both advantages and disadvantages– refuse to accommodate it, and consider it a disability.

In your world, deaf children are often deprived of language in their critical period, because their parents don’t sign. In my world, this never happens. Is the problem deafness, or is the problem the fact that no one uses sign for no reason I can understand?

It’s a petty example, but think about video games. In my world, many first-person shooters include extra information through sound, but also include loud, distracting or unpleasant noises. (You know, the way that it actually happens during wars?) That way, the experience is fair for both deaf and hearing gamers. Your world refuses to make games that deaf players can play on an even field, and then claims that it’s their fault for not being able to hear!

Or think about movies. You CAN put subtitles in movie theaters. I have seen it. Why don’t you put subtitles routinely? Or cars honking. Why do cars honk? You can hear! It is unpleasant for you too! Replacing it with a flashing bright light, as we do, minimizes the effect on innocent bystanders.

Of course, not everything in our society accommodates deaf and hearing people equally. For example, our world’s musicals are traditionally signed and sung at the same time: the singing is what the characters are saying to each other, while the sign conveys their underlying emotions and thoughts. Of course all musicals have subtitles, but the experience is not at all the same.

In general, dance for us is much closer to song than to the abstract artform of your world. The distinction between dance and poetry, in particular, is often not clear: much poetry is intended to be signed, as poetry in your world is often intended to be read aloud. And this reminds me of the complexities of written sign! The way even fiction in written speech uses written sign to talk about what gestures people make, the various ways people have come up with to indicate a shaky hand or an abortive movement, the meaning of whether you use written sign or written speech or switching between them…

This is a tangent and I intend primarily to complain about your universe’s poor design. I have complained about subtitles and video game design, but above all you need to learn sign. I propose an intensive program of education in the nation’s elementary schools: full immersion in ASL from the moment they step into kindergarten. After a generation’s investment, all hearing people will be able to use both speech and sign, and your world will be tremendously improved.

Please ask me any questions you have and I’ll be sure to answer them over the course of today! I hope I will be able to convince you all of the necessity of learning sign and depathologizing deafness.

Link Post for June

Tags

disability, effective altruism, not like other ideologies, ozy blog post, rationality, wild animals

Social Justice

“Being taught by Milton Friedman makes you less likely to give long sentences on certain kinds of criminal activity, particularly around like drug crimes.”

Simultaneously “I understand why this was your best choice in this situation” and “aaaawkward”: “To top it all off, reports that Disney had been “browning up” some actors on set… drew a swift response from Disney, noting… that “diversity of our cast and background performers was a requirement and only in a handful of instances when it was a matter of specialty skills, safety and control (special effects rigs, stunt performers and handling of animals) were crew made up to blend in.””

A man whose mother has a severe intellectual disability discusses his relationship with her.

[cw: child sexual abuse] Why Honduran women are being driven to the US border. (Sample excerpt: “When doctors told [12-year-old] Sofia she was pregnant and explained that pregnancy meant she was going to have a baby, Sofia, in her soft, small voice, asked whether she could have a doll instead.”)

From the ‘social model of disability’ files: “In theory, a social definition of infertility—one laid out in terms of intentions and identities rather than diseases and disabilities—circumvents these problems. But it creates complexities of its own. Last year, researchers from Yale and the University of Haifa, in Israel, shared the results of a study in which they asked a hundred and fifty women who have frozen their eggs to explain their motivations. The overwhelming majority of the women cited what might be called “man problems,” including divorces, breakups, and male partners who weren’t yet ready to have children. It takes a conceptual leap to see a recent divorcée and a woman with endometriosis as equally infertile, but Campo-Engelstein argues that they are “similar enough that they should be treated the same.””

Effective Altruism

Is effective altruism growing? “Overall, the decline in people first discovering EA (reading) and the growth of donations / career changes (doing) makes sense, as it is likely the result of the intentional effort across several groups and individuals in EA over the past few years to focus on high-fidelity messaging and growing the impact of pre-existing EAs and deliberate decisions to stop mass marketing, Facebook advertising, etc. The hope is that while this may bring in fewer total people, the people it does bring in will be much higher quality on average.”

The uses of life history classification in understanding wild animal welfare. A thoughtful and nuanced review. (I’m cited!)

A foundational result on the question of how much wild animals suffer is wrong. I am mentioning this 10% because it’s cool and 90% to brag about my role as a catalyst here. (I complained at everyone I could find that this result didn’t make any sense because I was bad at math, and then it turned out to not make any sense because it was wrong.)

Rethink Priorities has an excellent in-depth summary of the evidence that invertebrates suffer, which incidentally explains a lot of really foundational issues related to animal consciousnes in general. Check it out!

Rationality (Practice)

Visualizations of different meanings of probability.

This LW post makes an interesting point about the difference between the norms and goals of science, but I’m mostly linking for the worldbuilding about ALIEN SCIENCE.

People view things as abstractions rather than as atoms, which causes them to miss ways they can interact with things to reach their goals. My summary is boring but the list of examples is very interesting and I really do recommend checking it out.

Subtle errors people make with the concept of conservation of expected evidence.

Weird situations with reasonable explanations, or “why 90% sure is way less sure than you think it is.”

List of examples where one man’s modus ponens is another man’s modus tollens. Again, the list of examples is incredibly interesting and much better than my summary.

The uses of divination.

Moral realism and moral nonrealism lead to very similar behavior for different reasons.

Rationality (Community)

I don’t agree with everything Ray Arnold wrote about the village versus the mission, but I think he crystallizes for me some important distinctions about the rationality community and moves the interminable conversations about rationalist community norms forward.

Again mostly of interest to rationality community people: rabbit hunts and stag hunts as a metaphor for community participation.

Parenting

Why you should sometimes change your mind after saying ‘no’. I follow this advice personally. My son Viktor only knows a few words and therefore has a hard time expressing preferences without crying. A strict ‘no giving in to crying’ rule would basically mean I couldn’t reassess my decision based on the strength of Viktor’s desires. I am probably going to enforce a ‘no giving in to tantrums’ rule once he’s old enough to express preferences with words, but until then ignoring his communication just seems unethical.

Just Plain Neat

Overzealous cleaner ruins artwork worth 690,000 pounds.

Types of loneliness.

The Secret Rebellion Of Amelia Bedelia, The Bartleby Of Domestic Work.

This is so profoundly my shit that I honestly can’t believe it’s a real article: Georgette Heyer’s crossdressing novels as forced masculinization sexual fantasies.

Why AO3 is one of the best-organized sites on the Internet. “One wrangler, who goes by the handle spacegandalf, pointed me to the example of a character from an audio drama called The Penumbra Podcast who didn’t have an official name in text for several episodes after he was introduced. Yet people were writing fanfic—and trying to tag it by character—before they had any name to tag it with. Because spacegandalf had listened to this podcast—AO3 deliberately recruits and assigns tag wranglers who are members of the fandoms that they wrangle for—they had the necessary context to know that “Big Guy Jacket Man Or Whatever His Name Is” referred to the same person as his slightly more official moniker “the Man In the Brown Jacket” and his later, official name, Jet Sikuliaq (and that none of these names should be confused with a different mysteriously named character from a different audio drama, the Man in the Tan Jacket from Welcome to Night Vale).”

This was recommended to me as one of the best profiles ever written, and it really is: the story of Ricky Jay, one of the greatest living magicians.

Universal Design for Parenting

Tags

disability, neurodivergence, ozy blog post, parenting

Due to family history, I have a child at higher risk of certain disabilities: mood disorders, borderline personality disorder, ADHD, and autism spectrum conditions. Even if I don’t have a child who is disabled enough by these conditions to qualify for a diagnosis, they may have subclinical symptoms.

So there’s sort of an interesting question, which is how– as a parent– you deal with knowing that your child is at elevated risk of having one of these conditions.

My philosophy as a prospective parent has been affected by the principles of universal design. Basically, it is much easier and less expensive to design things ahead of time with the needs of disabled people in mind, rather than to retrofit a building or an object which was designed without thinking about disabled people. Think about architecture. If you’re planning for disabled people ahead of time, you can incorporate a ramp into the original blueprint and build it along with everything else. If you wait until the first person with a wheelchair wants to use your building (or until regulations require you to let them in), then retrofitting is probably going to be really expensive, result in an ugly and awkwardly positioned ramp, and require you to close the building for six months for construction.

I think there’s a similar thing for parenting disabled children. Parents of disabled children often grieve the loss of their expectations and hopes for their child. In some tragic cases, the parents become bitter and angry at their children for not being the children they wanted, in some cases going so far as to accuse the children of ruining their lives. Discovering a child is disabled involves a major reworking of a number of aspects of family life, whether that means setting aside time for physical therapy with your child each day, learning techniques to manage your emotionally or developmentally disabled child’s meltdowns, searching for wheelchair dance lessons, or simply shuttling your child from appointment to appointment.

There’s also a cost for the children. Children with many disabilities– particularly invisible disabilities– may go undiagnosed for years, in which time their needs are not accommodated, they aren’t learning the skills they need to succeed as disabled people, and they may acquire toxic shame and anxiety that follows them for the rest of their lives. In some cases, a lifelong disability may not be diagnosed until the person is an adult, in which case they’ve gone through their entire childhood without appropriate accommodations or support.

Universal design for parenting doesn’t mean assuming that all children are disabled: of course, even in families with a history of disability, many children will be abled. But it does mean parenting in a way that would be good parenting whether the child is disabled or not.

For instance, I’ve mentally prepared myself for the prospect that my child is disabled, including forms of disability I might otherwise have a particularly hard time dealing with (such as intellectual disability, the child being nonverbal, or violent meltdowns). I’ve talked to my husband about disability to make sure we share the same values, the same way I would talk about other parenting issues like discipline or education or screen time. My children are at risk of childhood-onset depression, so I’m taking the perhaps unusual step of proactively taking them to psychological checkups. Hopefully, they will feel comfortable talking about their symptoms with a therapist, even if they don’t want to bring them up with a doctor. (Of course, I am not going to look at my children’s therapy records; since children have no legal right to confidentiality, it’s particularly important for parents to be conscientious about allowing them their privacy.)

There are also some accommodations I can implement without a disability. I can make a particular effort to validate my children’s feelings, because invalidating environments tend to exacerbate symptoms in children with a genetic predisposition to borderline personality disorder. I can proactively teach emotional regulation skills. If it seems like my child might benefit from social stories or visual schedules, commonly used to help autistic children, I can use them. I can purchase toys that help develop fine and gross motor skills, which autistic children are particularly likely to have trouble with. I can have a daily routine, which helps children with ADHD and autism. I can avoid shaming my child for forgetting or losing things, which leads to the comorbid anxiety that causes so many problems for adults with ADHD. I can try giving children clear instructions (“put your toys on the shelf,” not “clean your room”), which helps children with ADHD remember things.

Naturally, I haven’t done universal design for parenting for every conceivable disability. For instance, there is a step outside my front door, even though this would be inaccessible for a child who uses a wheelchair. I haven’t learned ASL, even though Deaf children with access to sign language have higher academic performance, and have no intentions of raising my children bilingually in sign and English. That’s because both of those would be fairly costly for me– I’d have to move, I’d have to learn a new language– and I have no reason to expect my children are any more likely than average to be Deaf or use wheelchairs. But I think if your child has an above-average chance of having certain disabilities, it’s worth it to be prepared.

Ozy Elsewhere

Tags

disability, ozy blog post

There is a secret blog post up over at my Patreon; if you’re a backer, go check it out.

I also wrote about Peter Singer, effective altruism, and the murder of disabled babies for NOS Magazine, a disability rights magazine.

Why I Support A Welfare State

Tags

capitalism is NOT MADE BY BIRBS, disability, ozy blog post

I am fairly libertarian-leaning, but I have qualms about going full libertarian.

Prices are really great. Prices are a really great thing about markets. For instance, consider flow restrictors (example chosen for being extremely unimportant and having a delightfully pissed off article written about them). Most showers in the US have flow restrictors, which means that their showers use less water, but also are less enjoyable, at least to some people.

Prices are a much better way to solve this problem than requiring flow restrictors is. If the price of water reflects the costs of water– either due to the Magical Free Hand of the Market, or because the government has put a tax on it equivalent to the externalities of using too much water– then that guy who wrote that delightfully pissed off article can have as unrestricted a shower as he pleases. If he pays for it, that is prima facie evidence that the shower is more valuable to him than the cost of the water. On the other hand, if you’d rather spend your money on hookers and blow, you can install your own flow restrictor, or take a shorter shower, or some other method of conserving water. Since people have different preferences, this lets everyone satisfy their own preferences.

At least, as long as everyone has the same amount of money. If we both make $20,000 a year, the fact that I take that shower and you don’t is a pretty good sign that I care more about the shower and you care more about hookers and blow. If I make $20,000 a year and you make $200,000, it might just mean that you can’t be arsed to install a flow restrictor to save an amount of money that is comparatively meaningless to you.

Of course, you don’t actually want to require that everyone make the same amount of money. Some jobs are more desirable than other jobs. If your job is soul-crushingly mind-numbingly boring and my job is taste-testing ice cream, then it makes sense that you earn more money. We can model that as you and I working the same job, except that I paid a $180,000 Getting To Eat Ice Cream For A Living fee.

(Totally worth it.)

The same thing goes for jobs with longer hours vs. shorter hours, jobs working with nice people vs. jobs working with complete assholes, jobs that help people vs. tobacco company executive, etc. If your job has good traits other than money, then– all things equal– one should expect you to make less money at it.

But all things are not equal. In fact, you can observe that the jobs that make the least money are often the worst in terms of working conditions. Fast-food employee, retail clerk, guy who holds up a sign telling you that there’s a “sale!!!!!!” at the jewelry store– these jobs are ill-paid and also terrible.

The reason is that people have different abilities. Through no fault of their own, some people are smart, hard-working, and charismatic; other people are dumb, lazy, and in possession of voices so soporific that Pfizer is considering marketing them as a sleep aid. Some people have parents who are willing and able to pay for them to get training or the $100,000 conscientiousness and intelligence certificate; other people don’t. Some people have friends who can tell them about well-paying jobs and vouch for their good qualities; other people have friends who can tell them about the fact that the McDonalds down the street is hiring; still other people don’t have friends at all. Some people inherit billions; other people grew up on the street. None of these have anything to do with your desires: if you’re in the fifth percentile in conscientiousness, you probably really want to be more hard-working, but as it happens you were born with a lazy brain and you’re probably not going to become as rich as an effortless workaholic.

The most striking case of this is disabled people. Many disabled people– including myself– are incapable of working a job that will support ourselves. Many others require significant and potentially expensive accommodations to work a job.

What this means is that the market will tend to oversupply the preferences of some people (those that have skills and abilities that mean they have a lot of money) and undersupply the preferences of other people (those that don’t). From many moral perspectives (including utilitarianism, contractualism, and veil-of-ignorance Rawlsianism) this is unsatisfactory. It is unfair that society cares less about someone’s preferences just because they were born stupider than other people.

Of course, it’s often hard to distinguish impairments and preferences. It is hard for a government or society to tell apart “I am low conscientiousness but would prefer to be able to do more work than I am capable of” from “I don’t like working that much and am gladly taking a lower salary so I don’t have to.” (Hell, it’s hard for an individual to tell those two apart.) We want to care about group #1’s preferences as much as we care about everyone else’s. But we also want The Magic of Prices to allow group #2 to make an informed decision about how much they should work.

I think the least distortionary way of dealing with this problem is by transferring sufficient cash to poor people that they can maintain a reasonable standard of living, gradually phasing it out as people earn more money, such that people will always earn more money the more they work. That isn’t perfect. Some unimpaired people will not pay the full social cost of their desire to work less. And it isn’t treating impaired people completely equally; they still won’t have the option to work $200,000/year jobs. But I think that that is the least imperfect tradeoff. It makes sure that impaired people can fulfill their most important needs, while minimizing the distortion to prices.

I also think it makes sense to transfer cash to disabled people, with more money to more severely disabled people. Most disabled people are impaired, not people with unusual preferences. Of course, any attempt to give something to disabled people and only disabled people creates gatekeeping problems: wherever you draw the line, some disabled people will not be able to take advantage of it and some people who probably aren’t that impaired will be able to. But the other option is undervaluing the preferences of all disabled people, which I think is worse.

Book Post for May

Tags

disability, lois mcmaster bujold, ozy blog post, science side of tumblr, there is no justice and there is no judge

[Thanks to Jonathan and Cliff for giving me books!]
[you might say “Ozy, this is observably not May!” Yeah, well, I’m bad at things sometimes.]

Among the Creationists: My absolute favorite genre of books is Books About What Fundamentalist Religious People Are Getting Up To, I don’t know why this is but I have accepted this fact about myself. Anyway, this is a perfectly good book if you happen to share my interest, and gives you a real sense of why creationists believe what they believe and what it feels like to be a creationist from the inside. If you aren’t interested in creationists, however, it’s definitely skippable.

Only A Theory: tfw you’re part of the way through your nice book about What Fundamentalist Religious People Are Getting Up To and you start having the creeping suspicion that the author believes in God

[content warning for Nazis on the next review]

Pride Against Prejudice: A Personal Politics of Disability: Interesting fact I learned from this book: the Nazi euthanasia program was originally motivated as much by ‘mercy killing’ as it was by attempting to improve the race. Until 1943, Jewish children were not euthanized, because it was believed that as a lesser race they did not deserve it. I think that is a really emotionally moving argument for– even if you happen to be in favor of suicide rights– emphasizing that suicide rights are about people having the right to decide what happens to their own bodies and lives, not about some lives being objectively “worth living” or “not worth living”.

This book has a really interesting exploration of the intersection between feminism and disability rights. Many feminists have advocated for institutionalization, on the grounds that it keeps women from having to be caretakers; however, disability rights advocates tend to oppose institutionalization. I appreciated some of the snark: for instance, in response to a theorist who argues that institutionalization allows disabled women to develop ungendered roles free from family-centric ideology, she proposes that perhaps if institutionalization is so beneficial nondisabled people should do it too.

The story that made my heart ache the most was of Annie, a girl with severe cerebral palsy who was assumed to be severely cognitively disabled and placed in an institution without toys, education, or activities; even the television was for the benefit of staff. A caretaker taught her to use a letter board and it turned out that Annie was, in reality, tremendously intelligent– among other things, she had independently invented multiplication after learning about addition and subtraction from Sesame Street. Not, of course, that it’s okay to neglect people who are severely cognitively disabled, but I think that shows the importance of presuming competence and not assuming that people who can’t talk are things that don’t have subjectivity or a sense of self.

[Spoilers for the Vorkosigan Saga. Did I read half the Vorkosigan Saga in two weeks? Yes, I fucking did.]

Ethan of Athos: So the Vorkosiverse had a bunch of gay separatist telepathic religious fundamentalists. That is going to be… really interesting in a couple of centuries.

I spent a large part of this book terrified that Ethan would suddenly discover that women weren’t so bad and he was attracted to them, or worse that he was in love with Elli Quinn. Fortunately, Lois McMaster Bujold would never betray me so, and he gets to date Terence Cee the telepath instead. Also I love how Elli being hot is established by Ethan being confused by why all the other men are constantly looking at her enlarged mammary glands.

It’s really remarkable how capable Bujold is of making characters likeable. I don’t think there’s any other series where I’m as invested in the continued health and happiness of every random character in it. I started out Ethan of Athos being like “well, he is kind of a misogynist” and by the second chapter I was like “Ethan! My kind, gentle, innocent son! I will protect you from all the scary galactic women and their mammary glands!”

Borders of Infinity: Sergeant Taura, my precious angel, my one and only, my favorite character in all of the Vorkosigan Saga. Like, every character is my favorite, but Sergeant Taura is my favorite favorite, if you understand me. I was misled by Effulgence, which I read before I read the Vorkosigan Saga and includes Vorkosigan fanfic in which the role of Sergeant Taura is played by Wolverine, and I did not expect that there would be KISSING and it is my favorite story in the whole Saga.

“How free can she ever be, in that body, driven by that metabolism, that face-a freak’s life-better to die painlessly, than to have all that suffering inflicted on her-”

Miles spoke through his teeth. With emphasis. “No. It’s. Not.”

To be honest, I cheered at my book when I read that.

Brothers in Arms: Old Earth! Also, one of the few mentions of religion in the Vorkosigan Saga– there’s a bit about a galactic going on the hajj. Like, I know that Betans are all atheists or agnostics or maybe Space UUs, but what about Barrayar? They do the whole burning-things-for-the-dead thing but are they ancestor worshippers? Do they pray to a god? There should be more religious worldbuilding in the Vorkosigan Saga IMO.

Anyway, clone shenanigans are the best shenanigans.

Mirror Dance: One chapter into this book I was like “eh, Mark, I’m not sure how I feel about Mark, is this whole thing going to be from his point of view?” By the time I finished I was like “I want another dozen books and all of them are about Mark!” Lois McMaster Bujold is a master of likeable characters, let me tell you.

This is the first book in the Vorkosigan Saga where I had not read an Effulgence of it first, and this lead to considerably more suspense in the plotline! Particularly since Miles died! I was extremely concerned that Miles was going to be dead permanently and then I was going to read about Mark ending death through capitalism for the rest of the series.

Memory: “In the last book, he died,” Lois McMaster Bujold says to herself. “How could I possibly top that? What could make the reader feel more suspense than the actual death of my protagonist? I know! I’ll get him fired!” Apparently getting fired is more permanent than dying, also!

This book is so depressing and I wanted to give Miles a hug the entire time and I was seriously concerned that he would have to be retired forever.

Komarr: I was sort of leery when I started reading this book because I knew Ekaterin would be in it and I was worried I’d have to spend the whole time being grumpy that she wasn’t Sergeant Taura, my favorite, or Linyabel from Effulgence, whom I continue to be disappointed does not ‘exist’ in ‘canon’ because she is technically from ‘Twilight’. Anyway, no worries, Ekaterin is awesome and I am 100% behind Ekaterin/Miles as a pairing.

Let me be perfectly frank: fuck Tien. Tien is probably one of the most effectively horrifying abusers I’ve read in fiction. Partially, it’s because Bujold does an excellent job of evoking how trapped Ekaterin is in her relationship– quite wisely, she concentrates more on how Ekaterin feels than on the gritty details of the abuse. Partially, it’s because Tien is kind of pathetic: he feels like the sort of person who actually exists, and you can see the process of rationalization that Ekaterin goes through to make her stay in the relationship. Basically, my cheering when Tien died was about as loud as my cheering about Sergeant Taura.

A Civil Campaign: Lois McMaster Bujold, apparently: “I am just going to put a Georgette Heyer pastiche in the middle of my military SF series, this is a perfectly reasonable decision which no one will ever question.” I wonder what her editor was thinking when this book hit her desk. “Uh, Lois… you seem to have forgotten the part where they blow each other up in spaceships…”

Lord Dono is the best representation of a trans dude in fiction ever. I appreciate that the role of “transphobes”, in this book, was played by a man whose other personality traits appear to be “smug smarmy douchiness”, “committing lots of rape”, and “literally murdering a puppy.” I mean, sometimes I want a serious exploration of the nature of transphobia, and sometimes I want a Georgette Heyer pastiche in which it is clearly explained that all transphobes murder puppies. This is cathartic.

Diplomatic Immunity: BABIES BABIES BABIES BABIES LITTLE TINY QUADDIE HERM BABIES

Cryoburn: I would like to nominate Kibou-daini for the position of Creepiest Planet. Also, I feel like DIY cryonicists rebelling against the evil cryonics establishment by making sure there’s immortality for everyone is the aesthetic.

Aral died! 😦 I don’t understand why this was allowed to happen! Mark was LITERALLY JUST ABOUT TO END DEATH, you guys! AAAAAAAAAA

Winterfair Gifts: I do not buy for one single solitary second that Ekaterin and Miles are in a monogamous relationship. You’re telling me that a monogamous guy is going to invite his ex-girlfriend to be in his wedding, and give strict orders that she is to be treated like she’s a princess and given everything she wants? And then in Cryoburn he’s going to drop everything so he can be by her bedside as she dies? And his wife not only has no problem with this but makes the ex-girlfriend her maid of honor? Nah, Sergeant Taura is and has always been Miles’s secondary partner and they have a great relationship.

Shards of Honor: This is a romance novel. This is literally a romance novel. There is, technically speaking, a war, but it is all strictly secondary to the question of Aral and Cordelia: Will They Kiss. “Commander Cordelia Naismith of the Betan Astronomical Survey has never had time for love. When she meets the mysterious Barrayaran Aral Vorkosigan, she’s intrigued by his rugged masculinity… and all too aware of his reputation as the brutal Butcher of Komarr. But when her passion for the strangely honorable general conflicts with her duty to Beta Colony, Cordelia will find herself making decisions that change the course of history…”

I am endlessly, endlessly pleased by Aral’s deep confusion about these strange Betan customs like “not yentas” and “not arranged marriages” and the fact that he didn’t quite grasp that in the Betan model you’re not supposed to propose marriage a week after meeting someone.

Beta Colony is fucking creepy. Add “vivid descriptions of psychiatric abuse” to the Lois McMaster Bujold: Weirdly Good On Ableism list.

Barrayar: Does the Vorkosigan Saga seem weirdly pro-fetal-personhood to anyone else? Like, first in Shards of Honor the fetuses that were a product of Barrayaran soldiers raping people were put in replicators and sent to Barrayar, instead of being aborted. And now in Barrayar not only is killing a disabled fetus presented as unambiguously a villainous action but said disabled fetus is the MacGuffin that propels the entire climax. I guess being anti-abortion is a lot more reasonable in a universe with uterine replicators.

TINY MILES. TINY MILES IS MY FAVORITE PERSON. I WANT TO GIVE HIM INFINITE HUGS.

Book Post for November

Tags

disability, joe haldeman, ozy blog post, polyamory, sex positivity, star wars, the trash of the thing

[Thanks to Picklefactory for getting me Chernow!]

Alexander Hamilton. Yep, that’s right, I am the trash of the thing.

I highly recommend reading Chernow if you’re a fan of Hamilton; there’s a lot of great character details and it’s very fun to see where Miranda drew his inspiration for various lines from. Things that didn’t make it into the musical: Hamilton/Lafayette; Hamilton confessing the Maria Reynolds affair to Jefferson and Madison, in salacious detail, while they said “…you really don’t need to tell us all of this…”; Hamilton supported the Alien and Sedition Acts, because he is my Problematic Fave; Hamilton is literally the only reason we have a functioning economic system; Burr and Eliza both had habits of staring at busts of Hamilton; Aaron Burr was a feminist; Aaron Burr filled his letters to his daughter with information about the hundreds of women he was sleeping with; Eliza consents to anything Angelica and Alexander might do together except that he love her more than he loves Eliza (“and that you are too reasonable to expect”).

One aspect which very much annoyed me is that Chernow has a different interpretation of Alexander Hamilton than I do, and so I spent a lot of time going “Wait, no, ‘Eliza adores both Angelica and Alexander’ is not a good argument for why her sister and her husband never had sex! Lots of people are extremely cheerful in the weeks leading up to a suicide attempt! Argh!”

The Forever War. Haldeman’s book is one of the most clever uses of a speculative element for a thematic purpose that I’ve ever seen. The book is about the feeling of coming back from Vietnam and everyone’s listening to different music and arguing about different political beliefs and making pop culture references you don’t get; the speculative element is (essentially) time dilation, so that when the hero gets back from the Space Wars society is literally two hundred years in the future. I very much appreciated the hero– a heterosexual– having to command soldiers from the heterophobic future who call him the Old Queer.

A Disability History of the United States. While I’m not familiar with Native American history enough to critique it properly, the chapter on Native Americans came off very much as “Native Americans are a culturally unified group of noble savages who all had the political views that I, the author, possess”. However, other chapters were fascinating: Deaf people briefly managed to convince the WPA that they ought to be an exception to its no-disabled-people rule on the grounds that they were not disabled but rather a minority linguistic community; deinstitutionalization was largely a product of conscientious objectors (a group selected for their idealism and altruism) working in asylums during World War II. Favorite passage, about a group of disabled soldiers in the Civil War:

In the midst of battle, Colonel Johnson’s commander sought reassurance from Johnson that his men would not retreat: “Will your invalids stand?” the general asked via a messenger. “Tell the general,” Johnson replied with deadpan humor, “that my men are cripples, and they can’t run.”

The Devil and Dan Cooley/Hell on High. Not nearly as good as the first book in the series; still enjoyable reads. Annoyingly, they do not feature Dayne, the protagonist of the first book, who is my favorite. And there isn’t nearly enough about Devil’s Point, the demon-run theme park. To be honest, I just want a five hundred page book explaining how the demon-run theme park works.

Heir to the Empire/Dark Force Rising. It is really great reading a book series that I’d last read in elementary school, because I keep having vague senses of “I think this character is evil” and “doesn’t this character end up getting married to the person she’s trying to murder?” and “oooh, I remember that scene!” Thrawn is, of course, the single best villain in Star Wars. Thrawn’s famous “studying species’s art to learn their weak points” strategy is actually mostly used for color and as a hook to make him a more memorable villain; Thrawn’s actual competence is mostly a product of the fact that he’s the only member of the entire Empire to have read a management guide other than How To Kill Friends And Influence People Via Force-Choking. Also I continue to have a crush on Mara Jade.

More Than Two. A very good polyamory advice book sadly marred by its psychiatric ableism. The section on dating mentally ill people, summarized: “you have to disclose your mental illness or if you’re a caregiver of a mentally ill person. Don’t become your partner’s therapist. Mental health issues can make relationships difficult and sometimes intractable.” I mean, I don’t disagree with any of that (except maybe the bit about therapy, which sort of comes off as “it’s okay to support your partner about Regular Sad, but as soon as it becomes a special Crazy Sad you have to call in a trained professional”). However, it seems to me like one also ought to put in “and also many poly people are in happy relationships with mentally ill people. Polyamory can be good for mentally ill people, because it allows them to spread out the burden of caretaking more easily. And being a relatively functional crazy person gives you a head start on all the CBT skills we spent the rest of this book explaining,” all of which are also true and give a little more balanced perspective on dating crazy people. (Also, it kept talking about “enabling” mentally ill people to not seek treatment, which, ugh.)

The best part of reading advice books, of course, is finding out all of the horrible life choices you’re not making. More Than Two delivers: from the man who told his heterosexual wife “we’ll have a one penis policy and you’ll become bisexual!” to the man who saw his wife come home happy from a first date and then forbade her from ever speaking to the person she went out with again to the man with a forty-five-page list of rules that his partners had to abide by. I think the common thread in a lot of these relationships is people who have managed to go through their entire lives without realizing that “Person did Thing, which caused me to be upset” is not the same thing as “Person did something wrong”, much less “I have a right to forbid Person from ever doing Thing again”. I would suggest that this is perhaps a sign that one ought not date neurotypicals, on account of most of us crazy people figure that out by the time we’re sixteen, but unfortunately I am not as much of a jerk as the authors of More Than Two.

The Whole Lesbian Sex Book. Fun fact: I first read this book in middle school when I had just figured out I was bisexual and, like a good nerd, had gone to research the subject of having sex with girls in the library. It’s a pretty comprehensive introduction: it covers everything from the exact mechanics of fisting to to how to make sure your sex parties are disability-friendly. (Do you have an ASL interpreter, by any chance?) While some of the information is out of date– the only thing that changes faster than Internet resources is acceptable trans terminology– overall it’s a book I’d recommend to most women who are considering having sex with women.

BDSM Questions, Answered

Tags

abuse tw, disability, mental illness, ozy blog post, rape tw, sex positivity

[Commenting Note: I am trying to be as charitable as possible to radical feminists in this blog post and I would greatly appreciate it if my audience would do the same]
[Content warning: extensive discussion of sex, BDSM, abuse dynamics, and sexual violence; brief, approving discussion of self-harm]

I recently read an article by a radical feminist asking five questions about BDSM she had never heard satisfactorily answered. And, you know, how else does one respond to a temptation like that?

1. How would you teach women that they are owed bodily integrity, freedom from violence, and mutually pleasurable activities if they are also taught that it’s normal for sex to be degrading, painful, and non-mutual?

I want to turn this around into another question: how would you teach women that they are owed bodily autonomy, freedom from domination, and activities they find pleasurable, if they are also taught that those rights only extend to activities no one finds sufficiently gross or incomprehensible?

My thoughts here are closely tied to neurodiversity activism. One concept arising from the intellectually and developmentally disabled people’s rights movement is dignity of risk. Even today, a lot of people decide that intellectually and developmentally disabled people should be protected– other people should make their decisions for them, because what if they make the wrong decisions? But if you’re not allowed to make bad choices, you’re not actually allowed to make choices. Actual autonomy involves the ability to take risks, to decide what costs you’ll accept for what benefits, to make decisions your guardians or peers disapprove of, to make mistakes, to fail, to fuck up. Otherwise it’s meaningless.

The policing of nondisabled women in our society is, of course, not nearly as bad as the policing of disabled women. But I still think a lot of sexism takes the form of “don’t worry your head about that, little lady. Just let someone else think about it for you. We’ve already decided what’s good for you.” So I think we should, at the very least, default to the position that, when a person’s choice is not directly hurting other people, you don’t have to like what they choose, you don’t have to understand it, you don’t have to want it for yourself, but they are making understandable choices given their own life circumstances, and you shouldn’t limit their choices without a damn good reason.

“Hey, wait!” you might say. “I have a damn good reason! Those women are hurting themselves!” The Icarus Project, in their excellent workbook on self-harm, gives examples of things that could reasonably be thought of as self-harm: running a marathon; not exercising; getting tattoos; working when you’re sick; skydiving; even undergoing psychoanalysis. The point, of course, is that it’s pretty hard to draw a hard line between the intentional infliction of damage on one’s body that we accept and even approve of, and the intentional infliction of damage on one’s body that we pathologize. Therefore, the line shouldn’t be drawn around acts, but around the relationship people have to particular acts. If someone wants to not work while they’re sick but has panic attacks whenever they try to stop, or it’s making them unhappy or making it harder for them to reach their goals or harming their relationships, then they have a problem. If someone cuts, and it calms them down and is a useful tool in their emotion-management toolkit and generally improves their life, and they’re taking appropriate safety precautions, then they’re fine. The best thing is to provide nonjudgmental, harm-reduction information that allows individuals to make the best decisions for themselves.

The same thing applies to BDSM. If someone wants to stop having kinky sex but feels compelled to do it anyway, or it makes them feel like shit, or it harms their ability to reach their other goals, then we have a problem. If someone is having kinky sex and it makes them feel happy and at peace, or more connected with their partners, or even just gives them some good orgasms and no other consequences– there isn’t a problem. It doesn’t matter what the act is. It matters what the individual’s relationship to the act is.

2. How do you expect to prosecute and prevent domestic violence when you promote controlling relationships, sexualized abuse, and psychological and physical abuse as part of “healthy” relationships?

The Conflict Tactics Scale is a commonly used method of measuring interpersonal violence. It typically finds that men and women are equally likely to abuse each other, and that a substantial number of relationships are “mutually abusive”.

Why? Because the Conflict Tactics Scale looks at individual acts of violence. If a man hits his partner because she burned the dinner, and she hits him back in an attempt to get him to stop, the Conflict Tactics Scale will record it as each partner having hit each other once, and therefore both the man and the woman are abusive and the relationship is mutually abusive.

The context of the relationship is not a minor detail. It is not something you can handwave past. It is not something you can leave out for simplicity. It is literally the entire difference between an abusive relationship and a nonabusive relationship. Abuse is not a particular set of behaviors. You don’t get two abuse points for name-calling and five for gaslighting and ten for shoving and if you get more than twenty-five the relationship is abusive. Abuse is, at its core, the act of maintaining power, control, and domination over your partner; hitting is just a popular strategy for doing so. If no one is trying to maintain power, control, and domination over anyone else, it ain’t abuse.

Now, this does get into the thorny issue of 24/7 relationships. As it happens, I tend to get decision-fatigued very easily. Therefore, I sometimes ask my partner to order for me at restaurants, or decide what task on my to-do list I’m going to do. I feel like this is fine. If I said “partner, I am going to be decision-fatigued for the next while, so just order for me at restaurants until I say for you to stop”, I think that would also be fine. It seems implausible to me that this setup would suddenly become unethical if I added collars or boners.

The important difference here is between my partner taking power and control and me giving power and control. In a healthy 24/7 relationship, the submissive is deciding, of their own free will, to do what their dominant wants; if they decide that they don’t want to do that anymore, then they can just stop. If you could stop abusive relationships by going “nah, I don’t want to be abused anymore”, there would be a lot less need for domestic violence shelters.

Look, I agree with you that consent is not enough. Consent is the bare minimum standard. “Enough” is that the sex contributes to the happiness and flourishing of everyone involved. But I don’t think you can strip a particular act from the entire context of the relationship and the people involved and be like “that! That is clearly harmful to the people involved!” People are more complicated than that.

3. How would you teach men to respect women and want to engage in mutually pleasurable activities if they are also taught that it is sexy to hurt, dominate, and coerce women?

Well, uh, to begin with, I don’t support teaching men that it’s sexy to hurt, dominate, and coerce women. I think one of the great things about the Internet is how polymorphously perverse it’s allowed human sexuality to be. I want there to be balloon fetishists and dragons fucking cars and knotting and Comstock Films and dendrophiles and transformation fetish and inflation and wetlook and feederism and giantesses and 200,000 word fanfics where they don’t fuck until word 180,000 and the Hydra Trash Party. The faster we get out of this vanilla/BDSM binary where the only alternative to cunnilingus and cuddles is bondage and flogging, the better, I say.

But even in that polymorphously perverse world some people are going to be enjoying the Hydra Trash Party, and therefore some men will get off on the idea of hurting, dominating, and coercing Sebastian Stan their sexual partners. However, in my experience, this is not related to actual abuse.

People in the BDSM community are probably at higher risk of experiencing sexual violence, although it’s confusing. However, the BDSM community also has a lot of casual sex. In a monogamous community, Jane Rapist will get married and rape her wife; in a casual-sex-heavy community, Jane Rapist will rape three, or four, or a dozen sexual partners– greatly pushing up the percent of people who have survived rape. In addition, the plausible deniability offered by such communities makes them extremely attractive to rapists. Does the BDSM community have a higher rate of rape than, say, the vanilla bar scene? I don’t know. But I suspect the answer is “no.”

To be honest, this is a hard question for me to answer, because of how absurdly distant it is from my own experience. The sex partner I’ve had who fantasized about the most objectively horrifying things is also someone I’ll be forever grateful to, because they were the first person to notice that I had a hard time setting sexual boundaries and deliberately teach me how to say “no” to things I didn’t want. My current primary is pretty fucking kinky, and also tremendously understanding about and patient with my disabilities in a way I’d never expected a neurotypical to be. Conversely, the partners I’ve had who most blatantly disrespected my preferences, limits, and boundaries all fantasized about sweet, loving sex with attractive women. I admit I am only one person, and this is only anecdote, but you understand why this question is much less satisfying than the others. I have no experience to draw on.

4. How do you expect to teach men about affirmative consent when BDSM practices themselves do not embody affirmative consent — including situations where consent is physically impossible?

I want to emphasize that we’re on the same side here. I agree that the BDSM community all too often fails to embody affirmative consent, and I agree that we should work on fixing that. In fact, the author’s very own FAQ quotes from an extended series of essays by a kinkster about preventing rape in the kink community.

If we applied the same standards to non-BDSM sex that this question applies to BDSM, we are all going to be celibate for the rest of time. The vast majority of rapes are not BDSM-related. The vast majority of rapes are oral sex, manual sex, anal sex, and PIV, because of the simple fact that most sex is oral sex, manual sex, anal sex, and PIV. Forced electricity play is essentially a rounding error.

Earlier in the FAQ, the author gives a more extensive idea of what she means by the BDSM community’s poor consent practices and situations where consent is physically impossible. She says, describing the former:

The author described the rapist’s grooming behavior (subjecting his victim to other forms of penetration and lying about what he was doing) thusly: “It’s not a bad way, this sort of mind game, to move towards opening up a limit.” [emphasis mine]. Respecting a boundary is to take the boundary as an absolute limitation on behavior; not something to be pushed, or worn down, or (euphemisms again!) “opened up.” The author condones the grooming because the victim “didn’t say no,” in spite of the fact that the victim was uncomfortable with the perpetrator’s behavior. Insofar as they condone grooming, manipulation, and coercion to violate boundaries (and this author apparently does), BDSM practitioners cannot claim that they respect consent.

On the same blog, this author dismisses unwanted torture and assault, as well as resulting permanent trauma, as “shit happens” (which sounds disturbingly like the oft-cited dismissal that various forms of sexual violence or abuse are simply “bad sex”). Some of this, he claims, is due to “miscommunication” and the fact that a “good top” is not going to do simply what has been explicitly discussed. A very flimsy excuse — if there is the slightest ambiguity about whether a partner is uncomfortable with a sexual activity, one can always ask.

I think these passages greatly misrepresent Millar’s points. First, it is a very unusual definition of “lie” which includes “I am going to put my fingers inside you and claim that it’s a knife. Is that okay?” Normally, “lie” implies that you are misleading people about facts. Do you also think that reading fiction to your partner is grooming behavior?

Second, I think this passage confuses you pushing my boundaries and me pushing my boundaries. If I say “no, I don’t want to do that” and you say “please please please please”, you are clearly being an asshole. However, if I say “I’m uncomfortable doing that, but I’m going to do it anyway. Can you help me work my way into becoming more comfortable?”, that is perfectly ethically fine. If it wasn’t, I would be morally obligated to never leave my house. (It’s true that Millar’s essay leaves it ambiguous which one is happening, and if it’s the former it’s obviously unconscionable.)

Third, the author fails to mention that what Millar calls “shit happens” are technical errors and emotional landmines. While those may have awful emotional and physical consequences, they are clearly not the same thing as actual rape. Millar does not dismiss the consequences of those acts; he compares the effect of an accidentally tripped emotional landmine to a tsunami. He simply points out that it’s no one’s fault, which is true.As someone with a hell of a lot of emotional landmines, the idea that my partner accidentally triggering me is the same as rape is absurd. And both of those are also issues in vanilla sex: the broken condom, the rape flashback.

I agree that people don’t check in enough during sex; a “can I pull your hair?” saves a lot of trouble and guesswork. However, people are still not perfect at reading each other’s signals. The problem comes exactly when from one person’s perspective there isn’t any ambiguity and no need to check in. Fortunately, most cases of miscommunication aren’t particularly disastrous, because in a healthy sexual relationship you can just say “actually, that’s not my thing”; legitimate sexual-violence-by-miscommunication is probably even less common than forced electricity play.

Next, she discusses cases when, to her mind, people cannot consent:

A submissive may be in such a state of fear, pain, or disassociation she is unable to give or withdraw consent: “Lots of bottoms, especially subs, are not really in a state of mind mid-scene to advocate for themselves… Some folks just can’t use safe words at all because they can’t access them in scene: they have to negotiate up front and then trust.” But if there is no consent if someone is in such a state of pain, fear, or disassociation — or for any reason feels unsafe expressing her feelings — that she cannot withdraw consent or communicate (certainly no one could claim that someone in such a state is actively giving consent).

First, this is clearly a misrepresentation of Millar’s point. Millar is not talking about “feeling unsafe expressing her feelings”– he would most certainly agree that making someone feel unsafe expressing their feelings so they can’t say “no” to sex with you is an act of sexual violence. What he’s talking about is that for many people BDSM induces an altered state of consciousness. For many people, altered states of consciousness make them vulnerable– think of it like having sex with someone who’s drunk.

(Tangent: nonverbal people are capable of communication. Everyone is capable of communication. When I go nonverbal and point to something, or make an upset noise, or bring someone a movie I want to watch, that’s communication. All you need to be able to communicate is the ability to move at least one (1) muscle. The idea that nonverbal people can’t communicate is regularly used to ignore the preferences and consent of disabled people, and you should not put it in your feminist blog post.)

Now, it is a defensible position that it is unethical to knowingly have sex with someone in an altered state of consciousness. Indeed, many people have a similar position with alcohol: if your partner is sufficiently drunk, you shouldn’t have sex with them. In that case, you don’t have to condemn all BDSM, you just have to condemn BDSM that puts people in an altered state of consciousness such that they are more likely to agree to sex acts that, in the cold light of morning, they wouldn’t approve of. However, I disagree. I believe that if I say to my partner “honey, when I’m really drunk, you can have sex with me if you want”, and my partner respects my limits and my drunken “no”, then this sex is ethically fine. And I believe that if I say to my partner “honey, I get very deep into subspace, but I’m okay with doing a scene with you”, and my partner respects my limits and my subspacey “no”, then that sex is also ethically fine. Riskier? Perhaps. But I don’t think it’s a risk that it’s wrong to knowingly take.

5. How would you prevent emotional and social coercion into these practices?

Now that’s one difficult as hell question!

I don’t think anyone has come up with a satisfying answer about how to prevent emotional and social coercion into sex. But that’s the thing– there’s nothing special about BDSM. The feeling of being socially coerced into a flogging you didn’t want is really not a whole lot different from the feeling of being socially coerced into cunnilingus you didn’t want. If you rule out BDSM but allow cunnilingus, you’re not going to solve the problem of social and emotional coercion into sex, any more than you’re going to solve it if you rule out cunnilingus and allow BDSM.

One important step, I think, is to get rid of the bullshit status games around sex. The quality of your sex life is measured in how much enjoyment you and your partners get from it– whether that means celibacy, missionary-position penis-in-vagina intercourse once a week, quadruple penetration while being suspended, or all of the above at different points in your life. Not being into kink doesn’t make you a prude. Not being interested in penis-in-vagina sex doesn’t mean you’re being unreasonable. Not wanting to orgasm doesn’t mean you aren’t liberated. And not wanting sex at all is perfectly fine– for whatever reason you don’t want it.

We should also get rid of the idea that certain sex acts are something we ‘owe’ our partners. Of course, we should strive to find partners we’re sexually compatible with: it’s tremendously convenient to have a partner who isn’t interested in the sex acts we aren’t interested in. And there’s nothing wrong with trying something out if you’re not sure if you’ll be into it, or doing a sex act because you like making your partner happy. But in the event that your sexualities change, or you discover new things about your sexuality, or perhaps you or your partner were not quite as open in communication as one would hope– you don’t have to engage in any sex acts you don’t want to. Period. End of story. If you decide to let your partner finger you, or fuck you bent over the desk, or diaper you, when that’s not your thing, it’s a favor you’re doing for them. There is nothing your partner is entitled to.

Finally, in a linked article, a person argues that widespread BDSM creates a form of social coercion. A woman who doesn’t like BDSM may have a choice between BDSM and celibacy. However, ending BDSM does not solve this problem. I myself have a hard limit around receiving oral sex. Let me tell you: there are a lot more people who will sulk when you say “please don’t touch my genitals” than people who will sulk when you say “please don’t tie me up.” I think there are about three solutions here. First, you can argue that being socially coerced into bondage is far, far worse than being socially coerced into a sex act that makes me dissociate from gender dysphoria, in which case, uh, good luck with that. Second, you can support mandatory celibacy for everyone. Third, you can support a diversity of sexual preferences, so both I and people who aren’t interested in BDSM can find sexually compatible partners.

Functioning Labels Are Kind Of Silly

Tags

disability, ozy blog post

The problem with talking about someone having “high-functioning autism” or “a high-functioning developmental disability” or “a high-functioning personality disorder” or “being a high-functioning sociopath” (thanks Sherlock) is that how well you function is a product of a whole fuckton of stuff, only one of which is your impairment.

For instance, what’s the environment like? I do great in environments where I have a lot of expectations and structure, and poorly when my brain has a lot of time to eat itself. An autistic person might appear a lot more autistic if they happened to live in a place with sirens going off constantly. This is particularly true because a lot of people tend to behave in more dysfunctional ways under stress.

Another important aspect is what people expect of the person. If you define “functions well” as “can speak”, a lot more autistic people are going to function well than if you define it as “can hold down a forty-hour-a-week job and have a romantic relationship.” That matters on a more micro level too: if no one expects me not to break down in response to routine life problems, I don’t have to hide my emotions, and then I can devote more energy into recovering better from my breakdowns.

Similarly, the person’s other abilities matter a lot: an autistic person who’s a tremendously gifted writer might easily find a workplace that tolerates her eccentricities, while an equally severely autistic person might join the 58% of autistic people who are unemployed. It also matters what coping skills they’ve developed or been taught: a person with a personality disorder who’s spent a year working with a really good therapist will probably do better than someone who hasn’t.

This is a problem because a lot of times people use high-functioning to describe the disorder, rather than the person. Saying “Joe has high-functioning autism” makes it sound like Joe’s autism is very mild. But, in reality, someone exactly like Joe, but with comorbid bipolar disorder, no knowledge of how his brain works and what sets him off, and a noisy environment full of people constantly talking to him and expecting him to do complex neurotypical social games– and Joe is going to look a hell of a lot less well-functioning.

Even if you use “high-functioning” to describe the person, it’s inaccurate to treat high-functioning and low-functioning as binary categories. A lot of times, whether someone comes off as high-functioning or low-functioning depends on what traits they choose to emphasize. Stimmy Abby writes powerfully:

Let’s take two girls with autism.

Trisha is an articulate and eloquent writer. She has autism, but that hasn’t kept her from presenting and preforming for large audiences. Her teachers have described her as introverted, bookish, gifted, and eager-to-please. She has multiple friends, she can take a train across the city independentally, and her mother thinks nothing of leaving her home alone with her younger brother.

Kailey cannot bathe herself and has trouble with dressing, eating and most activities of daily living. She spends hours engaging in self-stimulatory behavior and she routinely self-injures to the point of bloody sores. She has meltdowns in which she hits herself, bashes her head into walls, and destroys things; medication cannot control them. She has limited verbal ability and a wandering problem that has led to her almost walking into cars. She cannot function in a normal school.

Which of these people sounds “low functioning” and which sounds “high functioning”?

Guess what? They are both me.

For instance: a lot of people who come off as Aspie are nonverbal sometimes or otherwise have poor expressive language (for instance, forgetting common words and having to be like “that purple thing (makes rectangle hand gesture)” “you mean the Skittles packet?”). A lot of people who come off as Aspie headbang. I guarantee you, every single fucking thing you hear described as something that low-functioning autistic people do, there’s a ton of people who come off as high-functioning who do it too.

A lot of neurodiversity advocates think we should throw out functioning labels entirely. I don’t think that’s true! I think it’s important to talk about how some people function better than other people. However, when we’re talking about this, we should remember that it’s a vast oversimplification of a more complex reality. We should never say that a person’s disability functions well– instead, they function well. And we shouldn’t use functioning labels as a way to silence people, either by saying that people who function less well can’t speak for themselves or have opinions, or by saying that people who function better don’t count.