I feel betrayed by my adopted state of California; my Governor, Newsom; and my own Democratic party. On October 11, Newsom signed Senate Bill 43 into law, applauded by prominent Dem politicians, urban mayors, and real estate interests.
Before the deinstitutionalization movement within mental health professions in the mid-1970s, mental health diagnoses were weaponized to inflict indefinite incarceration and nonconsensual “treatments,” in a U.S. mental asyla gulag. Political dissidents and LGBTQ2IA+ people were especially targeted, and punitive treatments ranged from dehumanizing “token economy” conditioning to electro-shock aversion conditioning (torture) to “icepick” lobotomy. In California, the Lanterman-Petris-Short (LPS) Act was passed in 1967 to restore human rights and rights of citizenship to those with mental health conditions (or those accused of having mental health conditions) and has done so for 56 years.
Senate Bill 43 substantially turns back the clock on LPS and similar civil rights safeguards by lowering the bar for involuntary detainment, hospitalization, and conservatorship. It expands the term, “grave disability,” to include nebulous, ambiguous requirements of targeted individuals to “provide for their personal safety or necessary medical care” to retain their autonomy and personal liberties. This creates a Kafkaesque paradox for those singled out for political or bigoted reasons: refusal to consent to psychopathologization or treatment is once again grounds for detainment and conservatorship.
“…’gravely disabled’ means any of the following: (A) A condition in which a person, as a result of a mental health disorder, a severe substance use disorder, or a cooccurring co-occurring mental health disorder and a severe substance use disorder, is unable to provide for their basic personal needs for food, clothing, or shelter, personal safety, or necessary medical care.
“… ‘Necessary medical care’ means care that a licensed health care practitioner, while operating within the scope of their practice, determines to be necessary to prevent serious deterioration of an existing physical medical condition which, if left untreated, is likely to result in serious bodily injury –SB43
The bill does offer a fig leaf of protection against compulsory treatments: “Persons detained under this section shall retain their legal rights regarding consent for medical treatment.” However, this is of little consequence when personal liberties are held hostage. A Hobson’s choice to acquiesce to nonconsensual treatments is no choice at all.
The implications for Trans and Gender Diverse (TGD) people, who for political reasons that defy science, evidence, and conscience are still classified as mentally ill in the United States (DSM-5, ICD-11-CM), are bone-chilling. There is not one word of specific protection for LGBTQ2IA+ people who have historically been victimized by such laws and policies. These risks are compounded by the failure of California to sign AB2943 (the So-Called “Conversion Therapy” is Consumer Fraud bill of 2018) into law. Moreover, there is no specific protection in Senate Bill 43 for unhoused or Black, Indigenous, and people of color (BIPOC) communities that have historically been targeted for incarceration and denial of due process.
As a Trans woman, I am old enough to have experienced and (barely) survived the threat of such incarceration in the 60s and early 70s. I am fearful that this law and others like it will be weaponized to persecute TGD people in the future, as my generation experienced in our youth.
To deeply paraphrase Santayana–People of privilege and power who fail to remember the past condemn those of marginalized classes to suffer repeatedly.
Further reading
Text of SB 43: https://legiscan.com/CA/text/SB43/id/2834161
Disability Rights California opposition to SB43: https://www.disabilityrightsca.org/latest-news/drc-and-coalition-opposition-letter-to-sb-43-assembly-health-committee
Human Rights Watch’s Opposition to SB 43: https://www.hrw.org/news/2023/08/07/human-rights-watchs-opposition-sb-43
The status of California AB2943 (2018), which would have provided protection against sexual orientation/gender identity conversion practices on LGBTQ2IA+ adults: https://www.latimes.com/politics/la-pol-ca-conversion-therapy-bill-20180831-story.html
Copyright © 2023 Kelley Winters
Trans Policy Reform Blog 