Vertigo

• It has become an “overdetermined” concept, “absorbing wildly different ideas of what threatens the world”, writes American feminist philospher Judith Butler.
• For the Vatican, the traditional family will be ruined and children are now vulnerable to “ideological colonization”.
• And for right-wing politicians and heads of state, (from Liberal senator Alex Antic, who believes gender dysphoria is a “trend”, to Marjorie Taylor Greene and Vladimir Putin), gender is a weapon of social destruction.

• Butler’s overarching argument is that “gender” – the overdetermined concept to which “anti-gender ideologists” object –  is really a nightmarish bogeyman, a “phantasm with destructive powers, one way of collecting and escalating multitudes of modern panics”.
• Read more:
  Judith Butler: their philosophy of gender explained

Misplaced fears and misunderstandings

• The first, to which much of the book is dedicated, is to expose the absurdity of arguments against gender ideology.
• Butler demonstrates the ways “gender ideology” critics invert, externalise and project the very harms they claim “gender ideologists” pose.
• Then there’s the supposed threat of sexual violence to cisgender women if transgender women are allowed into single-sex spaces like prisons.
• Read more:
  'Toxic masculinity': what does it mean, where did it come from – and is the term useful or harmful?

More than two sexes

• Feminists like Butler reject “sexual dimorphism”: the belief there are two, and only two, sexes.
• But we expect to find two sexes because that is how many sexes we have learned to see.
• And we look for two sexes because we only recognise two genders.
• And because we expect to find two sexes in humanity, we automatically start to explain away any evidence (like intersex diversity) that would contradict this received truth.

Fighting back

• These rules, we think, apply both to ourselves and others.
• To critics, “gender ideologues” are breaking all the organisational rules of gender, inverting all sense and order.
• When we question gender as an organising principle, it introduces further questions about the right way to live.

• Ultimately, Butler’s point is that while gender seems scary to many, the reality is: it’s not.
• Take a pause and ask, they suggest: what are the agendas of those who may try to convince you otherwise?
• But in imagining a shared future together, we can “emerge into a world committed to cohabitation and equality across difference”.

Louise Richardson-Self receives funding from the Australian Research Council for two projects: DE190100719: Hate Speech Against Women Online: Concepts and Countermeasures; and DP200100395: Religious Freedom, LGBT+ Employees, and the Right to Discriminate.

• Otolith Labs, a medical technology company developing non-invasive wearable medical devices for the treatment of vestibular disorders, appointed Dan Wagner as Chief Commercial Officer (CCO) and Raphael Michel as an independent Board member.
• Otolith Labs’ technology is a head-worn wearable device being investigated for the treatment of vertigo episode symptoms associated with vestibular migraines.
• “Dan has been working with Otolith in an advisory role for over 5 years, so we are thrilled to have him full-time.
• “Raphael is one of our earliest industry advisors and has been providing critical counsel to Otolith Labs since 2016.

• Around one in seven Australians take antidepressants; more than 3.5 million of us had them dispensed in 2021–22.
• Guidelines mostly recommend antidepressants for more severe depression and anxiety but not as first-line treatment for less severe depression.
• So why are so many Australians taking antidepressants and why are prescriptions rising?

Enter the antidepressant ‘blockbusters’

• In the 1990s, pharmaceutical companies heavily promoted new selective serotonin reuptake inhibitors (SSRI) antidepressants, including Prozac (fluoxetine), Zoloft (sertraline) and Lexapro (escitalopram).
• These drugs were thought to be less dangerous in overdoses and seemed to have fewer side effects than the tricyclic antidepressants they replaced.
• Pharmaceutical companies marketed SSRIs energetically and often exaggerated their benefits, including by paying “key opinion leaders” – high-status clinicians to promote them.

Why are antidepressants prescribed?

• GPs also prescribe antidepressants to patients experiencing distress but who don’t have a psychiatric diagnosis.
• Another, who cried when informed she had breast cancer, was immediately offered a prescription for antidepressants.

• Most patients believe antidepressants restore a chemical imbalance that underpins depression.
• Antidepressants are emotional (and sexual) numbing agents – sometimes sedating, sometimes energising.
• Around half of users have impaired sexual function and for some, this sexual dysfunction persists after stopping antidepressants.

How long do people take antidepressants?

• Around half of patients who start antidepressants don’t like them and stop within weeks.
• Of those who do take them for months, many continue to use them indefinitely, often for many years.
• Read more:
  Antidepressants can cause withdrawal symptoms – here’s what you need to know

We need to adjust how we view mental distress

• Overprescribing antidepressants is a symptom of our lack of attention to the social determinants of mental health.
• GPs also need to ensure they discuss with their patients the potential adverse effects of antidepressants, and when and how to safely stop them.
• But the fundamental problem is social and can only be properly addressed by meaningfully addressing inequality and changing community attitudes to distress.

Jon Jureidini receives research funding from MMRF. He is affiliated with Critical Psychiatry Network Australasia.

Human medicines European public assessment report (EPAR): Spravato, esketamine, Date of authorisation: 18/12/2019, Revision: 9, Status: Authorised