Mainstream psychiatry asks: 'How do we make you functional enough to return to the machine?' Radical liberation asks: 'How do we dismantle the machine that broke you in the first place?'"— Reflections from Mad Studies / Radical Psychology Movement
Therapy, or mental health generally, is often deemed as apolitical in nature. When it comes to mental health, people's approach becomes very individualistic, and even if the environment is concerned, it is most definitely the intimate or closest one. A journal article titled, "LGBTQIA+ rights, mental health systems, and curative violence in India" (Indian Journal of Medical Ethics, 2022) critiques how mainstream mental health institutions perpetuate anti-LGBTQIA+ sentiment and individualize suicides (like that of bisexual student Anjana Hareesh) to sell psychopharmaceuticals and individualist therapy, completely erasing the toxic landscapes of institutional oppression and familial "curative violence." This particular approach avoids the most important conversation, which is society's influence on a person's mental health, especially when it comes to LGBTQIA+ people. It ignores the age-long stigma, mockery, misrepresentation, and extreme treatment towards LGBTQIA+ people which leaves them defenseless regarding their identity.

Meyer and the Minority Stress Model
Researcher Ilan H. Meyer developed the minority stress model, which explains how marginalized communities, especially the LGBTQIA+ community, go through chronic health and mental disparities due to stigma and discrimination. It talks about two kinds of stress: Distal (external) and Proximal (internal). External stressors are verbal abuse, physical harassment, or the lack of employment (which can be seen in the case of a lot of Trans people). The Transgender Persons (Protection of Rights) Amendment Act of 2026 also falls under distal stress, as it restricts an individual's right to freely self-identify their own gender without bureaucratic interference, contributing to the downfall of one's mental health, depression, and stress. Proximal stress includes internalized stigma and prejudice, and the expectation of rejection because of one's orientation or gender identity. This internalized prejudice or stigma often leads to self-hatred, feelings of shame, and worthlessness.

How Capitalism Plays Its Game
In his book, Capitalist Realism, Mark Fisher used the term "privatization of stress," where neoliberal capitalism strips any kind of psychological distress from its social context and rebrands it as an individual, biological malfunction. He noted: "The chemico-biologization of mental illness is of course strictly commensurate with its depoliticization. Considering mental illness an individual chemico-biological problem has enormous benefits for capitalism." The market economy commodifies the biological apparatus and coping mechanisms, making it very profitable for the pharmaceutical industry. DSM: Just a Manual? Or a Tool of Capitalism?
DSM-I (1952): Classified Homosexuality as a "Sociopathic Personality Disturbance," linking it with anti-social behaviors as well as sexual deviations.
DSM-II (1968): Listed homosexuality as a "Sexual Deviation.
1973 Revision: "Homosexuality" was voted out and "Sexual Orientation Disturbance" was introduced. This meant being gay was only a disorder if it caused the individual distress, shifting the blame from a hostile society to the individual’s internal conflict.
DSM-III (1980): Replaced Sexual Orientation Disturbance with "Ego-Dystonic Homosexuality" and introduced "Gender Identity Disorder" (GID).
DSM-IV (1994) & DSM-IV-TR (2000): Trans individuals had to undergo intense psychological interrogation to prove they fit a rigid, binary stereotype of what a "man" or "woman" was supposed to be, all to get "gender-affirming therapy", reinforcing state and medical control over bodily autonomy.
DSM-V (2013) & DSM-5-TR (2022): GID was renamed as Gender Dysphoria. This reframing was done by the APA to destigmatize the condition by characterizing it as "a psychological distress caused by incongruence of one's experienced gender and assigned sex."
Notice how the language has shifted from calling it a disorder and making the individual feel like the onus is on them, to acknowledging the psychological distress that the individual experiences. But even then, keeping it in the manual serves a capitalistic purpose, as the diagnostic code enables insurance companies and private medical institutions to monetize care, while the state is given the right to regulate and control.

Good Queer and Bad Queer: The Tale of Homonationalism
Jasbir K. Puar, a queer theorist, coined the term "Homonationalism" in their work, Terrorist Assemblages: Homonationalism in Queer Times (2007). Puar defined it as "a structural condition of modern state sovereignty, wherein certain queer bodies are granted temporary, conditional citizenship in exchange for their alignment with the state’s disciplinary, nationalist, and imperial projects."
Think about it as a modern-day "divide and rule strategy." In India, while we celebrate our 79th Independence Day in 2026, we are still holding on to the British's ultimate strategy, the divide and rule strategy, in a neoliberal and capitalistic way. Capitalism divides queers into two categories: the Good Queer (the useful one) and the Bad Queer (the not-so-useful one).
So, who are the Good Queers? The good queers are the privileged, upper-caste, upper-class people who are perfect candidates for Corporate DEI (Diversity, Equity, and Inclusion) campaigns, which showcase how "progressive" a company is while concealing its internal homophobia. They don't challenge the patriarchal system; instead, they want a same-sex version of a bourgeois lifestyle.
And the bad queers are the ones who are from the underprivileged classes, the non-sophisticated bunch, the Dalits, the lower classes, and the trans people who are forced to ask for money on the streets, who are not accepted as workers but are expected to survive under the radar. But incidents like the March 2026 Transgender Persons Amendment Act shatter this illusion. The state again proved that no matter how much the queer community tries to perform "good, palatable citizenship," the bureaucratic machine will still strip away their fundamental right to self-determination the moment it wants to. At the end of the day, it is proven again that the purpose was never liberation, and queers are merely tools.

Frantz Fanon's Sociogeny
Coming back again to the argument of whether the reasons behind mental suffering are inward-facing only, or if the system as a whole matters: previously, we talked about alienation and how that leads to self-hatred. Fanon stressed that it is the oppressed who internalize the oppressor's ideology to fit into a system that fundamentally rejects them. He emphasized the fact that one cannot heal a person's mind without challenging the oppressive system around them.

The Institutional "Combine": A Cultural Reflection
This weaponization of psychiatry to enforce conformity is vividly illustrated in Ken Kesey’s One Flew Over the Cuckoo's Nest. The novel serves as a monumental critique of the psychiatric institution, which the narrator, Chief Bromden, calls the "Combine" (a massive, mechanized social machine designed to standardize human behavior and crush nonconformity). Within the ward, Nurse Ratched operates not as a healer, but as a bureaucratic agent enforcing obedience through psychological interrogation and shaming masquerading as "group therapy." Crucially,characters like Harding (a repressed homosexual) voluntarily institutionalized themselves not because of an inherent biological defect, but because a hostile, homophobic society convinced them they were sick. Under early iterations of the DSM, their deviations from state-approved gender and sexual norms were explicitly pathologized, transforming medical diagnosis into an engine of social control. When the protagonist, McMurphy, resists this dehumanization, the institution utilizes the ultimate tools of psychiatric violence (electroshock therapy and lobotomy) to forcefully correct his defiance and reduce him to a functional, docile object.

Conclusion
Mainstream psychiatry remains bound to a single objective: forced adaptation. Fanon fundamentally rejected this baseline because, within his framework, true psychiatric healing cannot be separated from political liberation. Throughout its historical iterations, the DSM has served as a regulatory mechanism to cage the LGBTQIA+ community into sanitized labels, filtering human identity through the lens of the oppressor. Even today, the medical-legal apparatus continues to enforce patriarchal and cis-normative values, mandating that trans individuals navigate bureaucratic boards just to secure a certificate of existence. Ultimately, the artificial divide between the "good queer" and the "bad queer" dissolves under scrutiny; both remain deeply oppressed (one weaponized as a corporate token, the other subjected to direct systemic violence). The solution to both distal and proximal stress cannot be found by adjusting to a broken status quo, but by completely disintegrating the oppressive system itself.

"The truth is, you cannot love a system that does not love you back. True healing is an act of rebellion." -Audre Lorde