Aside from attempting to strike the usual balance between work, leisure, interests and various collisions of the three, part of what has kept me away from writing for so long has been a project which was intended to combine much of the work that already went into ‘The Production Of Plagues’. This new project was intended to look at the the connection between capitalism, neoliberal economic policy and healthcare in order to provide a cogent analysis of the response to COVID so far beyond provocative conspiracy theory manifestos and what could be described as a more vulgar Marxist analysis.
Unlike the other pieces which have largely informed some of my other work in political advocacy I intended this one to engage with the wider left as part of what was at that time a recent increase in political narratives that had sprung up around the lockdown protests and the lefts response.
Writing, for me, however has not always been a way of political engagement but also a way of working through my own thoughts and through conversation and narratives I’ve been exposed to in a similar fashion to a blog or journal. As time has gone on I’ve found it increasingly important to provide a more robust background for these thoughts given the contentious nature of some of the subjects and my increasing interest in further publicizing some of the work in which I’ve been engaged with. The following however returns to the original source of all my writing, blogging, in an attempt to jot down and work through some of the subjects that I’ve been ruminating on recently.
War is still a Racket
Since February 24th a war has been raging in Ukraine, an incredibly bloody conflict costing thousands of lives and displacing millions of people. The level of atrocity visited upon Mauripol, Kyiv and Bucha, is still being assessed as does the implications that the war could have on a fractious geopolitical sphere. Amidst the criticisms of Putin have also been, what might seem to be familiar talking point surrounding the North Atlantic Treaty Organization perhaps best expressed DSA International Committees letter which barely mentions Russia in favour of a critique of “western sensationalism”.
The letter went on to criticize the US presence in Europe including their involvement in the Maidan protests and the Ukrainian what the letter referred a “lack of implementation” surrounding the much discussed Minsk Protocols. I’ve typically occupied a staunchly anti-interventionist space in regards to foreign conflict however, what was concerning was the lack of attention of Putin’s own imperialist ambitions received, given historical moves into Crimea and Donbas justified by a particular vision of Russian nationalism and historical identity. Yet curiously it’s only US hegemony that received any attention in the letter a situation which contains eerie parallel’s to a certain silence over Iranian intervention in Syria.
While I remain staunchly anti-nationalist, self-determination and self-defense should be a principle that most on the left who historically have rallied around anti-colonial movements should understand. Reading the words of Putin’s 2021 article ‘On the Historic Unity of Russians and the Ukranian people” reveals a negation of Ukrainian national identity a perspective which justifies not only the annexation of supposedly Russian aligned areas but the entirety of Ukraine.
It also should be mentioned the subjugation of Ukraine under the auspices of the Kremlin is no alternative to the western capitalist consensus, a 2017 report by Credit Suisse reveals Russia is among the most unequal of the major economies with 10 percent of Russians owning approximately 87% of the wealth, the recently targeted oligarch’s, a shining example of the sharp concentrations of both wealth and power occurring within the country and the strong man character that underlines an ethic that is open to both capitalist exploitation and opposed to democratic economic participation. This is state of affairs which must be resisted and for the Russian army to be defeated in Ukraine would alongside popular resistance severely undermine its legitimacy.
I’ve found myself regularly perturbed by armchair commanders dispassionately discussing mass slaughter or gleefully talking up Russian casualties, or extrajudicial executions of soldiers rather than looking more broadly at the colossal loss of life on an incredible scale.
I welcome the picketing of the Russian Embassy and pressure placed on politicians on oligarchs to push the regime to enter peace talks and the ongoing attempts to transfer military equipment to Ukraine, the alternative as witnessed at Bucha and throughout Ukraine being horrific attacks that go beyond military engagement towards indiscriminate targeting of civilians. The goal of this involvement should however be clear, to defeat the regime in Ukraine and mobilize an antiwar movement from below in order to bring an end to hostilities as soon as possible.
Gender and its discontents
Closer to home the slow-burning opprobrium that appears to have followed attempts to reform the 2014, Gender Recognition Act, ironically begun under Theresa May’s leadership of the Conservative Party, spilled into the open, with the EHRC updated guidance on the management of single-sex spaces which appeared, contrary to the law, to widen the scope for the exclusion of trans people in spaces different to those from their sex assigned at birth.
Meanwhile the UK media turned into circus with minster after minister, repeatedly asked what specific genitals or genital configuration made someone a man or woman. In many ways I’ve regretted my involvement in protracted arguments around the salience of some of these questions, my perspective whilst not divorced from personal concerns, given the difficulties the increasingly poisonous discourse has caused people closely connected to me is in many, many ways not necessarily one rooted in a particularly well educated perspective of trans people but rather a centering questions surrounding of bodily autonomy, empathy and justice. That said there are some general questions that have repeatedly come up which I think it would be useful to address.
While I don’t believe Dworkin was necessarily a trans ally, her work highlights something particularly concerning about the current discourse. Contrary to many who might label themselves gender critical, Dworkin did not look to replace the certain social and cultural differences collectively referred to as gender with what might appear to be a far more robust definition based around sexual difference.
Instead her work regularly challenged the idea that these sexes were themselves discrete and opposite a reasoning that often appears to be at work in the justification for the exclusion of trans people. Dworkin instead believed that male supremacy was an attempt to reify and delineate the interests of a sex class called “men” over a political class called “women”. However gender critical feminism rather than challenging the hierarchy of these classes look to take the same reification and instead base it around “women”. While this might in some ways seem like a way of challenging the sex-class hierarchy it merely inverts and continues its institutionalization, the regular demands of the gender critical movement being often based around the enshrining of these divisions in every area of society.
This again is not to say that this system of gender polarity is not real certainly one can see obvious disparities in the treatment of women and men in society rather that they are not simply a consequence of sexual difference but are, as Dworkin set out, actively enforced through certain cultural practices from, violence, sexual harassment to objectification and discrimination. From a, materialist understanding of class, both women and men appear to cross class divisions, the circumstances of working class women and their bourgeois counterparts being, in many cases wholly dissimilar given often clear disparities when it comes to access to healthcare, habitation, employment and ones share of social reproduction.
At its core the argument I have presented is not so much for the erasure of sexual difference rather that I do not believe a project aimed at raising the status of women or indeed men in society can be an biological essentialist one, reification of these divisions, divisions which, as pointed out by Dworkin were deeply immersed in the same violence and hatred that a truly emancipatory project should wish to do away with. Dworkin’s vision, like mine is one fundamentally based on the doing away of not only gender polarity but also the social hierarchy that maintains it. As has been regularly pointed out the essentialism that sits behind the positions described as gender critical beliefs, perhaps inadvertently, gives space to a similar essentialism that historically looked to enshrine the role of men in society a role which ultimately subjugated women or indeed anyone who was not deemed a “real man”.
In some ways my thoughts surrounding conversion therapy have been perhaps among the least libertarian in calling for the initial bill to be passed, which prohibits conversion therapy for lesbian, gay, bisexual and transgender people. Largely this has been based on three main points. Conversion therapy is known to be actively harmful to those who undergo it and is rarely voluntarily pursued, the ban in its current form as it has been implemented in other countries has not had the “chilling affect” that critics of the bill have suggested it might. In no country where conversion therapy has been banned has there been a precipitous decline in doctors willing to work in the field of gender therapy.
It is not necessarily just opposition to the exclusion of trans people from the bill but rather the reasons given that led to me adopting my position, with the health minister Sajid Javid recently suggesting that dysphoria can be a symptom of abuse. While I don’t think this is in itself an entirely flawed premise, as while there is no evidence that trauma in itself causes dysphoria there is however some evidence that trauma can be linked to gender dysphoria.
Precision when discussing this is is key as there exists a particular ontological framing whereby trans lives are largely conceived in negative terms i.e a disconnect or rejection of an internal sense of self rather than euphoria at embracing oneself. Indeed this appears to be a common narrative touted by those who oppose transition where such euphoria is either regularly ignored or thought of as being paraphilic or fetishistic.
A constant thread in the discourse in fact has been the constant omission of trans people themselves from this discussion, with again little space given to trans people perspectives on their own treatment and the effect it has had on their lives. While arguments from detransitioners even at the highest levels of policy making have caused, even momentarily, monumental shifts in healthcare policy with Keira Bell’s court case momentarily causing the suspension of any gender affirming medical care for trans children.
Whilst I’ve been labelled somewhat inflexible the only real contribution I have is that any form of treatment ought to emerge from a consensual and patient derived approach to therapy. The parochialism of those that oppose the affirmative model for me, should be concerning for anyone who would prefer to have more input into the nature and delivery of their own medical care.
Opponents of the inclusion of trans people in the bill have cited the “harm” such medical interventions that can form a part of transition can cause however have failed to look at the resolution of or otherwise disappearance of comorbidities including anxiety, neurosis, suicidal ideation or depression following treatment. Harm when brought up in these conversations, is then often times a subjective measure with the harm of not having access to various therapies and treatments, supposedly less important than potential for either post-treatment regret or any form permanent change following treatment.
I am not naïve enough to suggest that harm is something that can only be determined by the patient in question however it does seem that in these conversations there is a disjunct between what external observers believe harm to be and the recognition of the needs as expressed by the individual when it comes to the delivery of their own care.
Reversing the direction of travel and removing the delivery of, what is ultimately a highly specialized and personal form of treatment from the sphere of politics and, in the absence of more radical solutions, placing it back into a consensual arrangement between the caregiver and the person seeking care in line with the patient centered healthcare model would respect both the autonomy of the patient and take much of the “sting” out of the current discourse.
COVID and other disasters
As mentioned earlier I was working on a piece that looked to consolidate a range of writing on the political economy of pandemics, specifically the impact and incompatibility of neoliberal doctrine, capitalist imperatives and highly contagious viruses. This was to some extent going to be written from a perspective that suggested there had been some sort of panacea reached in terms of peak infections and deaths which allowed many advanced economies to begin the process of reopening commerce, travel and entertainment.
However it rapidly became clear that this was not the case, while the 7 day average COVID death rate in the UK a country that was among the first to drop all restrictions is significantly down from its 2021 peak it’s still around the same level it was two months ago. This places COVID at the time of writing in third highest leading cause of death in England.
Perhaps equally concerning is the continuing research into long COVID which at this point in time is estimated to affect 1 in 5 hospitalized patients and is rumored to be partly behind what appears to be a long term shortage in labour with the American Brooking’s institute suggested it could potentially account for up to 15% of the absences from the US workforce. Some of whom, may never return. Other data points include unprecedented pay outs from life insurance companies that in 2021 hit 5-10x their usual rate, with projections that the continuation of such a pattern could potential eat into operating capital. Which has led to some reinsurers withdrawing coverage or raising their rates whilst readjusting their forecasts.
The continuing disruption caused by reinfections and waning immunity prompts an urgent change of direction, while new medicines and therapeutic techniques to both treat COVID and the symptoms are welcome as has been previously stressed allowing COVID to circulate at the levels it is currently circulating is in itself an experiment which has so far rendered results that are increasingly disturbing from unknown liver illnesses presenting in children to symptoms such as headaches, insomnia, skin rashes and heart palpitations persisting for months after initial infection with some even being severe enough to prevent children’s return to physical education or full-time schooling.
A recent BBC Future article looking at the current circumstances, suggests, while there have been other outbreaks that have caused long-term issues for healthcare systems, such as Epstein-Barr, COVID being so widespread appears to have increased the number of children requiring long-term support to deal with multiple comorbidities. For those still skeptical about the vaccine, this also serves as a grim reminder that many of those affected by these conditions were never given the opportunity to be vaccinated, the increasingly far-fetched idea then that attempts to link the vaccines to these symptoms and the lack of reliance on natural immunity seeming increasingly improbable given the increased incidences of long covid among unvaccinated populations.
When drafting Beyond COVID I aimed to go beyond prevalence of a strategy which across europe and the US has largely been centered upon the administration of vaccines, this was partly because as subsequently seen vaccines do not in themselves stop the spread of COVID-19 but also because of what appeared to be a divisive narrative that seemed to center the pandemic on the seemingly irrational behavior of the unvaccinated population. This again, is not meant to downplay the importance of vaccination rather, critique a view which sees the COVID vaccine in it’s current form as panacea.
There were also other reasons for this criticism, in Eric Laursen’s recent book, ‘The Operating System: An Anarchist Theory of the Modern State’ he ruminates on the origin of the pandemic strategy by examining a series of decisions made in 1978 following the Almaty declaration in Kazakhstan where world health leaders stated that “socio economic development was vital for health and that healthcare had to be integrated with goals like clean water and safe working conditions”
Crucially this particular conception of public health, which in itself for many became a controversial concept suggested that various public health provisions ought to be extended at every level of society as a way of forestalling epidemics and pandemics with part of the rational being that a health population is a more productive population and thus better placed to generate the kind of economic growth that both the state and capitalism depend on. However according to Stuart Blume it appeared that the various critics of the declaration many of them based in the United States argued that its goals were both unrealistic and unaffordable and instead future global health strategies should be premised on targeted interventions aimed at specific illnesses for which effective technologies of prevention or control already existed. These realistically being vaccines and perhaps also the package of measures that were collectively referred to as lockdowns.
Part of what has been of what has been critiqued under broad umbrella of the COVID regime is the spread of the consensus that followed, one that centered the expensive search for vaccinations over the extension of public health provision, leading to untold riches for those who developed and provided vaccines and national prestige for states found to have sponsored the most widely distributed vaccines. In a hurriedly buried speech the United Kingdom’s prime minister Boris Johnson praised “Greed and Capitalism” for the UKs vaccine success which whilst openly reviled revealed a certain kernel of truth. In a global system of system of states heavily sublimated to imperative of capital accumulation vaccines emerge as a solution most in keeping with the specific interactions between capital, state derived benefits and labour that collectively appear as the modern capitalist system, the subsequent competition over procurement which saw huge stockpiles of the vaccines amassed by rich countries predominately located in the global north a reflection of how, capitalist market interactions tend to benefit larger already established economies.
Part of what the ongoing project I have been working on has been aimed at addressing was how these tendencies can, I believe, more accurately explain much of the conspiracism both on the left and right that has marred activism around the pandemic.
The idea then is that rather than denying the legitimacy of COVID the left should be centering the call for public health and social care to be back at the center of socio-economic development. This I believe will believe will be key in the years ahead given at the time of writing historic heatwaves sweep across south-east Asia and the first case of human bird flu is detected in the Henan province in china, a reminder that if, indeed the zoonotic transference was the origin of COVID such circumstances are still ongoing.
Notes and Additional Reading