Death of the Clinic: Trans-Informing the Clinical Gaze to Counter Epistemic Violence
Abstract
This case study research (Patton, 2002, 2014; Flyvberg, 2006) has grown out of an awareness of deep resistance from the psy disciplines to trans-informed epistemologies as a source of legitimate knowledge (Tosh, 2015, 2016; Winters, 2008). It focuses on examining how the closure of The Gender Identity Clinic (GIC) for Children and Youth at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ontario, Canada, signaled a paradigm shift from the ‘treatment model’ to the ‘affirmative model’ with respect to clinical approaches for supporting trans and gender diverse children and youth. As such the case study involved tracing the significance of the clinic, including key figures and the clinical literature that flowed from it, and interviewing activists and academics who worked to challenge the pathologizing literature and praxes. Grounded in a critical approach to research known as bricolage (Kincheloe 201, 2005; Kincheloe & Berry, 2004) this case study was concerned to ensure that “lived experience was allowed to sit at the table of official meaning-making” (Kincheloe & Berry, 2004, p. 11), drawing “paradigmatic and textual analyses” into dialogue to examine “the various dynamics that shape what is called empirical knowledge” (Kincheloe & Barry, 2004, pp. 22, 7). This research applied multiple theoretical lenses including Foucault’s (1977, 1980, 1984, 2003) theorizations on power-knowledge and the clinical ‘gaze’, Stryker’s (2006) theorizations on (de)subjugated knowledges, and theorizations on epistemic injustice and violence (Fricker, 2007; Namaste, 2000, 2009; McKinnon, 2017; Teo, 2010, 2011). The conduct of the research entailed employing both ethnographic (Patton, 2002, 2014) and genealogical methods (Foucault, 1980, 1984); emerging as two case studies; one a micro-genealogical case study, and the other, a genealogically informed ethnographic case study. Though focused on the psy disciplines, this study raises important questions for educational research, which has privileged a ‘psychologized’ view of childhood (Teo, 2015), methodologism (Teo, 2017), and which has disciplined and erased gender and sexual diversity in schools (Martino & Cumming-Potvin, 2018). Ultimately, this research illuminates a legacy of harm while also documenting an epistemic insurrection required to trans-inform the clinical gaze.