The Theme of Institutional Violence and Pathologization in Justin Torres's Blackouts
Defining the Thematic Claim
Justin Torres's Blackouts (2023) launches a sustained critique against the psychiatric and medical institutions that have historically defined homosexuality as a disorder. The novel traces how clinical labels—from homosexuality listed in the DSM to the army-invented "Puerto Rican Syndrome"—function as instruments of control that inflict physical and psychological harm on queer and colonized people. Torres does not simply condemn these diagnoses as false; he shows how they seep into the bodies and minds of characters like Juan and the unnamed narrator, shaping their self-understanding, their institutions, and even their deaths. The thematic claim is that institutional authority pathologizes difference to maintain social order, and that the harm persists long after the official removal of a diagnosis.
Tracing the Theme Across the Plot
1. The Narrator's Psychiatric Hospitalization
In Chapter 1, the narrator arrives at the Palace already marked by institutional confinement. He recalls his own commitment to a psychiatric ward as a teenager, just shy of eighteen. The intake scene is a ritual of submission: the nurse recites a litany of rules—no private bathroom, no showering alone, no shoelaces, no sharps. The narrator's silence and compliance are themselves a symptom of the institution's power. He describes the room as windowless, furnished to "tolerate human filth," with walls scarred by previous struggles. This environment is a direct form of violence: it strips away autonomy and dignity.
The narrator's art offers a key allegory. He draws an ornate chair—a throne—wired for electrocution, with restraining straps. This image links the psychiatric ward to a history of medical torture. The narrator also builds a plywood chair with spikes protruding from the back, a "perversion" of a seat meant for sitting. These objects stand for the way institutions turn care into punishment, therapy into constraint. The narrator's suicide attempt, which landed him in the hospital, is tied to internalized shame—the very shame that the psychiatric label of "disorder" reinforces. For more on the narrator's perspective, see the narrator (nene) character page.
2. Juan's Education on the DSM and Puerto Rican Syndrome
In Chapter 3, Juan delivers a direct history of pathologization. He explains that until 1974 the American Psychiatric Association considered homosexuality a mental disorder, and afterward created a replacement diagnosis, ego-dystonic homosexuality, in 1980. Juan calls the DSM the biblia loca (the crazy bible). This history is not abstract: he connects it to his own life. Juan describes his childhood ataques de nervios—seizures shared by his sisters, brother, and aunt. At first, the family read these fits through folk beliefs like Espiritismo. But when Juan was older, military doctors diagnosed him with "Puerto Rican Syndrome," a label invented by U.S. army psychologists in the 1950s to explain the breakdowns of Puerto Rican soldiers. Juan reflects that the syndrome was a colonial projection: "Colonizer Syndrome," as the narrator calls it. Yet Juan also admits the ataques were real eruptions of accumulated trauma—the "detritus and minor shocks of corporeal difference… trapped under the skin."
This duality is crucial: the diagnosis is both an instrument of oppression and an attempt to name genuine suffering. The novel does not dismiss the reality of psychological crisis; rather, it indicts the institution for exploiting that crisis to pathologize a whole people. Juan's story is further developed on the Juan Gay character page.
3. The Sex Variants Study and the Erasure of Queer Testimony
The novel's central artifact is the Sex Variants study (1941), based on interviews with queer subjects. Jan Gay, a lesbian researcher, conducted the original interviews, but Dr. George W. Henry took control of the committee and published only those cases that fit a pathological frame. Juan finds copies of the two volumes with all the pages blacked out—erased into "little poems and observations." This blackout is a metaphor for institutional censorship: the medical establishment turned living queer testimony into a specimen of sickness, then literally obscured it.
The narrator inherits Juan's mission to recover this history. In Chapter 7 ("Blinkered Endnotes"), images and testimonies from the study are reproduced, including the narrative of Edna Thomas (pseudonym Pearl M.), a proud queer woman of color whose story begins the women's volume. Torres suggests that Jan Gay probably influenced the arrangement to foreground a positive example. The blackout thus becomes a symbol of both violence and the possibility of recovery. For a deeper dive, see the blacked-out Sex Variants volumes symbol page.
Character Connections
The theme operates through a network of characters, each occupying a different position within the institutional apparatus:
| Character | Role in Pathologization |
|---|---|
| Juan Gay | The pathologized subject; his ataques are diagnosed as Puerto Rican Syndrome, and his queerness is criminalized by the state. He becomes a historian of institutional violence. |
| The Narrator | Internalizes the labels; his suicide attempt and hospitalization stem from shame. He draws allegorical chairs and later works to preserve Juan's project. |
| Jan Gay | The erased researcher; her inclusive interviews were co-opted by Dr. Henry's pathologizing framework. She represents the lost possibility of nonclinical queer knowledge. |
| Dr. George W. Henry | The institutional authority; he leads the Sex Variants committee, selecting only pathology-confirming cases. He embodies the medical gaze. |
The Jan Gay and Helen Reitman page and the Dr. George W. Henry page offer further detail. The Thomas Painter page shows how even well-meaning participants became complicit in the pathologizing structure.
Symbol Connections
Torres uses potent symbols to condense the theme:
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The Blacked-Out Volumes: The most direct symbol of erasure. The black ink covers the faces and testimonies of queer subjects, mimicking the way clinical discourse obscures lived experience. Yet the act of showing the blackout—and Juan's work to "alloy fact with imagination"—turns erasure into a form of revelation. See the symbol page.
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The Gold Cross: The narrator clings to a gold cross associated with his father's gangster persona and his own survival after a suicide attempt. The cross becomes a talisman against institutional erasure—a fixed point of identity in a world that tries to define him as disordered. See the gold cross symbol page.
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The Hyena Laugh: In Zhenya's book Who's Afraid?, the hyena laugh is a queer cry of recognition that signals safety. It counters the pathologizing gaze with an insider code—a sound that escapes diagnostic capture. See the hyena laugh symbol page.
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The Palace: The dilapidated building where Juan and the narrator reconnect is a liminal space outside institutions—a "Palace" of the marginalized. It represents a fragile shelter from the violence of categorization. See the Palace symbol page.
Complexity and Contradiction
Blackouts refuses a simple condemnation of all medical intervention. The orderly who wheels the narrator to intake hums "Put on a Happy Face" as a kindness. The nurse who sits through the night offers medication with genuine concern. Juan acknowledges that his ataques were real and that Puerto Rican Syndrome "is describing something, isn't it?"—the pressure of living under colonialism. The novel does not reject diagnosis outright but shows how institutional frameworks can distort even genuine suffering.
A further contradiction appears in the narrator's posture toward the truth. In the Postface, he admits he "never tried to tell the truth on anyone." He willingly blurs the line between fact and fiction, between the real Jan Gay and the fictional Juan. This metafictional gesture suggests that any attempt to recover history from institutional erasure must embrace imagination as a form of resistance. The narrator also confesses his "cowardice" in dealing with Juan's body, refusing to look at death. This personal failure mirrors the larger institutional failure to see the humanity behind the label.
Torres thus complicates the theme: institutional violence is real, but so is the ambiguity of memory, the necessity of fiction, and the possibility of finding kinship within the very spaces designed to control.
Study Questions and Answers
1. How does the narrator's drawing of an electric chair throne express the theme of institutional violence?
The drawing literalizes the connection between psychiatric treatment and torture. The throne—a symbol of authority—is "wired for electrocution," suggesting that the institution's power is backed by the threat of physical harm. The straps, skullcap, and cables turn a chair for sitting into a device of punishment, mirroring how the psychiatric ward's rules and observation function as a form of disciplinary violence.
2. Why does Juan call the DSM the biblia loca? What does this reveal about the authority of diagnostic texts?
"Crazy bible" satirizes the DSM's quasi-scriptural authority over mental health. Juan implies that like a religious text, the DSM is treated as infallible truth, but its definitions are historically and politically contingent. The bible's "crazy" status points to the absurdity of labeling same-sex desire as a disorder, while also acknowledging the real harm done by such classification.
3. In what way is the diagnosis of Puerto Rican Syndrome a colonial tool?
The diagnosis emerged from U.S. military psychologists studying Puerto Rican soldiers who broke down after being sent into battle unprepared by a racist commander. The syndrome ignored the structural causes—colonial neglect, forced conscription, poor leadership—and instead pathologized the soldiers' response. Juan connects it to the "Puerto Rican Craze" of the 1950s, when increased visibility of Puerto Ricans in New York provoked a medicalizing backlash.
4. What is the significance of the "hyena laugh" in *Zhenya's story *Who's Afraid??
The hyena laugh is a coded signal among queer animals in a pre-Stonewall bar. It allows the lost boy to confirm his safe return without being detected by hostile authorities. Symbolically, it represents an insider language that escapes pathologization—a queer cry of recognition that cannot be captured by clinical discourse.
5. How does the novel's postface complicate the theme of institutional violence?
The postface reveals the narrator's refusal to decide whether Juan was real. This ambiguity suggests that the most effective resistance to institutional erasure may be not to provide authoritative correction but to leave space for imagination and multiple truths. The narrator's cowardice with Juan's body also shows that institutional violence is not just systemic but personal—the failure to witness death honestly is a form of ongoing complicity.