The long, twisting, and sordid legal saga of Aubrey Levin has finally come to an end. Originally found guilty on three counts of sexual assault in January 2013, Levin's five-year prison sentence was upheld by the Alberta Court of Appeal on Wednesday.
The case has garnered international attention, due to the Calgary psychiatrist's past as a military psychiatrist in apartheid-era South Africa. It is often alleged that during this time, he was affiliated with or led a project aimed at "curing" soldiers of being gay, by subjecting them to electroshock therapy or worse -- allegations he continues to deny.
The 2012-2013 Trial
It is important to separate what was said to have occurred in South Africa from what Levin was charged with in Calgary, in the interest of clarity.
Levin was charged with ten counts of sexual assault (one was later stayed) after an initial accusation in March, 2010 inspired as many as 22 former patients to come forward with allegations of abuse. The alleged incidents dated back as far as 1999. Levin was convicted on three of those counts and acquitted of two, with the jury deadlocked on another four (two of those four were retried, but that too resulted in a mistrial). In the process, Levin's wife Erica was charged with attempting to bribe a juror; that case is ongoing.
The 2010 charges stem from incidents in which Aubrey Levin was said to have fondled patients' genitals. The first patient who came forward was so concerned about being believed that he used a spy camera to record multiple sessions.
In his defense, Levin said that he was not fondling patients, but using a urological technique called bulbocavernosus reflex (BVR) procedure, which is used to address erectile issues. In one of the videos, though, Levin is seen fondling the patient's genitals for more than ten minutes, causing Calgary-area urologist Ethan Grober to dispute Levin's claim:
"What I saw was a prolonged... fondling of the penis. This was not a simple elicitation of a reflex."
And even if the technique could be characterized as a BVR test, there was no logical reason that Levin, a psychiatrist, should have been conducting it.
Levin's trial was a circus of delays and confusion. The length of time taken to bring him to trial was unusual in the first place -- 2 1/2 years, while police followed up with several former patients to determine how many charges could be laid.
From the beginning, Levin's attorneys sought extended delays because of health issues. The first was a request for three-month respite so Levin could get his fragile health in order. Calgary Sun reporter Kevin Martin elaborated:
Two doctors testified Levin was in such poor health that he needed to get in shape before he could sustain the mental and physical strain of what was then to be a six-week hearing. They said that perhaps in three months, should Levin be given the chance to rehabilitate his degenerating body, he'd be able to survive such an ordeal.
Had they seen Levin leaving court after his conviction -- to a gauntlet of news cameramen -- they might have thought his recovery miraculous. Using his wheeled walker as more of a weapon than a crutch, the good doctor raced at the photographers with the agility of a much younger man, forcing those with cameras to evade being struck.
After that request failed, there were questions about Levin's mental health and claims of vascular dementia (Martin noted: "But once he was declared fit, Levin became a new man, taking notes and instructing his counsel"). Then a drop in heart rate precipitated a medical emergency for which he was briefly hospitalized. Then, Levin fired his lawyers and began to represent himself.
Then he seemed unable to represent himself (certainly unable to cross-examine), and a new legal team had to be found. The judge had to consult with the jury about whether they could remain through the extensions, and there were fears the proceedings would collapse if they couldn't. All in all, the trial that was expected to last six weeks had been deferred from August 19th, 2011 to October 10th of 2012, and wrapped up three and a half months later.
In addition to attempting to undermine the credibility of his former patients, a key part of Levin's defense was to claim that the things that happened between them were consensual (we'll come back to this point), and then were later mischaracterized or maliciously distorted by his accusers. It's an argument that he and his legal teams argued successfully enough to achieve an acquittal on two charges and a mistrial on four others.
In this way, his case became difficult to prosecute even beyond the circus-style atmosphere of the trial.
Levin's defense tried to cut down the complainants' testimonies by focusing on their records or troubles, by accusing them of having ulterior motives (including one claim that they were motivated by money), or even alleging that the complainant who recorded the abuse had made passes at Levin, and then edited those parts out:
"I'm going to suggest to you ... that portion of the video shows you taking out your penis and waving it at the doctor," Archer said.
During the trial, all effort was made to keep Levin's past from playing a part, but occasionally revelations slipped out. On November 15, 2012 the Calgary Herald reported (page now offline):
R.B. said Levin would take down books from his shelves and show him "pictures of penises and vaginas. He would show me different parts that were sensitive for sexual acts. Other times, he would tell me about his past, when he was in the army, forcing men to rape women," he said.
Immediately, Wister cut off the witness and asked Court of Queen's Bench Justice Donna Shelley to dismiss the jury. Following discussions, Shelley recalled the jury and told them that there will be inadmissible evidence heard in the court room and it should be disregarded.
"Not everything you hear will be admissible," said the judge. "To the extent (R.B.) has said anything not relevant to what happened between 2001 and 2010, it is not relevant to these proceedings. It is not evidence. Disregard everything not related to these charges."
Authorities feared that a complete mistrial was inevitable if the jury heard too much of the shocking nature of allegations made about his years in South Africa.
The Aversion Project
What has drawn international attention to this case is that Aubrey Levin was said to have led the South African military project in the 1970s and 1980s designed to "cure" military recruits of being gay -- a program that allegedly included things like shock therapy (for which Levin was nicknamed "Dr. Shock"), chemical castration, and even forced genital reassignment surgery. While there are no mentions of Levin or the Aversion Project by name in the Truth and Reconciliation Commission's final reports, it's generally accepted that something of an indeterminate nature took place at Ward 22 of Voortrekkerhoogte Military Hospital, Pretoria.
The National Post had originally raised questions about these allegations, but quickly retracted them after Levin threatened to sue. Other media took notice and avoided mentioning Levin's rumored South African activities over the years that followed, although this did not deter international publications like The Guardian in the U.K. and South Africa's Mail and Guardian.
When he came to Canada, Aubrey Levin did not apply for amnesty, nor was he granted it. So he could have been subpoenaed to appear before the Truth and Reconciliation Commission... but TRC never made the attempt. While the allegations were raised on record, there was also considerable frustration among the public that the TRC did not pursue the line of inquiry.
For example, in the Health and Human Rights Project (HHRP)'s verbal submission on day two of the Health Sector Hearings on June 18, 1997, the group expressed some frustration that the Aversion Project was not being focused on:
"After those comments I just want to digress a little bit and particularly for the benefit of the lawyers who've trooped into this hearing, I think we, as the [HHRP] Project, want to register our concern for this whole process which has led to a situation where many of the cases that we have brought to the attention of the Truth Commission we cannot actually name the particular health professionals involved. We are not going to name those health professionals but we feel it is really a travesty of the process of truth to arrive at a situation where we cannot speak openly. We fought for many years for a situation where people will be free to speak the truth and it seems that legal mechanisms have been invoked to limit the extent to which the truth could be disclosed. We would like the TRC to take note of that, particularly the fact that as far as the Project was concerned we were able to supply the TRC with the names of the doctors as far as we understand within the required time.
"Just in that regard we can talk about the kinds of cases we would have discussed...
"We also raise issues around military health personnel and we particularly want to challenge the SAMS whose presentation yesterday did not touch on any of the issues that we've raised and I think Commissioner Ramashala has certainly posed the question to them, but we have presented evidence regarding programmes which involved the re-programming, the use of aversion therapy for gay men in the military and we believe that these cases require further investigation, and the TRC, we would hope, would follow up in that regard."
The South African Press Association (SAPA) described the shock therapy allegations raised by the HHRP in 1997:
The HHRP said Levine was first named in a December 1986/January 1987 edition of the War Resister, a publication of the Committee of SA War Resisters. According to the publication, Levin was chief psychiatrist at the military hospital at Voortrekkerhoogte near Pretoria in the 1970s, when he practiced aversion therapy with gay conscripts who were admitted to the psychiatric ward.
Electrodes were strapped to the arms of the subject and wires leading from these were in turn connected to a machine. The subject was then shown a picture of a naked man and encouraged to fantasise freely. While he was doing this, he would be subjected to electric shocks.
"The increase in the current would cause the muscles of the forearm to contract - an extremely painful sensation," the article said.
When the subject was screaming with pain, the current would be switched off and a colour Playboy centrefold substituted for the previous pictures. "The pscyhiatrist [sic] (in most cases Levine) would then verbally describe the woman portrayed in glowing and positive terms. Sessions were held twice daily for three to four days."
The HHRP said although the subjects had to give their consent, most were between the age of 18 and 24 and were still coming to terms with their sexualtiy [sic]. It said the practice of aversion therapy appeared to stop when Levine left the hospital.
The last comment is curious, as Aubrey Levin has denied participating in aversion techniques -- yet some of the allegations seem to point to him having championed them. The National Coalition for Gay and Lesbian Equality (NCGLE, now known as the Lesbian and Gay Equality Project), which asked for a commission to investigate the medical torture allegations, claimed to have:
...two boxes of papers documenting the 1968 Immorality Amendment Bill. Item B106 is an eager letter from a loyal member of the ruling, pro-apartheid National Party who claims to have successfully 'treated' homosexuals and wants to be invited to address the all-white Parliament on this subject. The letter is signed by Dr. Aubrey Levin, "medical practitioner and psychiatrist in training."
What is widely alleged is that as a colonel in the South African military and chief psychiatrist in Pretoria in the 1970s and 80s, Levin was in charge of a unit where electric shocks were administered to "cure" gay white conscripts. Levin was also claimed to have overseen the use of electroshocks and powerful drugs against conscientious objectors refusing to fight for the apartheid army in Angola or suppress dissent in the black townships.
From The Guardian:
Levin also treated drug users, principally soldiers who smoked marijuana, and men who objected to serving in the apartheid-era military on moral grounds, who were classified as "disturbed."
Levin subjected some patients to narco-analysis or a "truth drug", involving the slow injection of a barbiturate before the questioning began. In an interview with the Guardian 10 years ago, he did not deny its use but said it was solely to help soldiers suffering from post-traumatic stress.
Levin said he left South Africa only because of the high crime rate, and denied abusing human rights. He said electric shock therapy was a standard "treatment" for gay people at the time and those subjected to it did so voluntarily.
"Nobody was held against his or her will. We did not keep human guinea pigs, like Russian communists; we only had patients who wanted to be cured and were there voluntarily," he told the Guardian in 2000.
Aubrey Levin Comes to Canada
In the dying days of apartheid in South Africa, anxiety was high about the nation's transition to full democracy, about whether the transition of power could remain (mostly) peaceful, and about what the implications could be for people of who held positions of authority under the old regime (especially if they were English or Afrikaaner). In 1994, a general election was held amid car bombings and other scattered violence, and the Truth and Reconciliation Commission (TRC) was proposed. The inquiry would commence the following year.
Whether or not he left South Africa because of fears of crime as he claimed, amid that tide of change, the colonel and chief psychiatrist at Ward 22 in the Voortrekkerhoogte Military Hospital in Pretoria (and former head of psychiatry at the University of the Orange Free State) did what anyone afraid of uncertain consequences might do: he fled to a place that he felt was most friendly to his worldview, and most willing to look the other way about anything he might be alleged to have done -- regardless of whether those allegations were true or not.
And so, before he could be called to testify at the TRC, Aubrey Levin fled to Canada. There, after a brief stint as regional director for the Regional Psychiatric Centre in Saskatoon, he became a professor of Forensic Psychiatry at the University of Calgary and established a practice at the Peter Lougheed Hospital.
Canadian media continue to fear looking at the Aversion Project, due to the fact that the allegations remain untested in court. But in looking at this past, some patterns emerge.
"Consent" and the Clinic
The Daily Mail and Guardian published a 132-page study entitled "The Aversion Project," although it is now difficult to find it archived online. In that report, we find the one peculiar link that does in fact connect what happened in South Africa (whether Levin was involved or directed the Project, or not) to the incidents of abuse in Calgary for which Levin was charged: a gross distortion of the idea of "consent" within a clinical setting in which patients didn't genuinely have an option on whether to consent, and little to no information about what they'd be subject to.
The medical profession is reputed for pathologising any form of behaviour. For example, it is known that the military has a history of doing sex change operations-- many sex changes were done in Military hospitals. One has to ask to what extent this was experimental. (Workshop 1999) Although in any medical advancement there is always a cutting edge of experimentation, in total institutions there is a captive audience. The question then reverts to one of 'informed consent' and whether the choices people are given are limited because they cannot say 'no.'
In any total institution, one has a captive audience, and the medics have protective insularity through their profession, so the environment is open for abuses to take place. Therefore special care should be taken not to abuse people's rights. The Bill of Rights perspective should not only be applied to homosexuals, but seen in a broader light. There is the problem of marginalising groups again, but on the other hand the issues of the minority group should remain visible.
In a July interview for the Mail and Guardian for that study (now offline but referenced by the Gully), Levin was said to have admitted participating in aversion therapy, but denied some even more shocking allegations of forced gender reassignment. The Gully articles claimed that former army surgeons estimated as many as 900 surgeries took place (a number that seems to come from journalist Paul Kirk and writer Terry Bell, although it's not certain if this number includes chemical castrations or other medical procedures that differ from contemporary sex reassignment).
It's important to repeat that Levin has never been publicly charged with any of the things alleged here, and rumors and allegations should not be confused with convictions.
When Levin has referred to treatments administered at Voortrekkerhoogte, his claims that the treatments were given to consenting patients may seem true from his own perspective... if one overlooks the participants' situational vulnerability, the lack of information given to them, and the many various things that they could be threatened with -- dishonorable discharge, outing to families and communities, the potential for trumped-up charges, rewards for cooperation, and even the manipulation of internalized homophobic guilt, stigma and shame (which would have been much more common and seemed more monolithic in the context of the 1970s and 1980s).
The question of whether one can consent when the subject is a captive audience is a profound (though circumstantial) link between the Aversion Project and Levin's Canadian convictions. Even if he were simply present at Voortrekkerhoogte during the practices that the Aversion Project is known for, the application of those practices could have provided Aubrey Levin with the strategies to carry out his later abuses in Canada. And to him, they might have all seemed technically "consensual."
The Captive Audience
The power disparity, too, cannot be discounted.
I've never been to Calgary's Forensic Assessment Outpatient Service (FAOS), but I am familiar with its Edmonton counterpart, Forensic Assessment Community Services (FACS). FACS was the downtown clinic that dealt with many of the city's "hard" cases -- people who needed medication to manage psychosis, who were ordered by the courts to undergo psychiatric evaluation, who got into trouble and couldn't afford reputable help, who had no money or community supports, or who had been referred by hospitals after attempting to self-harm.
In Edmonton's clinic, it was also one of the two clinics in the province of Alberta that treated transitioning transsexuals... so I became amply familiar with it. It was a space thick with desperation and rage, a high-security clinic where the waiting room would at once be awash with tension and hopelessness and fear. One had to be buzzed into the back where the therapists' offices are, often escorted.
I hesitate to portray the clinics too negatively, because many of the people there have been held down by poverty and strife, and sincerely try to rise above the circumstances that resulted in their treatment. The clinicians, too, are often dedicated to their work, even if the extension of one hand in empathy is balanced with readying for conflict with the other.
Yet the setting can't help but feel oppressive. Some of the doctors were burned out; others had an intense dedication to their work, but the circumstances in which they practiced left them hardened, jaded. When one is at a clinic like FAOS or FACS, it's often because they have no choice, whether legal, economic or otherwise -- one has nowhere else to go, and usually has several hoops to jump through in order to access the care that one's life is in some way dependent on.
People are particularly vulnerable in a place like FAOS and FACS, and often not very respected when they go into care. There are often conditions at every step, such as required follow-up reports to probation officers, or else subsidized housing or income (such as Assured Income for the Severely Handicapped support) are dependent on continued treatment. It's also a setting where small gestures easily put one into a dependence scenario.
In a clinic like FACS or FAOS, a therapist is in a position of control from which he could threaten to withdraw his support for a patient's social assistance, or even terminate care in a way that would land them back in jail. And although outside of the mandate at FAOS, it's certainly possible that a therapist could increase patients' dependence by providing some food or loose change -- as happens, in that setting. This was all in addition to the intimidation patients would experience by the visible respect forensic therapists had within the psychiatric and legal communities.
It's obvious to me why the original complainant felt he had to record the sessions more than once in order to be believed by authorities (and why prosecutors found the trial particularly difficult). When a therapist takes someone to the private examination room, the patient could be more or less helpless to do anything other than play along. From the testimony of RB, the complainant (his name is under a publication ban) who secretly filmed two visits and who was seeing Dr. Levin by court order:
"I didn't know what to do, because I knew Dr. Levin could send me to jail by the snap of his fingers," the man said. "Now that I think about it I think he would say that I was delusional.
"I was scared that they would tell Dr. Levin that I said that... he would deny it and I would be in jail, or a straight jacket -- who knows."
Whether or not anything regarding Aubrey Levin's alleged association with the Aversion Project can ever be substantiated, the overlapping similarities between those things that are known provide some important lessons.
What remains to be seen is whether anyone hears and learns from them.
(Crossposted to Dented Blue Mercedes)