Emotional Support? Law, Social Control, and the Medicalization of the Human–Animal Bond

In recent years, the socio-legal concept of Emotional Support Animals (ESAs) has come under increasing scrutiny in the U.S. Widespread confusion about the legal status of ESAs versus service animals, and concerns about misrepresentation, led to a backlash and a cascade of new legislation addressing “fake service animals.” However, this backlash reveals a broader social problem rooted in policy lag: the integration of companion animals into society has not kept pace with the rise of multispecies families. This article examines law, policy, and public discourse about ESAs within two distinct social contexts: (1) the emergence of multispecies families alongside the systemic exclusion of companion animals from many private and public spaces, and (2) the medicalization of relational bonds and everyday life. Although well-intentioned, the ESA concept creates a two-tiered system where caregivers of companion animals must acquire a medical diagnosis in order to obtain equal access to basic necessities like housing. In addition to resting on weak evidence, it diverts attention from macro social issues by pathologizing the individual, creating a problematic medicalization of the human-animal bond that is ultimately detrimental to the well-being of companion animals, their caregivers, and people with disabilities. The legal and social construction of ESAs is also troublingly anthropocentric, centering what animals can do for humans without considering the emotional support needs and psychological well-being of the animals themselves. This article concludes by arguing that the ESA framework should be replaced with a multispecies social model that supports the human-animal bond without unnecessary medicalization. This approach advocates for equitable laws and policies, such as the expansion of pet-inclusive housing, that benefit families that include companion animals and the communities in which they are embedded.