#disability advocacy that does not interrogate why these systems require proof and diagnosis and appeals to medical authoirty

[trans-axolotl]

some of Eli Clare's writing about diagnosis feels very relevant to discussions on tumblr right now:

"It’s impossible to grapple with cure without encountering white Western medical diagnosis—ink on paper in the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases, a process in the hands of doctors, a system of categorization. I want to read diagnosis as a source of knowledge, sometimes trustworthy and other times suspect. As a tool and a weapon shaped by particular belief systems, useful and dangerous by turns. As a furious storm, exerting pressure in many directions.

Simply put, diagnosis wields immense power. It can provide us access to vital medical technology or shame us, reveal a path toward less pain or get us locked up. It opens doors and slams them shut.

Diagnosis names the conditions in our body-minds, charts the connections between them. It holds knowledge. It organizes visceral realities. It draws borders and boundaries, separating fluid in the lungs from high blood pressure, ulcers from kidney stones, declaring anxiety attacks distinct from heart attacks, post-traumatic stress disconnected from depression. It legitimizes some pain as real; it identifies other pain as psychosomatic or malingering. It reveals little about the power of these borders and boundaries. Through its technology—x-rays, MRIs, blood draws, EKGs, CAT scans—diagnosis transforms our three-dimensional body-minds into two-dimensional graphs and charts, images on light boards, symptoms in databases, words on paper. It holds history and creates baselines. It predicts the future and shapes all sorts of decisions. It unleashes political and cultural forces. At its best, diagnosis affirms our distress, orients us to what’s happening in our body-minds, helps make meaning out of chaotic visceral experiences.

But diagnosis rarely stays at its best. It can also disorient us or de- value what we know about ourselves. It can leave us with doubts, questions, shame. It can catapult us out of our body-minds. All too often diagnosis is poorly conceived or flagrantly oppressive. It is brandished as authority, our body-minds bent to match diagnostic criteria rather than vice versa. Diagnosis can become a cover for what health care providers don’t understand; become more important than our messy visceral selves; become the totality of who we are.

...

It is impossible to name all the ways in which diagnosis is useful.

It propels eradication and affirms what we know about our own body-minds. It extends the reach of genocide and makes meaning of the pain that keeps us up night after night. It allows for violence in the name of care and creates access to medical technology, human services, and essential care. It sets in motion social control and guides treatment that provides comfort. It takes away self-determination and saves lives. It disregards what we know about our own body-minds and leads to cure.

Diagnosis is useful, but for whom and to what ends?"

-Eli Clare, Brilliant Imperfection pg 41-42, 48.