#medical model of disability

[capricorn-0mnikorn]

Veterans were supposed to appreciate the new systems of medical and government attention by recovering rapidly. By physically and mentally adapting to retraining, disabled men were thought to be responding appropriately. Recovery was thus a way of performing gratitude with the body. Underpinning this physical performance was the state’s reassertion of the citizen’s duty. Disabled bodies were not just symbols of physical remedy, then, but also signifiers of the successful intervention of medical services and voluntary organisations in reconstructing the disabled soldier as a dutiful and useful citizen. Clearly, this put considerable social meaning and pressure on the recovering disabled person. According to Douglas McMurtrie (American Red Cross Institute for Crippled and Disabled Men), patients slow to recover were lacking in ‘personal character’ or were accused of harbouring misguided perceptions that ‘he has done his duty by his country and that he should now be supported for the rest of his natural days at national expense’.

-- Ana Carden-Coyne (2007) "Ungrateful Bodies: Rehabilitation, Resistance and Disabled American Veterans of the First World War", European Review of History: Revue européenne d'histoire, 14:4, 543-565

[Poster's Note: According to this article (which I agree with), It was in this period after World War One that the Medical Model of Disability really became codified in institutions and "charitable" organizations. And the U.S. military's solution to the "problem" of disabled soldiers that might come back home and rabble-rouse for revolution was to make sure those soldiers never get to leave the military; for the rest of their lives, they're subject to military hierarchies, and have to obey military commands, even though they are now home.

And then, the military's approach to "Rehabilitation" became the norm for all disabled people and what they have to do to get support and accommodation for their daily living needs, even if they'd never been in the military a day in their lives. Above the doors of many of those bureaucratic offices, and at the top of all those forms you have to fill out in triplicate is the word --

Handicapped.

And I think that's where the folk etymology (especially in the Disability Community) that the word comes from "Cap-in-Hand," and from the belief that the only thing a disabled person is good for is begging. That's not actually where the word comes from. But that's still what it feels like, when you're sitting in your state's Vocational Rehabilitation Office, in a prefab office cubical, listening to a bureaucrat talk down to you.

Which is why most online articles debunking that folk etymology (I'm looking at you, Snopes) make me clench my jaw at their condescending tone.

[neurotypicalabusesurvivor]

[toomanyacronyms]

I firmly believe that the "society causes disability" crowd would be the first ones to up the ableism once they realize disabled people are disabled regardless of how good society is. "What do you mean you're still disabled after all the work we did to reform society? Since you don't appreciate it, I'm going to be even more ableist toward you!"

Not to mention everyone likes to treat the Social Model of Disability and the Medical Model of Disability as two separate things when they need to be seen as one thing.

[oseberg-shipper]

Medical science, explaining the placebo effect: "So that's why when patients get warm, thoughtful care and focused attention from a nice expert, it makes them feel better and can even improve their health"

Medical practitioners, explaining the placebo effect: "So that's why you're a lying bitch who needs to get out of my office."

[eclecticelectriceccentric]

guys. we need to use BOTH the social model AND the medical model.

[babyspacebatclone]

As recently implied in another post, I’m fighting through a Major Depression episode. The net effect is very low, because I’ve been able to develop a fair bit of coping skills specific to these episodes; unfortunately, this means that even more of my energy than normal has been spent on being a Functioning Day Care Teacher, with almost no brain power left over for outside my job.

I just received a fairly rude reply on one of my posts, and that is NOT the issue.

I’m probably going to block them when I feel like it anyway; do not interact with that person.

The Point:

The comment brought up “Where is your research?” for this post:

And that is something I’ve been wanting to get into for a while, but been unable to work on because I’ve been fighting stress so hard since posting it.

I know for a fact my understanding of the effect of stimulants on ADHD (which was the basis of some of my other assumptions) is flat out wrong, and been working on updating my understanding there.

I want to be able to put up an updating “Here’s want I got wrong, here’s what’s still helpful” for a while.

Can anyone direct me to relevant research so I can better educate myself on the current understanding of the underlying mechanisms of ADHD and Autism, in contrast to the Medical Model (the symptoms that annoy outside neurotypicals enough to want to change) that dominates public understanding of the conditions?

[what-if-a-dragon]

It's the moral model of disability of the colonial era, something that a lot of scholars say was discarded in exchange for the medical model. This switch is often attributed to the rise in institutional medicine as if to say, "We're smarted than we were, and now we know that moral value isn't the cause of disability".

And it's often directed outward, but we also see it directed inward. That is how the diet industry gets people to participate, by blaming them for being 'sinful' (sloth and gluttony usually) and drumming up fear about medical risk. You can see it in the comment sections of fat/body positive accounts when people say they are 'just looking out for the poster' by recommending diet and exercise.

It's the foundation of our mindset, and we cannot move on from it without pulling out the roots.

part of the reason America still doesn’t have universal healthcare is that a large portion of the healthy population consciously or subconsciously believes that being sick is somehow a moral failing. someone randomly has a heart attack at age 30 and there are people like “well, you should have eaten better, exercised more and drank less” like a medical emergency is proof you were living a life of sloth and sin and it could never happen to them. 

[capricorn-0mnikorn]

Thinking about how to illustrate "Marginalization"

As an image of text on a page. The main story -- the one we're expected to follow and understand, is printed in the center of the page; other stories are considered tangents and "off-topic." If they're considered to be of interest at all to the audience, they're mentioned in fine print, in sidebars, in the margins, and even then, not much is said about them.

So I got the idea of making an info-graphic, showing just how wide the margins are in our culture, and how narrow the space for the "main story" is, in comparison.

I know it depends on context, but I decided that the most consistently "Centered" population is:

Non-Disabled, Straight, Native-English Speaking, White Men Between the ages of 18 and 65

Ironically, looking up that demographic online is a lot harder that searching for "Disabled population," or "LGBTQ population," etc., because they're considered the "default." And it's mainly "The Others" that it's considered important to keep track of.

But anyway, I thought I'd go to this U.S. Census Government page, and try to work it out by power of elimination. ... And my thinking got sidetracked by how the info was labeled (and also remembering that math was never my strongest subject)

Here's what I found:

Under Age and Sex: Persons under 5 years, 5.5%, Persons under 18 years, 21.7%, Persons 65 years and over 17.7%, Female persons, percent 50.5%

(Proof that men are the default: Women are labeled as a special category, but Men are not)

Under Race & Hispanic Origin: "White" is listed twice. "White, alone" is 75.3% (that's the first statistic listed). And there's also "White alone, not Hispanic or Latino," which is 58.4% (so clearly, some people of Hispanic and/or Latino heritage consider themselves White)

Under Health: With a disability, under age 65 years, 8.9%

(There was no listing at all for "With a disability over the age of 65 years". So if you're disabled over the age of 65, your disability somehow doesn't count? Also a sign that the Medical Model of Disability is the dominant one in the U.S. is that "Disability" listed as a Health statistic, and not listed under Families & Living Arrangements, even though being disabled, or having a disabled family member, has an enormous impact on family dynamics, and how and where people can live)

Even trying to think about all the overlaps in that multi-dimensional Venn Diagram is making my head spin. Especially if things like Disability is not evenly distributed throughout the population (especially in regards to race and ethnicity, and economic status). So I don't know if I'll ever make that info-graphic.

But just looking at how different people are grouped and labeled, officially, is revealing of prejudices.

[neurotypicalabusesurvivor]

ASPD is a prefect example how psychology and mental health industry is bullshit.

One of the main criteria for ASPD is a consent disregard for the rights of others. But what is a right? Who gets to decide what a right is? A right is just something someone feel entitled to. Men right activist, father rights, private property rights are things used to oppress people that claim to be rights. A "right" is just something people feel entitled to which may or may not be helpful to society. Even rights which are for the most part good, like freedom of speach can be used to advocate for genocide. The freedom of Assocation can be used by queerphobic parents to disown their queer children. Private property (liberal definition) rights can be used to justify artificial poverty. In other words people with ASPD do not buy into the entitlements of others.

under this logic all men have ASPD because of the patarachy. All white people have ASPD because of white supremacy. All ableist (both neurotypical and neurodivergent) have ASPD. So why are these groups of people who have a history of civil right violations not label as ASPD. Because they do so in a socially acceptable way. Sexism and Racism is still social acceptable to a degree even after many decades of social justice activism.

the basing morality in and of it self is inherently problematic as you are being dependent on a biological function to decide who is moral and admoral. there are many reasons why someone might not feel guilt or remorse. The chief amongst these is dehumanization, racism, sexism, queerphobia, ableism, ageism, classism is all rooted in dehumanization. as a result, a lot of abusers engage in similar behaviors as cluster Bs. This comparison is only on surface level. Abusers get away with abuse because their behavior are protected by society, the verry same society that condition them to be abusers. Are jails are filled with narcissist and sociopaths because they do not have neuronormative privilege. When they act "abusive" they do so in ways that are not socially acceptable. meanwhile rapist, child molesters, killer cops, imperalist soldier get away with their brutality.``

The status Quo doesn't want to admit that the patarachy exist, so when a man become a serial killers they claim they have ASPD refusing to admit that people with ASPD are not immune to the patarachy. If the patarachy did not influence people to become serial killer a equal amount of men and women would be a serial killer and they would kill for the same reasons. Tough ASPD may influence why the serial killer's behavior the ASPD is not the root cause. The role of the medical model of disability as will all forms of oppression is deradicalizations. Just as the ruling class and the privilege class redirected attention away by blaming the jews, immigrants or othger margalized people the medical model redirect attention away by blaming "mentally ill people"

This brings me to my next point neurotypes are social constructs. They are the interpation of human biology that involves the brain. These interpations is done so for the neruonormative gaze. We decide them by comparing neurodivergent people to a standard of health that is also socially constructed. Alot of time people are deemed "disabled" or "mentally ill" because they are not compatible with the status qou, as status qou that is also socially constructed, but also socially constructed for the benefit of the ruling class at the expense of everyone else.

but.... but.... alot of these people are neurodivergent. Neurodivergent people can benefit from the oppression of other neurodivergents who is not the same support level as them and neurotype as them. Being neurodivergent is not a magical pill that make you anti ableist. A neurotypical is just the highest possible amount of neuronormative privilege possible. Alot of neuronormative privilege is required to get a college degree and to become a psychologist or a neuroscientist so even if the mental health professional is neurodivergent they still have a respectable degree of neuronormative privilege.

What is to be done, You may ask? neurodivergents must seize control of the psych industry away from those who want to benefit from neuronormative privilege and weaponize it against those who want to benefit from neuronormative privilege. People who do not accept neurodivergent trait will be pathologized. We will subject them to the same trauma that neurodivergent was violently subjected to. where therapy was weaponized against neurodivergents and used as a excuse to maintain the status Quo. we will seize control of this industry and use it to oppress ableist. Instead of expecting neurodivergent to mask ableist will be expected to learn coping skills, cognitive behavior skills to reduce distressed cause by ableism. Gone will be the days in which ableist infantilize themselves by hiding behind a therapist and psych meds.

What if this system destroys the mental health of an ableist. If you're in a self defense saturation do you care if you defending yourself result in grave bodily injury of your attacker. Do slaves during a slave revolt care about the mental health of their master family or employees. Do feminist care about the mental health of there rapist. Oppressors forfeit there right by violating the justified rights of others. There has not been a single major civil right earned that did not involve violence and trauma. The peaceful protest of the liberal is a lie. When people with neuronormative privilege rape disabled women like it goes out of style, sit by and do nothing as killer cop gun disabled people down in streets, though certian neurotype in jail, the bourgeoise drive disabled people into extreme poverty, imperialist engage in wars that destory the mental health of the global south and homelessness how dare you care about the mental health of ableist. How dare you expect mentally ill people to care about the mental health of their oppressors.

[thejakeformerlyknownasprince]

So I got another rash of notes on this post like "And don't forget, Zuko's definitely disabled if he's partially blind!" And I wanted to clarify again: the social model of disability isn't about how much quantifiable ability you (don't) have. It's about how other people treat your body. And under the social model, facial difference counts as a disability in its own right. Zuko could have 20-20 vision and count as disabled, because of ableism.

Like, I have a cousin with ptosis. It's a minor condition that causes his eyes not to open fully, but doesn't affect his vision — he doesn't need glasses. However. He carries a card in his wallet that explains the condition, to show to cops at traffic stops. He's had many elective surgeries, the first one before he turned 10, to make his appearance more normative. He got sent to multiple offices by multiple teachers convinced he was on drugs. He gets rude questions about his appearance. He's disabled according to the social model of disability, because society thinks his appearance is "wrong" and reacts accordingly.

The medical model of disability is all about what disabled folks can't do, and how much they suffer. It's about quantifying with tests one's level of impairment. It would say facial difference doesn't count as a disability, because it isn't painful and isn't removing "normal" ability. The social model says, instead, that disability is all about what we consider average or correct, and what it means to be outside of those conditions. It says that a person with a large birthmark or scar on their face is likely disabled, because disability (and beauty) are social constructs that differ across cultures.

I'm very curious to hear your take on Zuko as a disabled character? All of your analyses of disability in fiction have been very interesting to read so far, thank you for sharing your thoughts/expertise.

Thank you!  Follow-on from this post about Toph.

What I mean by saying Zuko is a disabled character: the social model of disability basically states that disability is any bodily difference that gets problematized and/or treated as abnormal by society.  This definition includes facial differences, AKA any scarring, skin marking, and so on that leads to staring by nondisabled society or other forms of stigma based on the person’s appearance.  Part of the reason for this inclusion is about complicating the disabled-nondisabled dichotomy; facial difference and facial scarring are identities within that framework.  Part of the reason comes from the U.S.’s history of Ugly Laws, which literally made it illegal for people with facial differences to appear in public in some cities as late as 1974.  Part of it is the huge overlap between ableism (giving more privileges to the nondisabled) and lookism (giving more privileges to the normatively beautiful).

Avatar: The Last Airbender has some high-quality anti-ableism in showing Zuko’s story, including how other characters respond to Zuko and how Zuko’s appearance informs but does not define his characterization.

One of the ways this comes out is by turning nondisabled characters’ gaze back on them:

In “The Serpent’s Pass,” Jet says to Zuko “You know, as soon as I saw your scar, I knew exactly who you were…” and then goes on to describe his almost hilariously wrong conclusion that Zuko’s a Freedom Fighter waiting to happen because Zuko’s village was presumably also destroyed by the Fire Nation.  We get to see Zuko’s moment of terror that he actually has been recognized turn into incredulity as he then gets invited to join a guerrilla force opposing everything he (currently) stands for.  Jet looks stupid for jumping to conclusions based on appearances.

In both “Zuko Alone” and “The Cave of Two Lovers,” that same jumping-to-conclusions works in Zuko’s favor, because both Song’s mother and Li’s parents assume that anyone with a burn scar must be a veteran of the fight against the Fire Nation.  Again, the emphasis is on the fact that the people judging Zuko based on his appearance are wrong.

In “The Chase,” Azula becomes the only person we ever see mock Zuko for his appearance, when she covers her own left eye to draw out the “family resemblance” for Aang.  The moment gets a horrified reaction out of Aang — Zuko’s his enemy, but Aang also realizes that this is a nasty thing to do — and helps to establish Azula as not just a villain, but a sadistic one.

In “The Beach,” Zuko blows up at Ty Lee for commenting that stress can cause breakouts.  His response is unnecessarily mean-spirited, but it also draws attention to the relative level of privilege (the biggest skin problem she has to worry about is acne) that informed her careless comment.

In “Crossroads of Destiny,” Zuko assumes that, when Katara calls him “the face of the enemy,” it’s a way of calling him frightening to look at — and it’s Katara who looks like a jerk for implying it, even accidentally.

The other big way that this comes out is clapping back at the implied treatment of disability as demanding explanation, or the “But why are you like this?” form of ableism:

The show makes it clear that Zuko does not owe anyone — not Song, not Li, not Jet, not his crew, not his friends — an explanation for why he looks the way he does.  None of the Gaang ever ask Zuko what happened, and the few characters who do (Li, Song, Lieutenant Jee) don’t end up looking good when they do so.

“The Cave of Two Lovers” clearly underlines the show’s theme of “my body, my business” in the scene where Song tries to touch Zuko’s face.  The tone (including literal musical tones) signals that Song is being inappropriate and invasive.  It’s understandable that she wants to make a connection, but it’s also emphatically not okay to touch body parts of strangers one has not received permission to touch.

To be clear, taking people’s ostrich-horses is also not okay, Zuko, but Baby’s First Grand Theft Auto helps drive home just how thoroughly Song has let her curiosity and rudeness sour a budding connection.  It also shows that, while she’s right that she and Zuko have some things in common, she has privileges he lacks because she doesn’t have to disclose her scars if she doesn’t feel like it.  Plus, that moment contrasts to Katara and Mai both touching Zuko’s cheek — Katara just after they’ve shared a moment of vulnerability, Mai just before they start smooching — because they’re both doing so in a way that’s respectful to Zuko himself.

When he wakes up from a dream of turning into Aang, the first thing Zuko does is touch his left eye to make sure he’s still himself.  It’s part of his identity, and the only time we see adolescent Zuko without it (earlier in the dream sequence) it’s a way of showing that Zuko isn’t truly himself.

Zuko grapples with the fact that he’s always going to bear evidence of having survived abuse, and a big part of his character journey is concluding that he’s free to make whatever meaning he chooses of that scar, regardless of what Ozai might’ve intended.

There are other elements of Zuko’s story the Avatar writers do well.  He bears a superficial resemblance to the thousands of villains (especially in SF) who become villainous because they incur facial scarring, but of course his story is infinitely more humanized and nuanced than “skin bleached in a vat of acid, might as well go rob banks now.”  His appearance incurs very different reactions depending on his current wealth and political power, emphasizing the intersections of disability and imperialism.  He discusses the possibility of a cure with Katara, but also goes on to live a long and fulfilling life without one.

Maybe there’s no clearer evidence that Zuko counts as disabled in the sense of “society treats your body as a problem that needs to be solved” than the way that adaptations of AtLA treat the scar.  They tend to minimize, hide, or otherwise avoid it.

[Image description: Sepia-toned image of the Gaang from a Legend of Korra promotional that appeared on the Nickelodeon website.  Zuko has his head turned and his hair swept forward in such a way that none of the left side of his face is visible.]

[Image description: Screenshot of Zuko from the 2010 adaptation The Last Airbender.  Dev Patel has a very subtle amount of makeup meant to convey minimal scarring around his left eye.]

Like I said: facial difference counts as a disability because society treats it like one.  In the social model, that’s what counts rather than, for instance, how much peripheral vision Zuko does or doesn’t have.

I’m not linking to any of many works of fan art that depict Zuko tilted to the right, occasionally even when other characters are presented facing directly ahead.  Nor am I going to link to any of the equally-plentiful works of fan fiction that keep most other elements of canon the same but specify that Zuko’s face is unscarred.  (A similar number, it’s worth noting, also make Toph sighted.)  This isn’t a callout.  It’s an explanation of how Avatar does an effective job of showing how Zuko’s facial difference informs his identity without making that difference the sum total of his identity.

[cripvideoproductions]

Fall 2024 disability talks and screenings

On October 16th 2024 I (Margot) I had the privilege of having gave four presentations on disability. I spoke to two medical student classes about disability and bioethics such as how many disability rights activists see euthanasia and medical assistance in dying, and certain genetic testing, as a violation of disability rights (Not Dead Yet 2024). This conversation highlighted the importance of understanding how society views disability and the ethical implications that arise from these views. I discussed how side effects of medications can be disabling, and how invisible physical disabilities can sometimes be misdiagnosed and therefore dismissed as psychological disorders. It’s vital for future healthcare professionals to recognize that not all disabilities are visible and that the impact of treatments can vary greatly among individuals. Then I spoke to a group of college faculty about accessible teaching strategies like UDL. Last I spoke to a class of special education teachers, and paraprofessionals about accessibility and my life story.

On October 24th 2024 I spoke to another class of students learning to be general education and special education about the film “A Stroke Of Endurance” and modifications that can be made and addressing both mental and physical disability. This session highlighted the importance of recognizing each student’s unique needs and the role of educators in facilitating their success.

On December 5th I screened “Drama Sighted” for another group of teaching students to discuss the impacts of bullying of disabled students. The conversation turned into a discussion of “A Stroke Of Endurance” when an audience member mentioned they knew someone who had died of an ischemic stroke recently. One student said they thought Crip Video Productions main mission was to let disabled people know they matter and are valued. 

[cyanomys]

Calling all body positive ppl

Does anybody have recs for fat & body positive creators I can follow. Especially about movement and intuitive eating.

But also just seeing other fat people doing hobbies and being visible on the internet would be nice. I like gaming, books, the usual nerd package.

I’m having so much trouble searching for these sorts of creators without getting suggested fatphobic or pro-ED content instead which is very upsetting :(

Even if you don’t have answers please reblog so I can find people who do!!

[thestarlightforge]

This very question needled at me for a long time. But after much pondering (and a lifetime of using a wheelchair), here’s the personal TL;DR I came to:

My impairments are the medical things “wrong” with me (i.e. everything from chronic pain or illness to sensory processing problems).

My disabilities are the institutional barriers which prevent me from participating in society to the extent I medically could, if proper accommodations were provided/allowed.

So my impairments (noun) are: Brittle Bone Disease and assorted complications—including Scoliosis, conductive hearing loss, and chronic pain and fatigue—as well as a smattering of neurodiversity (anxiety, depression, PTSD, etc.).

But these medical conditions do not disable (verb) me. Instead, I am disabled by (and this is an incomplete list, mind you): Shitty wheelchair access, systemic discrimination, and a lack of access to accommodations (both physical and logistical, from extra time for things to better-designed spaces) that would allow me to take better care of myself, both physically and mentally.

This follows the social and economic models—making the institutions that refuse to be inclusive responsible for ableism, and recognizing the economic motivations behind that eugenic behavior, rather than individualizing the results of widespread discrimination (i.e. we need to fix you, not our stairs)—while still leaving space for folks who legitimately want their medical issues addressed, to improve their personal quality of life (i.e. their choice, not a decision the state or outside parties pressured onto them). It also holds space for disabled people to form intersectional, interdependent communities, both for their own disability-specific reasons and for activist purposes, like with other oppressed identities.

Almost all disabled folks have their own feelings about person first, identity first, reclaiming slurs, the different models of disability—and as long as they consider themselves part of the community, I respect their opinions. This is just a sliver of where I’ve landed, for now.

"disability only exists because the world isnt accessible" idk how to tell you this but chronic pain still hurts

[psychoticallytrans]

There are three main models of disability that are in common use. The moral model, the medical model, and the social model.

You may not have heard of the moral model before, but if you are disabled, you have felt the impact of it. The moral model is disability as a failure of character. It sources the problem of disability in the character of the disabled person. It's the people who insist that if you just tried harder, were better, had a better attitude, that you would no longer be disabled. It is a model that is used by ableists in order to conceptualize of disability as a failing of the individual. An extreme example of this mindset are the Christian Scientists, who believe that all illnesses and disabilities should be healed by the grace of their god and that if you are not healed, something is wrong with you. It is the the most cruel of the models, and the least successful at assisting disabled people.

The medical model is the model used by the medical establishment and by those who put their stock in medical authority. It sources the problem of disability in the body. It measures disability against a theoretical average person, and seeks to make disabled people match that average person more closely. This model works very well for disabled people with disabilities that can be measured, have a potential treatment plan, and want their disability gone. It does not work very well for people who do not match all three criteria. If they match the first and second but not the third, then strict adherents of the medical model often fall back on the moral model, stating that they are stupid, lazy, or selfish for not being interested in being cured. This also often happens if treatment fails to improve the condition of the disabled person.

The social model is a newer model, largely designed by disability activists and scholars and often defined in opposition to the medical model. It sources the problem of disability in the interaction between the disabled person and their physical and social environment. It argues that the solution of disability is to change the environment so that impairments are no longer an issue. This model works very well for disabled people who consider their disability not to be an issue when fully accommodated. It does not work well for people who consider their disability an inherent impairment and/or desire a cure. Strict adherents of the social model often fall back on the moral model when considering these people, stating that they are short-sighted or that they worship the medical model. These are the people who state things such as that depression would not exist in a world without capitalism.

When a disabled person fails to behave as expected by the model a person has of disability, the moral model is almost always the fallback position, because many people cannot conceive of why someone would disagree with them other than a lack of good character. This is a problem, because the moral model proposes no solution but to ignore or abuse the disabled person until they behave as expected.

Another notable interaction is that adherents of the medical model can often be persuaded to support the more traditional parts of the social model, such as providing large text resources to people with impaired vision, so long as there is empirical research backing it. However, they rarely support more radical arguments that challenge how we define disability and how society should be structured or restructured.

All three models have major failure points. The moral model fails every disabled person it is applied to. The medical and social models both fail different disabled people when adhered to strictly. The best approach at the moment seems to be hybridizing the social and medical models, so that they cover each other's weak points and fit the needs of the widest spectrum of disabled people. The main barrier to this is that they are often defined in opposition to each other.

[ipsogender]

The Social Model of Intersex

I recently wrote up an explanation of the social model of intersex and here I'm gonna take what I wrote the other day and expand on it.

Exposition: Some Disability 101

The social model of intersex is based on the social model of disability so first we need to know that terminology:

The medical model of disability views disability as something inherently disordered, requiring treatment/cure.

In contrast, the social model of disability sees that what is disabling about a disability is how society treats disabled people. There aren’t ramps and elevators for wheelchair users. There aren’t enough people who know signed languages or Braille. Videos don't come with quality captions and audio description. Etc.

(image from here)

The Medical and Social Models of Intersex

The medical model of intersex is analogous to the medical model of disability. Being intersex is seen as disorder that needs to be cured. The terms disorder and difference of sexual development (DSD) are sometimes used by people who think of intersex this way. This is the dominant model that most people in Western society use to think about intersex, and similar to how the disability rights movement is resistant to the medical model, intersex people as a community want our medical model to lose its dominance.

The social model of intersex is similarly analogous to the social model of disability. It sees intersex variations as natural bodily variations. What sucks about being intersex is the intersexism - the stigma, discrimination, isolation, and shame that surrounds being intersex; the fetishization of intersex bodies (usually ambiguous genitals); the medical violence/trauma that comes from being coerced into gender-conforming treatments; and so on.

Authority and Gatekeeping

The two models have different epistemic implications, i.e, whose knowledge is important and valid. The medical model places (perisex) doctors and biologists as the authorities on intersex. Being intersex is a result of medical diagnosis, and doctors are the gatekeepers.

The social model places actually intersex people as authoritative, and what emerges from intersex communities is less emphasis on diagnosis and more emphasis on how your bodily variations have affected your life experiences.

And once you get people talking about life experiences and failing to meet a perinormative standard, it becomes apparent that common diagnoses like PCOS and gynecomastia are frequently associated with the same sorts of life experiences that people with diagnoses that everybody agrees are intersex.

For intersex people, having intersex be a big tent is an advantage. We suffer from isolation so terribly. Having more people in the community helps break that isolation. And having more community means more ability to mobilize against harmful practices like IGM.

Edit to add: the social/experiential aspect of being intersex is one of many reasons why intersex people react negatively to non-binary people saying they want to "transition to intersex".

The Futures We Want

For social model folks like me, the ideal future is that intersex people are accepted, respected, given considerate medical care that respects bodily autonomy, and given access to safe and inclusive community.

In contrast, medicalists think the ideal future is that there are no intersex people, because we have all been “cured”.

This is part of why so few intersex people find out their diagnosis is an intersex variation from their doctor (if they're even lucky enough to get and be told their diagnosis). This contributes to why so many intersex people don't figure out we're intersex until adulthood. Giving patients a label to help find social support and organize politically for better conditions just isn’t something in the mental toolkit of somebody who is stuck in the medical model.

Where The TERFs Come In

The medical model encourages the intersex community to stay fractured into different diagnoses, and to view us as rare anomalies.

This is why TERFS and other transphobes love the medical model of intersex. They cannot handle the idea of intersex being common. They need it to be rare so they peddle their narrative that biological sex is simple.

Even though the biology is clear that sex is really complicated and there is no clear line between male and female, and a whole bunch of middle ground, the anti-trans lobby isn't willing to listen.

To them, there is no middle ground. There is instead two separate categories - male and female - and with each categories you have a tiny subset of "disordered males" and "disordered females".

This is why we see anti-trans posters trying to sow doubt about POCS as intersex. PCOS is common. It affects primarily women. And recognizing hyperandrogenism PCOS as intersex is a direct threat to their messaging about sex and gender.

Summary

The medical model contributes to so much of the intersexism that intersex people face, notably from the anti-trans lobby and from doctors. We suffer from seen as being broken/disordered, from coercive medical interventions, and from the isolation that comes from being told you're uniquely broken. The social model allows actually intersex people to be seen as the authorities on intersex; and for us to find community, healing, and political power.

[whumpinggrounds]

Writing Disability and the Idea of Cure

Heyyyy it’s me. Wanted to write about this following my post about Writing Deaf Characters.

Please note - this post is intended for people writing about disabled characters, not a nuanced, in-depth discussion of disability and the idea of cures. I’m happy to discuss that too, if anyone wants, but I’m not going to make a big long post about it because my thoughts and feelings are too complex to be summarized in that way. Anyway -

Conceptions of Disability

There are many, many ways of looking at disability. I’m going to highlight two here that are extremely common today in America. They each have upsides, and they each have downsides.

The medical model of disability treats disability as an individual medical problem to be solved. In this framework, disability is a bodily impairment that should be solved through medical means and medical interventions.

The upsides of the medical model include the fact that it acknowledges that disability or its consequences can be uncomfortable, inconvenient, and undesirable in themselves. Someone who experiences chronic pain saying they wish that they weren’t in pain is not ableist, nor is it self-hating, in the view of the medical model. This mode also prompts progress in seeking ways to medically alleviate symptoms.

The downsides of the medical model are that it does not acknowledge inaccessibility or ableism, nor does it allow for joy and identification with disability. The problems associated with disability are located firmly within the disabled individual - the problem is not with the world, but with the disabled person themselves. Disability is always something to be fixed or cured, and choosing to identify with one’s disability or feel proud of it is bizarre at best.

The social model of disability views disability as a social condition, wherein disabled people are impaired by ableism and an inaccessible world. In this framework, disabled bodyminds do not need to change, rather, it is the world and neurotypical, able-bodied people who must adjust.

The upsides of the social model of disability range from encouraging disabled pride to centering the massive harm that ableism and inaccessibility do to disabled people. It recognizes and promotes human diversity, and asks that the world adapt to the people in it, rather than adapting people to the world.

The major downside of the social model of disability is that in many cases, it ignores very real impairments that do affect people’s lives and treats bodily difference as irrelevant. Even if every set of stairs had a ramp beside it, a person in a wheelchair still cannot walk, though they will have the same access to places that people who are able to walk do. This difference matters to many disabled people, and acknowledgement or mourning of that does not mean that the disabled people in question are not liberated, or are experiencing self-directed ableism.

There are many other models of looking at disability! I may do a write up about that later if people are interested. If you want to do your own research, I would advise understanding the charity model, as it can be easy to slip into and is not a good thing. More positive models to explore are Discrit. Alison Kafer’s political relational model, and the general concepts guiding disability justice.

In Whump

Adding this because I’m in the whump community, and it feels very relevant, so -

It is super tempting to inflict serious injuries on an OC for pain and suffering, and then have them recover very quickly with little to no lasting repercussions. Whump is imaginary, and people should do what they want in their writing, however, I would urge people to think about what messages they’re sending with these fast, flawless recoveries.

For instance: What fears do your whumpees have around acquiring disabilities? How does your whumper feel about their target acquiring disabilities? What are your caregiver’s goal’s in helping your whumpee, and what do they believe that “recovery” means?

What About the Idea of Cure?

The idea of cure is deeply complicated, deeply political, and ultimately, deeply personal. Everyone’s perspective on cure is different. For some people, being cured of their disability is a positive thing. For others, it constitutes an erasure of their identity and community.

For some, cures are not possible in their lifetime, or maybe ever. This can be a painful idea or a reassuring one.

Some communities more than others have a majority opinion about the idea of being cured. Most people know that Autistic people reject the idea of being cured, or even the idea that there is something to “cure.” Deaf communities tend to feel similarly. On the other hand, people with cancer, Alzheimer’s, cystic fibrosis, or degenerative muscular diseases may welcome the idea of being cured and the progress being made to cure them.

Some ideas of “cure” center on aborting fetuses that present with the disability in question. This is massively controversial, deeply painful for some, and personal to all. Some communities have public stances condemning the practice of aborting affected fetuses. Notably, this includes the Down Syndrome community and Dwarf community.

What Does This Mean For You And Your Writing?

As I have hopefully made clear, I am not in the business of telling people what to write. Many disabled people feel that it is not appropriate to ever write stories in which disabled characters are cured. My feelings are more complicated than that, but I won’t say that those people are wrong. I also won’t say that they’re right.

The following are some ways to think about disability and cure that might help deepen your characters. I am not commanding anyone to do anything; you can write whatever you want. Hopefully you find this interesting and very hopefully you find it helpful.

If you are writing a story in which a disabled person is not cured: Think about what that really means for them in terms of impact on identity, ability, and their life more broadly. How does their community react to the decision to avoid, or the lack of, medical solutions?

If you are writing a story in which a disabled person is cured: Think about your motivations for writing this particular story. How does this cure take place, and how does the character feel about it? What impact does the loss of their disability have on their life? How would a real-life person with that disability feel, reading your story?

Lastly, if you are writing about a diagnosis and the idea of cure comes up, please do some research into how that community feels about cures/medical intervention. Individuals in your writing may have different feelings about cure than their real life community, but it is worth thinking about why that would be.

If you are writing about a diagnosis and the idea of aborting affected fetuses comes up, please do some research into how that community feels about it. Please also understand that whatever your intentions, what you are writing about is a form of eugenics. 

I promise you that real life opinions exist about all of these things and all of these diagnoses, and I promise you that these opinions are valuable and worth reading. Please think about what you are saying about those communities when you write.

Thank you so much for reading! If there’s something else you’re wondering about, or would like to see, please hit me up! If you want to talk about something in this post, please also hit me up! I am not infallible, nor is everything I’ve written an objective fact. I’m doing my best, and always happy to get feedback. Happy writing!