Queer Disability: Meeting health needs beyond biases, assumptions, & compulsory identities

Tori

I have bad luck in healthcare settings. If there’s a health practitioner with misinformed or oddly prejudicial ideas about any identity or behavior, I’ll probably find them. On one night in particular, a friend had to take me into the emergency room after a mental health-related episode. Typically, this friend and I are read as hearing and psychologically normative, respectively, and are both perceived as straight. Neither of those identities are true for us, however, which the med student we met with realized a few minutes into his check-in. His uncomfortably offensive, joking inquiry of,

I only have time to fix one handicap, girls. Deaf, gay, or crazy: which’ll it be?

was pretty illuminating to how people view disabilities and queer identities. They’re both considered problems, and you’re only allowed to occupy one at a time.

Disability studies and health practice around marginalized sexualities can speak to and inform one another, though. Theories of queer identity are taken up by disability studies to explain ableism, discrimination, and how a disablement/impairment dichotomy does not hold true for many individuals. A narrow understanding of what constitutes sex acts pathologizes sexual practices of people with physical, neurological, or psychological disabilities; similarly, it alienates many LGBTQ+ people from conversations around healthy sexualities. Acknowledging the similar goals within queer theory and disability studies can help create a broader understanding of intersecting identities, or ways of being an ally and giving support. It can also help in disseminating knowledge of other people’s lived experiences. Expounding the barriers encountered by people with disabilities alongside those faced by LGBTQ+ individuals can strengthen the work of marginalized people, and serve as a skill-exchange between groups forced to navigate the structures of society in specific ways.

Numerous theories address disability and queer identities, and many others speak to the intersecting identities people belonging to both communities can possess. When first delving into the literature, however, a helpful starting point is to compare the subjugation and erasure of LGBTQ+ people and people with disabilities. In Robert McRuer’s crip theory, disability is put forth as a way of “queering” normative bodies, or destabilizing their assumed certainty in society the same way queer theory takes on compulsory heterosexuality. Crip theory also looks to the ways in which society creates barriers to enforce an able-bodied culture (McRuer, 2004; McRuer & Berube, 2006). McRuer claims that disabilities and queer identities are considered deviations only because the dominant ways of being in this world are so strictly monitored and inflexibly maintained (McRuer, 2004; McRuer & Berube, 2006). Rosemarie Garland-Thomson (1997) calls queer and disability theories together by proposing a “universalizing view of disability” (p. 22) that draws from other social movements such as critical race theory, feminisms, or post-structuralist thought in questioning the certainty of assigned identities. Addressing the forces against marginalized people is relevant to a number of oppressions, Garland-Thomson writes, by pragmatically handling both constructivist and essentialist theories of the body (1997).

While most (“most”) health research no longer understands LGBTQ+ identities as being pathological, the same cannot be said for disabled identities. Certain bodies or mental functionings are still largely categorized as deviant (like how that med student felt he had to “fix” a deaf identity). The goal of many different health initiatives is to correct or repair, without considering that these bodies and the people occupying them are not faulty, and that the barriers or hardships people with disabilities face come in part from ableism, oppressions, and having to operate in a world designed to maintain an able-bodied ideal. Embodied diversity is not celebrated or seen as an identity people can proudly claim. However, many groups such as [“big D”] Deaf community, mad pride, fat activism, and natural birth movement have rejected this pathologization, and reclaimed their representation. In doing so, these groups have redefined the meaning of impairments or disabilities in ways that match movements to de-stigmatize queer identities.

McRuer argues that, just as LGBTQ+ people are more than “non-heterosexual,” people with disabilities are more than an addendum to the notion of a normative body (McRuer, 2004). In both cases, research around sexual practices and the dissemination of sexual health education to these groups needs to be more comprehensive than simply forcing people into a footnote. Health practitioners need to take into account the experiences, identities, and histories of people living in a society that considers them unnatural. As such, special attention should be paid to certain aspects of sexual health studies of people with impairments or disabilities.

Before and throughout education and research, one should make sure they are not placing their own hierarchy of needs on another individual. Assuming a person with disabilities has more important or pressing concerns than sex maintains negative attitudes towards sexuality, and also assumes a superior position to the person with whom one is working (the paternalistic, “I know what’s good for you” attitude that runs rampant in health programs). Sex may have changing levels of importance for different people, regardless of their ability status or current situation, and the decision to have or not have sex should come entirely from the person or people having it. Another prejudicial misconception many people have about sex is that everyone should intrinsically know how to have sex, and also be invariably successful at it. This does not allow for people to figure out or develop their sexuality over time, and can serve as a barrier to people gaining more information or becoming more satisfied with the sex they are having. It’s also crucial to keep in mind that everyone has sex in drastically different ways, that there is no set definition for what is or is not a sex act, and that assumptions around what someone is doing or with whom they may be doing it are never appropriate.

If you are working with a marginalized community of which you are not a member, it’s important to:
1. Check your assumptions
2. Educate yourself so as not to require constant explanations of basic concepts from the individuals with whom you’re asking to cooperate
3. Always defer to community members for their preferences in language and involvement. Addressing the needs of individuals rather than assuming problems or issues is crucial for work around sexuality or disability, but the principles around respecting identities and not relying on dominant cultural beliefs are relevant to any social service or people-focused work. As health practitioners working around issues of sexuality and sexual health, it’s important to constantly re-evaluate one’s goals or intention. A critical examination of the ways health research or campaigns are being executed is also needed; affirming the positions of the people one is serving, especially those whose bodies or health status are traditionally abjected or othered, can help people gain perspective on the issues they’re tackling.

References

Garland-Thomson, R.. (1997). Extraordinary bodies: Figuring physical disability in American culture and literature. Columbia University Press.

McRuer, R. (2004). Composing Bodies; or, De-Composition: Queer Theory, Disability Studies, and Alternative Corporealities. Journal of Advanced Composition, 24(1), 47–78

McRuer, R., & Berube, M. (2006). Crip theory: Cultural signs of queerness and disability. NYU Press.

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