3:52am May 25, 2014

Disability hierarchies

Disability hierarchies are different depending on which disability community you’re in.

In most of the disability rights movement, the people on top of the hierarchy are people with pure motor impairments of very specific kinds. Paras and quads with spinal cord injuries, amputees, other wheelchair users. With those who look the most normal, higher up than those who drool, who have twisted bodies, who look significantly different and could never pass as a nondisabled person sitting down. But even they are fairly high on the hierarchy as long as their impairments are (or can be passed off as) entirely physical.

Blind and deaf people are pretty high on that hierarchy too.

The lowest people on the hierarchy tend to be:

Developmentally disabled people of all kinds (I’m not using DD as a synonym for ID here).

Cognitively disabled people of all kinds (I’m not using cognitive disability as a synonym for ID either).

Psychiatrically disabled people of all kinds.

But even within those groups at the bottom, there are hierarchies, and those hierarchies also shift around a lot.

For instance, a person with non-psychotic depression is higher on the hierarchy than just about anyone with psychosis, and may not even always be that near to the bottom of the disability hierarchy at all, even though they technically have a psychiatric disability. It all depends on the person and their circumstances.

Autism is a weird situation. It can bring you very high in many hierarchies, and it can also bring you to rock bottom of every hierarchy. It’s all situational. I remember being in DD groups where they were proud that “even some autistic people” were involved, because they thought autistic people were so cut off from the world that it would take a miracle for us to be involved in a self-advocacy movement. I also know that the autistic self-advocacy movement often puts itself above other DD people, and is seen by others as better than other DD people. It cuts both ways for some reason. And it can also depend on what kind of autistic person you’re perceived as and what context you’re in right at that moment.

Intellectual disability is always pretty damn near the bottom, but is sometimes above a few other disabilities.

Some extremely severe physical disabilities, such as a very large percentage of people diagnosed with persistent vegetative state (whose impairments turn out to be physical rather than cognitive), will get you so far to the bottom of the disability hierarchy that some people will say “That’s not a disabled person, that’s a dead person. It’s different. They shouldn’t be in this movement and they shouldn’t have any rights.” And of course they say that of anyone who’s diagnosed with PVS or coma and doesn’t end up proven to actually just have a severe physical condition. That stuff will get you so far down the bottom of the disability hierarchy that people will debate your right to be considered a living human being, let alone disabled.

Dementia gets you at least as far down as intellectual disability if not further.

If you get four people — one with dementia, one with autism, one with intellectual disability, and one with schizophrenia, what you’ll often get is a bunch of people whose place in the hierarchy shifts and moves around depending on all sorts of factors. And they might all be fighting to be seen as better than each other.

Different disability communities create different values, and those values usually center around the abilities retained by the disabled people who made the values. I actually remember reading a list of advantages to being disabled, written by a famous physically disabled member of the phys-dis disability rights movement, and they were all cognitive abilities! And to her, having those cognitive abilities should be the basis of disability pride. She had no conception of how fucked up this was.

In the developmental disability community, which is led largely by people with intellectual disabilities, the things valued are often social skills that autistic people might find difficult in some contexts.

In the autistic community, the things valued are largely academic abilities that people with intellectual disabilities often find difficult. Also they’re often specific abilities that only the most dominant group of autistic people actually have, shutting out, for instance, autistic people like me, who are almost the inverse of the dominant group of autistic people when it comes to abilities.

The mad pride movement often involves valuing specific intellectual abilities as well. There’s a “mad people are smarter” thing that goes around, where “smarter” doesn’t mean smarter the way I’d mean smarter, but rather better at specific abilities that people with intellectual disabilities would have trouble with. (In my conception of what smart means, there’s no disability that would make you not smart. But in these people’s conception of smart, it’s about specific abilities.)

It’s not wrong to value your specific abilities, mind you. What becomes wrong is when those become a measure of worth as a human being or membership in a movement. And when those values start shutting out disabled people who have trouble in those exact areas.

Anyway, at the bottom, there’s a lot of people scrabbling around to raise themselves up and push others down in the process, and it gets rather ugly at times. And each community has an internal hierarchy of its own even among those who would seem to be valued.

I think it’s easier for me to see a lot of these things because I have such a wide number of disabilities, which makes me privy to most of these communities and yet somewhat of an outsider in all of them, even (perhaps especially) in the ones where I have gained prestige. I am physically disabled, cognitively disabled, developmentally disabled, psychiatrically disabled, and chronically ill, and that gives me entry to many different communities at once while also giving me problems in every community I enter. The developmental disability community is the one closest to where I could ever find a home, partially because developmental disability is more based on age of onset than type of disability and it contains more diversity than most disability communities.