In February 2019, Cheema, Meagher, and Sharp posted a blog on “Multiple Marginalizations: What Bioethics Can Learn From Black Feminism” (Multiple Marginalizations: What Bioethics Can Learn From Black Feminism | Bioethics.net) In this blog post, the authors discuss the necessity of using intersectionality as a theoretical framework for Bioethics: “The convergence of social inequities and marginalization, like racism, poverty, religious persecution, sexism, or homophobia produces unique vulnerabilities and social inequities.”
In considering multiple marginalizations and disability, I propose that we cannot overlook multiple marginalizations within the disability community. Disability is never a singular identity. It is always experienced as an intersectional identity lived as “AND” or “NOT ONLY.” Sins Invalid (2020) has led the way positioning “Disability Justice” as the next evolution to the Disability Rights movementIt directly addresses intersectionality and acknowledges how Disability Rights historically has been a “single issue identity” which does not recognize race, gender, sexuality, age, etc. Within Disability Justice, we lift the voices of the most marginalized including those with multiple marginalizations.
A surprising omission within listed +characteristics is disability itself. It may be counterintuitive that a list additive to some X characteristic should also include that characteristic, but it should. While one person can possess X trait (Gender) and Y trait (Disabled), another person can have the following combination of traits: X1= trans, X2=gay, Y1=diabetes, Y2=leg amputation.
The importance of multiples is a foundational thread in disability history which directs our gaze to the “all” in the “Education for ALL Handicapped Children Act” (which became IDEA). Some children with disabilities were educated, others trained for routinized employment, and still others were considered only worthy of custodial care and excluded from training and education and from society writ large.
On what basis? The children who were most excluded from education were often those with so-called “multiple handicaps” (PARC v Commonwealth of Pennsylvania). While this category also included multiple diagnostic disabilities such as both intellectual and physical disability, they also included things perceived to be profoundly debilitating characteristics such as self-care/incontinence, performative language skills, and body aesthetic such as drooling. The “most marginalized” in disability has always included a myriad of less valued traits of bodies/minds which, per Cheema et. al., have produced “unique vulnerabilities and social inequities” including the acceptance of pervasive violence made acceptable through de-humanization.
There are systemic structures within the disability communities that have both fostered strong identity and (sub)cultures while simultaneously dividing and even stratifying disability subpopulations. Examples include:
- Common yet segregated experiences driven by service/funding funneling by label into congregate settings as “State Training Centers” or institutions for individuals with ID/DD, state hospitals for individuals with mental health diagnoses, schools for the Deaf and/or Blind, and nursing homes for the elderly, especially those with dementia and those who require personal care supports. These spaces facilitate enculturation through specific language (medical, regulatory etc.), rules and regulations that confine the minds, bodies, and behaviors of residents, as well as explicit hierarchies of power.
- Affiliations with single diagnostic labels and created communities of belonging: Deaf Culture, Little People of America, Autistic Self Advocacy Network, National Federation of the Blind, National Association for Down Syndrome, Jerry’s Orphans.
- Multiple single issue Disability Rights Movement(s) such as “Deaf President Now’ and “We Will Ride,” to name but two. Our history of many advocacy movements, each were powerful and transformative, were also separate and exclusive to singular disability populations.
In short, separating ourselves historically helped provide identity, (sub)culture, and transformational progress. But as we advance to the next stage of the movement and consider disability justice through the lens of intersectionality, how do we remove the barriers between subcultures? And as we embrace multiple marginalizations, is there room for us to understand the multiples in our own community, for example:
- About 10% of children identified with Autism also have chromosomal conditions such as Down Syndrome (CDC, Data and Statistics on Autism Spectrum Disorder)
- About 50% of individuals with Down Syndrome have Alzheimer’s in their 50’s/60’s (Alzheimer’s Association, Down syndrome and Alzheimer’s Disease)
- Adults with disabilities report frequent mental distress almost 5 times as often as adults without disabilities (CDC, The Mental Health of People with Disabilities)
- Co-occurring conditions with diabetes can include cardiovascular disease, kidney disease, amputation and blindness (CDC, National Diabetes Statistics Report 2020)
- About 25-40% of Individuals with Cerebral Palsy (CP) will have a seizure disorder — one of many conditions that may co-occur with CP (MT DPHHS, Health and Safety Guidelines, Cerebral Palsy)
How do we extend the theoretical framework of intersectionality to expand perspectives of multiple marginalizations? We must take intentional strides to make room at the table welcoming all configurations of bodies/minds and embrace lived plurality in aesthetics, abilities, languages, gender, nations/states, race, religions, sexuality, etc.