Medical vs. Social Model of Disability
Some people think that people are disabled because they’ve sinned or are otherwise being punished for moral unfitness and need to repent. Most believe that people are disabled because their bodies are broken and they need to be fixed. But the people who are disabled, often believe that we are disabled because we live in a society that refuses to accommodate and include us simply because we are different.
The medical model of disability—the idea that disability resides within an individual and that the remedy is to change the person to be more like the typical population—dominates our capitalistic society. Why? Because it’s extremely profitable.
Big Pharma and hospital board members first create a demand by unilaterally deciding that our bodies are problems, then, they create a market by instilling fear into individuals and their families through deficit models built on shoddy science and rampant ableism, and finally they control the price and accessibility of the supply they create to meet the made-up demand (that they also created).
When profits are everything, interchangeable people is the goal, differences are the problem, and conformity and eugenics are the solution. This is not a flaw in the system—this is how our capitalistic system was designed.
In 1974, the Union of Physically Impaired Against Segregation (UPIAS)—a group of bold disability activists in Britain—put forth the idea that disabled people are an oppressed minority group that is regularly denied equal access to housing, employment, and public spaces and services. They argued that the lack of access is what disables us, and not our physical differences. In 1983, this lens of looking at disability was coined the “social model of disability.”
The social model of disability recognizes that society is fully capable of providing access, inclusion, legal protections, and independent living options for many disabled people, but it simply chooses not to. Most people in our society have been fed a steady diet of ableism since they were first born, so to them, we are either an inconvenience or a tragic mistake, and our unjust treatment seems reasonable. While some disabled groups (such as people with painful degenerative illnesses) would like a medical remedy to their disability, they too would like social and financial barriers to be removed, so that they can get their needs met with dignity.
Many disability activists today—including Autistic advocates—are still fighting for the social model of disability to be adopted by the greater population. Autistics recognize that our autism is central to who we are and how we experience the world. If my autism was “cured,” I would die, and a more acceptable copy would live behind my face. I cannot exist without being Autistic. I do not want to be erased—I want to be accepted for who I am.
Instead of supporting and fighting alongside Autistics, the largest autism charity in America, Autism Speaks, raises millions of dollars to pursue eugenics to try to prevent our births, or at least to make us more convenient for other people through the chemical alteration of our young. (If you think I’m being hyperbolic, please check out this commercial they put out. *Trigger warning: extreme ableism).
The medical model of disability also falsely perpetuates the use of abusive “therapies”—primarily ABA therapy in the Autistic community (more than a billion dollar a year industry). ABA therapy trains autistic children through a system of punishments (including electric shock collars in some practices) and rewards—like an animal—to suppress all of our natural, Autistic instincts and behaviors in order to make us more socially acceptable within the bounds of the dominant culture—they want to “civilize” us. ABA does not help Autistic people—it gaslights and abuses them in order to appease the people around them who do not want to accept their natural (and harmless) differences. It is akin to conversion therapy and it was founded by Ivar Lovaas—the same man who layed the foundation for queer conversion therapy.
Unfortunately, the medical model of disability is rooted in our colonialist history, and it has pervaded our capitalistic society. When disabled people seek accommodations we are often met with accusations of wanting “special treatment,” being “weak,” “lazy,” or “incompetent.” When we look for support services, we find that few exist and those that do are under-funded and often ableist in their definitions and requirements (such as practices of marriage inequality). Under these circumstances, it is incredibly difficult for us to survive (autistic suicide rates are 6-9x higher than the typical population), let alone thrive. We know that we have unique gifts (like the autistic hyper-connected brain) to offer society, but society refuses to enable us to participate and contribute fully.
Capitalism, by definition, centers profits, which means that it de-centers people and completely discards and oppresses those who are deemed “unprofitable” under the capitalistic model. Capitalism cannot exist without ableism. As long as our society is capitalistic, it will also be ableist.
What we need is:
an adoption of the social model of disability,
for disabled people to be centered in all conversations about disability,
for disabled people to be authentically portrayed in the media by disabled creators and artists,
for our legal protections to be observed and easily enforced,
and robust social programs that help disabled people access equal education, employment, housing, and full participation in society.
I live in the wealthiest country in the world, and yet, I know many Autistics who cannot begin the arduous work of accessing legal protections, services, or accommodations because they cannot access and afford the prerequisite: a formal diagnosis. Many “experts” (non-autistics who learned from non-autistic professors, who assigned books written by non-autistics, who all learned under the medical/deficit model of disability—you know, the same model that the Nazis used to mass murder disabled folks), continue to gatekeep autism diagnosis and insist that only young non-speaking boys can be diagnosed. That is as absurd as it is cruel, ant it is not okay…but it is the reality.