The Disability Hierarchy 1 - An Introduction

I've touched on the disability hierarchy many times before, but there have been so many things lately that have got me thinking about this again. I began to write one post, but it threatens to extend to at least three. Sorry!

The disability hierarchy describes the way that different disabled people are more acceptable than others in our culture. More acceptable to be seen, to be heard and to be accommodated, as well as effecting the way we are treated every day and things like how, if at all, people like us are represented on television and in culture. Government, the media and even sometimes our own representatives use this hierarchy to differentiate between those of us who are deserving of help and support and those of us who are not.

This doesn't mean that if a disabled person ticks certain boxes, they get a better deal than another disabled person who does not. But there's a reason why a politician can compare (inaccurately) the number of blind people and the number of people with alcoholism in receipt of a disability benefit and make it sound like a scandal. There's a reason why, when arguing against unfair time-limits on incapacity benefits, another politician can talk about the number of people with cancer who will be affected, ignoring thousands of other people with a variety of physical and mental, chronic and terminal conditions who are in exactly the same position. This doesn't mean it is better to be blind than to have alcoholism, or that it is better to have cancer than emphysema, MS, bipolar disorder, autism, back injury etc.. It merely means that society finds some disabled people more acceptable.

As with all matters involving social privilege and disadvantage, the hierarchy is complex and dynamic. This is not a hierarchy of impairment – although the nature of impairment matters a lot. Nor is this hierarchy based on how much sympathy a person is seen to deserve, although this is another important factor given the dominance of a Tragedy Model of Disability. This hierarchy is about what makes people comfortable, as against what makes them uncomfortable, when they consider disability and difference.

So for example, a fit young white male soldier who has lost a single limb in combat is a very acceptable disabled person – a hero, in fact, near the top of the pile. The impairment is entirely physical, easily understood and relatively uncomplicated in its effect. These chaps receive compensation for their injuries and the very best medical care, cutting-edge prosthetics and so on . His injury has been acquired in heroic circumstances and it doesn't interfere too much in his ability to be an attractive young physically-active masculine man.

Young male veteran amputees are a very common image of disabled people. It's possible that they appear on television more than any other group of us, often engaged in some sporting activity "despite" their impairments, reinforcing their hero-status. As with all disabled people in film and fiction, they are sometimes embittered by their injury, but Dr No is the only amputee mega-villain that springs to mind. And on the subject of springing, there's Harold's uncle in the wonderful Harold and Maude, who salutes with his empty sleeve by use of a pull-cord, but his injury did not, like so many other disabled characters, lead him to a desire for world-domination.

The soldier with an amputation is far more acceptable than his colleague who performed the same heroic deeds and acquired severe facial burns. Nobody would stop short of calling the veteran with burns a hero, but he doesn't make such a great picture. Burns are far more medically and socially complicated than amputation. Heroes with burns are much less common on television. They are much less common in fiction and film, and burning as a injury is frequently associated with turning evil (e.g. Darth Vader, too many DC bad-guys to mention, plus at least seven James Bond villains have some kind of scarring) or extreme social isolation. Simon Weston is one famous veteran with burns, but he made himself well-known by offering up his experience to others - he made an impact on my own life when I heard him speak as a disabled teenager. He is currently advising the Downton Abbey crew, since the First World War is about to break out in the drama.

The veteran with burns will, in turn, be more acceptable than his colleague who came home physically unscathed but has persistent Post Traumatic Stress Disorder. PTSD can be extremely complicated, painful and dangerous to a person long after the injury is acquired. A person's susceptibility to psychological injury is complex, depending a lot on subtle factors around the individual, the trauma and its direct aftermath, and has no bearing on one's courage or strength of character. Yet there are still some voices who talk about soldiers with PTSD as if they simply weren't cut out to do the job they signed up for. However, even the veteran with PTSD is more acceptable and admirable than a civilian with PTSD following a car crash or a sexual assault. The veteran was at least trying to be a hero when he acquired what is seen by some as an unheroic impairment.

So that's all about impairments, but how these people are treated changes again if say, we change their gender. Mental ill health is perhaps seen as more acceptable in women, but it is more expected and thus seen as less serious – how did she expect to cope with the explosions and the corpses in the first place? When a man has a mental illness, his defenders often point out how very masculine he is, not the kind of person to cause a fuss or cry (like a girl) or generally be a sissy. Meanwhile, physical injury of any kind is seen to compromise a woman's attractiveness to a much greater extent, and her attractiveness is seen as more important in the first place than say, physical strength or independence (in turn, women with conditions that cause physical weakness are more acceptable than men with the same conditions). So our burnt or amputee soldier becomes less acceptable, because she makes people uncomfortable. At the same time, women don't look like soldiers, so you are less likely to see a fit young woman with a missing leg and think she must be a hero. She probably lost it trying to parallel-park.

Similarly, tragically, it is also rare to see wounded black and Asian soldiers represented, as if they aren't proper British soldiers. In fact, it is rare to see disabled people of colour at all on television or in film. Our culture seems to struggle with people who tick more than one “diversity” box; being black or Asian, queer, disabled or female means being under-represented, but being more than one of these things and you might as well not exist. The exceptions I can think of coincide with the catergory "Comic book villains Samuel L. Jackson has played". The vast majority of disabled people represented anywhere are white, straight, cisgender men.

Meanwhile, the relative privilege of being a veteran among disabled people lasts only as long as people know that you were injured serving your country. It fades with time. It fades when, for whatever reason, you stop looking like a soldier. It goes if you stop acting like a hero. For example, alcohol abuse is a significant problem among our current and former military personnel, but an alcoholic is no kind of hero at all. Even when he has other heroic impairments, a young man loses a great deal sympathy and acceptability when he drinks to excess or takes drugs. We expect these men to use alcohol as a coping mechanism, to remain strong and manly, but then we see it as a personal weakness when this gets out of hand. Some of the alcoholics who claim disability benefits will be ex-service personnel.

It's worth noting that all the people I have described here may not actually identify as disabled. Young amputees with very good prosthetics often don't, because their impairments are relatively minor and certainly with prosthetic feet and lower legs, most other people may simply not know about their impairments. In the documentary series about facial disfigurement Katie: My Beautiful Friends, young people with severe facial burns and other disfigurements frequently referred to their gratitude that at least they weren't disabled. Of course, Post Traumatic Stress Disorder is not always a long-term condition, but almost every year at Blogging Against Disablism Day, people with chronic mental ill health express doubt about whether they count as disabled.

And alas, refusing to identify as disabled is itself often seen as an admirable stance. When someone who has a same-gender lover says that they're straight, we find that a bit silly, but when someone with a missing limb says they're not disabled, it only adds to their perceived heroism. I think usually people do this because they feel that real disabled people are less fortunate than themselves, but there's also an element of I could call myself disabled but I'm positive and strong and I'm not going to let my misfortune get the better of me by associating myself with that bunch - I speak from guilty experience. It is ironic that this very defiance is part of the dominant disability narrative, and part of what makes an acceptable disabled person acceptable.