Saturday, February 13, 2016

Pay here for inclusion I

Hi. I know. It's been a while and lots has happened (cough The Mighty finally having to look at the shit job they've been doing, cough, among other things), but I'm actually not here to address any of that. Plenty of folks have done such an amazing job on many of the current topics that my half-assed is not needed at all. No way.

I'm here to talk a little bit about inclusion.

But not really about inclusion, not in the traditional way anyway.

The research that supports meaningful inclusion for all and rejects any self contained settings as inferior and worse for all kids, is out there. Plain as day. And there's nothing that I can do, but support inclusion for all with all of my might. Because of my kid and her peers, the disabled, the gifted, the typically developing, the shy, the extroverted, the athletic, the polite, the artistic, the strange, the weird, the wonderful and the plain, the cute, all of them. All.

But the general message of the importance and benefits of inclusion is not really what I'm about today. Although it always is.

Today I need to say something about inclusion that keeps insidiously making it into a privilege, some sort of service that some are entitled to, invited in for, that's afforded to those who either qualify or whose parents have enough resources and reserves, mental and financial, to ensure it happens - both on paper and in reality.

I need to tell you a story about a disagreement I had on the telephone today.

The bridge-burner-never-talk-to-her-fucked-up-ass-again that I am, I still know a lot of folks. I do lots of things where I meet people who are themselves disabled or who have disabled children. Most of them I'm pretty in tune with and we are often passionate about the same things:

Acceptance, meaningful inclusion, and equity.

Oftentimes it can be defeating to have to realize in conversations how far there is to go, but mostly it's also really excellent and always reassures me that there are plenty of folks who'll have my kid's back and whose backs she'll have once she's a little older. Sometimes, we even start things. Good things that focus on elevating disabled voices and take the lead from disabled advocates.

We're doing an inclusion 101 workshop for parents of very young children, so the kids can find community and the parents can learn about their kids' rights in the school system. Informal, nice, cool, networking, no one's left in the dark about ADA or IDEA, which we've unfortunately experienced is far too rampant, or hits you in the face like a brick on the eve of your kid's third birthday and sends you reeling. We will talk, answer some questions, and eat some cookies.

Coooookiiies….

Or so we thought.

I reserved a room from the local library system and we set out to plan the invite flier and content of the workshop. So awesome, right? Connecting with likeminded parents and taking the "individual battle" down to a minimum with the backing of folks with a similar vision. This is NOT, after all, about fighting an individual battle, but working towards a system change, making a difference in lives besides the ones you meet at the breakfast table. Perfection, I'm telling you.

We are reaching out. Because we have precariously connected with other parents and count ourselves lucky. We want to spread the camaraderie, maybe even to educators.

Then the library got back to me:

"Sorry, rooms at the library are limited to non-profit clubs and organizations"

What? If someone's paying me for anything, I'm definitely not cashing the checks. I mean, I do fancy myself like a mix between a mean psychiatrist and a supportive life coach with a dash of a drunk pastry chef thrown in there, so there's that, but it's not exactly something I can be printing on business cards anytime soon. Not even if I'm willing to put things like 'Killer of your benign dreams, with chocolate' on it. I am so not employed. I just got my Green Card.

"But you are a business," they said when I called them. The lady on the phone and the person who had vetted our reservation, whom I could hear in the background.

"You are advocates for inclusion. That's a paid service. You are a business."

What? What? What?

"No. I'm not employed by anyone. I just want to talk to other parents about how to understand ADA and IDEA better, how to write their kids' IEPs in ways that support inclusion, how to collaborate with classroom and school staff, how to make it more likely for their kid to be accepted, truly included, and better supported in the actual community that they live in."

"You're a business. Are you going to offer a free, introductory workshop and then contact people to offer your paid services?"

"What paid services?"

I don't even do laundry at my house. or bath time. I think a lot though, about several different issues and whatnot. Maybe someone wants to pay me for that?

Big sigh.

Could it be that inclusion as a civil right isn't really as clear as we think it is, or nearly as clear as we think it ought to be? Why would a public institution immediately jump to the conclusion that talking to people about how to have their disabled children better included in their neighborhood schools is a paid service? That being an advocate for inclusion is a job, not a passion, or part of a value system. That inclusion is something that is achieved through an excruciating process that involves hiring and paying people, not something that is the responsibility of the schools, the community at large, to ensure.

What does that then say about the individuals who are not currently included in their schools, communities, or the society? Who we've chosen to not belong. That them or their parents aren't wealthy enough to pay for inclusion? That inclusion is a privilege reserved for those with the money and the resources?

As it would turn out, there is an incredible amount of very sad truth in that last paragraph. And we don't confront, talk about, face, revisit or anything that nearly enough. We still continuously frame inclusion as something that disabled children must qualify for, be granted, or afford. We discuss ways of playing the system rather than changing it. And all to often we accept segregation as inclusion.

Even the librarian "knew" that.


Wednesday, May 13, 2015

On PKN and "disability awareness" (Or: Just say no to awareness.)

Pertti Kurikan Nimipäivät, or as they are internationally known, PKN, will be representing Finland in the upcoming Eurovision song contest. The contest is a big deal (alright, for Europeans such as me) and the fact that all of the members of PKN have an intellectual or a developmental disability is too. 

A big fucking deal. Totally. No doubt. PKN was chosen to represent Finland by popular vote. And this was no pity vote either. These guys fucking kick ass.  

But we don't want to be in those rooms so
No one looks after us, doesn't even come into the rooms to see
What happens to us orphans in those rooms? 

CH: Those in authority deceive
Those who deceive are in authority
When they don't care about us intellectually impaired at all 

This is not awareness. Not a chance. This (and most of their other work as well) is revolt. This is fighting oppression through art. This is being angry at a society that excludes. This is mayhem in the service of a greater good. This is protest.

PROTEST.

NOT fucking awareness.

We must listen to the message, not try to make the messengers fit our agenda.

Really, if we take this act of assertion and let it become about awareness (as in: Hey, a man with Down syndrome plays drums just fine and is playing at an international song contest. Busting expectations there, buddy!), we're squishing ALL of the delicious juice straight into the trash and offering the world the driest, most inoffensive part of it all -

"Disability awareness"

SCREAM!

Seriously, and I don't know these guys personally and have never even met them in real life and have only followed them since they emerged on the scene of 'what we Finns like to be proud of i.e. the education, prison system, lakes and forests, being honestly strange, and Pertti Kurikan Nimipäivät and their no fucking apologies tack' so I'm only assuming when I say that I really don't think PKN has 'inoffensive' as something they'd like to be.

Just guessing, but yeah. A pretty good guess, right?

So let's just nip this whole awareness bullshit in the bud and respect the band and the guys in it for what and who they are.

PUNK that FIGHTS THE SYSTEM.

[video of PKN performing I hate the world at a festival]
Free our people. 

Saturday, May 9, 2015

Why I'm not in love with The Mighty

I have been getting an ad pushed into my Facebook feed a lot lately. That ad has been telling me that I "don't have to face a diagnosis alone." That ad is for The Mighty, a new-ish, fast-growing, and highly professionally built website.

Now, you might wonder, as I did, what my diagnosis would be. The closest I've come to a doctor in the past three years is trying to convince the US government that they should let me stay by getting a few vaccine boosters. I swear. So, as you might have guessed, The Mighty is not actually referring to my diagnosis (seeing as I have none), they're referring to my kid's diagnosis of Trisomy 21, Down syndrome.

Ah, of course this is about my kid, a minor, not me, a consenting adult.

This is about my family - my husband and I - and how we must struggle because the person who started The Mighty did:

"Lying in bed that night we were shaken and lost. This was not the life or family we had planned. I remember feeling small and hollow, a powerless husband and father. Whether it was a futile attempt to comfort my wife or a way for me to make sense of it all, I told her that we were going to do something good with this. How, she asked. I had no idea. We were in tears."

It is clear that there are no evil intentions behind The Mighty, just an attempt to make sense of a very personal situation, of one person's circumstance. However, should that mean that a powerhouse should be beyond criticism, because the intentions are benign and in accordance with one person's understanding of "doing something good" with a situation they didn't want to find themselves in? I don't think so. Of course not.

What does The Mighty aspire to? They write that they "...joined forces to build The Mighty because we all believed that a media company could be more than a business. At its best, it could actually help people."

Noble, you might think. Seems like something that could be good, right? But what does "helping people" entail in the world of disability? Who do they want to "help" and how? Why are they telling me that they don't think I should "face a diagnosis alone?"

Who is The Mighty for? When do we cross the line to inspiration porn aimed at the non-disabled, non-marginalized audience? Is it okay, as a non-disabled person, to want to feature

"Stories that inspire people – that can change the path of someone’s day, as my wife says – are a great start, but we are going after much more. Ultimately we want to improve the lives of people facing disease, disorder and disability."

Where are disability pride, disability culture, and creation of new value in "facing disease, disorder and disability?" Where is empowerment in "improve?"

They're not there.

As far as changing the path of someone's day, that happens to me most every time I come across an article, especially about Down syndrome, being featured on The Mighty. I come away from the encounter a little more defeated and angered, and feeling like I continue to bang my head against an ableist wall of inspiration. But that's just me.

Come on, the site's harmless and at least it's not disparaging and filled with hate (unlike you), you might be thinking, but hopefully aren't.

Is it though? Is it harmless to keep the grief narrative alive and well and more powerful than ever? Is it harmless to center the parents, the family, as opposed to the disabled person themselves? Is it really harmless to tell a new parent trying to suss out whether they're truly grieving a diagnosis or simply concerned about how their kid will fare in the world that is not designed for someone not considered typically developing, that it's okay to cry and grieve the "child they lost" and to let no one tell them they shouldn't? Not harmless in my book. Seems rather damaging for a kid who is everything but "lost."

Is this a site for suddenly disabled adults looking for community and "facing a diagnosis?" Doesn't seem like it. The majority of the articles featured seem to be written by parents of differently disabled children. To The Mighty's credit, however, I feel I must mention that there are articles written by disabled adults. They do exist on the site, they do. They are not the majority, and I'm not often sure what their purpose is, but they're there. So who is the site for then? By the looks of it, it is targeted to the non-disabled parents of newly born disabled or newly diagnosed children.

So. This is not a site for or by disabled people. This is a site about disabled people. About someone other than themselves coming to terms with their diagnosis, or sometimes seems like, their existence.

The Mighty could be so good, so empowering. There are inklings of this. I hope they refocus and redefine. I hope they become less satisfied with themselves and their general crowd appeal of feel-good and glossy, and truly help create something new.

With, not about.

I don't ask for much, but I do ask this: Do not pull the rug from under my kid's (or her peeps') feet. Just don't. There is no grace, love, or acceptance in something that ultimately hurts her.

As long as we keep centering the parents, the families, regardless of how good our intentions are, we are not creating strong advocates with their own strong voices, and their allies. The disabled voices remain erased, no longer buried in institutions but nonetheless largely drowned out by those who mean well.

We can do better. I know we can.

[A photo of the back of a blond child's head with slightly blurred metal chains in front of the child] 

Free our people. 

Saturday, May 24, 2014

Birds and why they're sometimes flipped

Begin </sarcasmfont>

Every once in a while I get lulled into this state in which I believe that only the truly bad and disgusting people in the world will be unable to perceive of my kid as her own unique self and will just see Down syndrome. This is a blissful state. Good, nice and respectful people are easy to like and get along with, and evil people are easy to hate and yell at. These villains are easy to identify and dismiss, what with the tentacles, overt candy-stealing habits, and the Mr. Burns fingertip-tent. And then there's the cackle. The cackle is a dead giveaway.

Boo!

I love the above state. That state is easy. It's nice. And it really does make sense, based on all of the things us humans do for and say about our fellow humans, to believe that this is the state that we're comfortably in, as a society. With all of the religions and philosophies so popular in today's world (by which I mean based on the crowdedness of my Facebook feed with cat-photos, inspirational memes, and bible verses), it makes sense to think that most people wouldn't want to intentionally tread on the fragile lives of others. Right?

TinyFurryKittens, Mahatma Gandhi, and Jesus and fam all tell us not to.

Lull. Blissful lull, I tell ya.

Then something happens.

Someone, let's say a school district, who is supposed to be an ally to their students, those with disabilities and those without, not only stumbles and falls, but thinks they're not falling nor stumbling. Wait, they're perfectly upright! Yey! They're firmly perched on where they need to be. For them it's perfectly okay to be looking down on this poor kid who has had this horrible, oh so terrible tragedy happen to her in the form of being born with 47 chromosomes in her cells.

Oh the horror of a genetic variant. 

Whoopsies, I mean MONSTER, of course. 

Or, actually, no. Aren't they supposed to be happy all the time?

Poor defective kid, her. Poor, poor child. Let's make sure she has at least some modicum of life. Let's help her, let's give her the tools to be able to live in her parents' modified basement, under constant monitoring, while she stays a child, for forever. Screw her future hopes and dreams and aspirations, she needs to be working on her IEP goals to ever be able to live. Seems they're thinking.

"She has an actual medical diagnosis. Causing significant delays," someone says and looks pityingly at this kid who is doing her all to ingeniously escape from her mom's clutches because it's a boring meeting and, well, there's bound to be a tinytot-sized way out of this place. There always is, for a persistent, inventive child.

But.

A specter of a Down syndrome past has entered the meeting room before the person with Down syndrome and the school district's not really interested in shifting its gaze. They're too busy staring at this abomination of a debilitating condition.

Down syndrome and inventiveness are not comorbid, Down syndrome and segregated for one's own good are.

Duh.

The self-contained classroom "might not be the least restrictive environment, but it might be the environment where we can meet her needs best," that someone continues with in an impending violation of Individuals with Disabilities Education Act. Through him, the school district lays it out.

No one has evaluated the kid in any way yet. This is the first time anyone from the district lays eyes on her. What they have is paperwork with her "actual medical diagnosis" on it, which according to them seems to mean that an inclusive preschool program is likely beyond her. This "actual medical diagnosis" also means that she will have to be evaluated by the school nurse, among others, because, obviously, OBVIOUSLY, Down syndrome is the same as ill health. Period.

Well, maybe the school nurse can diagnose a hole in her heart that specialists with ultrasounds and echocardiograms couldn't. Could happen, right? After all, Down syndrome is what killed Ethan Saylor too.

End </sarcasmfont>

My blissful lull is blown to smithereens. By someone who doesn't have a single tentacle and doesn't even cackle.

A person who means well says "they will be able to spend some time in the inclusive classroom too."

My kid is left at the very far margin of what it means to be a student, a participant, an agent, a person with an undefined future. By virtue of her chromosomes she has become someone who needs, an eternal recipient, a burden on the system. Someone to be rescued, aided, and helped.

Never an equal, always a case.

Thanks a bunch. Yeah.






Thursday, March 27, 2014

A few thoughts on the DS-Connect registry.

There is a government registry of people with Down syndrome that purports to provide "an important resource to individuals with Down syndrome and their families," and to link "those seeking volunteers for their research studies with those who most stand to benefit from the research."

"Wow, great!" you might think, "What research?"

Well. At first glance the "Goals of NICHD Research on Down syndrome" seem to have some reasonable, important points: such as research into leukemia and heart disease as well as assessing real world access to healthcare. Incredibly important stuff, that. But.

But:
 
Even without picking apart the language as I'm wont to do and as is sorely needed in this textbook medical-model document, what is it that's really there? How many of these points center on something relating to cognitive function, or cognitive development?

From this document it emerges that there is no difference, diversity, or divergence in cognition, just cognition that is the issue in Down syndrome. Which is Down syndrome, while other stuff is co-morbid. Much effort and much emphasis is on research to do with affecting cognition or its development.

Here are a few examples of what's made it into mainstream and professional media about the current research efforts and Down syndrome (that isn't about prenatal detection of Ds):

IQ-Boosting Drugs Aim to Help Down Syndrome Kids Learn

Can Down Syndrome Be Treated?

People With Intellectual Disabilities Get a Say in Drug Trials

New Drugs May Transform Down Syndrome

A Drug for Down Syndrome

Yet, often the registry is sold - meaning that enrolling a child, or a dependent (I assume no effort has been made to make the process accessible for people with Down syndrome themselves, or at least I couldn't locate an accessible enrollment process on the site?) is strongly encouraged with talk of "improving" a person's quality of life - with research on Alzheimer's and dementia, heart defects, and leukemia, which are often issues that literally do diminish one's quality of life, unlike intellectual disability.

We all know that talk of cognitive research is a mine field still.

On one end of the continuum of thoughts on this debate, there are people who cannot understand why someone wouldn't want to have as 'typically developing', 'independent' and sometimes even as 'socially acceptable' a child as possible if they had the chance, and on the other end there are those who believe that their children are exactly who they were meant to be and wouldn't imagine doing anything that might alter what they understand as their kids' 'essence' in any way.

But it's not only about what the parents say and most definitely shouldn't be, perhaps at all (another post, on guardianship, coming soon). There are people with Down syndrome who say that they are proud of who they are just the way that they are and regardless of their perceived intellectual disability wouldn't want to change their cognition, and there are other people with Down syndrome who would like help in making their "brain better" (at least in the studies in this link, there's emphasis on listening to the actual participants and making sure they want to participate, and that they understand what they're participating in and why.)

The DS-Connect registry is sponsored by National Institutes of Health (NIH) which state that "In developing DS-Connect™, the NIH listened to information and expertise provided by families of people with Down syndrome, researchers who study Down syndrome, and other members of the public" (My emphasis).

If I had a genetic condition someone was creating a registry about, I'd want to have been offered the chance to be heard, not just those around me. But that's just me, I like to have a say in matters that directly affect me.

I can only speak for myself, and only hypothetically, since I don't actually have Down syndrome, or another genetic condition that there is a research registry about. But I do know that I wouldn't want to change my cognition. I like my cognition fine the way it is and yet basic math overwhelms me, something I don't mind especially or would want to change. Why would I? My inability to do basic math has worked and still constantly works to steer me to humanities. Something I wouldn't change for the world. It also allows for me to delegate every single task in our household involving calculations to my husband, and leaves waiters loving me when I accidentally tip them 60% if I don't use an app to calculate the tip.

Maybe I would feel differently if the world kept telling me that there was something wrong with my cognition, instead of helping me out when numbers overwhelm me? But wouldn't that mean that I should be getting angry at the world for telling me such lies instead of trying to make myself more tolerable to others, or instead of wanting to provide brain tissue samples so that researchers could study my difficulties with fractions in hopes of treating them?

Where do we draw the line between medical and social?

I don't know if my child would or will consent to being part of  the DS-Connect registry, and I can't know whether the data I might be able to view would be data collected after consensual participation by the person with Down syndrome. So that I, as a parent not involved in any kind of research, can view "similarities"?

This should not be a debate or a discussion of whether Down syndrome should or can be "treated" and whether that's something one supports as a course of action, this should be a discussion on what makes us think and believe that intellectual disability (so not leukemia, not heart defects, not celiac disease, not hypothyroidism) is a pathology that consists of impairments that should be done away with with different kinds of chemical and physical interventions to the greatest possible extent, instead of accommodating for differences in cognition, ability, and memory.

If we call them challenges, the narrative of overcoming is sure to tag along.

I'm not willing to compromise the kind of world we live in. I'm not willing to say "I'll take the trickle of good research efforts focusing on actual medical issues with the river of what is sold as suffering from mental deficits and lack of independence." I'm not willing to set aside my disgust at the rhetoric of "treating Down syndrome" and "improving" those with memory and cognitive deficits for what, if anything, might emerge about treating childhood leukemia, sleep apnea, or congenital heart defects.

Research efforts don't take place in a vacuum. They help shape people's perceptions, especially when they make the news. If we keep telling the world that we welcome "medical solutions" to this "problem of cognitive deficits" what are we really doing to people with Down syndrome? To acceptance? To inclusion? To equality? To civil rights and liberties?

What the research can all too easily imply and promote is that intellectual disability is a "medical problem" in need of a "fix", "treatment" or a "cure" instead of the result of a society that considers intellect, and alongside it a specific kind of independence, as inherently valuable as well as a necessity, with that specific kind of independence as proof thereof, for something like "adequate survival" in life. This is something that we need to think about, consider, and discuss. We need for people with Down syndrome to take the lead.

What exactly are we putting out there about Down syndrome, and about people with Down syndrome?

Maybe I am throwing the baby out with the bathwater and being unfair to my own child. That's a thought I'm definitely considering constantly as I muddle along on this path of parenthood. I want to look at this, as I do most things, from all angles, and I want to do right by my kid and others with Down syndrome. There's also the chance that I'm telling the world that "people with Ds count, and that we want more for them," by not buckling under the pressure to sign someone other than myself, who really should have her own say about this once she's able, up for something that just might end up reinforcing perceptions of her as a lesser being who should be treated, fixed, and improved or at least mitigated as soon as possible.

I'm not inciting a revolt against the registry, I'm simply telling you why I personally find it difficult to jump in head first, especially since I don't have my daughter's guidance on this just yet, into those murky waters that end up splashing all over mainstream news and thus greatly shape thinking and eventually the way that people with Down syndrome will be viewed in society, professionals and researchers included, and why I think the entire foundation of the registry, the process as well as the forces that brought it about need much further consideration. I am outlining my concerns in response to the, frankly rather ridiculing assumption that I'm either "overwhelmed" by paperwork, or that I find the registry "creepy" or "complicated" in some Big Pharma conspiracy-theory way, since I haven't signed my kid up yet.

I'm not denouncing the registry entirely either, I simply think that instead of our gushing support and guilting rhetoric to round up participants, it would be nice to see pressure placed on those consortium members who are, after all, the representatives of those at the center of this, individuals with Down syndrome. For them to keep listening to those they represent, and to actively constantly assess whether what's happening is in their representees' best interest, and how it will influence all areas of their everyday existence in society.

That's not something I've witnessed at this point. I sincerely hope I just haven't been looking hard enough.

Checks and balances aren't in place with the registry just yet. Fundamental concerns remain largely unaddressed. Certain efforts seem misplaced and misguided. I'd like to see more discussion about the basics, about the directions of research, about consent and need. About agency and voice. About people with Down syndrome, not about "families living with Down syndrome."

Here's a story you might find interesting (by which I mean horrifying): Forced sterilizations of "feebleminded" people were carried out in the US in hopes of eradicating said "feeblemindedness" and creating a kind of a super race. A public policy that was cited by Nazi doctors, in their defense, during the Nuremberg trials.

Are we still hung up on a super race, a member of which never needs assistance with anything? Just not actually using the words super or race, but independence, intellect, and productivity instead? Where does medical stop and social begin and vice versa?

Friday, March 21, 2014

#WDSD14

Today is World Down Syndrome Day.

Today is not about creating or spreading awareness (FYI, not really about awareness, like, ever, yo), not even really about acceptance (although every single day should be about active acceptance, so there's that. Heh).

Today is about celebration, about pride, about culture, about rights.

About the kind of celebration of difference that doesn't try to see past or beyond the disability by ignoring it completely or by only searching for similarities, but the kind that views it as an accepted part, sometimes a defining one if the disabled person so chooses herself, of a person. The kind of celebration  that acknowledges and respects a disability, like it acknowledges and respects someone's race, sexual orientation, and chosen gender. The kind of celebration that embraces how a person chooses to define herself.

A celebration of taking PRIDE in one's self. All of one's self.

Today is not about how regular we all are - and we are, most of us anyway, I and my daughter included - but about enjoying life, and having access to learning and community. What these self advocates speak of in this clip:



Today is about access to healthcare and not having one's health concerns brushed aside with "We often see this in Down syndrome." What this clip speaks of:



Today is not about my kid being the best advocate for acceptance, meaningful inclusion, and equality for people with Down syndrome just by living her life or some such esoteric babble (Another FYI, it never is, she's not your campaign until, if ever, she wants to be), or about us as "a family affected by Down syndrome" (Yup, you guessed it: never is), or how our life looks or is, or, deep sigh, about "advertising" for Down syndrome to stall abortions or something, another deep sigh. Nope.

Today, or any day really but you know what I mean, is about recognizing, talking about, accepting, celebrating, and accommodating for Down syndrome. Today is about people with Down syndrome.

"I have Down syndrome, and I am proud of who I am," say the self advocates on the first clip. Not a single eyebrow should be raised, not a single scoff heard. This should not be, and isn't, a radical idea.

I want my daughter to be able to say "I'm proud to have Down syndrome."

That's what World Down Syndrome Day is about.

Mother Nature thinks so too and gives Down syndrome two thumbs up:



One final thought, because it's eating me up. The same one I had last year also so maybe I should scream it today?

WHAT DO FUNKY SOCKS HAVE TO DO WITH DOWN SYNDROME? WHAT? WHAT IN THE...? WHY...? Can we have a reasonable explanation, and can someone reassure me that regardless of all evidence, associating strange socks with Down syndrome isn't counterproductive to acceptance after all, please? And why does supporting this absolute incongruence seem to cost money? Anyone? No, really, ANYONE?

Thought so.

I'll see your socks and raise you pride. For free. How's that for a good start to a celebration?

Thursday, March 6, 2014

Prenatal testing and "debilitating" disabilities

When William Saletan writes about abortion, reproductive rights, and the political right in these words:

"So I cling to the mushy, unprincipled belief that while there ought to be fewer abortion decisions—and there would be, if pro-lifers would magically redirect their energy from abortion bans to birth control—when those decisions arise, they’re best made by the people directly involved."

I can't but agree wholeheartedly. There isn't much I'm going to say about abortion in this post.

Because aborting fetuses with Down syndrome is not about abortion, not about whether it should be legal, how far into the pregnancy it should be legal, whether it should be allowed especially or denied especially because of the fetus having Trisomy 21.

Eugenics is not about abortion. Attacking abortion will simply lead us astray, lead us to ignoring the reality in play and the real, actual people who are already here. Abortion is simply a (legal) means for a eugenicist mindset. Targeting the means might feel appropriate to many, especially to those who feel abortion in general is wrong, but that won't allow us to even scratch the surface of what is at issue here - the devaluation of some members of humanity by other members based on random strangers' internalized arbitrary standards, as well as the process that leads to that internalization.

Even the eugenicist mindset is not the root of it all, it's simply the product of these value judgements placed on certain individuals, sometimes based on perceptions of health or longevity, often a kind of assumption of productivity, other times an estimated 'cost' to society, spiritual, mental, or material, at times even esthetics, and many other "reasons" all of which, once put through the wringer, come out on the other side as casuistry and reliance on what are essentially very flawed and very antiquated pieces of "reasoning" and "logic".

Although I'm well aware that they exist, I'd be hard pressed to find an individual in favor of exterminating everyone with Down syndrome. Because, when I put it like this, we'd be talking of genocide, something akin to Hitler's T4 campaign. Not many people approve of the tactics used by the Nazis in their quest to 'purify' the Aryan race. There exists a clear denunciation and abhorrence of Nazi ideology in modern societies. We seem to agree that Hitler's logic was faulty, his aims delusional and disgusting, and stemming from a place so dark that many of us don't care to identify it as a place that could exist in a person.

Yet, in reality, when we really look at how we're proceeding here as humans, at the ways that disabilities, and especially Down syndrome, get talked about, when we consider how language shapes our perceptions of the world, how it doesn't necessarily reflect anyone's lived experience but takes its cue from a standard presentation, how it can be used to favor a medical professional over a passionate person, parent, or sibling, it can leave us gasping for air when we follow its pointers to their logical end.

I don't think we give "just words" enough credit in the maintenance of the oppressive systems that plague most of our societies today.

In the past week (two weeks now since life got the better of my editing and publishing intentions) I've encountered two articles about prenatal testing. Both mention Down syndrome. Both are from respectable mainstream sources.

Al Jazeera America published a piece by Kat McGowan titled: Will new prenatal tests scare parents into bad decisions? 

NPR ran a story by Rob Stein titled: Blood Test Provides More Accurate Prenatal Testing For Down Syndrome

(Lisa at Life as I Know It came across a third article and blogged about it.)

McGowan's piece does not directly deal with testing for Down syndrome, but focuses on a specific sex chromosome aneuploidy, Klinefelter's syndrome. However, possibly because Down syndrome is the most well known of aneuploidies, she uses it to set up a kind of a severity hierarchy of aneuploidies. She attaches the term "debilitating" to Down syndrome in a much greater degree than to Klinefelter's syndrome. "[Sex chromosome aneuploidies] are nowhere near as debilitating as Down syndrome." she writes. A photo caption for the story talks of "...Down syndrome and other serious health problems…" Several times McGowan refers to phenotype as "symptoms" as if both SCAs as well as Trisomy 21 are diseases.

Voila. Regardless of what the headline of the article purports is the question the article addresses - whether expectant parents might be making decisions to terminate a pregnancy in the case of an aneuploidy too rashly - in fact, our beliefs that all aneuploidies are bad news, and of all those aneuploidies some are worse news than others are reinforced by word choice. It is set up as fact that all aneuploidies debilitate, as in "make someone weak and infirm", but some of them, and I can't but wonder whether what we understand as intellectual disability isn't one of the major defining factors in arriving to this degree of debility - for McGowan specifically in this instance, but really for the cultural constructs she draws from to make these broad statements on disability - make someone even more "hindered, delayed, or weakened" than others.

The article begins by all but picking up a paint brush with red paint on it and repainting the edges of that box with the giant tick-mark in it that says NORMAL in bold.

But what is normal here? Who are we employing as this non-debilitated example whose life is smooth sailing and not hindered, delayed or weakened by a condition?

Well, of course a person without an aneuploidy. Duh. Or in the specific case of this article, a person with a sex chromosome triploidy that can be fully remedied to practical nonexistence if only detected early enough. Double duh.

Disability is bad, yo. Normal is the new (and the old) black.

However, the only guaranteed difference between a person with and a person without an aneuploidy is the number of their chromosomes. There are no guarantees on what those chromosomes are doing for their owner. intellectual disability is not unique to Down syndrome. Heart conditions are not unique to Down syndrome. Celiac disease is not unique to Down syndrome. Neither is leukemia. On the flip side, high intelligence is not guaranteed in a state of no aneuploidy. Neither is a happy marriage, a paying job, chocolate, good books ad libitum, great friends, being able to stick to your budget, or you know, living a happy, long life while contrasting oneself to those with a short life of suffering that is the unequivocal result of an aneuploidy.

The only guaranteed result of an aneuploidy are people who will have, or who other people will perceive to have a more difficult time functioning in a society that was specifically designed in ways that do not meet their needs, ignores those needs in favor of meeting the needs of a statistical illusion, deems those needs less valid in a multitude of theoretical as well as material ways, and justifies not meeting those needs in subtle ways through language, arguments focusing on an unchallenged concept of 'common good', access and its denial, and beliefs and belief systems.

If it takes you longer to process things, or if you are unable to easily comprehend whether someone's being sarcastic or earnest about what they're saying, or if you don't really understand what being sarcastic is all about and prefer to listen to the words and decode their literal meaning does that mean you are debilitated? Does that make you unhappy? Is debilitating the same as suffer?

Of course not. If someone whose condition debilitates them is unhappy with their life then Down syndrome is not a debilitating condition. At least statistically.

Yet, the word 'debilitating' and its connotations and baggage are there in the article, as are other words that subtly work to first introduce and then reinforce how anyone reading the article will view aneuploidies in particular and disability in general. The language subtly props up the medical model while downplaying the social model. The language sticks close to the notion of people as pathologies, instead of everyday, regular individuals.

And we read on, while we read in, take on board, integrate, let shape and set in.

Without our even truly realizing it, we are steered towards the understanding that disability is something to be fought, eradicated, in need of curing or fixing. We are lead towards thinking that all disability equals suffering and aborting an 'abnormal' fetus is a morally, not only acceptable, but the caring parenting choice to make.

I did say parenting choice. When disability is concerned even murder is sometimes cloaked in the language of parenting and love. It's a slippery slope my friends. Eugenics and what we consider especially despicable about Nazi ideology can be found right there, right within the word "debilitating."    

Abortion is not the problem, neither are the prenatal tests, the problem is that both are painted as the compassionate thing to do, for the better, in order to ensure the 'natural progression of things', when it comes to providing a balanced view in the mainstream, run-of-the-mill media (I'm not even touching on the arguments that rival Hitler's or the kind of people that peddle them, or their adversaries who present us with the equally disturbing pedestal ableism opposition). Although in the case of the prenatal tests discussed in these 'balanced' articles, the notion of knowledge and information being good things is almost always invoked, and rightly so in my opinion, these are almost always made to signify the medical aspects of a genetic variant ("1 in 2 children with Trisomy 21 will present with a heart condition."), and how to plan for those medical "adverse health effects." Information as power is almost never invoked in order to foster acceptance, culture, or community for anything but "peer support."

The language in these articles, and these articles are only examples, illustrate the greater issue, and are in no way especially horrifying cases, remains deeply ableist and problematic. And the intent, if there ever was one, to present something multifaceted and complex, is crowded out by the dogma inherently there in the chosen language. No measure of considering context or a multitude of potential meanings will stop the internalization of the construct brought on and reinforced by the reading.

Reinforcing an existing fallacy will do nothing to affect change. It will do the opposite. The paradigm won't shift if we turn the other cheek or appreciate the intent.

McGowan's piece leaves the reader on a hopeful note, which I greatly applaud, but that contrasts with the language employed in the piece. "Better information for parents and better-trained genetic counselors could help broaden social definitions of what’s normal. After all, everyone has minor deficits and imperfections. 'It could widen the margins of tolerance for what’s an acceptable human condition,' he says." she writes quoting a bioethicist. However, the worry the headline of the article alludes to is not a concern over someone aborting a fetus with Down syndrome because they haven't been provided enough information about the variant. Somehow Down syndrome doesn't seem to be included even within this broader definition of "acceptable human condition."

The story on prenatal tests by Stein, published on NPR, seems to be more concerned with how accurately the tests actually detect Down syndrome in a fetus than anything else. The main focus is the fear that women will end up terminating a "perfectly normal" pregnancy because of a false positive and the hope that these tests will lessen the number of "unintended miscarriage[s] resulting from a procedure that didn't need to be performed in the first place." There is one line about anti-abortionists, after which the article mentions "Advocates for people with Down syndrome" (my emphasis) and their concerns with the prenatal tests, as if people with Down syndrome have no agency or voice, no opinion on prenatal testing for the thing that they share, that they have, that is a seminal part of their lives. That only they can ever definitively know.

Journalistic balance and different points of view won't truly emerge by presenting the medical and official arguments in a 'sophisticated' and 'factual' light while presenting a medical expert, Dr. Skotko, as making an emotional plea. He is one of the world's leading experts in Down syndrome, yet all too often, as happens in Stein's piece, he becomes the passionate, loving sibling (which he is, but it doesn't diminish his expertise as a doctor or his authority in matters dealing with Down syndrome.). He is  allowed to express his brotherly love in a way, I have to note, that stinks faintly of 'a sister only a brother could love' type of thinking, to readjust a cliche, a kind of a 'well, what is he supposed to say?' type of a deal. A message underscored by a quick return to the real problem with the tests: "but these tests might enable for someone to terminate for non-debilitating reasons." Sigh.  

It doesn't seem to me that it is possible to provide a balanced article when the rhetoric employed is biased, prejudiced, and ableist language, that implicitly designates someone's chromosomal count as inferior, unnatural (Yes, they engineered my kid in a lab, she came in a box with a fancypants manual. O.o), and someone's lifespan and illnesses and issues related to that life as much worse than the illnesses and issues related to the life of a typically developed person.

I'm now going to leave you with a sentence that I'm stealing from a Slate article that I enjoyed, but can't remember what it was about and thus can't find again, but that influenced this post and made me realize how much that post that I wrote way back when we were living in South Africa, about renaming places that had Apartheid-related names, made sense, and how long I've been mulling on this: "And out of the ground the LORD God formed every beast of the field, and every fowl of the air; and brought them unto Adam to see what he would call them: and whatsoever Adam called every living creature, that was the name thereof."   'Naming' as owning, as having dominion.

Here's the Slate thought:

"Symbolic change and practical change have a symbiotic relationship"

No point? On point?