Hi Sam. In a recent post about disability you made reference to "the medical model, social model, or biopsychosocial model of disability". Please could you share some more information about these different models? You can just tell me to go google it, but I thought it might be okay to ask since you're clearly very knowledgable in this subject area and I find you are good at explaining things! Thanks.
The Medical Model (or Biological Model) of disability is the one most people are familiar with it. It views disability in the same light as illness. It is something that is wrong and it must be fixed or cured. This is the model that is shaped by doctors and healthcare providers as a whole, and represents the primary view of the medical industry, psychology industry, education industry, and society in general.
The primary problem with the Medical Model of disability is that it makes no room for a disabled person. The person does not matter - what matters is the disability, which needs be cured - whereupon you will be left with a person. This is the driving social force behind inspiration porn, microaggressions, and segregation. An example of this model would be that we must find a cure for autism, regardless of what that cure may be.
The Social Model of disability is the dominant model subscribed to by activists and self-advocates with some notable exceptions that are borrowed from the Biopsychosocial Model. This model of disability removes the medical from the person, and argues that disability is not inherent, it is a social construct. Universal accessibility is attainable (and it is), so the only reason why disability exists is because socially we choose not to attain it. Achieving universal accessibility removes disability by inherently putting everyone on the same footing without requiring special accommodations. Basically, you normalize “medical” disability being ok, and no one is disabled because their life is accessible.
This is a laudable view, but not without its problems. First, it entirely removes the Medical Model from the person. It makes no account for the reality that some of us have unpredictable disabilities that inherently cannot be accommodated. It is also unrealistic. Disability is an infinitely varried spectrum. We will never be able to accommodate everyone, and someone will always be left out. That doesn’t mean we can’t do better - and we must - but it is unrealistic to expect that we can effective account for all scenarios. This is also the view that spawned person first language - which is a deliberate attempt to remind society that we are people that have a disability not a disability with a person somewhere underneath like the Medical Model. Many activists that subscribe to this model borrow identity first language from the Biopsychosocial Model. Using autism as example, this model states that autism is a neurotype and should not be cured because different is not bad.
The Biopsychosocial Modelof disability does two major things. First, it combines the Medical Model (bio) with the Social Model (social). Second, it adds a third element, Psychology (psycho). This is an explicit acknowledgement that there are medical aspects of disability that are very real to the people who experience them, but also an explicit acknowledgement that there are social aspects to disability that are caused explicitly and entirely by society. It also introduces the idea that psychology, and in particular identity, play a large role in how any given individual experiences their disability. This is the model by which it is possible to understand that researching a cure is okay as long as you put that cure in the hands of the people who want it and not in the hands of those who don’t. This is the model that supports identity first language.
This model is also not without its problems. The biggest of these problems is that there is a very delicate balancing act that has to be done between acknowledging the medical realities and the social realities of disability. For example, this model recognizes that autistics that want a cure deserve a cure, and therefore we should research a cure. The social reality of this is that the only cure for autism is in utero testing and abortion - eugenics. We’ve seen this with Down Syndrome if you would like a reference. Clearly, this is not good for autistics that want a cure any more than it is for those that don’t. But what about a medication that limits meltdowns, or evens out hypersensitivity? Sounds good, but directing society in that direction is horrible difficult fight that isn’t even on the radar. In a lot of ways, it can be as unrealistic as the Social Model. It is also exceptionally easy to swing to far into the Medical Model or Social Model, in an attempt to be as inclusive as possible to people with various identities.
So that’s the general breakdown, in broad strokes. I didn’t have the word for it until recently, but my own beliefs align with the biopsychosocial model of disability. I believe that my disabilities are, at least in some ways, medical in nature, and I can and do take steps to alleviate specific aspects. This includes specific aspects of my autism (in particular meltdowns and shutdowns).
I also believe that a large portion of my disabilities are entirely social. A huge amount of my issues with ADHD and autism would simply vanish if true universal accessibility were a thing. Poof. Gone. This would do nothing, however, for the fact that my hands hurt, that the air is touching me, and that these things distress me even when the environment around me is accommodating and accessible. It doesn’t matter that I can hip check a button to open the door instead of pulling it, my hands still hurt - which is why the medical model is pertinent to my life.
And I hope it is obvious that I am an activist and self-advocate. I believe that there is a line between these to walk, and I believe that there is a lot of nuance between those two that is exceptionally important and ignored by those two models. I believe that the most fundamental personal right is autonomy, which includes the right to identity and self determination. Put this all together and I am squarely in the biopsychosocial model of disability.
Right oh. So this is longer than I thought it would be, and my wrists are screaming, so I’m going to end this hear. I hope this is a good beginning, and if you have more questions please feel free to send them.
In the mean time, give a lot of thought to the ideals versus the reality of disability, and be brutal with yourself. Figure out where you really stand on a day to day basis (I frequently struggle with falling squarely into the social model and taking radical stances on topics that, frankly, have a lot more nuance than I understand), and where you really want to be. Then fight for it. Hopefully, we don’t end up on opposite sides!
Can we please stop with the “autism isn’t REALLY a disability so autistic people should be accepted and included in society”? Like, a) autism is a disability in our current society regardless of whether we’re using the social or the medical model of disability and b) we don’t have to separate ourselves from disabled people to be deserving of accept and inclusion.
thank you, sir. we were worried you’d search us and discover Akira’s dubious pain medications and realistic model gun collection.
uh, what was that?
nothing, sir. just telling dumb jokes. we don’t want to waste time in your, um, busy day of serving the public.
but don’t you always say the police are nothing but a bunch of insecure high school drop outs that want to use total strangers and a loaded gun to live out their power fantasies because the only thing they were ever any good at was being under qualified at everything except for murdering innocent minorities?
There are two fundamental ways of viewing disability in relation to society: the social model of disability and the medical model of disability. Supporters of the medical model of disability says “autistic people don’t fit into our society, so we must fix autistic people” while supporters of the social model of disability says “autistic people don’t fit into our society, so we must fix society.” People who advocate for autism acceptance support the social model of disability.
The two models of disability comes down to one basic question - do we need to change individual people so that they can fit into our current society, or do we need to change society so that it becomes inclusive of and available to the many neurodivergent and disabled people who are currently left on the sidelines? It’s not enough to be aware of autism if you still see autistic people as mistakes to be fixed, which is why we support autism acceptance instead of autism awareness. Most people in the western world are aware that autism exists - but what does it matter that we’re aware of the existence of autism if we don’t use that awareness to accept and include autistic people for who they are?
We object to the idea that autistic brains are “wrong” and “bad”. We object to the idea that having an autistic brain is inherently negative. We object to the idea that autistic brains should be fixed. We support neurodiversity - the idea that autism and other developmental disorders and neurodivergences aren’t mistakes, but that they are natural variations of human neurology which should be embraced and accepted and acknowledged for their unique contributions. Neurodiversity is the belief that neurodivergent brains don’t need to be fixed or corrected, but that they’re a natural and important part of human diversity.
We object to the idea that autism should be cured. Instead of focusing on fixing and curing individual autistic people, we should dedicate our money and our activism and our energy to changing society so that autistic people can get the support and accommodations they need to live happy, fulfilling lives as autistic people.
This April - April is autism awareness month - you should take a stand against the medical model of disability and its fear-mongering cure rhetoric. Take a stand against Autism Speaks and their “awareness” and their use of words such as “broken”, “dangerous”, “epidemic”, “tragic” and “missing.” Listen to autistic people instead of listening to the words of organizations whose goal is that we shouldn’t exist, that we shouldn’t be a part of the future. Listen to autistic people instead. We don’t want to be fixed. We don’t want to be cured. We want to be a part of the future. We want to be accommodated and accepted for who we are instead of being eradicated and changed. This April, spread the word of autism acceptance, neurodiversity and the social model of disability. This April, stand with autistic people. We need your support.
medic has inward front teeth and an overbite heavy has gum recession and mandibular crowding i was about to say spy has perfect teeth but they’re all fake. EDENTULISM. soldier has all flat maxillary teeth and an under bite sniper has THE WORST TEETH he has an under bite, enlarged incisors, a few missing teeth before his cupsids, enlarged canines (1st bicuspid), mandibular crowding (maybe because of enlarged/pointed mandibular cuspids) a crossbite and low gums. engineers central incisors are enlarged width wise and he has an underbite demoman has an overbite and enlarged canines scout has an enlarged maxillary plate, bicuspids and canines, an overbite and pointed mandibular cuspids
Victor stops the car, turns off the engine, and Yuri rolls out the car with the attitude of every slightly inconvenienced teenager. Yuri flips his shades up, stares in disbelief at the sign in front of the well-manicured lawn squished between two old barber shops: DETROIT DENTAL AND ORTHODONTICS.
Why is no one talking about the death of Raudha Athif?!??!!!!? And all the suspicious circumstances surrounding her “suicide”??!
“Maldivian medical student and model Raudha Athif is believed to have committed suicide by hanging herself.
Prof Mansur Rahman of Barind Medical College, chief of the three-member medical board that performed an autopsy on her body on Friday, said they did not find any strangulation marks on her neck. There were no injury marks on her body either.
“All members of the board are of the view that it is a clear case of suicide,” he said.
But many people are spectacle, believing her death was a murder, including her own family.
“We’ve seen her body, her tightly-held fists, wide strangulation marks on the neck and multiple bruises as if somebody strangled her. We are not ready to believe it was a suicide,” said Raudha’s mother Aminath Muharrimath. Raudha’s brother, Rayyan Atif, has stated that they “are considering seeking a second autopsy by an independent authority”.
On the night of her death, students of the dormitory saw Raudha going out of the hostel around 11:00pm. She went to see a doctor at the college’s hospital as she was vomiting and felt sick. One girl from the hostel accompanied her to the hospital and another girl saw her return around 11:30pm, said the mother.
“The college authority on Thursday did not allow us to see her prescription, meet the doctor she saw or talk to security guards. They claimed that she did not go to the hospital. How is it possible?” said Muharrimath.
On Friday night, the college authority allowed the family members to talk only to the security guards who informed them that Raudha went out at 9:00pm, she said, adding: “I called her at 12:40am but I was put on call waiting, which means she was talking to someone.”
Abdul Aziz Riyad, secretary of the medical college, said they were not “officially aware” of Raudha going outside around 11:00pm. They learned that she went outside around 9:00pm as she was having stomach pains.
Rayyan said the authorities claimed that students broke into the room seeing her hanging and got her down. “We did not see any sign of breaking in … no cracks, dents on the door,” he said.”
What makes me really angry is how hard it is to find any sort of news on Raudha’s death. Such a cruel, unfair death. Whether it be from suicide or murder, she was taken too soon and deserved better. I hope she is in a better place and my prayers go out to her family.
It only takes me three days to get to what I’m really trying to say, after a great deal of dancing around the issue, but I suppose part of getting know the point is understanding where the deficits in understanding lie. I have seen this conversation happening for so long that perhaps I simply forgot to begin at the beginning.
We understand that, we, Autistic people are a minority group, making up less than 2% of the population. We understand that about half or a little less than half of us, whether we are diagnosed or not, need significant support in order to achieve a decent quality of life. We understand that we are different by nature, that there was not a time before our Autism, in other words, we were born like this, and that we cannot be changed in a fundamental way that will make us not Autistic.
What many of us want people to understand is that we consider our condition to be an expression of a functional gene that has demonstrated evolutionary success (much like other forms of diversity have contributed as well: sexual dimorphism, though not unique to humans AT ALL, as well as skin color, and the variety of sexual preferences). Autism allows the human brain to function utilizing a totally different operating system than the average or “typical” person. It gives rise to both intellectual disability and intellectual hyper functioning, and both deserve to be seen and respected. Many contributions to humanity were made by people who were simply different; diverse by their very neurology, if you will. If all humans were born with typical brain function, there wouldn’t be anyone to notice things in a different way. Please note that humans are a predominantly social animal, so it also takes 98% of the population with a typical neurology in order to maintain that safety through social living. This is the very nature of diversity: it is functional.
That’s why we see ourselves as a community, as an expression of diversity rather than as having an illness that needs to be treated. Also, because Autism is a fundamental part of who we are, it is abusive to use the medical model to try to change us. Most of us just want to be happy, to be accepted, to be seen for who we are, and to be able to contribute to our communities without having to necessarily “fit in” with the dominant culture.
As a medical student, I was lucky to receive training on how to properly address genitalia for transgender patients. Are there certain situations, etiquettes, or practices that you see in the medical community that you find unsuitable, insensitive, or ignorant of issues often faced by the transgendered community?
I’m so happy that you received this training because there is still a lot of work to do with regard to trans cultural competency in the medical field – unfortunately, not everyone receives that training so there are still a lot of practitioner’s who don’t know how to treat and advocate for trans folks. Many providers don’t ask about pronouns, or preferred names, or about what names individuals use for their body parts. Stereotypes are also pervasive and extremely problematic – there is this idea that all trans people have or are at risk for contracting HIV, that all trans women are engaged in sex work – these things are true for some of us but to focus exclusively on these stereotypes is dangerous and harmful. Medical providers need to understand that being trans is not in and of itself an illness – being trans doesn’t harm us, transphobia does. Many trans folks are suffering because of transphobia and the violence it perpetuates. Many trans folks are also thriving and demanding dignity. We need to demand a medical model that lets people take the lead in terms of what their care looks like, that creates opportunities for providers to really listen to patients. There are still so many barriers to be removed to insure that trans people have access to health care that is not only culturally competent but that is accessible, affordable, and safe.