physical violence – UAB Institute for Human Rights Blog

Violent Ableism: A Structural Epidemic

Warning: This blog includes content on violent acts against people with disabilities.

Last week, James Quilter was nearly strangled to death last week by his own mother. Quilter, 21, is a nonverbal autistic man with Langer-Giedion Syndrome. His mother became enraged after seeing a mess created by her son. Screaming for him to die, Gidget Quilter pushed James to the ground and choked him in front of her other six children.

Stories like this are not uncommon. Children with disabilities suffer from physical abuse at a rate over four times higher than children without disabilities (WHO). Parents of children with disabilities may lack a nuanced, informed understanding of disability. Lack of knowledge in itself shouldn’t be demonized, but ableist misinformation has dangerous and even fatal results. Abled parents may think of their child’s disability in terms of their own experience, creating selfish motivations with detrimental results. This perspective has led to disability advocacy organizations that are operated by and designed around abled caregivers and parents. In these spaces, the conversation is warped to emphasize “fixing” and eradicating disability instead of empowerment. This perpetuates dangerous stereotypes and justifies people like Gidget Quilter.

Protesters from Autistic Self-Advocacy Network hold signs that say "I am not a puzzle, I am a person" and "Autism Speaks does not speak for me" at the Walk Now for Autism fundraiser in Portland, OR. — “not a puzzle.” Source: Philosophography, Creative Commons.

As I have discussed in earlier posts like Disability History: Overlooked but Not Forgotten, ableism is a phenomenon based on implicit negative bias towards disability that is played out on every level of society. Ableism is rooted in widespread bodily expectations of “perfect” ability. All actors within ableist systems have the burden of meeting sociocultural bodily expectations. On an abstract level, anyone not meeting ability expectations is expected to accept the risks that come with perceived weakness/vulnerability; anyone who meets the standard for ability expects immunity for enforcing ability expectations, even if violent. In a society that rewards and idealizes normality, hatred is often directed at anyone showing otherness or “abnormality.” Audre Lorde discusses this frankly in her classic collection, “Sister Outsider.”

“Institutionalized rejection of difference is an absolute necessity in a profit economy which needs outsiders as surplus people. As members of such an economy, we have all been programmed to respond to the human differences between us with fear and loathing and to handle that difference in one of three ways: ignore it, and if that is not possible, copy it if we think it is dominant, or destroy it if we think it is subordinate” (Lorde, 1984:77).

In blogs like the one mentioned above, I chose to leave out details on the suffering of people with disabilities. This was intentional, as I wrote, “It’s exhausting and demoralizing to read about these things as a disabled person. It also encourages unneeded pity from non-disabled people. Though pity may come from good intentions, it only reinforces dehumanizing attitudes.” I stand by this sentiment, especially in the context of empowering historical narratives, but it feels critical to bring attention to violent ableism in its own piece.

Violence is a mechanism by which individuals assert ableism, but not all cases of ableist violence are as visible as the attack against James Quilter. Violence, according to Galtung, is enacted when “human beings are effectively prevented from realizing their potentialities,” (1969:170) or when there is an ability to avoid harm that is neglected in favor of others’ benefit. This encompasses deprivation of health through personal violence (direct violence) and social injustice (structural violence). Personal or direct violence is further understood as having both physical and psychological components. In the following subsections, I will identify psychological/internal violent ableism, physical/direct violent ableism, and the structural violence of ableism. All of these elements compound into a fundamentally ableist world in which people with disabilities face endless barriers to empowerment and liberation.

This image shows a red figure in a wheelchair that appears to be made by fingerpainting. There are three lights shining at the top of the image. — “Disability.” Source: Abhijit Bhaduri, Creative Commons.

Psychological / Internal Violence

Disability has long been viewed as a deficit in ability, with blame for impairment placed upon the disabled individual. This framework instills a deep sense of inadequacy and shame for people with disabilities, amplifying when the disabled individual relies on the assistance of others or social welfare programs. Internally, shame is generated by the weight of burdening others in societies that assign value to self-sufficiency. Shame reinforces a lack of self-esteem that further impedes participation in society. This process has been disrupted with personal empowerment made possible with the social model of disability. Per Tom Shakespeare, “The problem of disability is relocated from the individual, to the barriers and attitudes which disable her. It is not the disabled person who is to blame, but society. She does not have to change, society does. Rather than feeling self-pity, she can feel anger and pride,” (Shakespeare, 2006:200). Read more IHR blog posts about the social model of disability here and here.

This has been revolutionary for the empowerment of disabled people, but society at large has not yet embraced this perspective. Ableist bias runs deep and is clearly manifested in the discrimination and exclusion of people with disabilities in society.

Direct Violence

In part due to these fears and biases, persons with disabilities overwhelmingly experience disproportionately high rates of direct violence. Davis writes, “People with disabilities have been isolated, incarcerated, observed, written about, operated on, instructed, implanted, regulated, treated, institutionalized, and controlled to a degree probably unequal to that experienced by any other minority group” (2006: xvi). Per the National Crime Victimization Survey conducted by the U.S. Bureau of Justice Statistics, “the rate of violent victimization for persons with disabilities was at least 2.5 times the rate for those without disabilities.” Disabled women face violent victimization at a rate of 32.8 per 1,000, compared to abled women at 11.4 per 1,000 (Harell, 2017).

The disaggregated nature of the disabled community translates into a preponderance of data for specific impairments. For example, people with cognitive/developmental disabilities are up to ten times more likely to be victims of crime, and often face repeat victimization (Petersilia, 2000). Per the same source, sexual assault rates for women with developmental disabilities are over fifty percent higher than in the general population. This is partially due to the physical vulnerability of people with disabilities but can also be tied to broad assumptions that dehumanize disabled people as well as structural factors that increase vulnerability. A study published in the Journal of Interpersonal Violence found that “structural violence was shown to underpin all other forms of interpersonal violence,” which, they further conclude, increases the vulnerability of persons with disabilities in addition to isolating them from society (Neille and Penn, 2015).

A man in a wheelchair looks back as he wheels down the street. He is wearing a bright pink hat and has a backpack hanging off the handles of his chair. — “The Wheelchair Wanderer.” Source: Edward Allen Lim, Creative Commons.

Structural Violence

Structural violence is more difficult to identify and prohibit than direct physical violence, and its impacts are much deeper. Injustice is built into the structure of our world, which “shows up as unequal power and consequently as unequal life chances” (Galtung, 171). Centuries of global ableist conduct explains why the structural violence of ableism is so deeply wrought, and why it is such a challenge to identify the full extent of its power. I will attempt to explain the roots of ableism, violence as an enforcing mechanism, and the current manifestations of this structure.

Disability cannot be an “other” unless conceptions of the body are expected to fit some standard or ideal physical form. In other words, deviance can hardly be defined outside of its distance from an ideal. Though modern culture is normalized to judge anything by its “average” or “normal” form, these concepts are relatively new. The field of statistics gained steam in the early 19th century, heralded by a group of European eugenicists looking for a way to improve humanity – first by establishing an ideal for mankind, and then acting to eliminate wrongful deviations. “Eugenics became obsessed with the elimination of ‘defectives,’ a category which included the ‘feeble-minded,’ the deaf, the blind, the physically defective, and so on” (Davis, 2006). The hierarchical conceptualization of the body was used to uphold classist structures and elite institutions of power.

These ideas, aided by the popularity of social Darwinism, became prevalent and were applied into political, social, and legal institutions – effectively cementing structural ableism.

Impacts of Structural Ableism

Reproductive violence is a significant type of violence enacted against disabled people on a structural level. Forced sterilization is a major component of this. People with disabilities have historically been forced to undergo sterilization in a variety of countries and time periods, including 20th century America. By 1931, nearly thirty states had compulsory-sterilization laws, aimed at “the insane, ‘feeble-minded,’ sexual perverts, drug fiends, drunkards, epileptics, and ‘other diseased and degenerate persons,’” (Hubbard, 2010:95). The fact that so many states implemented compulsory-sterilization laws is a testament to the pervasiveness of ableism. This foundation was laid in the 19th century but, like many other forms of systematic oppression, is continuously self-reinforcing.

“In the case of disability, [oppression is reinforced] by a circuitry of power and ideology that constantly amplifies the normality of domination and compresses difference into classification norms… of superiority and normality against inferiority and abnormality.” (Charlton, 2006:225).

Unchecked ableism has created a world in which people with disabilities face endless barriers to empowerment and liberation. One major mechanism of ableist structural violence is economic injustice; this, perhaps, has been the most recognizable form of indirect violence for disabled people. Poverty is both a cause and a consequence of disability, forming the disability-poverty circle. Over 27% of individuals with disabilities live in poverty in the United States – nearly double the 12.5% rate for the general population (Wohl, 2014:3). Discrimination in employment, inaccessible urban environments, and lack of accessible transportation make it incredibly difficult for people with disabilities to generate an adequate or stable income. Lack of insurance with overpriced medical bills often exhaust disabled peoples’ resources, while restrictive qualifications for government assistance complicates life further.

“Getting fitted out for a better future.” Source: Kanishka Afshari/FCO/DFID, Creative Commons.

Globally, disabled people, particularly in periphery countries, are “the poorest and most powerless people on earth,” (Charlton, 2006:218), facing a compendium of internal, interpersonal, and structural violence. Political economy is a critical area to investigate here, being the system that informs the hierarchy of wealth/poverty, production/exchange, power and privilege. The political economy has evolved to be ruled by “laws of capital and profit,” (Charlton 2006:218) with no room for deviation, impairment, or mercy.

Conclusion

Persons with disabilities face violence at the psychological/internal level through shame and stigma; at the interpersonal level through direct/physical violence between individuals; and at the structural level through norms that “otherize” deviance, discriminatory policy, and institutions like the international political economy. Violent ableism is an intentional mechanism to reinforce elitist structures of power that benefit “superior” groups and eradicate “inferior” deviants. Ableism is a self-perpetuating cycle that operates through internal assumptions, individual interactions, and structural manifestations in policies and institutions.

Structural ableism will stay rooted in place until positive peace for the disability community is actively pursued at every level – challenging internal bias, practicing social compassion, and preventing future manifestations of ableist structural violence through the destruction of that system and the active, inclusive construction of a better one. Stay tuned to the IHR’s Facebook and Twitter for my next blog on what positive peace for the disability community looks like, and how we can achieve it.

Works Cited

Charlton, James I. “The Dimensions of Disability Oppression: An Overview.” In Lennard J. Davis, Disability Studies Reader, 2nd ed, 2006, pp. 217-230.

Davis, Lennard J. “Constructing Normalcy.” Disability Studies Reader, 2nd ed, 2006, pp. 3-16.

Davis, Lennard J. “Disability Studies Reader,” 2nd ed, 2006. Routledge, Taylor & Francis Group. New York, NY,

Finkelstein, Vic. “To Deny or Not to Deny Disability.” In Handicap in a Social World, edited by A Brehin et al. Sevenoaks: OUP/Hodder and Stoughton. 1981.

Galtung, Johan. “Violence, Peace, and Peace Research.” Journal of Peace Research, vol. 6, no. 3, 1969, pp. 167–191. JSTOR, JSTOR, www.jstor.org/stable/422690.

Harell, Erika. “Crime Against Persons with Disabilities: 2009 – 2015 Statistics.” National Crime Victimization Survey, Bureau of Justice Statistics, 11 June 2017.

Lorde, Audre. “Sister Outsider – Essays and Speeches.” The Crossing Press, 1984.

Shakespeare, Tom (2006). The Social Model of Disability. In Lennard J. Davis (ed.), The Disability Studies Reader, 2nd ed., 2006, pp. 197-204.

Patterson, Cynthia. “‘Not Worth the Rearing’: The Causes of Infant Exposure in Ancient Greece.” Transactions of the American Philological Association (1974-), vol. 115, 1985, pp. 103–123. JSTOR, JSTOR, www.jstor.org/stable/284192.

Wohl, Alexander. “Poverty, Employment, And Disability: The Next Great Civil Rights Battle.” Human Rights, vol. 40, no. 3, 2014, pp. 18–22. JSTOR, JSTOR, www.jstor.org/stable/26408468.

What is Gender-Based Violence?

Growing up, I was resentful of the social freedoms my male friends naturally enjoyed. Unlike the parents of my male friends, my parents were very strict about things like curfews, not being outside at night alone, and avoiding certain neighborhoods. My dad would always say, “We trust you, but we don’t trust the people around you”. Although I was still resentful, I know my father enforced those stringent rules because he was trying his best to protect me from gender based violence (GBV). GBV is defined as violence towards an individual that is motivated based on his or her gender identity, biological gender, “or perceived adherence to socially defined norms of masculinity and femininity”. The term ‘violence’ encompasses physical, sexual, and psychological abuse along with coercion, threats and compromised liberty. Examples of GBV include sexual violence like rape, domestic violence, and human trafficking. Both men and women are affected by GBV; however it is recognized women and girls are at most risk for exposure due to the imbalanced power relations between men and women “which have led to domination over and discrimination against women by men … and that violence against women is one of the crucial social mechanisms by which women are forced into a subordinate position compared with men.”

Violence against women and girls is a prevalent human rights violation resulting in disproportionate negative consequences on females’ physical, mental and sexual and reproductive wellbeing including but limited to including, but not limited to: “i) fatal outcomes; ii) acute and chronic physical injuries and disabilities, iii) serious mental health problems and behavioral deviations increasing the risk of subsequent victimization and iv) gynecological disorders, unwanted pregnancies, obstetric complications and HIV/AIDS .”

International Womens Day Strike. Source: Molly Adams. Creative Commons

Some troubling statistics on GBV:

In 2014, a UNICEF study projected that ~120 million girls (almost 1 in 10) under the age of 20 have been forced to perform sexual intercourse or other sexual acts during some point of their lives.
Almost half of the women killed in 2012 were murdered by a family member or intimate partner.
Globally, the WHO estimates 35% of women worldwide have experienced either physical and/or sexual intimate partner or non-partner violence or sexual violence. Other national studies have estimated up to 70% of women experience GBV.
“Women and girls together account for 71 per cent, with girls representing nearly three out of every four child trafficking victims. Nearly three out of every four trafficked women and girls are trafficked for the purpose of sexual exploitation.”

Although a pressing issue, it wasn’t until 1992 when the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) formally adopted General Recommendation No. 19: Violence against Women (GR 19), which legally categorized violence against women a distinct form of discrimination. Likewise, it wasn’t until 1993 the United Nations General Assembly adopted the Declaration on the Elimination of Violence against Women (DEVAW), forming the first ever internationally-recognized definition of GBV. Both documents explicitly outline how GBV violates basic human rights mentioned throughout the UDHR such as the right to life, dignity, and health.

Health Effects of Exposure to GBV

Sexual and Reproductive Health
GBV is a major public health concern contributing to mass amounts of mortality and morbidity. Specifically, the relationship between GBV and HIV and other STIs has been recognized as an important pathway for the contraction and spread of such diseases. WHO states that, in some regions, women facing sexual partner violence are 1.5x more likely to contract HIV, and 1.6x more likely to contract syphilis. Here’s how:

First, increased vulnerability to HIV and STI’s stems from sexual violence such as rape. “Violence reduces victims’ abilities to influence the timing and circumstances of sex, resulting in more unwanted sex and less condom use, including situations where women are coerced or pressured not to use condoms.” For example, of the estimated minimum 250,000 women brutally raped during the Rwanda Genocide, 70% of those survivors tragically acquired HIV.

Second, another important pathway from GBV to HIV is men who are physically violent are also more likely to be HIV positive. Studies find violent men are more likely to engage in risky sexual behavior such as having multiple sex partners and utilizing transactional sex, increasing their chances of contracting and spreading HIV and other STIs.

Along with the spread of disease, women and girls experience unwanted pregnancies due to GBV. The WHO states that women with previous exposure to GBV are more likely to account having had a self-induced abortion. Globally, “80 million unintended pregnancies each year, at least half are terminated through induced abortion and nearly half of those take place in unsafe conditions.” A study analyzing the relationship between GBV and sexual and reproductive health among low-income youth in three Brazilian cities, supports WHO’s statement that women in abusive relationships are more likely to experience unwanted pregnancies. The study found adolescent females who became pregnant as teenagers were more likely to have been victims of controlling behavior or physical abuse compared to teenage girls whom have never gotten pregnant. Among the girls who got pregnant as a teenager during the study, “20% reported having suffered physical violence from a partner and 10% reported having been subjected to sexual violence from a partner, compared to 5% and 3% respectively of those who did not get pregnant as teenagers.”

Mental Health:

Along with physical harm, studies highlight women and children face serious mental health problems after enduring traumatic experiences with GBV. “Exposures to traumatic events can lead to stress, fear and isolation, which, in turn, may lead to depression and suicidal behavior.” According to the WHO, women abused by a non-partner are 2.3 times more likely to have alcohol use disorders and 2.6 times more likely to have depression or anxiety. A cross-sectional study based on the Australian National Mental Health and Well-being Survey in 2007 found that of the 4,451 female respondents, 1,218 (27.45%) of the women have experienced one of the four types of GBV analyzed in the study (IPV, stalking, sexual assault, and rape). Of the 139 women who experienced at least three types of GBV, the rates for mental disorders were 77.3% for anxiety disorders, 47.1% for substance abuse disorders, 34.7% for attempted suicide, and 56.2% for PTSD.

Right On. Source: Liz Spikel. Creative Commons

Potential Solutions to Address Gender-Based Violence

In light in of April being sexual assault awareness month, itself a form of GBV, it is essential to break through the culture of silence. Our health care system can be more active is addressing the prevention of GBV, and also the aftermath of GBV. First, providing survivors with mental health services such as counseling is critical for these women and girls to address their psychological trauma and progress with their lives. Mental health services are vital in providing survivors a voice to express themselves. Second, our health care system could potentially be a major stakeholder in identifying and stopping GBV.

“GBV is very common, but most health care providers fail to diagnose and register GBV, not only due to socio-cultural and traditional barriers, lack of time, resources and inadequate physical facilities; but even more so due to lack of awareness, knowledge and poor clinical practices with limited direct communication and failure to do a full physical examination, not to mention register and monitor the effectiveness and quality of care.”

Moving forward, there needs to be a systematic change within in the health sector. The World Bank, amongst other NGO’s, have provided approaches on how to address this issue. Some strategies to consider include, but of course not limited to:

1) Requiring GBV screenings during doctor visits to ensure early intervention
2) Train and educate health care personal about GBV to improve provider’s knowledge, medical services and attitudes towards GBV.
3) Providing survivors access to adequate infrastructure within hospitals which includes private counseling and examination rooms.

Women are approximately 50% of our global population, yet gender-based violence is one of the most prevalent and widespread human rights violations. Gender equity is an inalienable right protected in numerous human rights documents, however change will never be achievable until we break this vicious cycle of violence through education and strict policy changes. Ultimately, women have proven they are just as equally capable as men, and gender-based violence and discrimination over an uncontrollable biological factor is simply unjust.