Disability and LGBTQ identities

Disability and LGBTQ+ identity can both play significant roles in the life of an individual. Disability and sexuality can often intersect, for many people being both disabled and LGBTQ+ can result in double marginalization.^[1][2] The two identities, either by themselves or in tandem, can complicate questions of discrimination (in workplaces, schools, or otherwise) and can effect access to resources such as accommodations, support groups, and elder care.

LGBTQ+ identity and its relationship to disability has also been analyzed by academics. LGBTQ+ identities have been pathologized as mental disorders by some groups, both historically and in the present.^[3][4][5] Alternatively, some activists, scholars, and researchers have suggested that under the social model of disability, society's failures to accommodate and include LGBTQ+ people makes such an identity function as a disability.^[6]

Rates of disability

In general, studies have found that LGBTQ+ populations report higher rates of disability than the general population.

In studies looking at populations in the United States, LGBTQ populations report higher rates of disability compared to the heterosexual and cisgender majorities.^[1][7][8] According to the Movement Advance Project in 2019, an estimated 3 to 5 million lesbian, gay, bisexual and transgender people in the United States have a disability.^[9] A 2022 report about the United States by the Human Rights Campaign reported that 36% of LGBTQ+ adults have self reported having a disability while 24% of non-LGBTQ adults self reported having a disability.^[10] A 2024 report on American LGBTQ youth found that 29.7% of the 3,100 youth polled were diagnosed with a disability, with these numbers being higher for trans youth (33.3%) than cisgender LGBQ+ youth (20.6%).^[11]

In a 2020 study of Australian LGBTQ people, 38% of respondents reported having at least one disability.^[12]

In a 2022 study of Canadians with disabilities, 8.7% of the disabled population also identified as 2S (two-spirit) or LGBTQ+ . The same study found that "the 2SLGBTQ+ population with disabilities is younger than the non-2SLGBTQ+ population with disabilities". Of the 2SLGBTQ+ population with disabilities, the majority (69.9%) reported a disability related to mental health.^[13]

In China, a rough estimate of cantong, or LGBTQ people with disabilities, is about 5 million people.^[14]

Academic theory

Academics writing about queer theory and disability studies have drawn from one another's work, as both examine what society deems as normal and how those people outside of that definition are treated.^[15] For example, theorist Robert McRuer has used Adrienne Rich's idea of compulsory heterosexuality to examine how society might also perpetuate "compulsory able-bodiness".^[16] In Feminist, Queer, Crip Alison Kafer's "engagement with the intersections of gender and cripping time is never stronger than in the instances where she makes explicit the mainstream responses to gendered disability narratives".^[17]

History

Until 1990, the World Health Organization classified homosexuality as a mental disorder.^[3] In 2019, the organization also removed "gender identity disorder", referring to transgender people, from the International Statistical Classification of Diseases and Related Health Problems.^[18]

United States

Street Transvestite Action Revolutionaries (STAR), a group founded by Marsha P. Johnson and Sylvia Rivera, worked both to support trans and gay people and disabled people.^[19] STAR called for the end of non-consensual psychiatric incarcerations of LGBTQ+ individuals, something Johnson had experienced in her life.^[19]

Other activists in the United States involved in both the gay rights and the disability rights movements include Kenny Fries,^[20] Barbara Jordan, and Connie Panzarino.^[21]

In the late 1970s, disabled attendees and groups were recorded at San Francisco Pride.^[22]

In the 1980s and early 1990s, the case of Sharon Kowalski was taken up by both disability and gay rights activists.^[21] Kowalski, a lesbian, had become disabled after a car accident, and her father had been awarded custody of her. Her father then moved Kowalski to a nursing home five hours away from her partner, Karen Thompson, and prevented Thompson from visiting Kowalski. In a victory for both groups of activists, the Minnesota Court of Appeals ruled that Thompson be made Kowalski's legal guardian, in line with Kowalski's wishes.

Disability Pride Month was founded in 1990, inspired by both gay and Black pride.^[21]

In June 2014, the White House hosted a panel on LGBT issues and disability.^[23]

Medical care

Until 1973, homosexuality was included in the Diagnostic and Statistical Manual of Mental Disorders.^[3][4][24] Although many gay liberation activists celebrated its removal, others were blase or wary about aligning the wider community with psychiatric associations or providers.^[25] Before its removal, both anti-psychiatric and gay liberation activists had used homosexuality's inclusion in the DSM as leverage to criticize psychiatry as a whole.^[25]

In the late 1970s, Bobbie Lea Bennett became the first trans woman to have her gender-affirming surgery covered by Medicare. Bennett, as a wheelchair user with osteogenesis imperfecta, was already covered by the policy, which forced the courts to decide whether the surgery was considered a "legitimate medical treatment"; up until this point, transgender activists trying to have their surgeries covered under the policy had to argue that being transgender, in and of itself, was a disability.^[26]

The Americans with Disabilities Act of 1990 (ADA) made disability a protected class in the United States. However, the law purposefully excluded homosexuality, bisexuality, and "[t]ransvestitism, transsexualism...[and] gender identity disorders not resulting from physical impairments" from the act's definition of disability.^[6] This exclusion has led to some cases in which prosecutors have argued that gender dysphoria is a "gender identity disorder" that therefore cannot be accommodated under the ADA.^[6] In 1998, Bragdon v. Abbott confirmed that HIV was considered a protected disability under the ADA, which has been used to protect HIV-positive individuals in years since, many of whom are members of the LGBT community.^[6]

In 2017, Kate Lynn Blatt became the first trans woman who was allowed to sue her employer under the ADA for not accommodating her gender dysphoria.^[27]

Challenges

LGBTQ+ individuals with disabilities are subject to higher rates of childhood bullying^[28] and lack of comprehensive sex education.^[28]

LGBTQ+ individuals with disabilities who are assisted by family or caregivers may have more difficulty finding time to be intimate with or have sex with their partners.^[29] Those who live in group homes might similarly have difficulties with maintaining privacy within relationships.^[29] People who cannot drive or require assistance while traveling may have more limited opportunities to attend LGBTQ+ support groups, community spaces, or events.^[29]

Limited travel opportunities may lead some disabled LGBTQ+ people, especially those living in socially conservative areas, to pursue online or long-distance relationships.^[14]

Discrimination

Medical care

In some cases, medical providers or other authorities will use a transgender person's disability status to deny them gender-affirming care, using the argument that the person is not capable enough to give informed consent for such care.^[6] Similarly, people may deny LGBTQ+ self-identification on the basis of someone's disability, particularly intellectual disability.^[30]

Alternatively, LGBTQ+ individuals may avoid seeking needed medical care, such as STI testing,^[31] or accessing disability services because of prejudiced comments or treatment by their healthcare providers.^[6][32][33] Those who do seek medical care, but do not disclose their identity, may have adverse health consequences when their identity is not taken into account by their physicians.^[33]

LGBTQ+ individuals with disabilities that need in-home care may be especially vulnerable, as they may be less likely to have family that can care for them, and nurses or other hired caregivers may make prejudiced or uneducated statements to their patients.^{[30][29][34][35][36][37]} Some individuals may choose to change their appearance or behavior so as to appear straight or cisgender to caregivers.^[34] For people who are unsure of their sexual or gender identity, caregivers or assistants may be unwilling to discuss the topic with their client.^[29]

Interpersonal relationships

Both LGBTQ+ people and people with disabilities face high rates of sexual assault compared to the general population; for people who are both LGBTQ+ and disabled, the statistics are even higher.^[8]

Employment

Limited opportunities for employment may drive some disabled LGBTQ+ people to remained closeted at work, to avoid being fired.^[14] For disabled individuals who are out, their disability and LGBTQ+ identity may further limit job opportunities.^[38]

A 2020 study of American lawyers found that nearly 60% of respondents who were both LGBTQ+ and disabled reported having experienced discrimination in the workplace related to their identities.^[39]

Intercommunity issues

A common complaint among disabled LGBTQ+ people is that the LGBTQ+ community does not discuss disability, and the disabled community does not discuss queer identities. This is particularly an issue among the LGBTQ+ movements in countries such as China^[14] and Nepal.^[38]

Within the LGBTQ+ community, accessibility remains an important issue.^[9][40] Not all LGBTQ+ community spaces, for example, have accessible buildings or parking, sign language interpretation, Braille signage, or TTY services.^[9][41] LGBTQ+ events, such as Pride events and marches, may have routes which are difficult to navigate for those in wheelchairs or using mobility devices, or spaces that are too overwhelming for those with sensory sensitivities.^[42][43] Lectures, gatherings, or film screenings may lack sign language interpretation or closed captions.^[42] This may be further complicated by limited budgets that organizations or groups have, leaving little funding to better cater to disabled people.^[44]

Ableism more widely is also an issue within the LGBTQ+ community.^[29][45][46] LGBTQ+ people with disabilities have also expressed that a focus in the community on appearance can lead to disabled people feeling excluded or undesirable as partners.^{[40][47][48][49][50][51]} Attitudes that disabled people are inherently asexual are also still prevalent.^[48]

Within disabled communities, homophobia and transphobia remain as important issues.^[40]

Related organizations

Multiple organizations have been founded that specifically aim to serve those in the LGBTQ+ community with disabilities. International organizations include Blind LGBT Pride International.^[52]

In the U.S., these include Services & Advocacy for GLBT Elders (SAGE). In the U.K., these include Brownton Abbey,^[53] Deaf Rainbow UK,^[53] ParaPride,^[48] and Regard.^[53] In Australia there is Inclusive Rainbow Voices (IRV)^[54] and Rainbow Rights & Advocacy.^[10]

In media

Disabled LGBTQ+ characters in movies and television tend to be rare; a 2021 report by GLAAD found zero such characters in any major American movie releases that year.^[55] Their 2022 report found only 27 characters - 4.5% of all counted LGBTQ+ characters - who were also disabled.^[56] However, some movies and television shows featured disabled and LGBTQ+ characters do exist, such as Margarita with a Straw (2014), about a bisexual student with cerebral palsy,^[57] Queer as Folk (2022), which features a wheelchair-using side character, and Special (2019), a series about a gay man with cerebral palsy.^[58] Such characters have also been included in some children's shows, including The Dragon Prince (2018), which has a recurring Deaf lesbian character, and Dead End: Paranormal Park (2022), which has an autistic bisexual protagonist.

Some LGBTQ+ magazines have specifically addressed a disabled audience, such as the magazine Dykes, Disability & Stuff, from Madison, Wisconsin, which was founded in the late 1980s and was published until 2001.^[59] More general LGBTQ+ magazines have also addressed disability; lesbian magazine Sinister Wisdom, for example, made "On Disability" the theme of their Winter 1989/1990 issue.^[60]

See also

• Sexuality and disability
• Homosexuality and psychology
• Disabled gay men
• Queer Crips
• List of LGBT medical organizations
• Neuroqueer theory

Further reading

• Surfus, Chris R. (April 19, 2023). "A Statistical Understanding of Disability in the LGBT Community". Statistics and Public Policy. 10 (1). doi:10.1080/2330443X.2023.2188056. S2CID 257458044.

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