Disabled people don't need a sex license

Everyone, including all disabled people, deserves the right to comprehensive, science-based sexual education that includes anatomy, reproduction, STIs, preventing pregnancy, including all genders and sexual orientations, and which affirms the necessity of affirmative consent for all activities.

That kind of education is important, necessary, and a human right.

HAVING SAID THAT.

The right to have sex does not depend on being adequately educated.

Two cases of disabled people being prosecuted for having sex with other consenting adult disabled people have made news recently.

Even among people who recognize this as injustice -- even among self-identified disability rights advocates -- people have responded with conditional support.

"As long as they've had sex ed," these prosecutions are wrong. Or "As long as someone is making sure they understand." Or "As long as they know how to use protection." "As long as..." some condition is met, then they should have the legal right to have consensual sex.

Again I will reiterate that yes, everyone should have comprehensive sex ed. However, sex ed is not like driver's ed. It's not a test you have to pass to get your sex license.

Abled people are not held to this standard. While, unfortunately, many abled people lack adequate sex education, in no circumstances is sex with a sexually ignorant abled person a criminal offense.

An issue I've written about in a few different contexts on this page is how denying autonomy to targeted populations (disabled people, women, young adults) is defended on the basis of "protecting" them from sexual exploitation. But autonomy can't be conditional. It's a human right for all humans.

This is aside from the practical concerns of making disabled people's right to sexuality contingent on "if they've had sex ed" -- parents and family members can intentionally deny sex education to their disabled relatives, then have their relatives' partners prosecuted.

Furthermore, what most people primarily mean by "sex ed" for disabled people is "how to prevent pregnancy" -- and while everyone absolutely should learn how to prevent pregnancy, making this a condition for the right to sexual autonomy sets the stage for disabled people's planned, wanted pregnancies to be cited as evidence of "not understanding" pregnancy prevention.

Putting conditions and limits on disabled people's right to sexual autonomy doesn't promote sex ed. It promotes disabled people's status as second-class citizens.

Hypothetical (and actual) autonomy

 Did you know that you have the power to make hypothetical scenarios pop into being faster than the most prolific of novelists could dream of?

Just say "forced medical treatment is always wrong," and people become instantly creative, coming up with convoluted scenarios in which they're absolutely sure that forced medical treatment must be necessary.

It's important to remember that these bizarre hypotheticals are always, invariably, made in bad faith. They are never genuine attempts to parse out ethical lines. They are rhetorical traps designed to imbue false "nuance" into the abolitionist position -- if you cede that involuntary treatment might be justified in whatever bizarre scenario they've dreamt up, they claim that it's therefore all just a totally hazy gray area no one has any room to judge! And if you deny that their bizarre hypothetical is justifiable grounds for forced treatment, you're proving that abolitionists are rigid and heartless monsters who don't care when "real people" (bizarre hypothetical constructs) die for our ideology! (Actual Real People suffering and dying from forced treatment are, of course, quickly dismissed as irrelevant or the products of "a few bad apples.")

Despite their transparent bad faith, some of the hypothetical arguments I've encountered most frequently are worth examining for what they reveal about their speakers' underlying beliefs about neurodivergent/Mad people.

The most common hypothetical I encounter is the person about to jump off a ledge to his death. The ledge itself is an oddly specific motif -- sometimes it's a bridge or a cliff, but it's always an imminent death by height. This is truly a bizarre hypothetical scenario to invoke as justification for forced medical treatment, because it isn't even a medical situation. There are many ways to get a desperate, possibly-suicidal person off a ledge (some of them coercive, some of them not), but none of them involve any kind of medical treatment. (Though I did recently argue with someone who claimed that the act of pulling someone off a ledge constituted "medical treatment," to which I give the honorary Mr. Fantastic Award for World's Stretchiest Reach.)

What the people invoking this scenario actually mean, of course, is that someone rescued from a ledge should then, subsequent to their rescue, be placed on some sort of forced-treatment regimen, but they're hoping to conflate that with the immediacy of an imminent life-or-death emergency.

So what does the popularity of this hypothetical argument reveal about its proponents' underlying beliefs about Mad/neurodivergent people?

First and foremost, that suicidal distress is always and only ameliorable by medical treatment. But also, because these immediate life-or-death scenarios aren't actually medical situations, the underlying assumption is that allowing a neurodivergent person to choose to go about life is equivalent to letting them fall to their death from a ledge. That the desire to refuse unwanted treatment is, essentially, a death wish.

This is tied closely to the belief that Mad/neurodivergent people are always and inherently "suffering" from our Madness/neurodivergence, that medical treatment brings relief from this suffering, and therefore, that the only reason Mad/neurodivergent people would choose to refuse treatment is that we must have some self-destructive, self-hating drive to make ourselves suffer. This is why, having set up the "hanging from a ledge" scenario, people who make this argument inevitably expand it to "risk of self-harm" (a category so broad it can mean whatever anyone wants it to mean). It's not actually about any immediate life-or-death risk; it's about "rescuing" us from the suffering they're convinced we're inexplicably inflicting on ourselves by existing.

Another hypothetical scenario often invoked is a pregnant person refusing medical interventions necessary to save the life of their unborn child (a commonly cited example is someone refusing a necessary c-section). I have to give this one credit for being, unlike the ledge-hanging person, an actual medical dilemma. The answer is pretty straightforward, though -- just as non-pregnant people cannot be compelled to donate blood or organs to save someone else's life, pregnant people cannot be compelled to use their bodies to save their future children's lives. However, like the other examples, this question reveals some interesting underlying assumptions about neurodivergent/Mad people.

Because pregnancy is associated with women, pathologization of pregnant people occurs at the intersection of neurobigotry and misogyny (I coined the word "neuromisogyny" for this purpose). The Crazy Woman is a specific cultural threat, and the Crazy Mother is even more so. In this hypothetical scenario, the rhetorical fetus is a proxy for the threat that Crazy Mothers allegedly pose to their children by existing while neurodivergent.

This is why "children of mentally ill mothers" is an actual literary genre. This is why the CDC classifies having a Mad/neurodivergent parent as an "adverse childhood experiences" alongside traumas like abuse, neglect, poverty, and death. And while abusive fathers can just be called "abusive," abusive mothers are usually called "mentally ill." So in popular imagination, an abusive mother and a neurodivergent/Mad mother are one and the same. A common term applied to this constructed supercategory of abusive mothers and Mad/neurodivergent mothers is "narcissistic," which is the opposite of the selflessness that Good Mothers are supposed to embody. (The same "Good Mother/ Bad Mother" dichotomy that classifies neurodivergent/Mad mothers as abusive for existing also places a lot of actual child abuse above criticism, because it's practiced by neurotypical Good Mothers.) So the hypothetical pregnancy emergency is used to fears and judgments of the Narcissistic Crazy Mother, the Inhuman Unwoman selfishly prioritizing herself over her child.

Another hypothetical example brought up in defense of forced treatment is "What about a person who is unconscious, choking, or otherwise unable to express consent?"

This, again, is an attempt to paint disability rights and medical autonomy advocates as heartless extremists who don't care about human life -- what kind of dispassionate ideologue would wait for verbal consent before giving CPR to an unconscious person?

Well... none. No advocates actually propose that. This is an entirely fictitious strawman. But as with the other examples, it reveals some underlying assumptions about neurodivergent/Mad people.

To begin with the most obvious point, unconscious people literally cannot communicate. They cannot give or refuse medical consent. The ethical basis for performing emergency, life-saving treatment on unconscious people is that we presume, absent evidence otherwise (like a signed advance directive) that, if they were awake and talking, they would choose to be saved.

Mad/neurodivergent people can and do communicate their wishes, either through speaking or another communication method. There is no need to speculate about what neurodivergent/Mad people "would" want, because they're right here, saying (or typing or signing) what they do want.

So the people making this analogy are equating the expressed, stated wishes of Mad/neurodivergent people to the unknowability of the wishes of someone unable to communicate.

Furthermore, while no one objects to administering emergency, life-saving treatment to unconscious people, taking advantage of a patient's unconsciousness to bypass consent for non-emergency, non-life-saving procedures is, in fact, unethical. As I'm writing this, the practice of performing non-consensual pelvic exams on unconscious people at some hospitals is being widely (and rightly) denounced.

So as with the "person hanging from a ledge" hypothetical, the attempt here is to impute the immediacy of a life-or-death emergency onto ordinary treatments that could absolutely wait for a person to give consent if, in fact, they are temporarily unable to. Because, again, the people making this argument equate "correcting" someone's "defective" brain chemistry to be as urgent and as necessary as reviving someone having a heart attack.

If someone tries to argue for forced medical treatment using these hypotheticals, or any other bizarre, bad-faith hypotheticals, we are not obligated to argue on their terms. We know that these strawmen are ridiculous and made in bad faith. We know that they know that. But we can see that they reveal what people really think about our brains -- that we're irrational, destructive, dangerous to children, and that our very existence constitutes some kind of crisis necessitating emergency action protocols. That is how aggressively we are dehumanized. By being aware of it, examining it, and pointing it out, we can try to challenge it.

Community care

 

Disabled people need a guaranteed standard of living, not dependent on whether other people individually like us. We deserve assistance from professionals who are not our friends or family. We deserve food, shelter, and healthcare on a guaranteed continuous basis, not dependent on whether anyone feels like helping us that day.

Image: Still from the cartoon "Pinky and the Brain" showing the two white white mice, Pinky and The Brain, exchanging the following dialogue:
"Charity doesn't work, Pinky"
"Not even if you call it 'community care'?"
"No"

Four models

 A rough overview and gross oversimplification of four paradigms of mental difference, written as a handy summary since I get asked about it a lot.

One is the strict behavioral/moral model paradigm. This view completely disregards brains and mental inner states in general, and is focused solely on socially normative behavior. In this view, every individual has a moral obligation to obey authority and to adhere to normative social standards of behavior -- in a family, in mainstream, top-down schools, and in a workplace as a successful seller of labor. Being constitutionally ill-suited for these structures is no excuse not to conform to them. People should be punished for failing to obey authority or conform to normative social standards, regardless of their brains or mental states.

The second is the mainstream medical model. This is the view that most influences public policy decisions in the U.S. In this view, there is such a thing as a normal, healthy type of brain. People with this type of brain are able to conform to social norms and authorities with minimal difficulty. There is some disagreement about what exactly a "healthy" brain is, but essentially, it is a brain possessing of qualities that proponents of this paradigm consider desirable -- so as is generally understood, a "healthy" brain is one conforming to American upper-middle-class, politically centrist attitudes, behaviors, ways of communicating, and ways of learning. According to this paradigm, deviations from this healthy, normal way of being are caused by physical illnesses or chemical imbalances in the structure of the brain. The solution is either medication to "correct" the "chemical imbalance," or behavioral therapy to train the brain to operate in more normative ways, or a combination of the two. Using these methods to achieve as close as possible to a normative brain is considered the morally correct and socially responsible course of action. And because this paradigm conceptualizes some brains as objectively defective, some people with such brains are unable to make reasoned, logical, correct decisions about their own brains, and should therefore be legally coerced into treatment against their will. This practice is considered both humane (because it is correcting an objective defect, the subject cannot possibly be unhappy with the result -- or rather, any unhappiness with the result can be attributed to the uncorrected defect, and is evidence that further coercive correction is needed) and necessary for public safety, since this paradigm also often equates violence and abuse with brain defects.

A third paradigm is the recovery model. This is similar to the mainstream medical model in its conception of what constitutes a normal, healthy mind, but differs from the mainstream medical model in that the recovery view adamantly rejects the premise that mental differences are caused by structural or chemical differences of the brain. Instead, this paradigm holds that deviations from the "normal, healthy mind" are caused by traumatic experiences, and that the solution is some form of trauma-informed therapy. Once the traumatic experiences are therapeutically processed and healed, the mentally deviant individual will "recover" to what this model posits is the default state of a normal, healthy mind. Like the behavioral/moral model and the mainstream medical model, the recovery model holds that a mentally deviant individual has a social responsibility to correct their deviance. But while proponents of the behavioral/moral model tend to emphasize obedience and conformity as virtues in their own right, and proponents of the mainstream medical model tend to emphasize the premise that mental deviants are incompetent to make their own decisions, proponents of recovery tend to emphasize "healthy relationships." The obligation to seek treatment is justified from the premise that exposure to people's mental differences (or, in the framework of this paradigm, "symptoms of unresolved trauma") cause emotional burdens to those around them, and that excising these mental traits is necessary to have "healthy," non-burdensome relationships.

Finally, there is the neurodiversity model, which is why this page exists. Under this paradigm, there is no such thing as a "healthy" or "normal" mind, and no such thing as an "ill" or "disordered" mind. There are just... minds. That differ from one another. That have different strengths and weaknesses, but that are not inherently better or worse than any other. If a person is ill-suited to a school, or a workplace, or a social institution, the solution is to change the social institution to be more welcoming and accommodating to all ways of being. Furthermore, since all minds are equally valid, all minds are equally competent to make decisions about their own host bodies. No one is better equipped to make a decision about an individual's body's or mind's best interests than that individual themself -- therefore, practices like forced drugging, involuntary hospitalization, and other forms of overriding individuals' bodily autonomy for their alleged "own good" are inherently unjustifiable.. In this view, neurodivergent people are not burdens; rather, the expectations of neuro-normative society are the burdens on neurodivergent people. It's important to note that this paradigm does not preclude the voluntary use of brain-altering medication or therapies. Rather, it reconceptualizes them as tools an individual may find useful for enhancing their quality of life, not as "treatments" for any kind of illness or disorder. It's also important to note that, under this paradigm, brains and emotional states are distinct from planned, chosen beliefs and behaviors (whether those beliefs and behaviors are good, bad, or neutral). No one's brain "causes" them to be a murderer or an abuser or a Nazi (or a kind and honorable person).

Because the neurodiversity model is the least popular and least well known of these, people who encounter it for the first time often mistake it for an offshoot of one of the other three. There are points of overlap -- like proponents of the behavioral/moral model, we acknowledge that humans have the capacity to make moral choices, and that no one's brain "causes" them to be a murderer or a Nazi. Like proponents of the mainstream medical model, we accept that physical, structural brain differences exist, corresponding with different ways of thinking, feeling, and learning, and that people cannot change their brain structure by force of will alone. Like proponents of the recovery model, we believe that forced drugging is abhorrent, and that material and social conditions are a much bigger factor in people's happiness or unhappiness than brain chemistry. But despite these superficial overlaps, the neurodiversity paradigm is fundamentally distinct from, and incompatible with, these other three. The neurodiversity paradigm is fundamentally radical, in the literal sense of "from the root." We challenge the root premise that mental difference needs to be changed or fixed, and switch the focus to providing tools that individuals can choose to use to connect their brains to their goals.