Today, May 4th, 2024, I am attending a book launch for my very good friend and colleague, Georgia Vine. Her long-awaited book, “Occupational Therapy Disability Activism and Me,” is finally here, and I can’t wait to celebrate with her.
In true Georgia style, she has made her book launch a continuing professional development event. She has asked me to speak about my experiences as a Lead Occupational Therapist with Intersectional Characteristics.
Below are some highlights from what I plan to say. I have removed some content as it is very personal to my lived experiences and is difficult to share in such an open platform.
First and foremost, it is an honor and privilege to be asked to speak today. Normally, I do not care for the word “inspiration,” but on this occasion, I will use it because the woman whose journey we are here to celebrate is truly inspiring.
She is not only inspiring because she has cerebral palsy, which happens to be the best disability to have (although I may be biased), or because she has achieved so much at such a young age.
What truly makes her inspiring is her perseverance. She continues to overcome obstacles, shares her experiences with the world, and keeps moving forward.
I have been tasked with presenting on the concept of intersectionality and my lived experiences. Intersectionality refers to the overlap or intersections of various identity factors such as gender, race, ethnicity, sexual orientation, gender identity, ability, and class. Highlighting inequality can be complex as these factors can intersect and interact to shape individuals’ experiences of privilege and oppression in unique and intricate ways.
I would like to share some thoughts on how we can all work on challenging our own discriminatory thoughts in a friendly and positive manner, connecting the concept of intersectionality and considering its impact on our occupational therapy practice.
Let’s remember that we all have biases and prejudices, whether we are aware of them or not. It is important to take a moment to reflect on where our beliefs come from and whether they are based on stereotypes or actual experiences.
Let’s make an effort to educate ourselves about different cultures, identities, and experiences. By doing so, we can broaden our perspective and gain a better understanding of the diverse backgrounds of others.
Engaging in open and respectful conversations about discrimination with others can help us learn and grow together. It can be challenging at times, and some people may be resistant to changing their minds, but that is their burden to bear.
Let’s not forget to acknowledge our own privilege and use it to support those who may be marginalised or disadvantaged. And if we witness discrimination happening, let’s speak up and take action to address it.
Let’s remember that this is a journey of continuous learning and growth. By challenging our own discriminatory thoughts, we can contribute to creating a more inclusive society for everyone. Let’s work together to make a positive impact!
What about my privilege wheel?
I am a citizen of the United Kingdom, born in Enfield, London, but moved up north at a young age and was educated in the northeast town of Middlesbrough. There is still life expectancy, health, and education inequality in the north-south divide, but other factors also play a part here.
I am white, with a family bloodline on my father’s side being white English and on my mother’s side being white Irish. I am a cisgender woman with a strong socialist and feminist identity. I am in a committed heterosexual marriage that does not conform to traditional gender roles.
I was born with cerebral palsy, which was diagnosed when I was about two years old as I wasn’t reaching the normal physical milestones. My cerebral palsy is hemiplegia, which affects the right side of my body. In terms of cerebral palsy, it’s fairly mild but has an impact on my daily energy levels. I think I was about 13 or 14 when I realised that it wasn’t normal to be in pain every day.
One of the biggest challenges is managing my energy to engage in the occupations I want, need, and am required to do within the context of social norms around being fit and healthy. This constant battle between managing pain and staying physically active is a continuous struggle.
I hold a degree but have faced personal challenges with education throughout my academic journey. I was a statemented child at school, meaning there was a formally recognised contract with my local authority that detailed the needs and support I required, but obtaining this was not easy. There seems to be a recurring theme here.
During the transition from primary to secondary education, I encountered difficulties as the local authority initially considered placing me in a special school due to assumptions about my capabilities and cost considerations. However, my mother advocated for a tailored support package within a mainstream school.
I speak English well and can articulate my needs. However, I am neurodivergent and have a diagnosis of dyslexia. This has impacted my ability to write in the English language and has been a barrier to learning other languages and reading for pleasure.
Both my physical and mental health have been impacted throughout my life. Often, one affects the other. I have a diagnosis of depression and continue to take medication for this condition.
When it comes to accessing health and social care, there has always been a power imbalance, with healthcare professionals including occupational therapists working with a medical model that only focuses on the singular reason I am seeing them, whether it be a broken leg, COVID, or another issue. They often fail to see me as a whole person with an intersectional identity that requires personalised assessment and treatment.
I am a second-generation occupational therapist, which is a great privilege. It is often true that people follow in the footsteps of family members when it comes to a career, but having a mother well known within the profession has definitely given me an advantage.
Hopefully, I have given you thoughts that privilege and power are complex and that everyone’s experiences of discrimination will intersect with how society labels them.
We must truly see that privilege is more than just what is on the surface. There are often many factors that can impact our ability to progress in life. On the surface, I have a lot of privilege that grants me power, but how do the challenges I have faced impact the power I hold? Or is it about how I chose to navigate those experiences, knowing that it can often lead to exposure and criticism?
We just need to reflect on recent years to understand that having privilege and power can lead to unfairness, injustice, and exploitation rather than positive outcomes for everyone. When individuals or groups possess significant privilege and power, there is a risk of them using it to benefit themselves at the expense of others, perpetuating systems of oppression and marginalisation.
Privilege and power can hinder understanding and empathy towards those who do not have the same advantages. This lack of empathy can result in decisions and actions that worsen existing inequalities rather than resolving them.
It is important to acknowledge the responsibility that comes with privilege and power and to use them in ways that support equality, justice, and positive change for all members of society. This may involve actively working to dismantle oppressive systems, giving space to marginalised voices, and advocating for policies that address systemic issues.
Whenever I think about my own experiences, Maya Angelou’s words come to mind: “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
It reminds us that empathy and understanding others’ perspectives are crucial in being client-centred and maintaining a focus on personalised occupational goals.
Disability does not discriminate; it affects individuals from all walks of life. However, when disability intersects with other marginalised identities, individuals may face compounded challenges, discrimination, and inequality. This leads to disparities in accessing healthcare, education, employment, and other essential aspects of life.
My experiences as a white, middle-class, educated disabled person may be in stark contrast to another disabled person who has other marginalised characteristics.
When we apply this concept to health and social care, we uncover layers of complexity that shape individuals’ health outcomes and experiences within the system. Often, by the time a person reaches occupational therapy, they have already had to navigate barriers to services based on their intersecting identities.
To address these intersecting inequalities in health and social care, we must adopt an intersectional approach that recognises the complexities of individuals’ lived experiences. Health and social care practitioners must receive training to recognise and mitigate biases, advocate for equitable policies, and tailor care plans to meet the diverse needs of the people they work with.
Additionally, policymakers must prioritise dismantling systemic barriers to healthcare access and invest in community-based initiatives that tackle the social determinants of health.
Intersectionality is not just a theoretical concept; it is a reality that significantly influences individuals’ experiences within the health and social care system. By embracing an intersectional approach to health and social care, we can work towards a future where everyone, regardless of their intersecting identities, has equal opportunities to achieve optimal health and well-being.
Throughout my life, I have encountered challenges stemming from societal biases and ableism, which have impacted my own beliefs about my capabilities. These prejudices have been ingrained in me through interactions with caregivers, peers, organisations, and institutions.
One early memory that stands out is from my time in primary school, where I often felt excluded from social events due to doubts about my abilities to fully participate. I once was not invited to a trampolining birthday party due to the parents’ perception that I would not be able to join in. In response, I requested a trampoline birthday party for myself, even though I was uncertain about what it would involve. The point is that this memory of exclusion still evokes the same feelings of feeling different or too hard to manage.
Going away for my 30th birthday, I chose to engage in activities like raft building to encourage my friends to attend. I knew they would enjoy this activity even though it wasn’t necessarily appealing to me. I participated in the parts I could, conveying the message that I always wanted to be included and that I would figure out what I can and can’t do.
Other times, my access needs are seen as an issue for inclusion or ignored when coworkers make plans to socialise that don’t consider accessibility. I have an internal voice that always questions others’ thoughts about my abilities.
Balancing the need for accommodations for my safety with the desire to push my limits has been a constant struggle. From having personalised support in school to receiving extra time for exams and reasonable adjustments in the workplace, I have always had to advocate for the resources necessary for my success.
Ableism is a daily battle, sometimes without even realising it.
I have had to persistently advocate for the accommodations that enable me to perform at my best. This takes extra time and energy. Getting tasks done might take longer, and that has often been challenged in the workplace. This means I use a lot of my free time to catch up and be seen as achieving the same as my colleagues.
Within my career, I have experienced receiving special treatment or being judged based on my need for assistance or doing things differently. It is often expected that one demonstrates independence; however, it is important to recognise that independence does not exclude the interdependency we all share in the workplace.
The outcome is that others see me as special or inspirational, possibly in need of protection or exhibiting needy behaviour. If those involved in my education and healthcare had a better understanding of intersectionality, they may have had a more inclusive view of my needs.
The truth is that everyone has different needs and approaches due to their lived experiences, privileges, and disadvantages.
Occupational therapy is based on the belief that participating in meaningful activities is crucial for health and well-being. However, individuals’ ability to engage in these activities is influenced by various factors, including race, ethnicity, gender, sexuality, socioeconomic status, disability, and more. Recognising and addressing these intersecting identities is essential for occupational therapists to deliver effective and inclusive care.
Occupational therapy aims to promote dignity, respect, and agency for individuals with disabilities. “Inspiration porn” refers to the portrayal of people with disabilities solely for the purpose of making able-bodied individuals feel inspired or grateful for their own lives, often by highlighting their accomplishments in ways that may be objectifying or patronising.
Engaging in inspiration porn can undermine the dignity and autonomy of individuals with disabilities by reducing them to objects of pity or sources of inspiration rather than acknowledging their full humanity and agency. It can perpetuate stereotypes and reinforce societal attitudes that view people with disabilities as “less than” or in need of pity rather than respect and equal treatment.
Occupational therapists must strive to empower their clients to live fulfilling lives and participate fully in society, focusing on their strengths, goals, and individual needs rather than promoting a narrative of overcoming disability for the sake of inspiring others. By promoting inclusion, accessibility, and respect for individual autonomy, occupational therapy contributes to creating a more equitable and just society for people of all abilities.
Professor Katrian Bannigan delivered the Elizabeth Casson Memorial Lecture on April 24th, stating that the time is now for occupational therapy to lead a collective social movement as a profession, recognising that we possess the skills and knowledge to do so.
But what does this mean in practice? Occupational therapists can benefit from understanding collective social movements in various ways:
1. Social Determinants of Health: Understanding collective social movements can help occupational therapists address barriers to accessing therapy and challenge prejudices.
2. Advocacy and Empowerment: Learning from social movements can improve advocacy skills and empower marginalised clients within societal structures.
3. Cultural Competence: Occupational therapists must be culturally competent to effectively work with diverse clients, and understanding social movements can deepen cultural awareness.
4. Intersectionality and Allyship: These concepts help therapists understand and combat systemic injustice, using privilege to support marginalised groups.
5. Community Engagement: Therapists can engage with social movements to collaborate on community-based interventions and promote social inclusion and justice.
6. Policy Advocacy: Occupational therapists can participate in policy advocacy efforts to promote health equity and well-being for clients and communities.
By integrating knowledge of collective social movements into their practice, occupational therapists can effectively address the social, cultural, and political factors influencing their clients’ health and occupational participation.
The “Action on Inclusion Health Framework for NHS” focuses on addressing the health needs of marginalised populations, including the homeless, refugees, and sex workers, among others who are socially excluded. This framework aligns with intersectionality and occupational therapy principles by recognising the various forms of disadvantage individuals may experience. It emphasises person-entered care, collaboration, and advocating for social justice to reduce health disparities.
In essence, the “Action on Inclusion Health Framework for NHS” is a valuable resource for understanding and addressing the health needs of marginalised populations from an intersectional perspective. By adopting the principles and approaches outlined in this framework, occupational therapists can contribute to efforts aimed at promoting health equity, social inclusion, and meaningful participation for all individuals, regardless of their social identities or circumstances.
Overall, embracing intersectionality in occupational therapy enhances the quality of care provided to clients by promoting a more inclusive, culturally responsive, and socially just approach to practice. It allows therapists to better understand and address the complex and intersecting factors that influence clients’ health and well-being, ultimately leading to improved outcomes and greater client satisfaction.
Get the Book
Georgia’s book, “Occupational Therapy Disability Activism and Me,” is available for purchase now, featuring reflective logs in each chapter to facilitate a deeper understanding and demonstration of your learning as you engage with the material.
