I have been thinking about writing this for a while, usually after finding myself in yet another conversation where I am trying to explain what I mean by non-disabled privilege. I am increasingly tired of having these conversations, particularly when they are with other occupational therapists. That does not mean I am tired of talking about disability, ableism or inclusion. We need these conversations, and I will continue to be part of them. I also do not expect every occupational therapist to automatically understand what it is like to be disabled. Disabled people are not one homogeneous group, and my experience is only one experience.
What frustrates me is having to repeatedly explain the basic principle of non-disabled privilege within a profession that should already have many of the tools needed to understand it. As occupational therapists, we understand that participation is influenced by much more than what somebody’s body or mind can do. We consider environments, attitudes, systems, resources, relationships and opportunities, and we know that changing an environment can completely change somebody’s ability to participate. So why does this sometimes become so difficult to understand when the disabled person is another occupational therapist?
Privilege does not mean your life has been easy
One difficulty I encounter when talking about privilege is the assumption that describing somebody as having privilege somehow dismisses the difficulties they have experienced. That is not what non-disabled privilege means. Someone can experience poverty, racism, sexism, homophobia, trauma or other forms of inequality while still experiencing privilege in another aspect of their life. Crenshaw’s (1989) work on intersectionality helps us understand that people’s experiences cannot be reduced to one part of their identity. Different forms of advantage and disadvantage intersect. Recognising that somebody has non-disabled privilege therefore does not erase other inequalities they may experience. It simply means they are less likely to encounter particular barriers because they are not disabled.
The things you do not have to think about
For me, one of the clearest ways of understanding non-disabled privilege is to think about the things you are able not to think about. When I apply for a job, I have to consider whether I can physically access the workplace. When I am invited to speak at an event, alongside thinking about what I am going to say, I need to know whether I can get onto the stage. Staying away from home can mean studying photographs of hotel bathrooms and trying to work out whether somebody else’s definition of an accessible room will actually meet my needs. Going somewhere new involves thinking about accessible toilets, parking, transport and how I will move around once I get there.
The same applies to occupations that are meant to be about enjoyment and spending time with other people. If I want to see a play or go to a gig, only a handful of tickets may be available in the part of the venue that provides the access I need. Those tickets can sell out even when hundreds of other seats remain available. I may only be able to book a space for myself and one other person, meaning I can’t go with a larger group of friends or family the same way everyone else can. I can participate, but unwritten restrictions limit that participation. I have less choice about when I go, where I sit and who I can share that occupation with. Most non-disabled people will never know those restrictions exist because they have never needed to know.
Some occupations also have barriers so significant that I don’t seriously consider them. Travelling abroad is currently one of those for me. I do not have the energy or confidence to contemplate everything involved in travelling by plane. There is getting through the airport, transferring onto and off the aircraft and relying on assistance being available and actually meeting my needs. I would also have to hand over responsibility for my wheelchair and trust that something I rely on every day will arrive safely and in working order at the other end. For many people, thinking about travelling abroad begins with deciding where they would like to go. For me, the first question is whether I could manage everything involved in getting there. At the moment, that is enough for me not to consider it. That is something about privilege that I think we can easily miss. Barriers do not only make occupations more difficult. Sometimes they restrict our choices about how we participate, who we participate with or whether we even see an occupation as a possibility for us.
The social model of disability is particularly relevant here. Developed through the disabled people’s movement and articulated by Mike Oliver, it challenged individualised and medicalised understandings of disability by shifting attention towards the social conditions and barriers that disable people (Oliver, 1983; 1990; 2013). RCOT has also recognised the social model as aligning with occupational therapy values (RCOT, 2025). As occupational therapists, this should make sense to us. If we understand that environments and systems can disable people, we should also recognise that those same environments and systems advantage people who do not encounter those barriers.
The barrier is often only the beginning
Another, less visible part is the work involved in encountering and trying to remove a barrier. Sometimes the solution is relatively simple. It might mean moving furniture, changing a room, providing information in another format or making sure there is wheelchair access to a stage. However, as the disabled person, I am often the one who has to identify the problem, raise it, explain why it is a barrier and suggest how it could be resolved. If the proposed solution is not actually accessible, I have to explain why and start the conversation again.
I also think carefully about how I raise these issues because I don’t necessarily want somebody to feel I am accusing them of deliberately excluding me. Part of my energy therefore goes into managing the relationship as well as addressing the barrier. All of this happens before I even start doing what I was actually there to do. This is not simply my individual experience. Heffron, The and Harrison (2025), in their research with disabled occupational therapy practitioners, identified ableism at ideological, institutional, interpersonal and internalised levels. Their findings remind us that the barriers disabled occupational therapists experience cannot be understood as a series of isolated incidents. This is also why telling disabled people to “just ask if you need anything” is not enough. Of course individual access needs matter, but inclusion cannot mean waiting for disabled people to identify every barrier and then giving us responsibility for finding the solution.
Why I expect more from occupational therapy
This is probably where much of my frustration comes from. Occupational therapists already understand environments, barriers, participation and occupational choice. We understand that treating everybody exactly the same does not necessarily result in equity, and we talk about occupational justice and people’s opportunities to participate in meaningful occupations. WFOT’s position on occupational therapy and human rights places participation, inclusion and occupational justice within a human rights context and identifies a role for occupational therapists in challenging conditions that restrict participation (WFOT, 2019). Surely these principles cannot only apply to people accessing occupational therapy. They also need to shape the profession we create for occupational therapists, students, educators and researchers.
Working in a profession that supports disabled people does not make us immune to ableism. Knowing about disability professionally is not the same as living with disability, and good intentions do not prevent our systems, environments or practices from creating barriers. Ableism can exist within buildings, policies, recruitment, education, working patterns and professional expectations about what an occupational therapist should look like or how they should work. RCOT’s equity, diversity and belonging work recognises both ableism and privilege and acknowledges that inequity can operate at individual and institutional levels (RCOT, 2024; RCOT, n.d.). Rather than simply asking ourselves whether we are ableist, perhaps the more useful question is what ableism exists within the environments and systems around us, and what are we doing about it?
What I am actually asking for
I am not asking non-disabled occupational therapists to feel guilty about being non-disabled. Guilt does not make a meeting accessible, get my wheelchair onto a stage or change an inaccessible recruitment process. I am asking people to notice what they do not have to think about. Notice what has already been designed around you and which ways of working are automatically considered normal. Notice who has to ask for something different, who repeatedly has to explain why they need it and who is doing the additional work required to make an environment accessible. Then think about what you can do with the privilege you have.
Disabled people’s voices need to be central to conversations about disability and ableism, but centring lived experience should not mean making disabled people responsible for fixing ableism. There is a difference between listening to lived experience and expecting disabled people to educate everyone else. Listen when disabled colleagues tell you about barriers and believe what we are telling you. Include us in decisions that affect us, but also do your own learning. Challenge inaccessible practices when no disabled person is in the room. Think about accessibility before somebody has to ask, and when somebody identifies a barrier, resist the temptation to immediately explain why it exists or why changing it might be difficult.
Often we already understand why the barrier exists. What we need is for other people to help remove it. I do not expect perfection. I certainly do not understand every disability or every access requirement, and there will be barriers that I do not notice because they do not affect me. There will also be situations where I hold privilege that somebody else does not. Recognising privilege has to work in all directions. I expect occupational therapists to understand that participation is shaped by much more than an individual’s body or mind. I expect a profession that talks about occupational justice, equity and belonging to be prepared to look critically at inequity within itself.
Disabled occupational therapists should be part of these conversations, and our lived experience brings valuable knowledge to our profession. However, we should not have to keep providing the introductory lesson before we can move on to the harder conversations about what actually needs to change. I will keep talking about ableism and occupational justice, drawing on both my lived and professional experience to challenge occupational therapy to do better. What I am tired of doing is repeatedly explaining why non-disabled privilege exists in the first place. I would much rather we moved the conversation from asking, “What privilege do I have?” to asking, “What am I doing with the privilege I have?”
Recognising non-disabled privilege is not about feeling guilty for the barriers you do not experience. It is about noticing that those barriers exist for somebody else and recognising that they should not continually have to be the person responsible for removing them.
References
Crenshaw, K. (1989) ‘Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics’, University of Chicago Legal Forum, 1989(1), pp. 139–167.
Heffron, J.L., The, K.J. and Harrison, A. (2025) ‘Ableism in Occupational Therapy: A Critical Qualitative Analysis of Disabled Practitioners’ Experiences in the Profession’, Occupational Therapy International, 2025, article 6295789. doi: 10.1155/oti/6295789.
Oliver, M. (1983) Social Work with Disabled People. Basingstoke: Macmillan.
Oliver, M. (1990) The Politics of Disablement. Basingstoke: Macmillan.
Oliver, M. (2013) ‘The social model of disability: thirty years on’, Disability & Society, 28(7), pp. 1024–1026. doi: 10.1080/09687599.2013.818773.
Royal College of Occupational Therapists (RCOT) (2024) Equity, Diversity and Belonging Strategy 2024–2027. London: Royal College of Occupational Therapists.
Royal College of Occupational Therapists (RCOT) (2025) Equity, Diversity & Belonging HCPC Guide 2025. London: Royal College of Occupational Therapists.
Royal College of Occupational Therapists (RCOT) (n.d.) Useful EDB terminology. London: Royal College of Occupational Therapists.
World Federation of Occupational Therapists (WFOT) (2019) Occupational Therapy and Human Rights. Revised position statement. World Federation of Occupational Therapists.
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