Mobility injustice adds up to “impaired citizenship rights and therefore a curtailed humanhood” for PWPD (Bonehill et al., 2020, p. 342). Goffman (1963) calls this jeopardized humanhood a type of “spoiled identity,” arising from stigma: it “reduces [someone] in our minds from a whole and usual person to a tainted, discounted one” (3). Disability is highly stigmatized (Abrams, 2014; Brune et al., 2014; Goffman, 1963; Healey & Titchkosky, 2022; Hunt, 1966). Inaccessibility produces bodies which are characterized by what they cannot do, where they cannot go, and what unpleasantness they must bear, constructing disability as a debased and degraded identity category. Social scientists have examined how exclusion from public life constructs disabled people as either abject and monstrous or vulnerable and needy, diminishing their agency, autonomy, and dignity (Edwards & Imrie 2003; Hughes, 2019; Altomonte and Munson, 2020)–examples of the taken-for-granted intuitions that position them as less whole and worthy. In addition to these stigmatizing views arising from others, inaccessible infrastructure also produces moments of “self-hate and self-degradation” even “when only [PWPD] and a mirror are about” (Goffman, 1963, p. 7, emphasis mine). Even for Goffman–who has been critiqued for his narrow focus on interpersonal interactions between PWPD and what he calls “normals” (Abrams, 5)–disability stigma arises not only from hostile or condescending interactions with others but also from degrading attitudes toward the self, including those which arise from encounters between the body and infrastructure.

When I am beset by abjection, the twisted braid of affects and thoughts I call by such a name does not have, properly speaking, a definable object. The abject is not an ob-ject facing me, which I name or imagine. Nor is it an ob-jest, an otherness ceaselessly fleeing in a systematic quest of desire. What is abject is not my correlative, which, providing me with someone or something else as support, would allow me to be more or less detached and autonomous. The abject has only one quality of the object—that of being opposed to I. If the object, however, through its opposition, settles me within the fragile texture of a desire for meaning, which, as a matter of fact, makes me ceaselessly and infinitely homologous to it, what is abject, on the contrary, the jettisoned object, is radically excluded and draws me toward the place_where meaning collapses. A certain "ego" that merged with its master, a superego, has flatly driven it away. It lies outside, beyond the set, and does not seem to agree to the latter's rules of the game. And yet, from its place of banishment, the abject does not cease challenging its master. Without a sign (for him), it beseeches a discharge, a convulsion, a crying out. To each ego its object, to each superego its abject. It is not the white expanse or slack boredom of repression, not the translations and transformations of desire that wrench bodies, nights, and discourse; rather it is a brutish suffering that, "I" puts up with, sublime and devastated, for "I" deposits it to the father's account [verse au pere—pere-uersion]: I endure it, for I imagine that such is the desire of the other. A massive and sudden emergence of uncanniness, which, familiar as it might have been in an opaque and forgotten life, now harries me as radically separate, loathsome. Not me. Not that. But not nothing, either. A "something" that I do not recognize as a thing. A weight of meaninglessness, about which there is nothing insignificant, and which crushes me. On the edge of non-existence and hallucination, of a reality that, if I acknowledge it, annihilates me. There, abject and abjection are my safe-guards. The primers of my culture.

Instead of radical communities constantly asking for ways to make child sexual abuse accountability less punitive for those who perpetuate it, I would like to first see it become less punitive for the children who have endured it.

Neoliberal regimes of biocapital produce the body as never healthy enough, and thus always in a debilitated state in relation to what one’s bodily capacity is ­ imagined to be. As such, the democ­ratization of disability as an inevitable state that ­will interpellate every­one, discussed earlier, is itself a repetition of this neoliberal framework, which produces profit from precisely this logic. Aging itself is seen as debilitation, as some populations live longer but also live with more chronic illness. Regenerative medicine produces the experience of “double biological time”: as the body ages, the (unrealistic) possibility of restoring its vari­ous parts to at least an “earlier” state proliferates, and a certain promised return to capacity accompanies the experience of aging through debility. Being “better than well” emerges as the alibi for the translation of sensation and affect into symptom and thus the rationale for all types of medical intervention, manufacturing the "continual enlargement of the domain of the therapeutic."

Crip nationalism, as Nicole Markotic and Robert McRuer argue, functions as a version of national recognition that proffers conditional, tentative forms of citizenship within human rights regimes, international forums of hyperpatriotism (such as the Paralympics), and transnational activist networks. As I discuss ­later, the Americans with Disabilities Act of 1990, for example, has arguably done less to incorporate ­people with disabilities into­ labor pools and more to cultivate a privileged class of disabled citizens; this would be one variant of crip nationalism. Crip nationalism draws attention to how some forms of disability now might possibly be read as “privileged” within internal national hierarchies and within transnational liberal rights frames. In networks of globalization, examples of crip nationalism abound. Neoliberal ­human rights and biomedical rights regimes may unwittingly impose definitions, evaluation, and judgments about what disability is across geopo­liti­cal difference. In tandem with the brutal liberalism of such frameworks, resources are distributed, missionary-­style and often unevenly, with effects that reor­ga­nize as well as reiterate hierarchies of bodily debility and capacity. Disenfranchised populations are with increasing frequency recruited for projects involving biomedical, genomic, and reproductive technologies that enable forms of capacitation for few. Crip nationalism functions both by marking investments in nationalism and national location and more perniciously by relying on the specific circumstances of a location that is unmarked, unaccounted for, and deployed as transparent universalism.

Not all the powers of a visionary space through which doctors and patients, physiologists and practitioners communicated (stretched and twisted nerves, burning dryness, hardened or burnt organs, the new birth of the body in the beneficent element of cool waters) have disappeared; it is, rather, as if they had been displaced, enclosed within the singularity of the patient, in that region of ‘subjective symptoms’ that—for the doctor—defines not the mode of knowledge, but the world of objects to be known. Far from being broken, the fantasy link between knowledge and pain is reinforced by a more complex means than the mere permeability of the imagination; the presence of disease in the body, with its tensions and its burnings, the silent world of the entrails, the whole dark underside of the body lined with endless unseeing dreams, are challenged as to their objectivity by the reductive discourse of the doctor, as well as established as multiple objects meeting his positive gaze.

What the WHO definition leaves implied but unstated is that the concept of the social model requires not merely social "action" but social analysis as well. The importance of the social model as a core concept of disability studies is not only that disability is more than individual pathology and deficit but also that its meaning is more than a personal problem. Disability must be studied in its social, cultural. and historical context as much as the personal conditions of impairment and functioning must be studied in their medical and educational contexts. This does not have to be an either-or proposition. Most scholars in disability studies readily acknowledge the personal reality of impairments. Studying the social history of intellectual disability does not mean that the personal experience is irrelevant. Indeed, much recent writing has urged renewed attention to the "embodiment" of disability (Finger. 2006; Shakespeare, 2006; Siebers, 2(08). Nor does the emphasis on the social model negate the importance of medical and educational research on diagnostics, assessments, treatments, and interventions. Even with these more traditional approaches to the health and education of individuals with specific impairments, however, disability studies can contribute a social perspective from which to view and interpret scientific findings. Indeed, for most disability studies scholars, this is not really a choice. All research, all knowledge exists unavoidably in a cultural and historical context. The only choice is in how openly that context is acknowledged and explored.

Disability is not a fixed state or attribute but exists in relation to assemblages of capacity and debility, modulated across historical time, geopolitical space, institutional mandates, and discursive regimes. The globalization of disability as an identity through human rights discourses contributes to a standardization of bodily usefulness and uselessness that discounts not only the specificity of location but also the ways bodies exceed or defy identities and subjects. The non-disabled/disabled binary traverses social, geographic, and political spaces. The distinctions or parameters between disabled and non-disabled bodies shift historically, as designations between productivity, vagrancy, deviancy, illness, and labor market relations have undergone transformations from subsistence work to waged labor to hypercapitalist modes of surplus accumulation and neoliberal subject formation. They shift geographically, as varied cultural, regional, and national conceptualizations of bodily habitations and metaphysics inhabit corporeal relations differently and sometimes irreconcilably, and issues of environmental racism are prominent. They shift infrastructurally, as a wheelchair-accessible elevator becomes a completely altered vehicle of mobility, one that masks various capacities to climb stairs, in many parts of the world where power outages are a daily, if not hourly, occurrence. They shift legally, administratively, and legislatively, as rights-bearing subjects are formed and dismantled in response to health care and insurance regimes, human rights discourses, economic opportunism, and the uneven distribution of resources, medical supplies, and basic care. They shift scientifically, as prosthetic technologies of capacity, from wheelchairs to cell phones to dna testing to steroids, script and rescript what a body can, could, or should do. And they shift representationally, as discourses of multicultural diversity and plurality absorb “difference” into regimes of visibility that then reorganize sites of marginalization into subjects of privilege, indeed privileged disabled subjects.

I contend that the term “debilitation” is distinct from the term “disablement” because it foregrounds the slow wearing down of populations instead of the event of becoming disabled. While the latter concept creates and hinges on a narrative of before and after for individuals who will eventually be identified as disabled, the former comprehends those bodies that are sustained in a perpetual state of debilitation precisely through foreclosing the social, cultural, and political translation to disability. It is this tension, the tension between targeting the disabled and targeting to debilitate, the tension between being and becoming, this is the understated alliance that I push in this project. The first presumes a legitimate identification with disability that is manifest through state, market, and institutional recognition, if not subjective position: I call myself disabled. But this cannot be the end of the story, because what counts as a disability is already overdetermined by “white fragility” on one side and the racialization of bodies that are expected to endure pain, suffering, and injury on the other. As such, the latter is an understanding of biopolitical risk: to extrapolate a bit from Claudia Rankine’s prose: “I am in death’s position.” And to expand: I am in debility’s position.

"Illness is a matter of testimony. You tell somebody else — generally, somebody who has more degrees than you — how you feel, and they, ideally, have the ability to recognize in your testimony something you lack the expertise to identify. And often the body itself testifies: a doctor runs a scan or tests your blood and gets an answer. You have information, and the doctors have understanding. But this dynamic, in practice, is rarely so simple. Illness is also a social negotiation between what you have to say and what your doctor is willing to hear — and the diagnosis that results from this dynamic isn’t exactly your illness, but a mutually agreed-upon fiction."

Disability studies diagnoses the social condition of disabled people as situated between these two cultural extremes—medical specimen and supernatural vision. There is no reference to physical or cognitive difference without a conscious or unconscious materialization of its historical meanings. Thus, like all material objects, disability comes to be constructed in a cathedral-like manner, in which competing cultural aesthetics leave their impression upon its surface. The project of re-engaging the body requires efforts to resignify a multitude of stigmatizing meanings assigned to disability throughout history.

But the disabled body does not serve only as the faulty body that prompts compensatory invention schemes. Disability also promises a longed-for access to the otherworldly, because bodily aberrancy has been historically interpreted as the material signature of a divine order. Throughout European history, the extreme physical marking inscribed by bodily excess or lack seemed to demand an explanation for its "unnatural" origins. Monsters and madness threatened the maintenance of an earthly order, but also bespoke a fraternization with the otherworldly; religion's "cures" of "demoniacs" and "cripples" reaffirmed the Church's contact with the Divine.

In fact, disability studies scholars largely refused to define those bodies or conditions that were disabling, opting in favor of an understanding of disability as: That in the body which exceeds deterministic efforts to predict a life trajectory. Following the work of Julia Epstein, we point out in the introduction to The Body and Physical Difference that the ill body and the disabled body are culturally distinct entities because “diseases ‘follow a course’ and therefore prove familiar and domesticated by virtue of a belief in their determinate status (i.e., the ability to confidently narrate their future). Disability might be characterized as that which exceeds a culture’s predictive capabilities and effective interventions” (Mitchell and Snyder 1997: 3). The goal was to disrupt the seemingly objective knowledge of aberrant bodies, not through alternative readings of their material meanings— that would merely replace one interpretive system with another—but by re-invoking disability’s resistant qualities. This disruption came by way of unearthing disability’s long-standing historical associations with the grotesque or supernatural as a form of theoretical resistance.

In this emergent field, the able body is no longer characterized as merely a false quantitative ideal, as it had been in body studies, but rather as an aesthetic product of cultural forces that oppress those categorized as disabled. This subtle shift in emphasis allows humanities scholars in disability studies to extend the discussion of bodily deviance from the context of rehabilitative institutions to that of wider ranging cultural locations. For instance, Lennard J. Davis (1995) analyzes the role of institutions for the Deaf in the historical development of disability activism and community in eighteenth-century Europe. Martin Pernick (1996) analyzes the influential role of public health films in the promotion of eugenics in Chicago prior to World War II. Through readings of nineteenth- and twentieth-century U.S. literary texts and cultural spectacles such as the freak show, Rosemarie Garland Thomson (1997) argues that disabled people’s bodies have been represented as unassimilable within a normalizing biological ideology that marks the disabled body as the inferior contrast to an able-bodied, white, masculine citizenry. Paul K. Longmore (1997) assesses television genres, such as disease-of-the-week movies and telethons, to dissect mainstream representations of disability as tragedies in need of eradication or overcoming. In our own Narrative Prosthesis (Mitchell and Snyder 2000), we theorize the pervasive utility of disability to literature in Europe and the United States by discussing the long-standing artistic recourse to disability as a staple feature of characterization. Disability studies scholars have also analyzed the opportunistic use of corporeal metaphors to emblematize societal weaknesses in literary and philosophical figurations of disability.

Canguilhem’s emphasis on adaptation over deviation situated the body as a historically contingent phenomenon. Bodies were not the product of averages, but rather interdependent vessels that shaped and were shaped by their environments. Within this formulation, the proper medical study of the body would be a concise description of organismic adaptive strategies. The norm thus becomes little more than a hostile imposition upon necessarily fluctuating organisms. Canguilhem argued that anomaly offered medicine a more appropriate gauge than dysfunction because it surrendered the violence of evaluation that infused any notion of deviance. Rather than interpret bodily and cognitive differences in terms of their degree of deviation from a standardized norm, anomaly recognized difference as the neutral expression of a biologically diverse species adapting to the pressures of environmental and internal forces.

Ronell's argument hinges on a recognition of empiricism's historical achievement in diminishing the power of disability's association with the occult in the social imaginary. Whereas the nineteenth-century freak show served to turn the prurient popular interest in things supernatural into a salable commodity, medicine's ascent to power was partially tied to its ability to abate such efforts. Scientists pitted themselves against supernatural beliefs by seeking to demystify disability and other phenomena and, in turn, place the inexplicable within their control—the control of man-made systems of knowledge. Yet, despite this project of containment, Ronell points out, "horror" would inevitably resurface—in the popular-culture guise of film monsters, for example—to challenge all efforts at keeping the demons at bay. Thus, science's attempt to domesticate disability fails, in an absolute sense, because disability's historical alignment with the grotesque (that is, the belief in the mysterious power of an "unassimilable" difference) continues to reverberate into modernity.

Anything to do with gynae is, I think, liable to land you in peculiar territory. Prior to surgery, I had to take the first pregnancy test of my life despite arguing several times that there was absolutely no point in my doing this. A miracle, the nurse joked, after it came back negative. It can be alienating, trying to operate within a system which repeatedly seems surprised to look up and find you standing there. (It’s a sensation which, of course, speaks to the larger issue of ‘women’s healthcare’ being a frankly troubled term. On the one hand, issues of abortion, pregnancy and reproductive health are important facets of women’s liberation. On the other hand, I’m not hugely interested in talking about what happened to me as being in any way synonymous with being a woman, given the blindingly obvious fact that women do not all have ovaries, that ovarian cysts are not something that only happen to women and that it’s reductive to the point of laughable to yammer on about the fact of femininity as it pertains specifically to the reproductive system. I mean, did we not just come from there? Did we not all just agree that it was bad?)