* An edited version of the following article has been published as: Gill, C.J. (1997) "The last sisters: Disabled women's health" In S.B. Ruzek, V. Olesen, & A. Clarke (Eds.) Women's Health: Complexities and Differences. Columbus, OH: Ohio State University Press.

THE LAST SISTERS: HEALTH ISSUES OF WOMEN WITH DISABILITIES *
by Carol J. Gill, Ph.D.

The needs and concerns of women with disabilities are less exotic than many
nondisabled people might imagine. In fact, the health issues that women with
disabilities highlight as critical may sound unexpectedly familiar. They should
sound familiar, because they are women's health issues.

When the women's movement caught national notice almost three decades ago,
many of us with disabilities embraced feminist ideology wholeheartedly. We had
not only experienced women's unequal status but also the "special" unequal
treatment society reserved for persons with disabilities. Our multi-minority
group membership impressed in every fiber of our being that destiny was not
determined by biology. Shortly after joining the struggle for "women's
liberation," many of us also joined the newborn struggle for "disability
rights." As our consciousness grew from both involvements, we realized that
most of the barriers we faced in life were not caused by our somatic
differences any more than by our sex. The major problems we experienced were
rooted in the way society responded to us--by the way we were socially
devalued, excluded from the playing field as women, and rendered invisible both
in the health service system and health reform movements.

Criticism of the women's movement regarding its middle-class, white,
college-educated leadership is addressed by Ruzek, Clarke and Olesen in Chapter
3. Properly, many feminist organizers responded to charges of elitism and
exclusion by reaching out to poor women, undereducated women, women working in
factories and in fields and in their own homes, women of all colors and women
in the third world. Increasingly over the past decade and a half, all have been
invited to join the sisterhood. In recent years, however, the movement has
encountered a fresh challenge: Women with disabilities have added a new element
to the conscience and consciousness of the women's movement. We have pointed
out its ableism. We have complained about meetings held in inaccessible
locations with no alternate formats for blind and deaf women. We have protested
our omission from agendas proporting to cover women's concerns. We have
called for a recognition of our sociopolitical issues and perspective. We have
been uniting to write and speak to let other women know that we are here, we
are women and we are sisters.

A striking article appeared in Ms. magazine in 1992 written by Bonnie Klein, a
Canadian who acquired a disability after establishing a prominent place in the
women's movement (Klein, 1992). As the permanent effects of her stroke became
apparent, she found herself treated as an outsider at feminist gatherings-- as
if she no longer had women's issues. Her article in Ms. described her process
of connecting with other disabled women activists and her successful efforts to
remain included in feminist circles as a disabled woman. Her message to her
sisters, used as the title of her article, was "We Are Who You Are."

Paralleling Klein's analysis, the message of this chapter is that "Our health
issues are your health issues." As women, we share many major areas of health
concern with other women. In many cases, our health service needs are identical
to those of any woman. Problems arise not inherently from our disabilities but
from socially constructed barriers--such as stairways and small print--that
impede our access to services. As a minority group of women, however, some of
our health issues have a different emphasis or intensity. Thus some of our
needs may be similar, but services must be adapted to the complexities of our
disabilities. For example, a woman with a cognitive disability may need
contraceptive instructions translated into simpler language or a physically
disabled woman might need more time for an exam to accommodate her arduous
transfers from wheelchair to examination table. Further, like women in other
minority or multi-minority communities (e.g., lesbians, African Americans), we
sometimes experience "unique" health service needs deriving in two ways from
our group membership:

1) unique needs determined by actual physiological and inherently related
lifestyle differences, and 2) unique needs determined by the distinct character
of our social oppression.

The reluctance and sometimes outright resistance we have encountered from
nondisabled feminists in acknowledging us as part of the sisterhood has been
painful, but matters are improving. Particularly frustrating, because it
remains incompletely resolved, is our lack of recognition as a social minority
group. Many in the women's movement agree, when confronted by our presence,
that we deserve inclusion as women and girls "with special needs." However,
acknowledgement of our issues as sociopolitical and of our community as a
positive and viable component of women's diversity has lagged behind. Yet
until the social origin of our marginalization is appreciated as readily as it
is for other minority women's communities--until the vile impact of ableism
is understood on par with all the other "isms"--our issues, including our
health issues, will remain muddled and we will remain unequal within the
movement for women's equality. We will be viewed as damaged women instead of
women who, like others, are unfairly stereotyped, excluded and restricted on
the flimsy pretext of biology.

A clear sense of disability as a sociopolitical status, then, is the crucial
foundation to understanding the health issues of women with disabilities. Since
the general economic, social, cultural and political realities of disabled
women's lives have already been well covered (for example, in Fine's and
Asch's invaluable 1988 text, Women with Disabilities), they will not be taken
up here. Emphasis will be placed, instead, on clarifying the interface between
physiology and social/policy factors in disabled women's health needs. The
relation of those needs to the health needs of nondisabled women will also be
explored.

At times, we have been treated in health service settings as if our
disabilities set us apart from other women when they did not. Conversely, we
have sometimes been treated as if our needs were not different from average
when they were. Both types of error are trouble for us. To be effective and
responsive, our health service providers must know more about exactly how our
experiences fit into existing knowledge and planned research on women's
health.

Any authentic discussion of health issues affecting women with disabilities
will reveal two leitmotives that surface repeatedly to link seemingly disparate
topics. One theme is invisibility. Women with disabilities have been working
hard to emerge from decades of neglect in medical services and research,
including programs expressly designed to encompass the diversity of all
women's health needs. The second theme is genderlessness. When women with
disabilities write about or tell each other our stories, we inevitably exchange
complaints of feeling treated not as women at all, but as some kind of neutral
gender or nonsexual being. Feeling invisible and feeling genderless go hand in
hand; if society or the medical system or even our own sisters in the women's
movement fail to recognize our womanness, we remain invisible when women's
health issues are researched--for example, in studies of pregnancy,
contraception, menopause, and sexual abuse.

In the 1990's, women with disabilities launched a health initiative of our
own, organizing across the United States and sometimes internationally. To halt
our invisibility and degenderization, we have been publishing, presenting at
conferences, developing service, resource, and education programs and
researching our health issues at an unprecedented rate. We are taking the reins
in defining our needs, guaranteeing our options, in short, making ourselves
hard to ignore. The remainder of this chapter summarizes our efforts.

Access
Women with disabilities share with all women a history of exclusion from health
services and research that have traditionally been open to men. Moreover, many
disabled women belong to additional disenfranchised groups, serving to
undermine further their access to health programs that may benefit them.

Gender Inequity
In healthcare access, women with disabilities encounter all the problems other
women do and then some. We experience the "double whammy" of discrimination as
women and discrimination as disabled people, and often that discrimination adds
up to more than the sum of its parts. If we hold membership in racial/cultural
minorities, have a devalued sexual identity, are old or experiencing the
poverty that often comes with disability, the resulting oppression escalates.
We have had much less attention focused on our health needs compared to men
within the specialty of rehabilitation medicine. Historically, medical
rehabilitation has focused on the needs of men: soldiers returning from war
with injuries; workers who have accidents and need therapy to regain their
status as bread-winners; athletes who go down in agony while pursuing the
thrill of victory. These have been the clients whom rehabilitation was
developed to serve.

Until the last decade, most rehabilitation research, medical and psychological,
included only men as subjects. Men dominated studies of organ system
functioning in the presence of various disabilities, sexuality, vocational and
economic outcome, marital adjustment, depression, and even relationships with
children. Women with disabilities have a lot of catching up to do. Like
nondisabled women, we reject having our medical needs estimated on the basis of
data collected exclusively on men. We must achieve parity with disabled men in
access to rehabilitation medicine research and services. Concurrently, we must
ensure that women with disabilities are not left out of national research
studies focusing on the health needs of women in general. Again, we seek
visibility as minority women and inclusion as women.

Service Barriers
Like all women, we want equal access to community health services--to
preventive services and treatment. Here, many of our issues are similar if not
virtually identical to those of other women. Poverty, loss of insurance, lack
of health information and lack of transportation often keep us from getting to
health service facilities at all. Two-thirds of persons with disabilities who
wish to work are still denied jobs, and disabled women historically earn
significantly less than either disabled men or non-disabled women. Women of
color with disabilities earn even less money, and aging women with disabilities
often experience increasing social isolation and loss of support for meeting
their health needs (Fine and Asch, 1988). Thus access obstacles may be more
intense and demoralizing for us than for most women.

Women with disabilities must contend with an additional array of barriers
unique to the experience of disability in this culture. Man made physical
impediments such as stairs and narrow doorways keep us from getting into
facilities once we find them. Programmatic barriers are a problem too, such as
scheduling that does not permit us the extra time we need to move or
communicate or understand, or not having people on staff who can assist us onto
examining tables or who know how to adjust equipment such as mammography
machines to accommodate our different sizes and postures. The absence of
teletypewriters (TTY's), sign language interpreters, and information in
Braille or in audiotaped form excludes full and equal utilization of services
by deaf or blind women. Most structural and programmatic barriers are addressed
in the 1990 Americans with Disabilities Act (ADA) which mandates the removal of
discriminatory barriers in buildings, the workplace, communication systems and
transportation. Increasingly, women with disabilities are learning to use the
ADA to construct fully accessible health service programs and to counter
exclusion in existing programs.

How many women with disabilities are stopped from getting routine physical
exams and other health services by remediable physical and programmatic
barriers, poverty, lack of insurance, lack of transportation, and
discriminatory attitudes in the health service system? It is impossible to know
because there is virtually no systematic research documenting the health
service experiences of women with disabilities. Baseline information about what
kinds of health services we are getting, what kinds we are not getting, where
we are getting our services, where we would prefer getting them is just
starting to be collected. I am directing such an investigation currently
through the Health Resource Center for Women with Disabilities in Chicago.1
Much of this basic fact-finding is being led by researchers and program
directors who are, themselves, women with disabilities.

Invalidation of Sexuality and Reproductive Health
In the area of sexuality and reproductive health, as is true for our
non-disabled sisters, insuring our reproductive rights and options has been a
long struggle. Unlike non-disabled women, who emphasize the right to delay or
bypass having children, we are still fighting for the right to become mothers
at all. Society generally invalidates disabled women's sexuality. If
anything, our reproductive potential is feared. We are presumed either
incapable of producing the kind of babies society wants--healthy babies--or
incapable of adequately nurturing children.

Women with disabilities share with non-disabled women a tradition of restricted
health service options and society's efforts to control our bodies. For most
women, such external control is directed toward ensuring the birth of the next
generation and satisfying the sexual and domestic needs of men. For disabled
women, whose procreative and aesthetic functions are both devalued, the
dynamics of social control are somewhat different. By casting us in the
stereotypes of the perpetual asexual child or dried up crone, society justifies
its invasive custody over women with disabilities and the prevention of our
fertility.

We have endured a long history of medical treatment without consent, including
involuntary and concealed contraception, sterilization, and abortion. We are
routinely denied critical information regarding our bodies and treatment
options while being subjected to unexplained procedures and medications
approved by family members, judges, and professionals. Women with disabilities
who are either very young or very old, who lack social support, who are
impoverished, or who have communication or cognitive disabilities are most
likely to be treated in this manner. This kind of thinking has been the basis
of a long history of forced sterilization for women with disabilities. It has
also been one of the reasons we have so little empirical knowledge of disabled
women's reproductive health.

In research, our status parallels that of nondisabled women who are past their
reproductive years. Stereotyped as non-breeders, we are not even considered in
reproductive research agendas. Although we are the ones who have the babies,
there has been more research on the fertility and sexuality of disabled men
than disabled women!

Right now, we know enough about our reproductive health issues to know that we
need to know more. We need more scientific information about hormone system
functioning in the presence of different disabilities, fertility and
contraception, and parenting. We know, for example, that women with some
mobility disabilities are likely to have more bone loss at an earlier age than
non-disabled women. But how do treatments for osteoporosis affect us? Is
calcium supplementation safe for our kidneys if our fluid intake and
elimination patterns are affected by disability? Is estrogen replacement safe
for women of limited mobility with compromised circulation in the legs? How do
specific disabilities interact with contraceptives and with pregnancy? There is
anecdotal evidence that pregnancy can be good for certain disabilities, such as
arthritis. On the other hand, we know that traditional birthing methods can put
some women with disabilities at high risk unnecessarily. For example, some
women with spinal cord injuries have died needlessly because their physicians
failed to realize that labor contractions can provoke dysreflexia, spiking
their blood pressure to levels causing strokes (Verduyn, 1994).

Some promising studies are emerging regarding sexuality and reproductive health
issues of women with disabilities. Beverly Whipple and her colleagues are
studying the sexual response cycle in women with spinal cord injuries (Whipple
& Komisaruk, 1993). At the Rehabilitation Institute of Chicago, several
physicians are examining the interaction between disability and treatment for
osteoporosis in menopausal and post-menopausal physically disabled women.

There are also some studies planned on contraception. Women with disabilities
need much more information on how available contraceptives affect us. We also
want better methods developed--ones that leave us more in control and less
reliant on physicians than the injectable and implanted contraceptives commonly
administered to women with disabilities. A recent study of high school girls
with disabilities revealed an unexpected and alarmingly high rate of unplanned
pregnancies in learning disabled teen-age girls (Wagner et al., 1992). Such
results underscore the need for more research on how disabled girls learn about
sex and conception as well as how we can provide them with better information.
For too long it has been assumed that disabled women cannot manage
contraception. It is imperative that we learn how to manage the most effective
contraception for us, if that is what we want, and how best to have children,
if that is what we want.

Women with disabilities are, in fact, losing custody of their children because
they are presumed to be incapable parents. Only one organization, Through the
Looking Glass in Berkeley, California, has actually formulated and implemented
substantial research on the relationship between disabled persons and their
children (Kirshbaum, 1988). What they found over the past decade refutes all
the stereotypes. Not only can disabled women mother in a variety of creative
ways, but research shows that our children accept and cooperate with our
parenting styles in ways that may, in fact, enhance the mother-child
relationship and the development of the child. For example, babies may benefit
when mothers who move slowly spend extra time on childcare tasks. Such children
learn to coordinate in a matter-of-fact manner with parents who function
differently, encouraging their later acceptance of human differences.

Abuse
Perhaps the most striking and dangerous example of disabled women's
invisibility is in the area of abuse prevention, intervention and research.
Like nondisabled women, many of us are victims of assault by partners,
relatives, dates, casual acquaintances, service providers and strangers. Yet we
are rarely included in research and service programs that deal with sexual,
physical or emotional abuse of women. I have encountered a shocking level of
naiveté on this matter in day-to-day interactions with both women's
protection advocates and disability service providers. As one incredulous
rehabilitation specialist queried when told of an assault against a woman
wheelchair-user, "Does this kind of thing really happen?"

We need much more research on violence as a factor in disabled women's lives,
including attention to the interaction of disability type, race, and age in
mediating risk. From what women with disabilities report, we are at high risk
at all age levels. In fact, the limited research and anecdotal evidence that
address abuse in women with disabilities suggest that our chances of being
assaulted may be double or even greater that of nondisabled women. The
perpetrators are often the persons we rely on for daily assistance in living,
including family members, spouses, and hired personal assistants. According to
Margaret Nosek, many disabled women report being abused by professionals in
medical settings (Nosek, 1995). The sexual assault of disabled women in
residential or educational institutions, including nursing homes and group
homes for persons with cognitive or emotional disabilities, is more the rule
than the exception. Some studies have indicated that more than 90% of all women
with disabilities will experience abuse in the course of their lives (Pelka,
1993). In Canada, Dick Sobsey (1994) and the DisAbled Women's Network2 have
been doing some important data collection on assault and women with
disabilities, but we need more.

In the meantime, the facts are strong enough to demand greater attention to
women with disabilities in services and programs for violated women. We must be
more widely acknowledged as a defined minority when assault reports are filed.
Our statements about the abuse we have experienced must be respected and
believed. When we are unable to report our experiences due to fear or because
of disability-related communication difficulties, the possibility that we have
been victimized must be considered by health service providers. Women with
disabilities who advocate for peers who have been assaulted, such as Veronica
Robinson of Access Living3, say that most shelters are still inaccessible and
unaccommodating to women with mobility, sensory and cognitive disabilities. The
sad truth is that many women with disabilities are forced to stay in dangerous
situations because they have been excluded from the safe places other women
have provided for each other.

Privacy
Safeguarding our privacy against both off-handed and deliberate violation
requires continual vigilance and assertiveness. Most women with disabilities
can recount disturbing experiences of medical exams performed with doors or
curtains left ajar, information about our private lives carelessly discussed in
public places, or authorities monitoring and reporting our sexual behavior.
Another form of violation so pervasive and traumatic to us that we have labeled
it and categorized it as abuse is "public stripping": the practice of being
forced to disrobe and display our different-looking bodies in medical
educational settings (Blumberg, 1990), often before mixed audiences of
professionals and non-professionals or photographers. In a 1993 telecast of a
popular prime-time "news magazine" show, a physician pulled up the T-shirt of a
12-year-old girl with cerebral palsy and, without even speaking to her,
displayed her scoliotic back to a national television audience (NBC Now, 1993).

In writing and speaking openly about these violations, women with disabilities
have been giving each other validation of our outrage and the courage to oppose
further disrespect. Many of us have committed our efforts to educating health
professionals and family members of women and girls with disabilities about our
rights to privacy, information and choice in medical settings.

Medical negligence
All women have long been victims of systemic medical negligence, in that our
needs have remained poorly researched and our access to adequate services has
been inconsistent. Like other women, women with disabilities often feel that,
compared to men, their complaints and questions are taken less seriously by
physicians. Devalued populations are also vulnerable to additional forms of
medical negligence. For example, physicians' tendency to view disabled women
as asexual can result in failure to investigate signs of serious conditions,
including cancer, pelvic disorders, sexual dysfunction, and sexually
transmitted diseases. Women with disabilities also commonly express the
conviction that they are dehumanized or objectified in medical settings--viewed
exclusively in terms of their disabilities, not as total persons or women.

I know physicians who have openly admitted their discomfort in responding to
disabled women's complaints, particularly those involving the reproductive
system, because they felt overwhelmed by the disability and saw the other
possible health problems as secondary in importance or unwelcome complications.
Such professionals seemed disturbed by the idea that reproductive health or
sexuality would be "significant" to their disabled patients. They prejudged
childbearing to be beyond consideration for women with extensive disabilities.

Disabled women commonly complain that their health service providers evade
questions about sexuality or body image. They report that their questions about
subjects such as orgasm, pain during sex, the advisability of getting pregnant,
childbirth, breast size, cosmetic flaws, and weight gain are often brushed off.
This can be devastating to women who are already conditioned by society to feel
unattractive and invalid as women.

Mental Health
The mental health needs of women with disabilities have received little
research attention. There is no reason to believe, however, that having a
disability would in any way immunize a woman against depression or other mental
illness. In fact, if stress, social isolation, devaluation, and being deprived
of meaningful roles contribute to emotional problems in women, as many experts
believe, women with disabilities should be considered a group at particular
risk.

Stress
According to those who experience it, being female and disabled is one of the
most stressful statuses to which you can aspire. Being a woman of color or
being a lesbian with a disability may compound the stress. A huge proportion of
disabled women are poor and dealing with life without a partner. Each day, such
women must deal with access issues, transportation problems, unmet health
needs, negative messages about their attractiveness and validity as women, job
discrimination, and unfair welfare policies that threaten to reduce even
further their paltry resources.

Depression and suicide
Depression shows up in women in the general population about twice as often as
men. A recent study completed by DAWN in Canada revealed that almost two-thirds
of their sample of 391 women with disabilities had considered suicide, and
almost a third of those had attempted it (Masuda, 1994). Some observers relate
disabled women's despair to social devaluation, our high incidence of abuse,
and the fact that society largely prevents us from stepping into the desired
roles of mother, partner, and worker. Yet we are often hard pressed to locate
accessible, affordable mental health services or professionals who understand
our issues.

We may not even receive suicide prevention services. Society seems increasingly
willing to sanction the deaths of some disabled women who despair. For example,
Jack Kevorkian's first eight "clients" were all middle-aged and elderly women
with chronic disabilities or illnesses. Some feminists with disabilities are
concerned that women with chronic conditions are becoming easier to discard
just as the cost of healthcare coverage for "incurables" is being debated
nationally. The National Organization for Women in several states has endorsed
physician-assisted suicide measures. Such endorsements, spearheaded by women
who view assistance in dying as a personal choice issue, do not reflect the
views of disabled feminists who fear such measures will further oppress and
endanger women whom society already views as defective and expendable.

It is imperative that women with disabilities and incurable conditions are
included in research on depression, suicide, and other emotional problems. We
also must be guaranteed adequate intervention and support when we despair. To
be singled out as a group deserving of a hastened exit from life before our
needs are adequately understood and our life choices are guaranteed may be the
ultimate act of violence against women.

Policy
The new wave of health activism among disabled women includes opposition to
public policies that reinforce our invisibility and de-genderization. Many of
us serve on committees or join disability rights demonstrations to fight for
employment equity, accessible transportation, and universal design in the built
environment. Unless discrimination is defeated in these areas, many of us will
remain segregated--literally invisible in the mainstream--and powerless to
achieve self-determination in other aspects of life.

Since a significant proportion of women with disabilities are unmarried and
unemployed, many support the idea of universal single payer insurance that
would not be based on employment status and would not exclude "pre-existing
conditions" or deny expensive disability-related equipment. We generally oppose
any plan that would permit capitation or rationing of coverage based on
"quality of life" measures or the "irreversibility" of medical conditions, as
these criteria too easily can be used to justify withholding benefits from
persons with disabilities.

Disabled women activists also publicly denounce policies that undermine or
directly oppose our entitlement as women to have children and form families of
our own choosing. For example, we fought for the right of Sharon Kowalski, a
lesbian disabled in an accident, to live with and have her health services
monitored by her chosen lover (Thompson & Andrzejewski, 1988). We oppose state
policies that wrest custody of babies from impoverished mothers with
disabilities, such as Tiffany Callo, who cannot afford private childcare
assistance (Mathews, 1992).

For many women with disabilities, the availability of a part-time or full-time
personal assistant is the deciding factor in whether or not we are able to live
in our own homes, raise families, or go to work. The availability of such
assistance is capricious, depending on the "in-home care" policy in that
person's place of residence, since each state is allowed to set its own rules
for the use of federal funds. In many states, in-home assistance is given low
priority and citizens with disabilities must have extraordinary information and
stamina to fight the bureaucracy to qualify. Consequently, thousands of women,
men, and children with disabilities who could live in their own homes with
reasonable assistance are incarcerated as "patients" in nursing homes for which
the government pays many times what in-home personal assistance would cost.
Disability activists across the country are demanding a national personal
assistance policy that would divert funds now supporting the profitable nursing
home industry into consumer-managed assistance programs that promote
independence and dignity.

In some states, even if a woman qualifies for personal assistance funding, she
may be penalized by policies that exclude child-rearing as an "activity of
daily living" for people with disabilities. Many states pay someone to assist a
disabled person with bathing, dressing, driving, food preparation, house
cleaning, and even gardening, but strictly forbid the paid assistant from
warming a baby's bottle or helping the mother position her infant for
breast-feeding. Disabled women across the country have denounced such policies
as punitive and disrespectful of our right to parent as well as invasive of the
private working relationship between personal assistants and the disabled
persons who hire them. Due to such policies, women with disabilities who are
impoverished by job discrimination and lack of spousal support have permanently
lost custody of their children.

Federal funding policies exact an impossible price from women with disabilities
who wish to have full lives and health coverage, too. Barbara Faye Waxman, a
colleague who has developed an ingenious program to enable disabled women to
gain access to federally funded family planning services4, now faces a profound
violation of her own right to form a family. She is engaged and wants to marry.
Disabled since birth, she uses a power wheelchair and ventilator as well as a
full-time personal assistant, all expensive goods and services in our current
health system. If she remains single, Social Security disability payments will
cover her disability-related expenses. If she marries, however, her husband's
income will be considered hers, negating her eligibility for government
assistance. Without this assistance, her husband's entire salary will be
swallowed by her disability-related expenses, and their new marriage will be
subjected to the torture test of instant poverty. As she put it, "I searched
until I was 39 years old for both a job that would utilize my worldview and the
right man to love me. Now Social Security policies are forcing me to give up
one of them if I want to move and breathe!"

We need more research on the way women with disabilities are affected by public
policies. We also need more support for programs that are attempting to apply
nondiscrimination laws, such as the Americans with Disabilities Act, to secure
our rights to accessible health services, protection from abuse, mental health
support, family planning, and dignified personal assistance in our own homes.

Gaining Visibility as Women's Health Activists
Our recent efforts to organize around health issues have helped women with
disabilities become more visible to each other. This energizing process has
revitalized our determination to be included in the women's movement and
women's health agenda. We want research and services that acknowledge the
complexity of our lives--that acknowledge the sociopolitical reality of
disability in our culture rather than merely viewing us through a disease
model--but that affirm our membership in the community of all women. We expect
to continue exploring and addressing the needs of our minority community in our
mentoring programs, health advocacy and resource projects, professional
training, and research. This will not, however, impede our intention to take
our rightful place in the community of all women as we collectively work for
the quality and inclusiveness of health services we deserve.

Increasingly, we realize and want others in the women's movement to realize
that by asserting our health needs as a minority community, we are adding to a
store of information that benefits all women. Here, diversity is at its
paradoxical best. The experience of women with disabilities is set off as
"different" when we focus on the particular constellation of variables that
determine our health needs. But while the constellation, itself, may be our
signature, the variables composing it--physiological, social, psychological,
cultural, political, economic--link us inevitably and inextricably to other
women. The experience of women with disabilities, when added to the experiences
of other women, then, bring all of us an increment closer to understanding how
these forces affect our health and our lives. The added benefit of our
inclusion is that together we are all the more powerful in pushing forward our
agenda for better and more inclusive policies and services for all women.

ENDNOTES
1 For more information on this research, contact:
Carol J. Gill, Ph.D.,
Chicago Center for Disability Research,
Department of Disability and Human Development,
University of Illinois at Chicago,
1640 West Roosevelt Road (M/C 626),
Chicago, IL 60608

2 DAWN CANADA: DisAbled Women's Network Canada is an organization of and for
women with disabilities that carries out advocacy, research, education, and
related services. They can be contacted at 776 East Georgia Street, Vancouver,
BC V6A 2A3 CANADA

3 Veronica Robinson is the former Deaf Services Coordinator for the Domestic
Violence Program at Access Living, 310 S. Peoria, Suite 201, Chicago, IL 60607.

4 Barbara Faye Waxman is the creator and Director of the Americans with
Disabilities Act and Reproductive Health Project through the Family Planning
Council in California.

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