DISABILITIES
or even assailed for peculiar or antisocial behavior.
Invisible disabilities can be easier in some ways than physically evident ones, but they can, equally, be more difficult. They have the advantages and disadvantages of secrecy.
The Americans with Disabilities Act, which marks its 30th anniversary this month, requires employers, businesses, public facilities, transportation and telecommunications to make accommodations for a disabled person whose physical or mental impairment interferes with one or more major life activities. While accommodating people with invisible disabilities is mandated by law, what specifically constitutes a disability is opaque, and what constitutes accommodation is just as vague. For many people, the ADA is a broad, blunt tool that does not always serve their specific needs.
The Center for Disability Rights lists the following invisible disabilities: “learning differences, deafness, autism, prosthetics, traumatic brain injury, mental health disabilities, Usher syndrome, bipolar disorder, diabetes, ADD/ADHD, fibromyalgia, arthritis, Alzheimer’s, anxiety, sleep disorder, Crohn’s disease and many more.” Posttraumatic stress disorder, epilepsy, multiple sclerosis and cystic fibrosis are other invisible disabilities. The center cautions, “Unless it is disclosed, no one knows for sure whether someone has an invisible disability.”
Because of the issue of disclosure, there is no way to track the number of people with such disabilities. There are rough approximations of the number of people with, for example, lupus or cystic fibrosis, but some of those people may view themselves as substantially disabled while others may not. According to one estimate from the World Health Organization, about 1 billion people worldwide are disabled. Of the 61 million adults in the United States with a disability, a census report found, only around 6% use visible supports such as a wheelchair or cane. The online resource Disabled World has suggested that 10% of Americans have some sort of invisible disability, including people with chronic medical conditions.
In the time of COVID-19, these numbers are certain to grow as people confront increasing physical and mental health issues.
Societal reactions to hidden disabilities can be harsh. Some parents of autistic children say that it is difficult to be in public with a neurotypical-seeming child who suddenly experiences a huge meltdown because of apparent sensory overload. People stop and stare, offer unsolicited advice or reprimand the parents for their presumed abuse or indifference in the face of their child’s outrageous behavior. People with schizophrenia have been spared some opprobrium by the invention of cellphones and earbuds: It can be hard to tell on the street who is engaged in imaginary conversation with nonexistent people. Yet while people with untreated psychoses are seldom dangerous, their behavior can be erratic and jarring, and because it is not always understood as being rooted in a mental health condition, it often provokes unpleasantness, even violence.
Wayne Connell founded the Invisible Disabilities Association in 1996 after his wife was diagnosed with multiple sclerosis and late Lyme disease. He was frustrated by the outside perception that she didn’t have a real infirmity.
People with invisible disabilities who are young or who look healthy are often accused of faking their condition or milking the system, and must fight to have their challenges acknowledged. Some women report being told that they are “too pretty or attractive to have a disability.”
People with hidden disabilities may experience significant physical or psychic pain that may not be legible to others. Ethicist N. Ann Davis has commented, “There is no reason to believe that the invisibility of a disability itself necessarily lessens its impact or makes the disability less serious.” Disability, she explained, is not “a purely factual matter” but is always being defined and redefined in relation to changing social architecture and norms. As one group of scholars put it, “Legislation is ‘one size fits all’ — invisible disabilities are not.”
The coronavirus pandemic has surfaced the particular problems faced by those with invisible disabilities. Many people who were in supported housing have left because of the risk of contagion and are now expected to care for themselves or find a family member who will take care of them. When someone who uses a walker leaves his assisted-living community, the walker is neither discarded nor confiscated, but for those whose disabilities manifest in subtler ways, the system of care is itself the prosthesis, and it has been snatched away.
Many of those who have “recovered” from COVID-19 will continue to face significant health problems for the rest of their lives. At a moment of record unemployment, disabled people are prone to face particularly steep challenges in finding work; at a time when, according to one study, nearly onethird of Americans are suffering from some form of psychological distress, including depression and anxiety, it may be hard to find a job candidate with a completely clean bill of health.
The pandemic may add to the ranks of the disabled. After this time of anguish, many people will want to return to the ostensible (and illusory) social norm of “ability” and robust well-being; we fear disability and illness now more than ever. It will not be surprising if people choose not to disclose their newly acquired limitations and instead bear the burden of secrecy. Stigma has not melted away while we’ve been in quarantine. There can be no question that accommodating disabilities is costly. Not accommodating disabled people is costly, too; when the disability is invisible, it often goes unaccommodated, ADA or no ADA.
This strategy of personal concealment serves no advantage at all: not for the person affected, for the employer or for a society deprived of the very real contributions people with invisible disabilities would otherwise stand to make.
Ethicist N. Ann Davis has commented, “There is no reason to believe that the invisibility of a disability itself necessarily lessens its impact or makes the disability less serious.”