INVERSE INTEGRATION AND THE RELATIONAL DEFICIT OF DISABILITY RIGHTS LAW

INVERSE INTEGRATION AND THE RELATIONAL DEFICIT OF DISABILITY RIGHTS LAW

Integration has long been a central tenet of U.S. disability law. In both doctrine and scholarship, however, disability integration has been understood to operate in only one direction: integrating disabled persons into mainstream society. This conventional approach has overlooked a different model, inverse integration, whereby nondisabled persons enter or participate in disability-focused settings or activities. As this Article demonstrates, inverse integration is surprisingly popular. For example, nondisabled children study in special education programs, nondisabled persons reside in housing projects for disabled individuals, hearing actors perform in Deaf theaters, and nondisabled athletes compete in wheelchair sports.

This Article develops a typology of inverse-integration practices and analyzes the interaction of such practices with existing U.S. disability law. It shows that legal and social norms generally hinder the involvement of nondisabled persons in disabled spaces or activities. Against this backdrop, the seeming popularity of inverse integration is a puzzle. What is driving this practice? The answer, this Article argues, involves interpersonal relationships. Combining insights from various disciplines, this Article demonstrates how inverse integration fosters relationships by allowing disabled and nondisabled persons to share experiences, interests, and common language with family members, friends, and significant others. These interactive features of inverse integration, in turn, highlight disability law’s failure to protect and facilitate interpersonal relationships, which is particularly problematic in an increasingly lonely society.

Drawing upon instances of inverse integration, this Article imagines what a more relational disability rights regime would look like and proposes specific interventions.

The full text of this Article can be found by clicking the PDF link to the left.

Introduction

More than a decade ago, a beer commercial featured a group of people playing wheelchair basketball. 1 @CaSjUs212, Guinness Beer Wheelchairs Basketball Commercial, YouTube (Sept. 6, 2013), https://www.youtube.com/watch?v=iiB3YNTcsAA (on file with the Columbia Law Review). In the ad, the game is raucous. The players shout, push, collide, and fall out of their chairs. Their shirts are soaked in sweat. When the game ends, however, all but one of the players stand up out of their chairs and walk off the court. It turns out that only one participant actually needs a wheelchair. This image, together with a voice-over about “loyalty” and “commitment,” suggests that this is a story about companionship. If one of the friends cannot run, the rest will play in wheelchairs.

While the commercial’s portrayal of disability drew both criticism and praise, 2 Compare Just One of the Guys—A Critique of the Wheelchair Basketball Guinness Commercial, Emily Ladau: Blog (Sept. 5, 2013), https://emilyladau.com/2013/09/just-one-of-the-guys/ [https://perma.cc/JY2N-K42U] [hereinafter Ladau, Just One of the Guys] (arguing that the ad depicts disabled persons as “needing kindhearted non-disabled people to pay them some attention”), with Aaron Taube, An Incredible New Guinness Ad Breaks the Industry Stereotype, Bus. Insider (Sept. 5, 2013), https://www.businessinsider.com/​new-guinness-ad-breaks-the-mold-2013-9 [https://perma.cc/WU68-NKHA] (lauding the ad for portraying the nondisabled friends as kind and sensitive). For further engagement with Ladau’s critique, see infra section II.A.1. one marketing aspect does not seem to be in dispute: the use of surprise. After all, most viewers probably did not expect to see individuals using wheelchairs for reasons unrelated to physical impairment. Indeed, in the popular imagination, disability integration generally goes in only one direction: integrating disabled 3 This Article will use identity-first language (“disabled persons”), rather than people-first language (“people with disabilities”), for the same reasons explained by Emily Ladau. See Emily Ladau, Demystifying Disability: What to Know, What to Say, and How to Be an Ally 10–13 (2021) [hereinafter Ladau, Demystifying Disability] (explaining that identity-first language “is all about acknowledging disability as part of what makes a person who they are”). people into mainstream society. People 4 This includes legal scholars. The few law professors who have discussed inverse integration in their work have generally done so without treating it as a distinct phenomenon. See Ruth Colker, When Is Separate Unequal? A Disability Perspective 6 (2009) (describing an inverse-integration practice employed by the preschool of the author’s son); Martha Minow, Making All the Difference: Inclusion, Exclusion, and American Law 85, 95–96 (1990) [hereinafter Minow, All the Difference] (proposing several practices that may constitute inverse integration, although not by that name); Yaron Covo, Reversing Reverse Mainstreaming, 75 Stan. L. Rev. 601, 615–61 (2023) (documenting and criticizing the way in which inverse integration in education has been implemented in the United States); Elizabeth F. Emens, Integrating Accommodation, 156 U. Pa. L. Rev. 839, 866 (2008) [hereinafter Emens, Integrating Accommodation] (noting that the question of whether “including nondisabled people in contexts principally populated by people with disabilities” could counteract stigma “deserves an empirical study”). rarely think about what this paper calls inverse integration, 5 A note on terminology: Some disability scholars and advocates prefer to use “inclusion” rather than “integration.” Covo, supra note 4, at 604 n.1. In the disability context, inclusion usually refers to changing societal structures and conventions by creating “communities of acceptance and support” that would be open to people “of varying abilities and social identities.” Scot Danforth & Phyllis Jones, From Special Education to Integration to Genuine Inclusion, in Foundations in Inclusive Education Research 1, 2 (Chris Forlin, Phyllis Jones & Scot Danforth, eds., 2015). In other words, inclusion is an ideology. The practices described in this Article, however, do not necessarily subscribe to this ideology. Thus, the word “inclusion” would be inappropriate for the purposes of this Article. a term that refers to nondisabled persons participating in disability-focused settings, frameworks, or activities.

Inverse integration may be surprising, but it is neither rare nor entire­ly new. In the past three decades, for example, an increasing number of high schools and colleges have started offering American Sign Language (ASL) courses to hearing students. 6 Russell S. Rosen, American Sign Language: Access, Benefits, and Quality, 1 Soc’y Am. Sign Language J. 6, 11 (2017) [hereinafter Rosen, American Sign Language] (noting that the number of U.S. national research universities recognizing ASL as a foreign language that meets the undergraduate admission requirements has grown from 48 in 1991 to 181 in 2015). For the reasons why teaching hearing people sign language may constitute inverse integration, see infra notes 73–75, 176–178 and accompanying text. As a result, ASL is currently the third most studied “foreign language” 7 On whether ASL should be considered a “foreign” language, see Brenda Jo Brueggemann, Deaf Subjects: Between Identities and Places 26–27 (2009); Russell S. Rosen, American Sign Language as a Foreign Language in U.S. High Schools: State of the Art, 92 Mod. Language J. 10, 11–12 (2008) [hereinafter Rosen, ASL as a Foreign Language]; Sign Language: A Way to Talk, but Is It Foreign?, N.Y. Times, Jan. 8, 1992, at B7 (on file with the Columbia Law Review). in higher education. 8 Dennis Looney & Natalia Lusin, Enrollments in Languages Other Than English in United States Institutions of Higher Education, Summer 2016 and Fall 2016: Final Report 6, Mod. Language Ass’n (June 2019), https://www.mla.org/content/download/110154/​file/2016-Enrollments-Final-Report.pdf [https://perma.cc/T7U9-M3BP]. Other examples abound: Nondisabled persons reside in housing projects for disabled individ­uals, 9 One example is the trend of integrating higher education students into elder care facilities and senior care homes. Such projects, offered by colleges and universities across the United States, often involve the provision of affordable housing arrangements for students who volunteer in cultural events with seniors, some of whom are disabled. See, e.g., Meet the 26-Year-Old Living in a Retirement Home, ABC News (Sept. 20, 2016), https://abcnews.go.com/Lifestyle/meet-26-year-living-retirement-home/​story?id=42222728 [https://perma.cc/AWG5-A8KY] (describing a program whereby music students join retirement communities where it is common “to see someone in a wheelchair”); Cathy Free, One Roommate Is 85, the Other Is 27. Such Arrangements Are Growing., Wash. Post (July 15, 2022), https://www.washingtonpost.com/lifestyle/2022/​07/15/multigenerational-housing-roommates-nesterly-senior/ (on file with the Columbia Law Review) (describing the move of a music student into a senior living community, where many of the residents “have limited mobility” (quoting Arlene DeVries)); see also infra note 168 and accompanying text (discussing other forms of inverse integration in housing). nondisabled students participate in “special educa­tion” pro­grams, 10 As early as the mid-nineteenth century, educators have included nondisabled children in classrooms designed for disabled students, a practice that is still widely used today. See Covo, supra note 4, at 616–17. hearing actors perform in Deaf theaters, 11 From the early days of the National Theatre of the Deaf in the late 1960s, it included hearing actors. See Carol Padden & Tom Humphries, Inside Deaf Culture 101–02, 108, 112 (2005) (“The hearing actors were given their own lines to sign . . . .”). Other theaters have followed suit, and today some Deaf theaters include both Deaf and hearing actors. Jessica Gelt, Deaf West Artistic Director David Kurs: Why Deaf Actors Should Be Cast to Play Deaf Characters, L.A. Times (July 13, 2017), https://www.latimes.com/​entertainment/arts/la-ca-cm-authenticity-deaf-west-20170713-story.html (on file with the Columbia Law Review) (noting that Deaf West Theatre includes Deaf and hearing actors); Heather Skyler, A Theater Experience for the Deaf and the Hearing, UGAToday (July 8, 2019), https://news.uga.edu/hands-in-theater-for-deaf-hearing/ [https://perma.cc/​F7EQ-4JB3] (“Both Deaf and hearing actors perform, but everyone signs their lines . . . .”). For more on the inclusion of hearing actors in Deaf theaters, see infra notes 278–282 and accompanying text. This Article distinguishes between the terms “Deaf,” which recognizes the cultural aspects of deafness, and “deaf,” which refers to deafness as an audiological matter. See Brueggemann, supra note 7, at 9–15. and, as the beer commercial illustrates, nondisabled athletes engage in wheelchair sports. 12 Whether nondisabled persons should be permitted to participate in competitive wheelchair sports has been in dispute for several decades. Currently, nondisabled athletes are not allowed to compete in the U.S. National Wheelchair Basketball Association or the Paralympics. See infra note 150 and accompanying text. In Canada and other countries, however, nondisabled athletes compete “at the highest levels of the sport.” Carl Bialik, Seeking Integration in Wheelchair Basketball, Wall St. J. (Sept. 7, 2012), https://www.wsj.com/articles/BL-DFB-19093 (on file with the Columbia Law Review) (describing the participation of nondisabled athletes in Canada’s wheelchair basketball league); see also Stefan Nestler, Wheelchair Basketball: How Disabled Do You Have to Be?, Deutsche Welle (Mar. 8, 2020), https://www.dw.com/en/wheelchair-basketball-how-disabled-do-you-have-to-be/a-54406662 [https://perma.cc/S555-DBTZ] (noting that nondisabled athletes are allowed to participate in Germany’s wheelchair basketball competitions); Rebecca Ramsden, Rick Hayman, Paul Potrac & Florentina Johanna Hettinga, Sport Participation for People With Disabilities: Exploring the Potential of Reverse Integration and Inclusion Through Wheelchair Basketball, Int’l J. Env’t Rsch. & Pub. Health, Jan. 30, 2023, at 1, 2 (noting that, in the United Kingdom, “21% of players in the national league are said to be non-disabled”). Moreover, in the United States, nondisabled persons sometimes participate in wheelchair basketball and other disability-focused sports at the recreational level. See, e.g., Mary A. Hums, Samuel H. Schmidt, Andrew Novak & Eli A. Wolff, Universal Design: Moving the Americans With Disabilities Act From Access to Inclusion, 26 J. Legal Aspects Sport 36, 46 (2016) (describing the participation of nondisabled children in a baseball league for disabled children); Community-Based Sports, Adaptive Sports Ohio, https://adaptivesportsohio.org/​community-based-sports/ [https://perma.cc/UM37-7E77] (last visited Jan. 22, 2024) (“Often, non-disabled family members and friends join in on the fun at our recreational drop-in [wheelchair basketball] sessions.”).

The seeming popularity of inverse-integration practices is a puzzle, however, since both legal and social norms seem to push in the opposite direction. On the legal side, disability rights law advances a “main­streaming” model of integration, 13 Jasmine E. Harris, The Aesthetics of Disability, 119 Colum. L. Rev. 895, 904–11, 921–22 (2019) [hereinafter Harris, The Aesthetics of Disability]; see also infra section I.A. which focuses on allowing disabled persons to enter predominantly nondisabled spaces. On the social side, disability rights advocates are often suspicious of initiatives in which the presence of nondisabled persons has the potential to disrupt the dynamics of disability-focused spaces or siphon opportunities and resources away from disabled persons. 14 See infra section II.A.1. To be clear, these suspicions do not necessarily translate into a wholesale rejection of inverse integration. See infra note 20 (noting support for inverse integration by disabled persons in some contexts). And then, of course, there is the fact that mainstream society still stigmatizes disability, which means that nondisabled persons are often reluctant to engage with disability culture in the first place. 15 See infra section II.A.2.

Thus, if legal and social norms are not driving inverse integration, then what is? This Article argues that what may motivate some disabled persons to invite nondisabled persons into disabled spaces, and what propels some nondisabled persons to enter those spaces, is the need to establish close interpersonal relationships. 16 See infra Part III. For example, inverse integration allows disabled and nondisabled persons to share experiences, interests, and common language with family members, friends, and intimate partners. 17 See infra Part III.

This understanding, in turn, sheds new light on the problems with the existing disability rights framework. Specifically, this Article reveals the relational deficit of traditional integration. While some scholars have noted that disability rights statutes are focused on commercial transactions rather than “humane relationships,” 18 E.g., Adam M. Samaha, Opening and Reopening: Dealing With Disability in the Post-Pandemic World, Slate (July 6, 2021), https://slate.com/technology/2021/07/​pandemic-disability-reopening-essay.html [https://perma.cc/5XDM-PQGT]; see also infra section IV.A (describing the relational deficit of disability rights law). this Article conceptualizes this issue as a systemic feature of disability rights law. By juxtaposing inverse integration against the existing framework, this Article opens the door to an examination of how the law can better promote and cultivate interpersonal relationships. 19 By close interpersonal relationships, this Article refers to interactions between individuals that involve interpersonal communication, reciprocity, and shared experiences. See infra Part III.

This is not to suggest, however, that we should give up on traditional integration or that inverse integration itself can end disability discrimination. In fact, even though some disabled persons find inverse integration desirable, 20 See, e.g., Nancy Spencer-Cavaliere & Danielle Peers, “What’s the Difference?” Women’s Wheelchair Basketball, Reverse Integration and the Question(ing) of Disability, 28 Adapted Physical Activity Q. 291, 304–06 (2011) (finding, based on a qualitative study, that disabled wheelchair-basketball players support inverse integration in sports, albeit not at the elite level); Ramsden et al., supra note 12, at 1, 5 (same); see also Samuel J. Supalla, Anita Small & Joanne S. Cripps, American Sign Language for Everyone: Considerations for Universal Design and Youth Identity, 4 Soc’y Am. Sign Language J. 43, 50 (2020) (advocating universal instruction of ASL to both deaf and hearing students); John Loeppky, Where Do Able-Bodied Athletes Belong in Wheelchair Basketball?, Defector ( July 14, 2021), https://defector.com/where-do-able-bodied-athletes-belong-in-wheelchair-basketball/ [http://perma.cc/A8JJ-VRSY] (quoting Mak Nong, a disabled professional athlete, as supporting the inclusion of nondisabled players in competitive wheelchair basketball); infra notes 221–225 and accompanying text (discussing a Deaf person’s support of hearing people learning ASL).
Other disabled scholars and activists have also provided indirect and implicit support for the concept. See, e.g., Haben Girma, Haben: The Deafblind Woman Who Conquered Harvard Law 49, 124 (2019) (“Blind hide-and-seek beats sighted hide-and-seek. It’s more challenging, more exciting, more fun. We could give sighted people sleepshades and teach it to them.” (emphasis added)); M. Leona Godin, There Plant Eyes: A Personal and Cultural History of Blindness 145 (2021) (“[R]eading and writing braille can be learned not only by the blind but by the sighted as well. Motivation is the key.”); Tobin Siebers, Disability Theory 93–94 (2008) (“[A]ll worlds should be accessible to everyone, but it is up to individuals to decide whether they will enter these worlds.”); Mia Mingus, Access Intimacy, Interdependence and Disability Justice, Leaving Evidence (Apr. 12, 2017), https://leavingevidence.wordpress.com/2017/04/12/access-intimacy-interdependence-and-disability-justice/ [https://perma.cc/NRY5-WKGV] (“The power of access intimacy is that it reorients our approach from one where disabled people are expected to squeeze into able bodied people’s world, and instead calls upon able bodied people to inhabit our world.”).
it may, in some cases, be detrimental to the disability community. Inverse integration can, for example, potentially involve tokenism, co-optation, or cultural appropriation. 21 See infra section II.A.1. Thus, rather than promoting inverse integration, this Article has the following three goals: (1) to identify interpersonal relationships as the underlying principle that likely drives inverse integration, (2) to use this relationality principle to test the normative underpinnings of conventional integration, and (3) to show how current disability law could benefit from the incorporation of this principle. 22 See infra Parts IV–V (arguing that U.S. disability rights laws suffer from a relational deficit and proposing a number of principles for incorporating relationality into these laws).

Studying a relationship-based model of integration is particularly exigent given that in-person interactions are becoming less frequent. 23 Vivek H. Murthy, Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community 13, 16, 19–20 (2023), https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf [https://perma.cc/3DCE-6SPU] [hereinafter Murthy, Our Epidemic of Loneliness and Isolation]. Indeed, despite research establishing the significance of relationships for individual well-being 24 See, e.g., Clare Huntington, Failure to Flourish: How Law Undermines Family Relationships 6 (2014) (“From ancient philosophers to modern psychologists, there is widespread agreement that strong, stable, positive relationships are essential for human growth and well-being.”); Murthy, Our Epidemic of Loneliness and Isolation, supra note 23, at 23–34 (reviewing scientific studies showing that social connection (1) “decreases the risk of premature death,” (2) is associated with “better self-rated health and disease management among individuals with diabetes,” and (3) may protect against depression, suicidal behavior, and the risk of dementia); Elizabeth F. Emens, Intimate Discrimination: The State’s Role in the Accidents of Sex and Love, 122 Harv. L. Rev. 1307, 1374–76 (2009) [hereinafter Emens, Intimate Discrimination] (surveying studies showing that intimate relationships and marriage are correlated with improved health and increased lifespan, happiness, and satisfaction); Julianne Holt-Lunstad, Timothy B. Smith, Mark Baker, Tyler Harris & David Stephenson, Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review, 10 Persps. on Psych. Sci. 227, 236 (2015) (estimating that “heightened risk for mortality from a lack of social relationships is greater than that from obesity” (citing Katherine M. Flegal, Brian K. Kit, Heather Orpana & Barry I. Graubard, Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories, 309 JAMA 71, 71–82 (2013))). and workforce participation, 25 See Tom Shakespeare, Disability Rights and Wrongs Revisited 189 (2d ed. 2014) (describing the workforce as a valuable network); Emens, Intimate Discrimination, supra note 24, at 1377; see also Samaha, supra note 18 (“I got my first post-college job when a friend was hired first and he left the impression that we were a package deal.”). people in the United States today experience high rates of loneliness and social isolation. 26 See Murthy, Our Epidemic of Loneliness and Isolation, supra note 23, at 4, 13, 22, 45; infra notes 331–332 and accompanying text. And this burden falls disproportionally on disabled persons, 27 Murthy, Our Epidemic of Loneliness and Isolation, supra note 23, at 19; infra notes 333–340 and accompanying text. This is not to suggest that disabled persons are the only ones who suffer from loneliness and social isolation. See infra notes 331–332 and accompanying text. Nor is it to say that disabled persons are the sole beneficiaries of relationships with nondisabled persons. See, e.g., Eva Feder Kittay, At Home With My Daughter, in Americans With Disabilities: Exploring Implications of the Law for Individuals and Institutions 64, 73 (Leslie Pickering Francis & Anita Silvers eds., 2000) (“In the case of my daughter, her dependence is most prominent, but nonetheless, I depend on her as well—on her welcome when I return home[,] . . . on her laughter to remind me of sunshine when I’m overburdened with commitments and sadness, on her love when I feel alone.”). Moreover, many disabled persons are satisfied with their social lives; others may actually favor more independent lives that involve less interference from family members and care workers. Andrew Pulrang, Disabled People Have Unique Perspectives on Solitude, Forbes (Mar. 25, 2020), https://www.forbes.com/sites/​andrewpulrang/2020/03/25/disabled-people-have-unique-perspectives-on-solitude/?sh=52938f2b5e73 (on file with the Columbia Law Review). who may be the only people in their families or communities with the specific type of impairment in question. 28 Unlike disabled persons, members of other marginalized groups—people of color, women, and members of low-income families—are more likely to share experiences, networks, or neighborhoods with people who share the same identities. Shakespeare, supra note 25, at 191; Ruth Colker, The Disability Integration Presumption: Thirty Years Later, 154 U. Pa. L. Rev. 789, 835–36 (2006) [hereinafter Colker, The Disability Integration Presumption]. Of course, disability often intersects with other identity axes, which means that drawing distinctions between disabled persons and members of other social groups can be analytically misguided. See Jamelia Morgan, On the Relationship Between Race and Disability, 58 Harv. C.R.-C.L. L. Rev. 663, 665–67 (2023) [hereinafter Morgan, Relationship Between Race and Disability]; see also infra notes 325–327 and accompanying text (describing the Disability Justice movement, which centers on intersectionality). In addition, families in which more than one person is disabled are not rare. But much of this Article’s focus is on the ways in which integration measures interact with specific impairments, as opposed to disability more generally. This focus raises an interesting question whether a situation in which a person with one type of impairment engages in a disability-focused activity associated with another impairment (e.g., a deaf person who plays wheelchair basketball) meets the definition of inverse integration. Although the definition proposed in this Article refers specifically to nondisabled persons, as a theoretical matter, the answer might be yes. See infra note 405 (describing how activist and author Simi Linton, who is a sighted wheelchair user, participated in a museum “blind people’s tour,” in which people are allowed to touch artwork). Drawing upon instances of inverse integration, this Article imagines what a more relational disability rights regime would look like and proposes specific legal and policy interventions.

This Article proceeds in five parts. Part I defines and elucidates the concept of inverse integration. It explains that the definition of inverse integration relies on three elements, each construed broadly: disability, focus, and integration. Part II explores the interaction between inverse integration and legal and social norms. It shows that social norms and the law are not the primary drivers of inverse integration. In fact, they often hinder the involvement of nondisabled persons in disabled spaces or activities. On the basis of this observation, Part II concludes that there must be another principle that facilitates inverse-integration practices. In Part III, this Article suggests a possible driver: the need to foster interpersonal relationships. Specifically, this Article posits that inverse integration offers unique relational opportunities by promoting three primary elements of interpersonal relationships: communication, shared experiences, and reciprocity.

Recognizing the relational advantages of inverse integration, Part IV uses it as a lens through which to evaluate traditional integration. This analysis shows that the mainstreaming model of integration suffers from a relational deficit in that it generally fails to protect, facilitate, and reinforce interpersonal relationships between disabled and nondisabled persons. Thus, the analysis of inverse integration serves as a vehicle to identify the flaws in disability rights law and shows the importance of incorporating relationality into the disability integration regime at the structural level. Last, Part V proposes legal and policy interventions aimed at strengthening the relational potential of disability rights laws in the United States.