Earlier this month we collaborated with the organizers the Socialism Conference to put together five sessions at this year’s conference on the political economy of health and disability.

In this session, "Decolonial Disability Politics and the Left" Death Panel podcast co-hosts, Beatrice Adler-Bolton and Jules Gill-Peterson, are joined by theorist, Jasbir Puar, and Shira Hassan, who has spent decades building, documenting and participating in systems of change and support outside of the societal frameworks of oppression and exploitation. This session explores the links between disability, debility, and empire: how neoliberal framings of disability structurally exclude people disabled by ongoing colonialism and global/national/local schemes of extraction, and how to expand our conceptions of debility, disability, and capacity to include populations that don’t fit within tidy frameworks of pride and respectability.

We unfortunately were not able to capture a high quality recording of this session, "Decolonial Disability Politics and the Left," due to a technical issue. We were, however, able to create a transcript of the discussion, which is below.

Thanks to Han Olliver for our Death Panel x Socialism Conference 2023 poster image, which is being used as the cover image for this episode on platforms that support it. See the full poster below, and find and support Han's work at hanolliver.com

We unfortunately were not able to capture a high quality recording of this session, "Decolonial Disability Politics and the Left," due to a technical issue. We were, however, able to create a transcript of the discussion, which is below.

DP x S23: TRANSCRIPT
Decolonial Disability Politics and the Left

[Beginning of transcript]

Beatrice Adler-Bolton 0:38
Hello and welcome to this conversation about the connections between empire and what we understand as "disability" and the idea of "worthy" and "unworthy" needs and "worthy" and "unworthy" people. My name is Beatrice Adler-Bolton. I'm the co-author of the book Health Communism, and I'm a co-host of the Death Panel podcast, which is sponsoring this session. And I'm honored to be joined on the video screen by my comrades Jules Gill-Peterson, Jasbir Puar and Shira Hassan.

Jules Gill-Peterson is also a co-host of Death Panel podcast, and she is an Associate Professor of History at Johns Hopkins University and the author of Histories of the Transgender Child. Her next book, A Short History of Trans Misogyny is forthcoming from Verso and January. It's really good.

Jasbir Puar is the author of The Right to Maim: Debility, Capacity and Disability, published with Duke University Press, and Terrorist Assemblages: Homonationalism in Queer Times from 2007.

Shira Hassan is the co-creator of Just Practice, a capacity building project working at the intersection of transformative justice, harm reduction and collective liberation. In 2022, Haymarket Books published Saving Our Own Lives: A Liberatory Practice of Harm Reduction, which is an anthology of essays from Shira with many collaborators, telling the stories of how sex workers, drug users, Black, Indigenous and people of color, queer folks, trans, gender nonconforming and Two Spirit people are and have been building systems of change and support outside of the societal frameworks of oppression and exploitation. So today, we'll explore the links between disability, debility, and empire.

There are many ways of describing and understanding disability, debility, impairment, capacity, and who is deserving, or not deserving of the label "disabled." We'll talk about how neoliberal framings of disability, like disability pride, can structurally exclude people disabled by ongoing colonialism and global, national and local schemes of extraction. And we're going to try today as a group to kind of expand our conceptualization of disability to include an analysis of debility, capacity and imperialism. And also to talk about: how do we, as a left, think through these ideas, not in a way that reproduces liberalism and the kind of disability that serves a liberal state. But how do we sort of conceptualize our impairments, our debility, as something that can fit many more things in it, that can sort of go beyond these tidy frameworks of pride and respectability?

So we've got three presentations from our guests. We're going to start with Jasbir, then we're going to do Shira and then we're going to do Jules. And then we're going to open it up for a discussion. So, without further ado, I'm going to turn it over to you Jasbir. [ Applause ].

Jasbir Puar 5:19
It's really good to be here, I'm sorry we're not all together. I'm really thrilled to be in conversation here with these wonderful co-presenters and discussants. And really excited just about all of the organizing that Death Panel did for the Socialism Conference this year, which I think is really fantastic. So [ applause ] thanks so, so very much for that. And just in terms of a—just to offer a description, I'm a medium skinned Indian woman with very, very grey hair, wearing glasses, and a black shirt. And I've got two dogs behind me doing all sorts of things.

And here today, I'm speaking as a scholar, but also as someone who's been involved in organizing in various movements, organizing structures. I'm in conversation with folks working on these issues in Palestine, and I will be making reference to Palestine quite a bit. But I'm also kind of speaking as someone who is developing global debility studies project, specifically in conversation with scholars in South Africa, who are doing quite a bit of work on the importance of thinking about debility and disability together, especially in a settler colonial context. So that's a little bit about how I'm positioning myself today.

Jasbir Puar 7:08
And so what I thought I would do, you know, this panel, titled "Decolonial Disability Politics and the Left," which, you know, I was really curious to kind of talk through even that framing as well, in terms of just disability politics and the left. So what I thought was important to do, first of all, which is: any decolonial disability politics, I think needs to begin with thinking about what we mean by "decolonizing disability." What that is. And how disability circulates as a legal category, a category of capitalism, how it circulates in identitarian terms, how it functions in rights-based platforms. Contributing to these kinds of colonial infrastructures of rights-based and NGO models, that are actually part of colonial conditions. Not just exacerbating them, but actually, you know, the structure of colonialism, neocolonialism, and settler colonialism.

I wanted to start with an article from 2011 from Helen Meekosha, called Decolonizing Disability. This is one of the foundational works in critical disability studies that is referenced often, but I feel like the import of that article has yet to be fully taken up and absorbed. And I'm moving back and forth between disability justice organizing and also critical disability studies, and partly because critical disability studies positions itself as an activist field. So I think that relationship is also really important. But one of the things that Meekosha states in this article, Decolonizing Disability, is it that the anti-colonial and anti-war work of ending what she calls "mass impairment" has to be central to what disability is understood as in a global sense. And this is, of course, something to take seriously if we continue to rehearse this kind of oft-stated statistic that 80% of the world's disability is in the quote unquote "global south." And I use north/south very provisionally, only to kind of mark the problem of geopolitics.

And so Meekosha is very interested and kind of pushing a recognition of impairment that falls outside of the social model, for example. Falls outside of liberal "rights" framing, for example. And also the understanding that disability is produced on a daily basis in the context of mass impairment. And that that kind of production of disability needs to be fully challenged, as opposed to thinking, particularly the way liberal rights frames do, about disabled people as a kind of pre-given population. That this population is constantly being rendered on a daily basis. And there's many examples of this all over, you know, in Gaza and Syria, in Kashmir, etc, that we can bring up in that regard. And then, she further argues that, despite fears of pathologization, and a return to the medical model—because often what she understands is a kind of resistance to talking about impairment—that impairment is not something that is marginalized as "incapable" or "lacking" but impairment becomes this incredibly valuable resource that is productive for capitalism, and it's productive for empire.

And this production of impairment in the global south—you know, increasingly the acknowledgement [of impairment] is often accompanied by this kind of liberal declaration of the value of disabled life, as if critiques of colonial violence that—given that focus on the production of disability—are somehow intrinsically ableist. This has come up quite a bit in terms of recent engagement with Frantz Fanon's work. For example, amputations, and this idea that disability is something that he is rejecting or something that he is against, or that he's ableist in his scholarship. And so this is a kind of rhetorical turn, I think, that misses the force of Meekosha's point. The main concern in these contexts for many in the Global South, she argues, is that the return, or the pervasiveness, of the medical model may not be a kind of main concern. But actually, the main concern is actually embedded in the struggle to quote "end global violence in all its forms." And so she summarizes very succinctly, quote "the key debates around disability and impairment, independent living," the medical vs. social model, "care and human rights are often irrelevant to those whose major goal is survival."

Jasbir Puar 13:02
And Meekosha then also reminds us that, quote, the "anti-colonialist politics of disabled people in the majority world have yet to be documented." And my thinking around this, too, is that it also may be the case that these politics actually surface less under signs of disability rights or disability activism, or even disability justice organizing, that they may transit through anti-colonial resistance movements more generally. And this has been my experience in Palestine, that while there are localized struggles that disabled activists are mounting against the Palestinian Authority, for example, because the kind of structure for rights-based resources is always being challenged or disintegrating, etc. That disabled Palestinians understand their orientation as an anti-colonial orientation, first and foremost, right? And disability justice organizing, by and large, I think, recognizes that all colonized bodies are deemed unworthy and unfit and actively works through these tensions by valuing and prioritizing the knowledges and experiences that disabled people bring to the struggles to end ableist hate and imperial violence, rather than kind of reiterating this false binary, for example, constructed around Fanon's work.

And so the second point I wanted to bring up is just what Beatrice has already mentioned around liberal rights, and NGO frameworks. She put it quite eloquently in her prompt to me:

"the liberal disability narrative runs cover for extraction and excludes many maimed in the colonial project."

And so what I have understood this to be in my own work, in The Right to Maim, is this kind of contradictory and perverse, yet totally structurally coherent with state violence, this relationship between disability rights on one side, and the state's right to maim on the other, right? And how we square those two things. And so there's many ways in which I've laid this out in The Right to Maim. In particular, around the war on terror, and what happens with a kind of understanding of the exploitation of impairment elsewhere, that happens through the war on terror, for example, in Afghanistan and Iraq, of course, and on so many levels in so many different ways. And while there's a kind of, you know, very, very liberal discourse around empowerment, that seeks to actually, you know, I think Beatrice put it perfectly well, "runs cover" for that project of empire.

But I also wanted to talk a little bit about the notions of disability that circulate in tandem with the kind of real injuries and violence lived by colonized populations as another way in which this kind of neocolonial structure works. So, you know, I've had concern over the years, about the rise of this lexicon around crip theorizing, crip organizing, crip temporalities. And the resonance of that kind of lexicon in a context where [the] "shoot to cripple" approach to disciplining, controlling the colonized has been a policy for a very, very long time.

And so this isn't just a question about lexicon, or words, or terminology, but really: what kinds of travels those terminologies inhabit, and how they reproduce particular kinds of relationships of knowledge over others, right? Concepts such as ableism, you know, this idea that we live in an able bodied world—which also means it is a kind of meta narrative that really has a lot of variation to it in some sense. "Ableism" as a kind of blanket accusation, access and accommodation, all of these concepts are kind of necessarily re-evaluated in the context of Palestine. What is "accessible" for example in Palestine centers relationship of occupied space, colonized mobility—bus and taxi drivers, for example, are constantly conjuring shifting access maps, for example, through monitoring and assessing checkpoints that are impromptu, divided highways, the violence of Israeli occupation forces, presence of settlers, increasing drone surveillance, unexplained road closures, protests and demonstrations, etc.

So this is a kind of mapping of the way in which mobility and access become a different way of thinking about how people are in relation to space and movement as well. And here, I just wanted to kind of point out the really rich terrain and conversation that can happen between social reproduction theory and activism that needs to more forcefully engage with disability and debility, I would say, insofar as the question of how one socially reproduces is something that disability justice activists have really taken up, with important concepts such as slow scholarship and slow care, and other kinds of things that actually do make sense in terms of thinking more globally about the ways in which disability is lived. There's another kind of framing that is often used in disability organizing circuits, this distinction between "descriptively disabled" and "politically disabled" as a way of kind of marking people who are organizing under this rubric of disability or identify around disability versus those who are disabled, but do not have that kind of political, relational kind of orientation towards disability.

And I think this is also a kind of difficult distinction to maintain and perpetuate in the context of Palestine, where disability is typically invoked as a descriptor, as a kind of transactional descriptor, that's very much so related to the way funding works, the way NGOs work. The way that colonial structures of medicalization work in the region, and disability, as a descriptor, kind of incorporated into a spectrum of debilitation. And so there's not a kind of falling neatly into being either descriptively disabled or politically disabled, because sometimes the relationship—that political relationship to disability—entails refusing that lexicon, actually. That lexicon then is understood as something that has to be negotiated as part of a kind of colonial framework, right? And, you know, one of the examples that I can offer here is the work of Rita Giacaman [ Note: we are double checking whether this is the correct attribution and will update when we know definitively ], who's one of the leading public health practitioners in Palestine, who has noted for quite some time—for decades now—this kind of overdiagnosis of PTSD. And this is a much longer conversation about the problems with diagnosis in general, but also with diagnosis of PTSD.

But that what was understood as over diagnosis was, in a way, an attempt to avoid dealing with the violence of the occupation itself, by creating this kind of binarized schema of disabled and non disabled people, as opposed to understanding the kind of general quotidien violence that people are dealing with in this colonial structure of domination. And she writes, "diagnosis functions as a form of enclosure. Describing a population, for example, as traumatized, as often happens with children in Gaza, risks an extractive and deep-lived [something] relationship to war and occupation.

Jasbir Puar 22:33
And then the last thing I wanted to bring up was to talk a little bit about the question of "debility," and what it offers us, and what actually might help us think through in terms of galvanizing different kinds of networks of solidarity. My genealogy of the term debility really comes from Julie Livingston's work, who spent many years doing research on mining injuries in Botswana. And she refers to debility as "bodily infirmities that are not regarded as disability." And in this case, these bodily infirmities are largely amputations from mining work. But these are not regarded as "disability" in some sense because they are understood as "expected impairments."

And so one of the important shifts that happens here—there are many relations between debility and disability that we could map out. Debility as a kind of process, as a structure, as something that's not an identity, that's wedded to the state. And how debility is kind of obscured by liberal rights frame quite intentionally, right? And then how disability becomes this kind of exceptional recognition by the state. This is in part what Livingston is pointing out in Botswana. But insofar as disability is wedded to a politics of minoritization, "debility" really talks about the massification of bodily impairments. And this is important both in terms of a kind of historical understanding of the effects of settler colonialism and the effects of the envionment, and I'm speaking, as this point, to the research that's being done in South Africa, where disability studies and disability justice organizing is 99% white. And so there's a particular kind of epistemic foreclosure environment that scholars and activists are fighting against there, that's the kind of historical weight of apartheid and ongoing settler colonial violence. But also this massification speaks to the future.

The rise of—[as has been] statistically qualified by the World Health Organization—increasing numbers of really unstable [populations], COVID as well, and the kind of ongoing lack of public health interventions around long COVID. And also the rise of the non-lethal weapons industry, which if you start reading about it, the way that injury is being positioned—intentional injuries—being positioned as the most humane and appropriate way of handling and addressing mass political mobilization. The growth of that industry is actually quite terrifying and has been for a long time, but even just the last 10 years with the growth of what is constituted as "non-lethal" and "humane," and the discourse around them are actually quite indicative of the way in which injury is being normalized as a humane form of violence. I wanted to just end with, I wanted to mention a scholar in particular, who's doing great work on this, is Kharnita Mohamed, who's at the University of Cape Town.

I just wanted to end this kind of where I started with this question about not just decolonial disability politics and the left, but actually disability politics—just disability politics and the left. Because so much of what I've just described is being done by disability justice organizations everywhere already. Sins Invalid is a fantastic organization that has been speaking to these issues for a long time. There's a newer organization, the Abolition Disability Justice Coalition, I believe Liat Ben-Moshe is part of that, has been doing this fantastic work and understanding these approaches for quite some time. So I guess the question that I have is really about: how it is that disability seems to be an afterthought in so much left organizing, and in particular in—and this is just what I can speak to best would be academic union organizing, right? So, you know, it's very confusing to me. The basic insights of Marxist theory around surplus labor—the wearing out of the body is a constitutive function of capitalism.

Jasbir Puar 27:51
So in union organizing in academia, I'm wondering, like, where, when, and why did adequate air filtration in classrooms drop off as a fundamental demand of that union organizing, right? And become, instead, this minoritized concern again? Right, we started seeing terms like "medically compromised," you know, and it became an accommodationist frame again. And again, this is where I think that debility has the potential to create a broader alliance of people that actually understand themselves in relation to disability without reproducing that kind of binarized framing as disabled or not disabled. Because I think that disability justice organizing has done so much work to break down that binary, and that is the binary that continues to be resurrected in this kind of weird tension between labor organizing and disability justice organizing, or just the way in which disability becomes this "accommodation"—roped into an accomodationist [approach] as opposed to a structural approach.

And there's also this kind of fetishizing of intellectual labor as not debilitating, and at the same time, there's a kind of truism that people "just need to accept" about bipoc women having to take medical leave during their early years in academia—or just the early death, for example, of so many of our Black feminist scholars, you know. So there is the kind of—you know, intellectual labor is not manual labor, but it is debilitating labor and it has aspects of it that is physical as well that is debilitating. But even just to go back to kind of Marxist thinking, my generous read is that Marx wasn't just speaking about physical and manual labor when he was talking about capitalism as a machinery that needs to constantly recycle surplus labor and wear out labor and reproduce surplus labor.

And so we shouldn't continually replay that problematic binary, right? In terms of the fetishization of intellectual work. So I will stop there. [ Applause ].

Beatrice Adler-Bolton 30:48
Jasbir, thank you so much. Members of the audience may have noticed that when I made the COVID announcement, I changed the language a little bit—I dropped a line from the COVID announcement that said, the mask policy is in place to protect all of us, "especially the immunocompromised" from the risks of contracting COVID-19. And this is a really good example of [the accomodationist frame] we're talking about here.

And I really appreciate you presenting Helen's work the way you did, Helen Meekosha is a fantastic scholar. Many people in disability studies say that they've read Helen's work, and cite Helen's work, but they are not taking it up in spirit. And one of the things that I'm hoping we can sort of think about and talk about today is how a lot of the kinds of ways that disability, as an idea, as Jasbir is just laying out, you know, disability is a category to the state. And to sort of global national regimes of capital accumulation, a disabled person becomes a subject for development, for investment, for creating pathways of extraction for NGOs, for grant money to sort of flow through, right? So when we're talking about what disability politics is, right, like, are we talking about disabled people? Or are we talking about, you know, the ways that disability relative to the state is a very specific category that has really, really specific economic implications.

So I'm so excited to turn it over to Shira now. I'm really, really excited for this presentation. So I'll be quiet.

Shira Hassan 32:40
Hi, can you all hear me, okay? Okay. I'm like taking a second to scrape myself off the floor. I just so appreciate—the mind-blowingness emoji is like all over me. [ Audience laughter ]. And so I just, I'm so grateful to be in a space where we're talking about disability and Palestine at the same time. That's a conversation I crave and don't often have the access to. So I just want to say I'm so grateful for that. And also so grateful to Haymarket, and all the co-sponsors and Death Panel for making not only the conference as accessible as possible, but also this presentation.

It's such a joy to see all your beautiful masked faces. It's not something I get to see anymore. And for a lot of reasons, and one of them is because of my own disability. I have several, and some of them are mental health related. And so I'm just unable to even be physically present with you for a number of reasons. But I want to—my topic is really about my community and the community that I come from. The only real scholarship that I have on it is just sort of the obsessive story collection that I've been doing since I was a young person and the people who are around me. And I think this is a big part of the culture of liberatory harm reduction and peer work, and peer survival work which I'm going to talk a little bit about.

So first, who am I how do I enter this work? I am someone with experience in the sex trade and street economy, especially as a young person. Later I identified as a sex worker. And a drug user is always who I am, and always who I've been. And I come from a family where that was also true and very complicated. And I am historically a part of a whole community that has intentionally defined themselves as "peer." I'm going to talk a little bit more about the term "peer," which has become co-opted by public health, but I want to talk first about what it actually means in the world that I'm from. And then we'll talk a little about the way that that's been taken advantage of. So I think like a lot of you in the room, some of the peer work that I do is just natural and and ad hoc, meaning we're not a part of a clear formation, but we're friends that are deeper than friends, because we're bound by common values. And we come together to support each other in long term ways, and especially through crisis.

And in my case, this is because we've been historically forced to function outside of state systems and we need each other to survive. So as a young person who was street-based, who was trading sex for money, and who was using drugs, turning to any kind of state system, whether that was healthcare, social service, or, you know, those many recommendations that we would constantly get to call the police for help or call the police to rescue us—those were non-options, because of the level of institutional violence that we not only experience on a daily basis, but knew we would experience, sort of like, the next level up if you call them yourself, you know? That's a whole nother level.

Shira Hassan 37:45
So the groups that I've sort of intentionally been a part of, and that have explicitly named themselves as "peer" for a political reason, were NYPAEC, which was started by Edith Springer, who's one of the people considered kind of the godmother of harm reduction—NYPAEC was New York Peer AIDS Education Coalition that was functioning in New York City from 1989 through 2000; Young Women's Empowerment Project (YWEP), which is another—all these projects were BIPOC centered and YWEP was BIPOC-led as well. And they were all led by and for people in the sex trade, some identified as sex workers, some, you know, things happen and you get paid. And then drug users, for sure, especially people who are injecting and smoking crack. And also people with various kinds of identities around mental health, either people who identified as psychiatric survivors or people who really embrace the importance, of the diagnoses they got for a lot of reasons that were in some cases validating, and in other cases, horrible.

I've also been really glad to be a part of 12 Step project that was led by harm reductionists, which I know to many of you who are familiar with both 12 Step and harm reduction, you sort of think of those as opposites. But they are actually beautifully blended in a lot of places when done intentionally. And so I have been very grateful, for the experience of being a part of those spaces, which is another explicitly peer-based space. And there's a really important reason why so many of the BIPOC and harm reduction spaces did so explicitly work to reclaim a lot of the principles of 12 Step including what some of you may be familiar with is intentionally apolitical, and bring that politics back into the room.

Before I was 18, I was also part of Our Team and StreetWorks project, in New York City, which was another intentional peer project. I can also argue, and I would love to hear what other folks think about this, if you were a part of INCITE!—women of color and people of color against violence—that it was a peer-based network of sorts. But I don't remember it identifying that way at the time. But I do think like, in retrospect, that was a lot of what I was bringing to it. And so maybe I just read myself into it in a way that wasn't exactly accurate. But anyway, those are the network of formations. And you know, peer formations come together for so many reasons. But again, people in the sex trade street economy, people who have multiple disabilities, who are mental health survivors, psychiatric survivors, queer and trans communities, and other survivors of violence, who are targeted and criminalized and actively stigmatized—our peer formations are intentionally politicized in response to the fact that our lives are graded to be thrown away. ... Yeah—it, it's just heartbreaking.

So I think this political lineage of care work—...deeply political work to invest in our survival in such a literal and meaningful way. So I think if you want to learn a lot more about all of the particulars of the political lineage of peer-based work, I think Saving Our Own Lives does our—I do my absolute best to try to document that. But I wanted to just also describe liberatory harm reduction. And why I think it's so critical to disconnect harm reduction from public health. In my world, liberatory harm reduction looks radically different from a lot of public health harm reduction. And in fact, public health co-opted people's practice of survival. And so I make the distinction between what I call public health harm reduction—which by the way, I want to exist, right, like I want all the access that public health harm reduction wants to give us, I also want a million things more than just that.

And I also want us to have access to our version of liberatory harm reduction that is not tied up in institutional liability, that is not tied up with meaningless diagnoses that are only meaningful in terms of being able to act as an institution sometimes. And institutional access is sort of inextricably tied to some of these diagnoses that I want us to be as free as we want to be from—but I also know, certainly in my case, diagnosis has also given me a lot of clarity. And so if there's a way to interact with all of this and still just let the fuck go of public health, and really remember where liberatory harm reduction comes from. So it's not new. It's decades. It comes from decades of revolutionary practice, arguably, centuries.

This goes with the definition that I'm going to just read from the book. Saving Our Own Lives was written in reflection with queer and trans activists and practitioners. Almost all of them BIPOC, some of them, I've been lucky enough to be in practice with for 30 years, and I spoke to them—as I was trying to sift and sort through these distinctions, because I was raised as a collective thinker, like in my peer communities, a lot of the other things that we do talk to each other all the time and try to reason out what we're experiencing. And so everyone who was a part of this definition I'm going to name has either worked in harm reduction, or has been in harm reduction themselves as a young person, or as an organizer, and we've all been working to end violence without the state and social services even before that was called abolition or transformative justice, using harm reduction strategies. So these concepts and ideas were reviewed and refined and written by Erica Woodland, Priya Rai, adrienne maree brown, Monique Tula, Kelli Dorsey, Emi Koyama, Micah Hobbes Frazier, Benji Hart, La Tony Alvarado-Rivera, Bonsai Bermúdez, Mayadet Patitucci Cruz, Sarah Daoud, Xavier MaatRa, Dominique Morgan, Monica Jones, Andrea J. Ritchie, Mariame Kaba, Deana Lewis, Rachel Caïdor, Dominique McKinney, Kelly McGowan, and Dr. Laura Janine Mintz.

Shira Hassan 46:28
And so I offer this with humility. Like everything I say, you know, we're just working with what we got, and the full hope and expectation that it will change over time, as it's honed by activists and practitioners that are trying to really name this intangible way that we keep each other alive, and how that philosophy becomes a practice. Or actually, the other way around. In liberatory harm reduction, the practice becomes a philosophy.

So as Dominique Morgan said to me at one point, “liberatory harm reduction is grace in practice.”

So what is it? [Liberatory harm reduction is] a philosophy and set of empowerment-based practices that teach us how to accompany each other as we transform the root causes of harm in our lives. We put our values into action using real life strategies to reduce the negative health, legal and social consequences that result from criminalized and stigmatized life experiences, such as drug use, sex, the sex trade, sex work, intimate partner violence, self injury, eating disorders, and any other survival strategies deemed morally or socially unacceptable. Liberatory harm reductionists support each other and our communities without judgment, stigma, coercion, and we do not force others to change. We envision a world without racism, capitalism, patriarchy, misogyny, ableism, transphobia, policing, surveillance and any other system of violence. Liberatory harm reduction is true self determination, and total body autonomy. The idea of keeping our communities safe from harm, through the practices of abundance, love and welcoming each other, as full people is deeply rooted in the cultural practices of many BIPOC communities that find ways to survive. And I'm specifically talking about the United States because that's where I've lived. And I'm talking about a lot of urban settings too, just to be clear. The risks of harm that we're reducing come from long term impacts of structural violence on our bodies, on our families and communities.

And one of the key differences between public health harm reduction and liberatory harm reduction is that the latter builds collective power through the unabashed and unconditional support of self determination and body autonomy. This practice reflects that support for our individual control over the choices that we make and builds our resilience and becomes the basis for being in control of our choices that goes beyond the individuals and encompass all about surviving and becoming our groundswell together.

Shira Hassan 49:17
So I want to talk for a second about peer work and what that is. It is fraught. It's also my whole heart, and the whole reason why I'm alive even this very minute. And it's a term that, unfortunately, has been slowly co-opted by public health and the nonprofit industrial complex. I do think it's important that we fight this co-optation and retain the political lineage of peer to peer work that can be traced back generations to every liberatory movement. And in most of the ones that I grew up in, we used sort of the definition of peer which is movable—like you can create your own truth about what is "peer" in your setting. But I do think the key pieces are that it exists outside the charity model, and that it operates between people who share the same walks of life and multiple intersecting and overlapping identities. It's nearly always unpaid work. And it is often intentional in that you're saying you're doing this on purpose, but it can be ad hoc, like I was talking about earlier.

I think that the term here remains precious. I think it remains radical. And I think it's critical, especially now to understand it as something that happens outside the carceral mainstream services that so many of us who share the identities that I have, and that I named, are sort of forced to interact with. I think it's also even important, especially in this time, to distinguish a little bit. And I've been in a lot of conversation with a dear friend, Dean Spade, around the distinction between peer-based work and mutual aid work. There's like a huge venn diagram and they overlap tremendously. So I'm not trying to like say "this is that" and then like, get really rigid around it. But there is—they do have differences, that I think, as you're forming your work, it's sort of important to know.

And I've been writing a piece that is coming out in October, called Painting the Ocean and the Sky, to try to name some of the nuances and these distinctions as we continue to create formations that honor our survival and that are anti carceral. And through the abolition organizing that we've been doing to end prisons and police, through the creation of responses that create opportunities for us to avoid, leave out, these systems at every turn—because as you already know, policing is so enmeshed in healthcare, so enmeshed in domestic violence services, that we really need our own alternatives. So there is a difference between peer-based work and mutual aid work that isn't peer based. A lot of mutual aid work is. And frankly, a lot of the peer work that we were doing before that word came to be—the terminology of mutual aid, we just didn't use that language but that's what we were doing, we were doing mutual aid work as peers.

And a lot of that has shifted a little bit since 2020, where mutual aid work is often solidarity-based, which is incredible and important and that's not a critique. But there's a difference between solidarity work and work that is done by each other. Right? And so, some of that nuance is really critical, because of the power differential that comes up there. So if I'm 16, and you're 16, and we're both trading sex for money, and we come together intentionally, to support each other, and the girls in our area that has a completely different power distribution than a solidarity group, who organizes to make sure that we have condoms and socks. Which I want. I want your condoms and socks. [ Audience laughter ] And I want the solidarity group to assist. But it is important to understand those power differentials. Not all mutual aid work is solidarity work. A lot of it is peer work. But I think it's critical to just sit with those distinctions. Because I would argue that even if—well, I'm not going to make that argument today. We don't have time. But I do think it's important. And I wrote more about that in something that'll hopefully be out in October.

So I think one critical piece that I want to name is what do we actually do? And so there are so many overlapping qualities, like I said, between peer to peer work and mutual aid groups. There's no absolutes, they occur inside one another. They can both be liberatory. They can both be radical. They can both change the game in your immediate peer world. And neither is better. And they're kind of best when combined. But I think that it's good to know that when it's peer-led, there's by-and-for that is different, and that is critical.

And so it goes beyond neighbors helping neighbors and into safe housing, into crisis response. We have done so much interrupting intimate partner violence, domestic violence and immediate sexual assault crisis response, as well as longterm crisis, sexual assault, support work for people. Overdose interventions, including Naloxone, those were started by the peer-based communities and peer-based organizers. Hormone support, including sharing hormones and keeping libraries of hormones, including places where people can learn to shoot and use hormones and drugs. Safe places to get high and be high. Sex worker safety, including childcare support, legal support, date support. I also want to make a plug for representation. I used to be in rooms where we were all sex workers. And now I'm in rooms where I'm often the only one who's able to name that that's a part of my history, and a really important part of my life and a really important part of my community. And there is something very sad about that, because there's a lot of reasons why people can't name that. But I do think there's a criticalness in making sure that sex workers are present in conversations that are often naming them, but not named by themselves.

I think in some cases, we've been able to do things like food sharing and other resource sharing, sometimes organized in one place. And there's these incredible bridge projects that exist now that are amazing. And some of those are mutual aid based, and some of them are peer based. And some of them are neighborhood based. And support with accessing health care, including emergency rooms, disability support, especially going through mental health crisis. There's been a really interesting rise in respite projects. And in the beginning, they were peer based. And now they're becoming a part of the nonprofit industrial complex. And because I want so many people to have alternatives to psychiatric health, I'm not mad that there's more responses period. But I will be really mad if we lose our peer responses, and they get sacrificed and co-opted, again.

We need so much mental health respite. There's also the daily reality of support that we need when we get off our meds. Alongside sort of like the ongoing truth that our bodies are different, sometimes minute to minute. And there's this belief that bodies are always the same. And so how we support each other on an ongoing basis, where we change the access needs based on who is in the room. Today, 10 minutes ago when we started meeting, versus like, the static, "this is what accessibility looks like and it's the only thing it can ever look like," feels like really, all of that is critical life saving peer work. So I just want to end by saying that, I believe in each other's survival. And I want us to stay actively in love with each other's survival.

Liberatory harm reduction was started by queer and trans people, it was started by sex workers. It was started by Black, Indigenous, people of color who wanted us to survive. It was started by people who were deemed disposable, who redeemed crazy. And we are here now, many of us, because of the legacy of that work that was passed on, and was so intentionally taught to us as a method of survival. And so the more we can remember and stay in love with each other's survival, the more I think we can have these conversations that get us closer to naming all of these important intricacies and complexities. So thank you. [ Audience applause ].

Beatrice Adler-Bolton 59:10
Shira, thank you so much. This really builds on the conversation we had yesterday [ Resisting Carceral Sanism ] with Leah Harris and Liat Ben-Moshe. I know there are a lot of questions sort of after that, of like "who is a peer?" "What is a peer?" Right? And our comrade Diana shared the experience of being trained as a survivor, as a peer worker, but then, you know, being sort of sucked up into one of these nonprofit quote unquote "peer work" projects where it's like, the work that they were doing was cleaning stuff, or things like that, you know, where it's a kind of really perfunctory transactional relationship to the idea of "peer."

And a lot of what we're sort of looking at today is like, so, you know, some people are allowed to be disabled. Sometimes you're not allowed to be disabled, sometimes using your diagnosis can get you access to services. But sometimes using your diagnosis can get you criminalized and could deny you access to services or the means to survival. Right? So it's like, when it comes to thinking through, you know, diagnosis, pathology, medication, right, like so often the left is like—the conversation is very reductive that we have, right? It can be like, maybe an anti-medication-only stance, or maybe, you know, it's medication's fine, "but it's overprescribed and we're seeing all of these people who are being overdiagnosed," right? And what all that's actually sort of looking at and actually talking about is the way that diagnosis functions for capital. Right?

And it doesn't necessarily function for our own survival in the same way, but when we talk about diagnosis equaling survival, right, that limits a lot of the options that we could iterate on, a lot of the different projects, you know, things cannot only be limited to the care, the treatment, the you know, shelter, whatever that an insurance company is going to pay for, that the NIH is going to write a grant for the, WHO, or the World Trade Organization is gonna fund, right? Like if we think about this category, in terms of like, how it functions to not just the US state, but the kind of global regime. This is like a tremendous way that, you know, quote, unquote, "vulnerable populations" are a tremendous avenue for capital accumulation, for the building of power, for things like public health and medicine, global trade regimes, etc. And none of that power is ever transferred to the people who supposedly need the care, that target population that gets that grant money, right? So I'm going to toss it over to Jules, but Shira, thank you so much.

Jules Gill-Peterson 1:02:08
Hi everyone and thank you. I’m grateful to be in dialogue with people who have contributed so much to how I think, including in what I want to share right now, which is a snippet of thoughts on the internationalization of gender self-determination and the WPATH brand of trans medicalization as gold standards in a global trans human rights project that is, I simply want to say, built on a colonial and disability edifice.

The context or motive for the critique is a concern for what I’d maybe call the reactionary liberalism and idealized gender politics that have flourished as flaccid responses to openly authoritarian and fascist anti-trans political attack in a range of different national contexts. The reaction of “trans rights” or “it’s just healthcare” tends to rationalize, if not alibi, an investment in colonial kinds of state recognition through coercive incorporation into regimes in which the optimization of some genders comes through the abandonment and policing of other ways of life. This is often accomplished through NGO and social service delivery to a generic transgender subject or population that then becomes a new layer of anti-democratic government; and, finally, I want to say something about their promotion of an ethnocentric medical model for valuing what gets called gender.

To be more concrete: If the psychiatric concept of “gender identity” is the privileged expert and vernacular framework for trans subjectivity, then “gender self-determination” is its companion mode for political assertion. Both emerged in the global north, but they are exported and entrenched through international human rights rubrics, NGOs, and various national trans movements.

In its liberal, statist version, gender self-determination is really just “gender self-identification”, the aspirational standard for laws on the books stretching from Canada to Nepal. The Yogyakarta Principles, the prototype for these laws, characterize gender self-determination as an individual right to state recognition, mainly through bureaucratic self-ID. The Yogyakarta Principles couch self-determination in the Western, liberal legal principle of bodily autonomy. While its implementation expands in some regions of the world, gender self-ID is also imperiled in countries like the US and UK, where anti-trans political movements, in concert with anti-abortion campaigners, are gleefully destroying the right to privacy on which it relies.

The imperative of gender identity manifests as a middle-class commandment to inhabit a psychologically consistent private self and experience a fantasy of seamlessness between that self and the world. This is precisely the subject who would best self-ID to the state. The impossibility of realizing this threshold is, I think, one reason that gender self-ID manifestly fails to deliver anything particularly useful, excluding both trans and non-trans people who cannot, or do not want to mirror its abstractions. In the UK, for example, the outrageous process of acquiring that frankly demeaning piece of paper called a Gender Recognition Certificate has meant, even before the Tories and Labor party stoked a moral panic around it, that embarrassingly few people ever obtained one.

In Argentina, travesti activists strongly opposed the country’s 2012 Ley de Identidad de Género authored out of the Yogyakarta Principles because its codification of Male and Female as the only grounds for trans inclusion explicitly excluded many travestis. That law, importantly, also codified a preference for the WPATH medical model into the Argentinian state, a protocol that completely ignored many of the ways that travesties have tended to alter their bodies. In the US, meanwhile, I’ve been tracking with Death Panel the disturbing codification of WPATH as an unaccountable layer of government through private insurance providers’ reliance on its standards of care for coverage, as well as in federal court injunctions on state laws banning gender affirming care for minors and adults.

What bothers me about the medical model is not just the neocolonial designs of universalizing an indefensible diagnostic and treatment model developed precisely through the United States and Europe’s relationships with countries like Mexico, Morocco, and Thailand, but also the emphasis on trans medicalization and state recognition as tools of social and economic rehabilitation--rehabilitation into privatized citizenship and a gendered division of labor that smooths national participation in the global division of labor, any deviation from which the state effectively deems an impairment to flows of capital.

The point of transition under these gold standards isn’t psychological at all, despite what gender identity commands; it’s meant to push populations into the labor market, get them out of mutual aid and informal economies, and to outflank a multitude of kinship structures, religious ways of life, and political movements in which they otherwise might participate. This process has been underway for at least a century since trans medicine’s modern form grew out of the German homosexual emancipation movement, but more speculatively and presently, I’m also asking whether there’s a kind of pseudo-shock-doctrine unfolding right now, to play with Naomi Klein’s term; one through which state power, institutional medicine, and the NGO-industrial complex are securing a coercive and ethnocentric schema for rehabilitating countless different ways of life into something small and productive we call “trans” by obliging self-determination through gender—and all of this as if it were the antithesis of anti-trans authoritarianism, rather than its kissing cousin.

Beatrice Adler-Bolton 1:11:10
Thank you all so much. This has been awesome for me and I'm sure I can tell from the audience I can feel the good vibes. This has been a really, really fun series of three talks. You know, I planned it out in my head and I hoped it would be like this but then actually living through it has been so fucking fun. So thank you both. All three of you for so much. I want to open it up for discussion. I know we got started late. …

[End of transcript, remainder of the session focused on discussion between panelists and participants which has not been shared to preserve privacy of participants]