How America’s Concepts of Disability and Family Were Created by Fascism

Our contemporary practice of segregating disabled family members from our lineage—and from society writ large—can be directly traced back to 20th-century German fascism. Disability studies scholars have examined in depth the origins of constructions of disability in Nazi-era rhetoric and practices. However, the effects of this fascist rhetoric on disability in families has not been examined fully—nor its reverberations on our current understandings of disability lineation. Disability’s central role in defining who is and isn’t considered family is directly linked to fascism and its aftermath.

Historian Carol Poore has examined how, unlike Jews, Communists, and other targets of dehumanization in Nazi culture, disabled people were viewed as an internal threat to “Aryan” Germans: “The existence of large numbers of degenerate ‘Aryan’ Germans endangered the hereditary health of the body politic (Volkskorper) from within.” The family, Poore notes, was the site of intense scrutiny for this internal—what we would now call genetic—contamination. German families were forced to produce family trees proving that they contained not only no Jewish ancestors but also no disabled ones. Our current rhetoric of “good genes,” and the delineating, ableist consequences of its supposed opposite for disabled people, is rooted in this fascist vision of the family.

Moreover, historians David Mitchell and Sharon Snyder have uncovered how the Nazis developed both the notion of the concentration camp and the mechanics of it in killing centers at hospitals for disabled people. Disabled people were first separated from the general hospital population and then, in the T4 program, exterminated in gas chambers. The Nazis worked out both their ideology and their methods, later scaled up in Auschwitz and other concentration camps, on disabled people. Though the details are gruesome and shocking, the rhetoric is familiar:

Between 1939 and 1945, Nazi doctors, under the guise of medical advancement, killed 300,000 disabled children and adults Disabled “patients” were identified by clinicians, psychiatrists and social workers, and required to register with Nazi officials. Diagnostic records characterized them as “useless eaters,” “lives unworthy of living” and “burdens upon themselves and the nation’s resources.”

While the language may be shocking today, the underlying notion of evaluating a human’s right to exist based on how independent they are persists. As Robert McGruer points out, we no longer use terms like “useless eater” to describe those who cannot contribute to capitalism’s labor force; instead, we’ve created a category called “severely disabled” to denote expendability. The persistence of sheltered workplaces where disabled workers are paid subminimum wages and segregated from “nondisabled” workers exemplifies this. The act of ableist sorting—giving the state or the doctor or the family the power to divide humans into two categories and murder, mistreat, and marginalize those in one of them—is itself rooted in fascism.

The very categories of disability we create to describe bodymind variation reflect our desire to mark some people as human and redeemable and others as disposable: discarded from society, separated from their families, cut off from their lineage. Historian Edith Sheffer has argued that the 20th-century creation of the categories of autism and Asperger’s syndrome by Nazi sympathizer Hans Asperger were made purely as a means of sorting disabled children into those to be “reformed” and experimented upon (Asperger’s), and those to be marked for killing (autistic).

Today, we know that neurologically, there is no fundamental difference between people with so-called Asperger’s syndrome and autism; therefore the DSM-IV, the diagnostic manual for psychiatrists, no longer recognizes Asperger’s as a diagnostic category. There is simply no scientific basis for the distinction between Asperger’s syndrome and garden-variety autism. Dr. Asperger’s construction of these two categories was part of the larger Nazi project of dividing and murdering.

This numbering, marking, and labeling of disabled people was the first step in the larger Nazi project of genocide. As Mitchell and Snyder describe:

They [disabled people] were loaded into vans with black-painted windows—nicknamed “death buses” by local children—and transported to the killing centers, countryside hospitals and institutions just outside of picturesque cities such as Dresden and Potsdam. In Berlin, “death committees” of physicians determined whether disabled people should be released, or, if their documents were marked with an ominous red cross, taken to their deaths.

Once in the death centers, the Nazis experimented with the best, cheapest, and fastest methods of mass murder. They quickly moved from starvation to cramming disabled bodies into small rooms and adding gas. Mitchell and Snyder grapple with why it was so easy for the Nazis to do this to disabled people, and why there continues to be less outrage on behalf of these victims and prosecution of the perpetrators than on behalf of other targets of Nazi genocide. Their work exposes how fundamental ableism is to other forms of oppression—and its genocidal consequences. It is disturbing to trace a direct line between the genocidal actions of German Nazis and the seemingly benign, mundane acts of my suburban, Jewish American family in 1970s America.

But it is undeniable that our contemporary American concepts of disability and family were forged by fascists. Unless we face this disturbing history and its foundational power in shaping diagnostic categories, institutionalization, and our concepts of family and disability, we are doomed to repeat it. Cousin XY’s erasure in my family’s lineage is directly linked to the black-windowed vans of T4: to Asperger and the rest. Mitchell and Snyder’s evidence is as unequivocal as it is horrific. That is our legacy. Mine, and my daughter’s.

The desire to construct some bodies as disabled and disposable and others as not, to sort and segregate, is not merely some leftover from the most extreme aspects of German fascism. It is rooted in American culture as well. These two forms of hatred are disturbingly connected. As scholars such as James Q. Whitman have argued, Hitler actually drew on US models of racial segregation—models that deployed racialized, ableist notions of the normate (presumed white) to justify the systemic segregation and dehumanization of African Americans—to construct his anti-Semitic rhetoric.

Numerous BIPOC disability studies scholars have similarly examined how American racism and ableism co-constructed one another, before and after the Nazi era, with disproportionate consequences for BIPOC communities. As Isabella Kresnash argues, “The existence of the economic system of slavery relied on the social idea that African Americans lacked sufficient intelligence to participate or compete on an equal basis in society with white Americans. This idea was confirmed with the creation of several diseases specific to Black people,” among them drapetomania—the “disease” of running away from one’s owner.

Moreover, long after reconstruction, Black disability continues to be disparaged and pathologized, while the disabling conditions of systemic racism that make Black disability both disproportionately prevalent and “more disabling” in effect than similar impairments in other populations is erased and effaced. Black, queer, crip scholar-poet Cyrée Jarelle Johnson traces how, from the antebellum outbreak of smallpox disproportionately affecting Black people due to living conditions produced by systemic racism to our recent Covid-19 pandemic, “Black illness is treated as inevitable and attributed to some inherent racial inferiority,” rather than to the racist conditions that produce it in disproportionate amounts and effects.

This all-American sorting of bodies as ill or disabled according to their race was borrowed by the German Nazis, retooled to fit anti-Semitic ideas about Jewish intrinsic illness, weakness, and disability, piloted on the bodies of disabled Germans of all religions, and implemented on a mass scale on Jews. The fascist rhetoric of the Nazis, rather than being originary, borrowed much of the racist-ableist rhetoric of post–Civil War US culture and then sent it back to the US in ways that continue in current rhetoric about disease and disability.

After World War II and the vanquishing of the Nazis by the allies, it is ironic—and tragic—that the fascist sorting systems and discourse of family fine-tuned by the Nazis were then deployed on disabled people in the US through institutionalization and de-lineation. In the hyperindustrialized culture of post–World War II America, disability was viewed as a symptom of unhygienic otherness that needed to be segregated, institutionalized, and delineated from the white family.

As the state returned white women workers to the home, medical discourse and institutional care replaced home care. Doctors replaced mothers as the makers and markers of who was “healthy” and white enough to be included in that family. Mass institutionalization of white disabled people in segregated institutions, often employing underpaid BIPOC care workers, and the continued disabling and pathologizing of Black people through racist ideas of health, produced Blackness itself as a disability. In effect, disability became a kind of racialized, dehumanized specter of the two-parent, single-breadwinner, white middle-class family.

At the same time, in part because of these new forms of de-lineation and segregation, the disability rights movement gained traction. After the war, the ranks of disabled veterans swelled, and the Barden-LaFollette act of 1943 expanded vocational, educational, and rehabilitative services for some veterans and other disabled people—those sorted as not too disabled. However, this incipient civil rights movement for some (white, war veteran) disabled people was coupled with increasing segregation and dehumanization of other (Black, “severely” or congenitally) disabled people.

Mass institutionalization of disabled people from the post–Civil War era until the late 1970s was the less-than-final solution to those sorted as having “severely disabled” bodyminds. Kim Nielson convincingly argues that as the US struggled to define itself as a nation after the Civil War, and as a modern one at that, the debate over whose bodies and minds should count increasingly was played out by defining, controlling, and institutionalizing those bodyminds deemed disabled. Segregated insane asylums helped construct Black desires for freedom and agency as a form of disability, echoing the antebellum invention of drapetomania.

Asylums, almshouses, and prisons were built on a mass scale to define and contain those the state wished to marginalize. As Ivan Brown and John P. Radford argue, “The institutional era needs to be understood not only as the operation of a series of large and separated building complexes [for disabled people] but also as a state of mind”—one that led to separating permanently the vast majority of people with intellectual or other “severe” disabilities from their families and communities.

Segregated educational institutions such as Gallaudet, set up for people with particular disabilities, proliferated as well, amid debates over who was included in the universe of supposedly universal public education. Whereas home care and integration in the community had previously been the norm in the Us, the industrialization and modernization that came in the wake of reconstruction, as well as debates about who qualified as a citizen, led to mass segregation and institutionalization of those labeled as disabled. My grandfather thought he was being modern—enlightened, humane—by insisting on institutionalization!

The parallel, segregated spaces of institutions defined, marginalized, and segregated disabled people, separating them from their families and communities. This often led to horrific abuse. It almost always resulted in de-lineation. However, in some cases, like educational institutions such as Gallaudet, these segregated spaces also afforded disabled people unprecedented opportunities for community building, self-determination, and the forging of a collective identity as disabled. Disabled people were not merely passive victims of this attempt to define citizenship against disability. Many disabled people became activists and leaders for the larger cause of disability rights.

Paul Strachan, for example, founded the American Federation of the Physically Handicapped in 1940 and created a sea change in policies, laws, and practices regarding the employment of disabled workers. Gallaudet (and its predecessor, the national Deaf-Mute college) produced numerous activists and innovators such as Agatha Tiegel, whose work as a disability advocate, educator, and feminist helped transform the opportunities available to deaf women6 But the success of these exceptional few happened in concert with the mass institutionalization of the majority of disabled people who were not deemed fit to work—and hence not human. People with intellectual and developmental disabilities suffered enormously from this system, as they were considered ineducable, unsocializable, warehousable. Their families were instructed to disown them.

While many families simply abandoned their children to institutions, some families maintained complex ties to their children, both de- and re-lineating them. My own family’s embrace of institutionalization demonstrates the complexity of how these bonds were severed, forged, repaired, and severed again as the institution replaced and ruptured the family.

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Excerpted from AllOur Families: Disability Lineage and The Future of Kinship by Jennifer Natalya Fink (Beacon Press, 2022). Reprinted with permission from Beacon Press.