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Bam! Pow! Zap! Battling Systemic Ableism in Technical and Professional Medical Communications through the Application of Graphic Medicine Grounded in Disability Justice

by Kristin C. Bennett

Indicative of the field’s social justice turn, technical and professional communication (TPC) has interrogated seemingly neutral communications that contribute to systemic oppression (Agboka; Haas and Eble; Jones; Walton et al.). Because TPC is “political and imbued with values” and since all documentation is motivated by “certain perspectives, viewpoints, and epistemologies” (Jones 345), social justice scholars argue that technical and professional communicators (TPCers) must critically examine their work’s sociopolitical impacts. Thus, social justice research calls for TPCers to challenge normative frameworks to “amplify the agency of oppressed people” (Jones and Walton 242). For example, Rebecca Walton, Kristen R. Moore, and Natasha N. Jones advocate for applying intersectionality in revising documents (12). Founded in efforts of Black women, specifically the Combahee River Collective and Kimberlé Crenshaw, intersectionality analyzes how race and other identity categories, such as gender, class, and dis/ability, mutually influence experiences of power and oppression (Collins and Bilge 2). Applying an intersectional lens thus asks TPCers to evaluate and address the effects of documents on marginalized identities to design more equitable constructions. 

TPCers have analyzed the intercultural and intersectional implications of health-related documentation for marginalized identities by engaging rhetorics of health and medicine (RHM) (Alexander and Edenfield; Gonzales and Bloom-Pojar; Harper; Yam) as well as disability studies (Melonçon et al.; Moeller). RHM furthers TPC’s social justice efforts by tracing the implications of medical documentation for a range of bodyminds((The term bodymind rejects the division of body and mind and designates the two as mutually informing embodied experience (Price “Bodymind”).)), such as disabled((I use disability-first language (i.e., “disabled person”) to position disability as integral to one’s embodied experience; in contrast, person-first language (i.e., “person with a disability) upholds the idea that one is a person despite one’s disability and disregards disability’s political context (Cherney 23-25).))

 folks. Specifically, TPC scholarship has examined medical documentation’s violent impacts on disabled individuals when it frames disability as personal lack (Browning and Cagle; Melonçon). Further, recognizing how the disability rights movement has prioritized white experiences and overlooked ableism and racism’s intersectional relationship (Bell “Introduction;” Jarman; Schalk), TPC scholars have begun to engage disability justice (Bennett; Bennett and Hannah). Disability justice recognizes ableism’s systemic nature and advocates for access through social change. Founded in the efforts of disabled people of color, disability justice attests to disability’s intersectional complexity and understands ableism as a systemic force that requires collective resistance (Lakshmi Piepzna-Samarasinha 22). Disability justice has thus motivated more equitable TPC articulations. 

Drawing from RHM, mental health rhetoric research examines the ideological implications of mental health articulations (Melonçon and Molloy 1) and has been vital for TPC’s interrogation of mental health discourse. In this article, I build on previous TPC applications of disability justice, RHM, and mental health rhetoric research by examining disability representations in graphic medicine, which traces “the intersection of comics and the discourse of healthcare” (Czerwiec et al. 1). Graphic medicine has celebrated comics’ capacity to amplify marginalized perspectives (Czerwiec et al. 2) and to challenge dominant medical structures by prioritizing disabled experiences (Fox n.p.). Following Lisa Melonçon and Cathryn Molloy’s 2022 call for transdisciplinarity in mental health rhetoric research, I integrate the fields of mental health rhetoric research, TPC, RHM, graphic medicine, and disability justice to evaluate the social justice implications of public health infographics and popular comics about anxiety. Based on findings, I offer methods to interrogate systemic ableism in public health documents and provide insight into graphic medicine’s social justice potential. 

Literature Review

Recognizing mental health rhetoric research’s transdisciplinary nature, I thread together here scholarship from TPC, disability studies, disability justice, RHM, and graphic medicine to offer a transdisciplinary lens for analyzing medical communications and popular comics about mental health. 

The Social Justice Implications of Disability for TPC 

Grounded in sociopolitical values, TPC discourse is influenced by “race as well as other intersecting identities, such as ethnicity, nationality, class, gender, generation, sexuality, ability and disability, and religion and spirituality” (Haas 283). This reality has inspired a turn towards social justice through scholarship that interrogates the sociopolitical implications of TPC documents to empower frequently marginalized perspectives (Agboka; Colton and Walton; Haas and Eble; Jones; Walton et al.). Previous TPC scholarship has traced discrimination’s systemic nature across institutional contexts and prioritized oppressed and “under-resourced” individuals (Jones and Walton 242) through collaborative research methods and collective activism (Agboka; Gonzales et al.; Haas and Eble; Jones et al.; Walton et al.). 

Dedicated to empowering marginalized populations, social justice theory has been integral to TPC goals of disability access (Bennett; Colton and Walton; Wheeler). Specifically, by engaging with disability studies, TPC scholarship has challenged ideas of disability as a medical lack and addressed disability’s physical materiality and sociopolitical implications (Browning and Cagle 443). Through disability studies, TPC scholars have identified “environmental and technological barriers” that contribute to disability (Melonçon 4) and critiqued professional commonplaces that normalize dominant identities (Konrad; Walters). Disability studies have consequently motivated TPC efforts to prioritize disability through design strategies that consider as many bodyminds as possible (Hitt; Oswal and Melonçon); through articulations of accessibility that require institutional transformation (Bennett and Hannah; Konrad); and through pedagogical strategies that teach students more equitable documentation practices (Colton and Walton; Wheeler). 

Centering Intersectionality in Disability Work

However, disability studies has frequently prioritized the experiences of disabled white folks while disregarding disabled people of color (Bell “Introducing White” 278; Schalk 6). In fact, marginalized groups, like people of color and women, may be hesitant to embrace disabled identities and discourses because the language of disability has historically been directed at “women and minority groups” to justify their systemic discrimination (Baynton 33) based on “mental/physical fitness, normality and abnormality, and biological superiority” (Schalk and Kim 40). In this way, ableist discourses have significant impacts on already marginalized identities as they further “racialized, gendered, classed, and sexualized ideas about bodily normalcy…intelligence, and competence” (Taylor 183-184) and “structural exclusion, neglect, and other forms of state violence” (Schalk and Kim 42). For example, eugenicists in the early twentieth century used “mental testing and family histories to ‘objectively’ demonstrate the lower mental capacity of…poor, uneducated whites, growing immigrant groups, and African Americans” (Jarman 18). Likewise, white supremacist capitalism has used disability discourse to exclude these folks from the workforce “by claiming that they lack physical, social, or technical characteristics that are deemed desirable for the economy” (Erevelles “Educating” 41). In this way, white supremacist capitalism has used disability to justify “slavery, colonialism, neocolonialism and the continued exploitation of people of color in contemporary times” (Erevelles Disability 103). Further, through what Jasbir Puar denotes as systematic debilitation, disability often results from “colonial violence, developmentalism, war…indeed, through U.S. settler colonial and imperial occupations, as a sign of global reach of empire” (xix). In other words, disability has functioned as a discursive tool and violent consequence of white settler colonial, imperial, and capitalist forces. 

Beyond scholarly engagement, disability activism by people of color has frequently gone unrecognized by disability studies as it differs from the efforts of the white disability studies community (Schalk 6). Likewise, people of color are underdiagnosed with mental disabilities like anxiety or depression; over-diagnosed with disabilities like schizophrenia; overmedicated with antipsychotics; and institutionalized due to “racial stereotypes” that frame them as dangerous (Mollow 74). Thus, it is vital that TPCers engaging with disability studies analyze how race and gender may complicate disability experiences. To do so, TPC scholars have integrated intersectionality in their research (Walton et al.). Intersectionality arose in the 1960’s and 1970’s from the efforts of Black women like Kimberlé Crenshaw, who recognized that the “single-focus lenses of social inequality” often applied in legal contexts could not account for the complex discrimination that Black women experience in terms of both race and gender (Collins and Bilge 3). Crenshaw coined the term intersectionality to demonstrate how “axes of social division in a given society at a given time, for example, race, class, gender, sexuality, dis/ability, and age operate not as discrete and mutually exclusive entities, but build on each other and work together” (Collins and Bilge 4). Intersectionality highlights how personal lives and political systems are affected “not by a single axis of social division…but by many axes that work together and influence each other” (2). Thus, intersectionality posits that social identity categories such as “race, class, gender, sexuality, dis/ability, and age” (4) mutually influence experiences of discrimination in “intersecting, interlocking, and inseparable ways (Walton et al. 12). Attention to intersectionality thus requires that TPCers understand oppression as systemic, interrogate the influence of these interconnected systems on documentation, and advocate for institutional change. 

To account for the intersectional nature of disability, TPC scholars have applied disability justice (Bennett and Hannah; Wheeler). A movement led by the efforts of disabled people of color, queer disabled individuals, and trans and gender non-conforming disabled folks (Lakshmi Piepzna-Samarasinha 20), disability justice recognizes ableism as “inextricable from white supremacy, patriarchy, heterosexism, transphobia, colonialism, and poverty” (Schalk and Kim 48). Disability justice thus highlights how ableism intersects with other oppressive systems like racism (Schalk 146). Specifically, ableism is “a system that places value on people’s bodies and minds based on societally constructed ideas of normalcy, intelligence, excellence, and productivity. These constructed ideas are deeply rooted in anti-Blackness, eugenics, colonialism, and capitalism’” (Lewis, n.p.). Consequently, disability justice examines the intersectional oppression of a range of disabled bodyminds and reveals the insufficiency of “state-sanctioned” rights that privilege as citizens white, wealthy, male, heterosexual individuals (Schalk 7). 

Pursuing Social Justice through RHM and Mental Health Rhetoric Research 

Both disability studies and disability justice have thus helped to transform technological and professional structures that create barriers for disabled individuals (Melonçon 5). Because of disability’s complicated relationship with medical discourse, TPCers have turned to rhetorics of health and medicine (RHM), as the field offers a lens through which to analyze the rhetorical interplay between medical communications, sociopolitical understandings of health, and embodied health experiences (Melonçon et al. 1-3). RHM supports TPC’s social justice agenda by evaluating how normative healthcare practices and discourses may contribute to oppressive systems (Scott 144). Further, RHM examines how the concept of wellbeing can oppress individuals by holding them accountable to embodied standards (Sointu 268). This article draws heavily from what Melonçon and Molloy refer to as the sister field of RHM: mental health rhetoric research. Mental health rhetoric research examines how the discourse around healthy bodyminds reinforces ideological structures that regulate individual action. Mental health rhetoric research scholars have noted that public mental health communications influence social perceptions of the mentally disabled; determine the linguistic frames through which individuals can articulate mental disability (Emmons 59); and limit the rhetorical legitimacy of the mentally disabled (Prendergast 57) by positioning them as “subhuman, even non-human” (Price, Mad 26). In this way, public discussions can dehumanize neurodiverse bodyminds and undermine their rhetorical capacities. 

Mental health rhetoric research scholars have thus advocated for the rhetoricity of the mentally disabled by amplifying perspectives that challenge medical discourse. Specifically, recognizing how public perceptions of disability often undermine disabled individuals’ citizenship and rhetoricity by framing them as “unreliable observer[s]” without “reason or judgment” (479), Katie Rose Guest Prayal urges scholars to consider how narratives can dismantle dominant perspectives of mental illness and help “those with neurological difference gain rhetorical authority” (499). Following this call, this article examines the power of graphic medicine, or narrative comics about medicine, to amplify the perspectives of mentally disabled folks. 

The Social Justice Potential of Comics 

Graphic medicine “combines…narrative medicine with…visual systems of comic art” to examine the “physical and emotional” experiences of patients often stifled by medical discourse (Czerwiec et al. 1-3). In this way, graphic medicine can disrupt the doctor/patient power imbalance and validate patient knowledge (20). At the heart of graphic medicine are comics, or “juxtaposed pictorial and other images in deliberate sequence intended to convey information” (McCloud 9). Engagement with pictures is “instantaneous” and requires “no formal education,” while the abstract nature of writing demands “time and specialized knowledge” from readers (49). As “hybrid texts,” comics “collapse the word/image dichotomy” (Hatfield 36), integrate meaning with emotionality (McCloud 135), and resist transparency by “generating [meaningful] tension” (Hatfield 67). Comics may thus improve TPC medical documentation since their fusion of images and text both simplifies and complicates medical knowledge. 

The social justice potential of comics is reflected by the popularity of zines, or self-published magazines. Zines have historic connections to pamphlets circulated in the revolutionary era of the United States and gained popularity through “fanzines of the 1950’s and punk zines of the 1960s” (Licona 109). This medium has been taken up by people of color to “challeng[e], re-imagin[e], and replac[e] exclusionary and oppressive discursive practices” (109). For example, Melanie Ramdarshan Bold conducted a case study of 58 zines from the People of Color Zine Project to trace how people of color have used zines to address “issues of racism and race, feminism and sexism, and gender and sexual identities” (225). In this way, zines demonstrate comics’ potential to undermine dominant, medical understandings of disability by attending to intersectional discrimination. 

Comics might also enhance TPC medical documentation because their linear structure lends itself well to patient instruction; their combination of words and images supports knowledge-making; their format communicates serious content in a “non-threatening manner” (McAllister 18); and their abstract nature elicits from readers “empathy and compassion” in ways other formats do not (18). Likewise, the narrative aspects of medical comics, such as character and metaphor, allow for reader connection often inhibited by general medical documentation. Narrative specifically can encourage TPCers to consider “relevant contexts” and facilitate “connection” through relatable situations (Gutsell and Hulgin 92). In other words, narrative comics can help TPCers highlight the personal and political nature of medical experiences. Although comics also can universalize experiences  to increase reader connection through cartoon images that represent a range of identities (McCloud 31), they may disregard difference, erase certain experiences, and alienate already marginalized readers. It is thus vital that TPCers center intersectionality when engaging comics for medical purposes.

While the visual medium of comics “might not initially seem most appropriate for representations of disabilities that are often termed ‘invisible,’” the visual and verbal qualities of comics allow writers to address the physically embodied experiences of the neurodiverse and the impacts of sociopolitical representations of disability (Birge, n.p.). In this way, comics are a useful tool for TPC. Despite their potential to support access, comics also create accessibility challenges. In “privileging the visual mode” (65) comics may reinforce an “ocularcentrism that underlies medical practice” and perpetuate an ableist logic of “seeing as knowing” (Wegner 70). Consequently, in this article, I draw on mental health rhetoric research, RHM, disability studies, and disability justice’s attention to intersectional theory to evaluate the potential impact of graphic medicine in facilitating accessible and socially just articulations of mental disabilities. 

Methods

In this section, I first offer an overview of the methodology informing my analysis and then discuss my choice of sites and analytical methods.

Methodology 

I follow Marie Moeller’s call “to confront the ways in which dominant ideologies are produced and sustained by medical technical communication on the Internet” (57) by evaluating the impacts of online medical communication and popular comics to determine whether and how these documents address systemic ableism. Through disability justice, this article analyzes how medical documents and comics consider “how structures of privilege and disadvantage, such as gender, race, and class, interact in the lives of all people” as well as “the ways in which these structures of power inextricably connect with and shape each other to create a system of interlocking oppressions” (Roberts and Jesudason 314). Intersectionality is a useful tool for this analysis because it encourages us to validate multiple differences while building connections across experiences of oppression to inspire social change (Roberts and Jesudason 325; Erevelles Disability 99). In recognizing the systemic nature of ableism, disability justice also understands access as dynamic and relationally collective. This article thus applies a disability justice framework to analyze how intersectionality is considered in representations of disability across medical documents and popular comics. 

Choice of Sites and Process of Analysis 

Because people of color have been historically underdiagnosed with invisible disabilities (those without physical markers), such as anxiety and depression (Mollow 73), I chose to analyze medical and comic-based representations of anxiety. Despite an under-diagnosis of people of color, anxiety is one of the three most common mental disabilities in the United States (“3 Most” n.p). As the National Institute of Mental Health (NIMH) explains, “anxiety disorders involve more than temporary worry or fear. For people with an anxiety disorder, the anxiety does not go away and can get worse over time” (“Anxiety Disorders” n.p.). Considering this definition, I was interested in evaluating how public health documents and comics contribute to knowledge regarding anxiety and whether these documents consider anxiety’s intersectional complexities in relation to race, gender, and socioeconomic status. 

To examine how comics and medical documents frame anxiety, I first analyzed NIMH’s public health infographics, as NIMH “is the lead federal agency for research on mental disorders. NIMH is one of the 27 Institutes and Centers that make up the National Institutes of Health, the largest biomedical research agency in the world. NIMH is part of the U.S. Department of Health and Human Services” (“About NIMH” n.p.”). I analyzed documents from this organization due to its national impact on mental health knowledge in the United States. I specifically studied documents from the Digital Shareables portion of their website because they include both images and text and are intended for digital circulation. I chose five NIMH infographics that offered insight into anxiety (refer to Appendix A). I next analyzed five comics from Introvert Doodles, a comic series about mental health by a comic named Marzi who has anxiety (Schuster n.p.). I examined six comics that discussed anxiety and general mental health (refer to Appendix A). I also analyzed comics from Everyday Feminism, an “educational platform” constructed “to amplify and accelerate the progressive cultural shifts taking place across the US and the world,” to help readers “apply intersectional feminism and compassionate activism to their real everyday lives” (“About Everyday” n.p.). I chose this site due to my interest in examining the capacity of comics to consider the systemic connections between ableism and other oppressive forces. I analyzed five comics about anxiety and general mental health disorders that included a combination of text and images (refer to Appendix A).

I used thematic coding to analyze the documents. A theme denotes “an extended phrase or sentence that identifies what a unit of data is about and/or what it means” (Saldaña 199). In other words, themes allow researchers to analyze “repeating ideas” and to make theoretical conclusions by examining their relationships. In building thematic codes, I drew from disability studies and disability justice principles to analyze how these documents may contribute to or challenge ableism, racism and other oppressive systems (refer to Table 1).

Table 1: Codes and Definitions

Code Definition
Static  Labeling what anxiety or mental illness definitively “is” and failing to consider disability’s intersectional complexities 
Dynamic Accounting for anxiety’s dynamic nature; referencing or picturing difference in relation to identity categories such as race, gender identity, age, socioeconomic status, or sexual orientation
Intersectional Framing anxiety as an intersectional phenomenon complexly and mutually influenced by race, gender, and/or socioeconomic status 
Unproductive Positioning anxiety as a threat to one’s productivity, social action, daily life, or capitalist value
Valuable  Valuing anxiety as offering generative social difference
Choice Articulating anxiety as a matter of independent choice and/or as a personal condition to be overcome
Relational  Framing disabled/able people as influenced by other people or by treatments 
Lack  Positioning anxiety as threatening one’s normative mental baseline, as inhuman/animal, as separate from one’s personhood, as threatening one’s humanity, and/or as in need of treatment 
Human Validating anxiety as human, normal, natural, or whole

I analyzed the frequency of these codes across documents’ words and images to identify their normalizing impacts. I composed written descriptions of each image, which I then coded. I first counted codes across individual documents at the sentence-level. I then counted codes across each document group. Next, I compared code frequency in the NIMH documents with those of the collective comics. Ultimately, I identified thematic trends based on findings, from which I offer recommendations for constructing more socially just comics about mental disability. 

Findings/Discussion

In this section, I offer a thematic discussion based on my analysis. I organize this thematic discussion around what Walton et al. refer to as the 3Ps: positionality, privilege, and power. To compose documents attuned to social justice, TPCers must evaluate the impact of such documents on the positionality, privilege, and power of marginalized populations (127). Identified themes contextualize my data analysis in accordance with the 3Ps and include validating white positionalities through static understandings of disability; marginalizing disabled individuals as inhuman through medical models; and perpetuating ableism and white supremacist capitalism. 

Validating White Positionalities through Static Understandings of Disability 

The first thematic tension in the findings reflected how the documents collectively presumed and reinforced disabled identities as predominantly white, wealthy positionalities. Positionality “asserts that the meaning[s] of identity categories (such as race and gender) are not essential but rather are fluid and contextual” (Walton et al. 63) and understands that all “aspects of identity (such as race, gender, nationality, religion, etc.) are complex and dynamic” (65). Attending to positionality means recognizing identity as “relational,” “fluid,” “situational,” “contradictory,” and “intersectional” (65). My findings indicated tension regarding the rhetorical influence of medical documents and comics on the agency of disabled positionalities, particularly for disabled people of color. This is unsurprising, as the disability rights movement has “a tenuous relationship with race and ethnicity” by prioritizing white disabled positionalities (Bell “Introducing White” 278). I identified this theme based on my analysis of anxiety as static, dynamic, relational, and intersectional in the NIHM documents and the comics. 

Centering White Disability in the NIMH Documents 

NIMH frequently positioned anxiety as static (52 instances, refer to Appendix B), or universally experienced, and thus disregarded how anxiety varies significantly depending on one’s intersectional identity. The static code was most frequent in Document 4, which notes “People with generalized anxiety disorder (GAD) feel extremely worried or feel nervous…even when there is little or no reason to worry.” This document defines people with GAD as having unreasonably “extreme” feelings of worry based on normative logics. In upholding static ideas of disability, such statements serve both ableist and racist agendas by legitimizing some worries as normal while framing others as problematic. In this way, ableist logics act as “cultural barriers” that bar disabled folks from equitable social participation, in much the same way that “homophobia and heterosexism, racism, and sexism deter queer-identified, racial minority, and female subjects from operating at their fullest potential” (Bell “Introduction” 1). 

Despite NIMH’s articulations of anxiety as static, they likewise frame anxiety as relational (140 instances) and dynamic (76 instances, refer to Appendix B). Most frequent in NIMH Document 6, anxiety as relational either discussed anxiety as resulting from contextual interactions with others or as an illness to be overcome. Although the document describes social anxiety as “fear of being scrutinized and judged,” it also notes, “The first step to effective treatment is to get a diagnosis, usually from a mental health professional.” Such relational articulations of anxiety fall short of their intersectional potential as they frame anxiety as a problem to be resolved and presume that all readers have equal access to medical care. This disregards the “lack of access to official disability diagnoses, services, and resources” experienced by communities of color (Schalk 14). The correlating image, an individual with neutral-colored skin and no facial features standing under a stage light, illustrates that while anxiety may be experienced individually, it is influenced by external circumstances. Yet, in attempting to universalize experiences of social anxiety through a stage fright metaphor, the document disregards how the anxieties experienced by people of color, women, and members LGBTQIA+ community may be rooted in institutionalized violence (14). 

The NIMH documents also framed disability as dynamic, or as influenced by one’s contextual surroundings and/or other aspects of identity. This code was most frequent in NIMH Document 4, which notes, “People who have a specific phobia…feel intense anxiety about specific types of objects or situations.” This document recognizes certain anxieties as resulting from one’s relational engagement. This is similarly reflected in the image of a woman surrounded by icons that represent a range of social responsibilities. Though less frequently, the document also considers how other aspects of identity, like age, impact anxiety. For example, it explains, “Children, teenagers, and adults younger than 25 may experience increased suicidal thoughts or behavior when taking antidepressant medications.” Although such claims account for potential difference in anxiety experiences based on identity factors like age, they do not consider the intersectional complexities of these ranging experiences or account for how these experiences may differ based on race. This is likewise reflected by the absence of intersectionality (0 instances, refer to Appendix B) in the NIMH documents. 

Centering White Disability in the Comics

Unlike in the NIMH medical documents, articulations of anxiety across the comics reflected strong emphasis on anxiety as a dynamic (99 instances) and somewhat frequent attention to anxiety as relational (38 instances, refer to Appendix C3). Discussions of anxiety as dynamic were most frequent in Everyday Feminism (refer to Appendix C3), which was unsurprising due to its mission to end intersectional discrimination. This was most common in Everyday Document 4, which discusses the complexities of having a mental illness and being trans. As the comic explains, “Anyone can have a mental illness, but when you have an identity that a lot of people think is sick, made up, criminal, or dangerous, those messages tend to amplify and validate the distortions that a mental illness creates.” Such statements complicate static understandings of anxiety by articulating how other aspects of identity, like gender, can influence disability. The correlating images likewise address the social impacts of difference; for example, some panels feature disembodied speech bubbles to indicate social perceptions on disabled experiences. Likewise, the comic features cartoon images of a trans narrator and their able-bodied acquaintance discussing the personal and political complexities of mental disability influenced by multiple forms of discrimination. 

In addition, both groups of comics frequently position disability as relational. In the Introvert Doodles comics, this was most common in Introvert Document 5. Intended to help able-bodied individuals support those with panic attacks, the comic upholds relational understandings of anxiety through statements such as, “Don’t get frustrated if your friend doesn’t seem to be listening to reason.” As this example reflects, the comics frequently applied relational understandings of anxiety to justify its erasure by imposing ableist standards of reason. The images in the comic echo this relationality, as a girl with short hair and dark skin asks for advice in supporting someone with anxiety, while the other, a blonde girl with white skin, offers insight into her anxiety experience. Interestingly, the relationship pictured here reinforces the idea of anxiety as a white disability. This is unsurprising, as people of color are often denied access to disability diagnosis, resources, and treatments (Schalk 14). 

Despite the emphasis on anxiety as both dynamic and relational, anxiety was frequently framed across the comics as static (19 instances, refer to Appendix C3). This was most common in Everyday Document 5, which personifies disabilities, such as anxiety, by offering insights from each disability’s perspective. Although the comic upholds as static certain experiences of mental illness, it simultaneously normalizes these conditions by representing them as human phenomena. Likewise, the images presented in each panel, such as an empty fuel gauge, allow readers to relate to the discussion. However, by relying on universalizing images, this comic does not account for anxiety’s intersectional nuance, particularly when considering race, gender, age, and sexual orientation. Similarly, by using examples like an empty fuel gauge, the comic presumes readers of a certain socioeconomic status. 

While upholding static ideas of anxiety, the comics also reflected little engagement with intersectionality (15 instances, refer to Appendix C3). In the case of Introvert Doodles, this was unsurprising, as the comic featured a white woman’s anxiety experiences. Although Everyday Feminism articulates a mission grounded in intersectionality, its comics also did not account for the intersectional impacts of race and other factors of identity on disabled experiences. Although Everyday Document 4 reflected references to disability’s intersectionality by articulating how experiences as a trans disabled person are complicated by systemic, social discrimination against both disabled and trans communities, its engagement with race was limited. For example, the comic notes, “Another black trans woman murdered last week. Police are not treating this as a hate crime.” While the comic references the violent intersections of race, gender, and disability by alluding to police brutality against Black and trans populations, it fails to unpack how the lived experiences of white disabled folks differ from those who experience intersecting forms of discrimination. This is unsurprising since scholarly attention to the intersections between disability and race have been tenuous at best (Bell “Introduction;” Schalk and Kim). 

Marginalizing Disabled Individuals as Inhuman through Medical Models  

My analysis of the NIMH documents and the comics likewise revealed a thematic tension regarding whether and how such documents privilege certain bodyminds as human. According to Walton et al., “Privilege is receiving unearned social, cultural, economic, and political advantages due to alignment with specific sociocultural identity markers…People have privilege when their identity aligns with socially constructed assumptions about what it means to be ‘normal’” (83). In other words, individuals whose identities are presumed normal within specifical social contexts receive unearned advantages within those spaces. In this section, I discuss how the interaction of data coded as lack, human, and intersectional across the NIMH documents and comics impacts understandings of disabled individuals as human citizens. 

Medical Framings of Disability as Inhuman in the NIMH Documents 

The NIMH documents most frequently reflect ableist assumptions of disability as medical lack (361 instances, refer to Appendix B), as each first offers an overview of symptoms followed by treatment options. This was unsurprising since medical organizations like NIMH often presume disability to be a problem in need of resolve. For example, NIMH Document 4 notes, “During a panic attack, a person may experience: pounding or racing heart…feelings of impending doom, feelings of being out of control.” Here, panic disorders are described as harmful to one’s health and independence. Lack also was reflected in the document’s correlating image of a woman with glasses, dark hair, and olive skin surrounded by smaller images representing responsibilities, such as a calendar and a to-do list. Because the woman is holding her face and has a scribbled thought bubble on top of her head, the image frames anxiety as a personal problem. While the document’s simplified image of everyday stressors and seemingly neutral tone may allow a range of readers to relate, it disregards how oppressive systems, like racism, may contribute to anxiety. These assumptions draw from and sustain both ableist and white supremacist capitalist logics of autonomy. As Nirmala Erevelles explains, “Notions of autonomy and rationality are, in fact, closely tied to the historical and material conditions of capitalism, where certain definitions of reason and autonomy become more plausible than others” (Disability 158). By framing white ableist logics as reasonable, universalizing disabled experiences, and encouraging disability’s erasure for the sake of productive independence, the NIMH documents contribute to both ableism and white supremacist capitalism. 

One of the least frequently coded concerns in the NIMH documents was anxiety as human (21 instances, refer to Appendix B), which was unsurprising as medical documents frequently describe disability as an obstacle to personhood. For example, NIMH Document 2 explains that while “everyone feels stress from time to time,” anxiety is abnormal stress that “interfere[s] with your life.” This ableist reasoning designates certain stress levels as normal and others as threatening to one’s autonomy. The human quality of anxiety is both enhanced and limited by the correlating image; while the figure’s neutrality enables reader relation, its indefinite characteristics occlude the intersectional complexities of human reality. This document illustrates how white experiences can define anxiety and consequently contribute to the under-diagnosis of invisible disabilities across communities of color. This is further illustrated by NIMH’s lack of attention to intersectionality (0 instances, refer to Appendix B). Specifically, by drawing from Western myths of autonomy, or the assumption that “all people are…independent beings that must provide for themselves” these comics frame disabled folks, women, and people of color “as dependents who weigh on others[’]…autonomy” (Bailey 146). The autonomy myth perpetuated by understandings of disability as lack may thus validate as human white, male, able, and wealthy bodyminds that are wholly and fully “self-sufficient and self-supporting” (Erevelles Disability 190) and further marginalize those who rely on external support systems. 

Medical Framings of Disability as Inhuman in the Comics

Unlike the NIMH documents, disability was most frequently represented in both comic sets as human (185 instances, refer to Appendix C3). For example, Everyday Document 2 validates readers’ anxiety experiences by assuring them that they can “Be anxious. Panic. Scream. Weep. Sit with it. Pace with it. Cancel. Leave.” Such statements encourage individuals to be present with their anxiety rather than to overcome it. While the comics use cartoons that reflect exaggerated characteristics, they also include images of individuals of varying races, ethnicities, and genders. Unlike the NIMH documents, such cartoons have the potential to inspire broader reader relation; however, because of the exaggerated nature of the comic medium itself, the images may potentially reinforce problematic stereotypes. The comics present characters in everyday scenarios to further normalize anxiety. For example, in Everyday Document 2, two women are in a grocery store; one woman, with long brown hair and dark skin, is smiling and pushing a shopping cart, while the other has light skin, is smiling, and is wearing a headscarf. The first woman says, “Thanks for coming with me! I was out of food but too anxious to come alone!” The other woman responds, “No worries! I missed you anyway!” In this way, the comic naturalizes anxiety as human. Yet, it reinforces certain sources of anxiety, like grocery shopping, as normal and manageable. In doing so, the comics disregard more systemic, violent sources of anxiety experienced by communities of color and do not account for how ableism intersects with “heteropatriarchy, capitalism, and white supremacy” (Schalk and Kim 38). 

Despite the potential for comics to privilege mental disabilities as human, my findings also indicated that they may perpetuate ableist understandings of disability as lack (182 instances, refer to Appendix C3). This was common in Introvert Document 1, which features a bingo board that frames anxiety as an everyday condition. Yet, the correlating statements, such as “shivering like a chihuahua,” “irrational,” and “rumbling tummy sounds like a birthing whale,” assume anxiety as lack. By comparing anxiety symptoms to a “chihuahua” and a “birthing whale,” this comic characterizes mental disability as nonhuman. Likewise, phrases like “irrational” normalize ableist logics. The rhetorical framing of non-dominant behaviors as irrational, “parasitic,” and “unruly” has historically justified discrimination against people of color and upheld white supremacist capitalism (Erevelles “Educating” 39). The frequency of this coded concern thus illustrates that while comics have the power to humanize mental disabilities, they also can also dehumanize them through ableist assumptions. 

The dehumanization of disability across the comics was further perpetuated by inattention to intersectionality (15 instances, refer to Appendix C3). This was surprising, particularly in the Everyday Feminism documents, since the publication’s mission centers intersectionality (“About Everyday” n.p). Discussions of intersectionality were most frequent in Everyday Document 4, which explains, “Anyone can have a mental illness, but when you have an identity that a lot of people think is sick, made up, criminal, or dangerous, those messages tend to amplify and validate the distortions that a mental illness creates.” Through such statements, the comic illustrates how ableism works in tandem with oppressive forces like white supremacist capitalism to frame certain identities as “criminal” or “dangerous.” Likewise, the comic explains that “You can’t always separate the experience of mental illness from the experience of oppression and trying to do so can result in gaslighting someone into further distrusting themselves or pushing them away.” This articulates how the forms of discrimination that multiply marginalized individuals face cannot be understood in isolation. 

Further, the comic alludes to the systemic institutional oppression experienced by marginalized identities, noting that “The trans community’s long history of being pathologized and discriminated against by medical and psychiatric institutions makes it difficult to talk openly about how mental illness affects us, and can seriously impact our ability to get help.” This indicates that disability is truly a relational phenomenon and that not all individuals have access to the same support systems due to systemic exclusion. The comic likewise considers the intersections between the violence experienced by disabled individuals, trans people, and communities of color by addressing how the state contributes to such violence. For example, the comic lists the names of Black men, women, and trans people whose murders have not only gone unrecognized as hate crimes by law enforcement but, in many cases, were at the hands of police officers themselves: 

Alfred Olango, Tawon Boyd, Terence Crutcher, Terrence Sterling, Levonia Riggins, Alfred Toe, Fred Barlow, Paul O’Neal, Donnell Thompson, Jr., Dalvin Hollins, Delrawn Small, Deravis Rogers, Clarence Howard, Antrum Shumpert, Ollie Brooks, Devonte Gates, Doll Pierre-Louis, Vernell Bing Jr., Michael Wilson Jr., Jessica Williams, Ashtain Barnes.

By including the names of real individuals impacted by systemic racism and ableism, the comic articulates intersectional discrimination’s significant life-or-death implications. Although intersectionality is largely absent from the corpus, this comic demonstrates the comic medium’s potential to address the complexities of intersectional violence. 

Perpetuating Ableism and White Supremacist Capitalism  

The final theme I identified was the connection between ableism and white supremacist capitalism through the framing of ability as productive. As Walton et al. explain, “an individual’s positionality and privilege in any given situation helps to define and determine how power can be understood and deployed for good” (105). In this section, I explore how assumptions related to anxiety as choice, valuable, and unproductive upheld notions of ableist, white supremacist capitalism across both the NIMH documents and comics.

Perpetuating Ableism and White Supremacist Capitalism in the NIMH Documents

In the NIMH documents, choice (176 instances, refer to Appendix B) was the second most frequent concern; this was unsurprising, as medical documents circulated online often guide readers’ independent actions. This concern was most frequent in NIMH Document 2, which recommends that in coping with anxiety, readers “Keep a journal…exercise and eat healthy, get regular sleep… identify and challenge your negative thoughts, [and] reach out to your friends or family.” This statement positions responsibility for overcoming anxiety on the individual, and it presumes readers of otherwise able bodyminds and privilege; specifically, it assumes that readers are physically able to exercise, financially able to eat healthy, and relationally able to socialize. Rather than recognizing access to care as a consequence of intersectional privilege, this document articulates care as a matter of choice. The image, a single figure with black hair and brown skin in a bed with their hands covering their face and a thought bubble of scribbles to indicate frustration, complements this emphasis on choice by individualizing anxiety as a personal experience. Featuring a nondescript image of a person of color, the document also disregards how disability is experienced complexly based on race. 

Further, the ableist framing of disability as a choice echoes a white supremacist capitalist agenda by articulating understandings of mental ability as integral to one’s economic value. Disabled individuals have systematically been “excluded from participating in economic activity” and are often understood as occupying “the lowest rungs of the social division of labor” due to their incongruence with capitalist demands for autonomous productivity (Erevelles “Educating” 40). For disabled people of color, this designation as socially unproductive is further exacerbated by capitalism’s privileging of the “white heterosexual male body as the most productive and profitable citizen” (166). That is, by prioritizing able productivity, these documents devalue disabled folks, particularly those of color.

Also somewhat frequent were NIMH discussions of anxiety as unproductive (35 instances, refer to Appendix B). For example, NIMH Document 1 references being able to “perform usual daily functions and responsibilities” as indicative of normal stress; anxiety is deemed problematic when interfering with one’s productivity. The correlating images, a neutral figure sitting in bed and a neutral figure walking underneath a rain cloud, contribute to an overall impression that anxiety impedes one’s productivity. In this way, the documents contribute to both ableist and white capitalist systems of oppression by framing valuable bodies as productively able. This document presumes that all readers value white Western capitalist productivity and fails to consider how race and other identity factors may impact one’s economic opportunities, one’s social privilege, and one’s recognition a productive citizen. 

Perpetuating Ableism and White Supremacist Capitalism in the Comics

In the comics, discussions of disability as valuable (6 instances) were likewise far less frequent than those of disability as a choice (50 instances) and as unproductive (15 instances, refer to Appendix C3). Anxiety as a choice was most common in Everyday Document 2, which explains, “Journaling about your anxiety can also help you deconstruct what makes you anxious.” The document positions anxiety as a matter of choice to be managed by individual efforts. The images in the comics reinforce this idea of choice, with each panel modeling steps for anxiety management. By positioning mental health as a matter of choice, these comics participate in ableism as well as neoliberal capitalist “legacies of eugenics, colonialism/ neocolonialism…urban redevelopment, and other oppressive practices and structures” that regulate people of color according to white nationalist norms and disregard how such systems deny them “life-sustaining resources” (Schalk and Kim 38). Specifically, by positioning medical care as a choice, these comics do not address the complexities of care for disabled people of color or unpack how communities of color had historically had to “fight for…access to medical care…free from racial, gendered, sexual, and (dis)ability discrimination” (Schalk and Kim 46). In other words, despite their humanizing potential, these comics further marginalize the experiences of disabled people of color by prioritizing white disability access concerns.

While anxiety as unproductive was a somewhat frequent concern of Introvert Doodles, it was a less common concern of Everyday Feminism. It was specifically most common in Introvert Document 1. This was unsurprising, as this comic also strongly upholds notions of disability as lack. In describing anxiety, the comic notes symptoms such as “saying ‘no’ when you wish you could say yes,” “under-achieving,” and “cannot adult today.” Such statements standardize as normal ableist, white supremacist capitalist productivity. White supremacist ableist capitalism frames disabled people “as neither normal nor autonomous” because they do not align with standard concepts of “will,” “ability,” and “progress” (Erevelles Disability 178). Specifically, by referencing “phobias, worries, concerns, fears, doubts, hang-ups,” the document frames anxiety as a personal impediment to one’s social value and ignores how the fear experienced by certain intersectional identities, such as communities of color or trans individuals, is rooted in systemic violence. 

The least frequently coded concern across the comics was disability as valuable. However, when used, such expressions upheld disability as a valuable aspect of the human experience. For example, Introvert Document 3 frames anxiety as a valuable source of strength by noting, “Every day you wake up. Look fear in the eye and stare it down. And that is the very definition of bravery.” Although the comic personifies anxiety as something outside the self and disruptive to personhood, it simultaneously frames anxiety as bravery. The everyday, relatable images included, such as the act of drinking coffee at a kitchen table, position anxiety as human. This comic thus creates tension between the need to erase disability and the idea that disability is an everyday, valuable quality. However, by associating anxiety with simple, everyday events like drinking coffee, the comic risks minimizing anxiety’s complexities; it disregards how people of color may be anxious because of the threat of ongoing violence due to confluence of their race, gender and/or sexual orientation. This is unsurprising, as “white (disabled) people have homogenized…what counts as disability in ways that exclude and even deny the experiences of Black disabled people” (Schalk 135). Although these comics normalize anxiety experienced by privileged and predominantly white identities, they do not consider how these experiences may differ vastly from those of people of color or those in the LGBTQ+ community. 

Composing Socially Just TPC Medical Comics

Findings indicated that comics’ narrative elements can resist medical discourse that frames mental disabilities like anxiety as problems to be overcome. However, findings likewise indicated that such media may also perpetuate problematic notions of mental disability that encourage its erasure. In addition, a lack of attention to intersectionality across the medical documents and comics resulted in articulations that validated white, wealthy, heteronormative understandings of disability while disregarding people of color. Following previous calls for the application of disability justice principles to inspire more equitable TPC communications (Bennett; Bennett and Hannah; Colton and Walton), I thus integrate findings with disability justice to demonstrate how critical attention to the narrative capacities of graphic medicine can help TPCers to facilitate more socially just accounts of mental disability. As Natasha N. Jones and Rebecca Walton explain, “Narrative is a promising tool for engaging explicitly with issues of diversity and social justice because of its capacities for fostering identification, facilitating reflexivity, interrogating historicity, and understanding context” (243). As Jones and Walton articulate, “narratives can enable critical insights through reflexivity” and influence readers’ self-understandings and “abilit[ies] to perceive relations of power that structure and operate in social contexts” (247). In this way, narratives can help frequently marginalized populations to reflexively challenge the sociopolitical systems that contribute to their oppression. In this section, I draw from findings to demonstrate how TPCers might promote such reflexivity through graphic medical narratives grounded in disability justice and intersectionality. 

Facilitating Critical Identification with Mental Disability through Attention to Difference

One key difference between the NIMH documents and the comics was that the comics facilitated narrative identification for readers. The NIMH documents included medical information for diagnosing and treating anxiety; while such general content may apply to a range of readers, it does not foster personal reflexivity. In contrast, the comics’ use of narration, character, dialogue, and expressive illustrations promote reader relation. Specifically, characters “encourage identification with an audience by tapping into commonly held ideals. This identification, in turn, provides a justification, exigence, and impetus for social action” (Jones and Walton 245). That is, when readers relate to characters in a narrative setting, they are more likely to connect with, reflect on, and act on the text’s rhetorical purpose. However, as findings indicated, because the comics predominantly reinforced white, wealthy narratives regarding disability, they fell short of their intersectional potential. As my analysis reflected, both Everyday Feminism and Introvert Doodles use cartoon illustrations, which, unlike more realistic art, have been recognized by scholars for their potential to increase reader identification (McCloud 31). However, by using a singular, white, blonde girl as a narrator, Introvert Doodles risks positioning anxiety as a condition associated with white women and invalidating the experiences of disabled people of color. Likewise, although Everyday Feminism incorporates images of people of color, its verbal narratives prioritize dominant, white disability experiences. 

Consequently, I recommend that TPCers complicate understandings of mental disability through intersectional identification. Because the lived experiences of disabled people of color are vastly different than white disabled experiences, it is vital that TPCers include a range of perspectives when engaging graphic medicine. In attempting to transcend difference to promote reader relation, the comics in this corpus alienate all readers who do not align with dominant, white, capitalist structures. In contrast, when readers are provided narrative accounts that offer diverse “perspectives on the same topic,” they are more capable of identifying with the narrative and of the “develop[ing] complex understandings of [intersectional] position and privilege” required to think more critically about social justice concerns (Jones and Walton 251). Thus, by prioritizing intersectionality, TPCers can engage more effective “alliance-building…[by] acknowledging the multiple intersecting lived experiences of all participants” (Roberts and Jesudason 324). In other words, narrative accounts that explore how ableism may collude with other oppressive forces like racism can help TPCers to facilitate reflexive work integral to social justice efforts. In this way, TPCers can pursue disability justice goals of collective liberation grounded in the needs and experiences of people of “mixed abilities, multiracial, multi-gendered, mixed class, [and who exist] across the orientation spectrum” (Berne et al. 229). 

Findings also indicated that while comics support discussions of mental disability, they may not attend to the accessibility needs of disabled folks. Specifically, graphic medicine’s visual medium prioritizes ocularcentrism and limits engagement by blind folks (Wegner 69-70). However, Everyday Feminism included transcripts of all comics to enhance accessibility. TPCers who compose comics about mental disability might thus anticipate other disabilities, like blindness, by including transcripts and/or captions. In this way, TPCers can increase readerly identification and promote a culture of collective access through their documentation. 

Attending to Ableism and Racism’s Intersectional Relationship through Context 

Findings revealed that the comics were more attuned to disability’s contextual nature than were the NIMH documents. While the NIMH documents offered information about anxiety conditions and treatments, the comics provided insight into embodied disability experiences. As Jones and Walton explain, “context positions actors within an encompassing social, political, economic, and ontological framework” (254). By locating experiences of anxiety in specific contexts, the comics help readers consider disability’s relational nature. Such efforts further TPC social justice goals because they demonstrate how sociopolitical and cultural contexts influence public perceptions and subjective experiences of disability (Melonçon et al. 1). 

However, the comics often presumed everyday situations associated with white, wealthy, heteronormative identities. The lack of attention to disability’s vastly diverse cultural, social, and historical contexts neglects the connection between the systemic violence perpetuated by ableism and racism. This is unsurprising, as disability is generally portrayed “as [an] apolitical and stable phenomen[on] rather than [a] material-discursive entanglemen[t]” (Hamraie and Fritsch n.p.). In addition, the disability rights and civil rights movements have historically functioned separately even though “both people of color and people with disabilities share a similar experience of marginalization and ‘othering’ and even though there are people of color with disabilities” (Roberts and Jesudason 317). As my analysis reflects, because disability is frequently framed as a static medical condition, the contextual factors that influence disability, particularly for people of color, are often disregarded. Likewise, both the NIMH documents and the comics drew from medical understandings of disability as lack and disregarded the fraught relationship between people of color and the medical industrial complex. 

I therefore recommend that when engaging graphic medicine, TPCers reject apolitical, medical frames of disability and prioritize it as a complexly intersectional condition heavily influenced by sociopolitical contexts. Attending to intersectionality means recognizing differences of privilege and power across diversely marginalized communities to “grapple with the ‘matrix of domination’ and develop strategies to eliminate power inequities” (Roberts and Jesudason 315). That is, intersectionality can facilitate analysis of ablest and racist discrimination to help TPCers deconstruct and address their mutual political impacts (Jones and Walton 255). 

Attending to the Sociopolitical and Historical Influence of Capitalism on Disability 

In addition, all documents in the corpus drew from problematic, ableist understandings of disability as lack; although the comics holistically positioned disability as a human condition, they still reinforced medicalizing discourses of anxiety and encouraged readers to manage symptoms for the sake of their productivity. In this way, the documents collectively drew from ableist, capitalist systems by idealizing productive bodies as those most able. Specifically, under capitalism, “the disabled body with its complex (ir)regularities is seen to resist attempts to commodify it” (Erevelles “Educating” 41), and disability is thus frequently deemed unproductive and unworthy of participation in the broader market (41). Further, these documents personalized disability and did not consider the ideological implications of mental health diagnosis, perception, and treatment. Specifically, these documents lacked attention to “historicity,” which helps readers to better understand how personal experiences can be influenced by “cultural-historical” contexts (Jones and Walton 252). These comics thus disregarded the historical relationships between capitalism, disability, and race and thus risked rhetorically invalidating the neurodiverse (Prendergast 57) and people of color by upholding certain “physical, social, or technical characteristics” as economically ideal (Erevelles “Educating” 41). 

I thus recommend that when engaging with graphic medicine, TPCers attend to ableism’s historical connection to other oppressive forces like racism. Specifically, understanding “Black disability politics” requires “engaging histories of anti-Black violence, scientific and medical racism, health disparities, [and] health activism” and examining “how Black people have conceptualized…disability, illness, and disease” (Schalk 10). In other words, to address difference in ways that promote coalitional alliances and inspire sociopolitical change, TPCers who engage graphic medicine must address the social, political, and medical histories in which personal experiences of disability are grounded. For example, while Black disability health activism often includes concerns related to disability, it might not discuss disability in the ways that disability studies does (Schalk 95). Likewise, spirituality, generally absent from disability studies, is integral to health discussions for many Black communities (96). In addition, the medical and social elements of disability are complicated by the fraught relationship of people of color with the medical industrial complex, as Black communities have been historically denied access to medical care and as disability diagnoses can have vastly different power implications for people of color (Schalk and Kim 46). Consequently, by attending to disability justice’s recognition of disability’s intersectional historicity, composers of TPC comics can address how capitalist systems have historically equated human citizenship with productive ability (Berne et al. 227) in ways that marginalize disabled folks of color. 

Conclusion

Graphic medicine is an exciting genre for TPC social justice work because it can personalize accounts of mental health while simultaneously deconstructing the sociopolitical influences of disability discourse. However, as this article demonstrates, it is vital that TPCers critically address disability’s complex intersectionality when engaging graphic medicine. Future research might expand beyond this study’s limitations to examine the sociopolitical functioning of comics in popular media and TPC. Specifically, while this article analyzed popular comics and medical infographics from three websites, researchers might study a wider range of medical documents and/or comics. Likewise, since this study analyzed anxiety documents, future research might examine articulations of other mental health disabilities. I also recommend that future research examine the impacts of critically engaging graphic medicine in the ways recommended in this article, specifically for disabled employees of color. 

Engaging graphic medicine in ways that further social justice requires TPC’s critical attention to ableism’s connection to other oppressive systems. As this article demonstrates, even the most well-intentioned mental health comics can perpetuate problematic ideas about disability without such critical considerations. By applying intersectionality through graphic narratives grounded in disability justice, TPCers can challenge white, heteronormative, capitalist, and ableist understandings of disability and frame disability as rhetorically transformational and valuably human across technical, medical, professional, and educational contexts. 

Appendix A: List of Analyzed Documents

NIHM Digital Shareables 

Anxiety: https://www.nimh.nih.gov/get-involved/digital-shareables/shareable-resources-on-anxiety-disorders

  1. NIMH Document 1: My mental health. Do I need help?
  2. NIMH Document 2: I’m so stressed out 
  3. NIMH Document 3: 5 Things You Should Know About Stress
  4. NIMH Document 4: Anxiety Disorders 
  5. NIMH Document 5: Occasional Anxiety 
  6. NIMH Document 6: Social Anxiety Disorder

Introvert Doodles Documents on Anxiety and Mental Health 

  1. Introvert Document 1: Anxiety Bingo https://introvertdoodles.com/comic/anxiety-bingo/
  2. Introvert Document 2: Urgent Emergency https://introvertdoodles.com/comic/urgent-emergency/
  3. Introvert Document: Bravery https://introvertdoodles.com/comic/bravery/
  4. Introvert Document 4: Happy Place https://introvertdoodles.com/comic/happy-place/
  5. Introvert Document 5: How to Help https://introvertdoodles.com/comic/how-to-help/
  6. Introvert Document 6: Panic Basically https://introvertdoodles.com/comic/panic-basically/

Everyday Feminism Documents:

  1. Everyday Document 1: 7 Illustrations That Capture Exactly What It’s Like to Have Anxiety https://everydayfeminism.com/2016/07/acknowledge-anxiety-illustrations/
  2. Everyday Document 2: 4 Major Ways to Cope with Social Anxiety https://everydayfeminism.com/2016/03/cope-with-social-anxiety/
  3. Everyday Document 3: The Experience of Anxiety https://everydayfeminism.com/2015/06/the-experience-of-anxiety/
  4. Everyday Document 4: The Tricky Thing About Being Trans and Having a Mental Illness

https://everydayfeminism.com/2016/10/trans-experience-vs-mental-illness/

  1. Everyday Document 5: I Have a Mental Disorder – And No, I’m Not Sorry

https://everydayfeminism.com/2017/03/mental-disorder-not-sorry

Appendix B: NIHM Coded Totals

Code NIMH 1 NIMH 2 NIMH 3 NIMH 4 NIMH 5 NIMH 6 Total
Static  0 11 0 24 7 10 52
Dynamic 0 7 0 45 10 14 76
Intersectionality 0 0 0 0 0 0 0
Unproductive 9 8 0 4 5 9 35
Valuable 0 3 1 0 0 0 4
Choice 30 42 4 29 35 36 176
Relational  13 11 2 41 29 44 140
Lack 43 44 1 118 71 84 361
Human  3 6 3 6 2 1 21

Appendix C1: Introvert Doodles Coded Totals

Code Introvert 1 Introvert 2 Introvert 3 Introvert 4 Introvert 5 Introvert 6 Total
Static  0 1 0 0 0 0 1
Dynamic 0 6 0 0 1 8 15
Intersectional 0 0 0 0 0 0 0
Unproductive  5 3 0 0 0 0 8
Valuable 0 0 3 0 0 0 3
Choice 0 2 2 2 0 1 7
Relational  0 0 0 0 10 2 12
Lack 20 9 4 7 7 9 56
Human  1 16 5 10 7 4 43

Appendix C2: Everyday Feminism Coded Totals

Code Everyday

1

Everyday 2 Everyday 3 Everyday 4 Everyday 5 Total 
Static  0 5 2 3 8 18
Dynamic 6 32 6 39 1 84
Intersectional 0 1 0 14 0 15
Unproductive 1 3 0 1 2 7
Valuable 0 3 0 0 0 3
Choice 1 37 3 1 1 43
Relational  1 16 6 3 0 26
Lack 26 35 24 35 6 126
Human  28 50 29 10 25 142

Appendix C3: Total Coded Concerns Across the Comics

Code Introvert Doodles Everyday Feminism Comic Totals 
Static  1 18 19
Dynamic 15 84 99
Intersectional  0 15 15
Unproductive 8 7 15
Valuable 3 3 6
Choice 7 43 50
Relational  12 26 38
Lack 56 126 182
Human  43 142 185

Works Cited

“3 Most Common Mental Health Disorders in America.” Access Community Health Network. 

November 18, 2021. https://www.achn.net/about-access/whats-new/health-resources/3-most-common-mental-health-disorders-in-america/#:~:text=The%20National%20Alliance%20of%20Mental,major%20depression%20and%20bipolar%20disorder. Accessed 5 June 2022. 

“About Everyday Feminism.” Everyday Feminism. https://everydayfeminism.com/about-ef/. 

Accessed 1 May 2022. 

“About NIMH.” National Institute of Mental Health. https://www.nimh.nih.gov/about. Accessed 

1 May 2022. 

Agboka, Godwin Y. “Decolonial Methodologies: Social Justice Perspectives in Intercultural 

Technical Communication Research.” Journal of Technical Writing and Communication

vol. 44, no. 3, 2014, pp. 297-327, http://dx.doi.org/10.2190/TW.44.3.e. Accessed 1 May 2022. 

Alexander, Jamal-Jared and Avery C. Edenfield. “Health and Medicine as Resistance: Tactical 

Folk Medicine.” Technical Communication Quarterly, vol. 30, no. 1, 2021, pp. 241-56. https://doi.org/10.1080/10572252.2021.1930181. Accessed 15 October 2022. 

“Anxiety Disorders.” National Institute of Mental Health. 

https://www.nimh.nih.gov/health/topics/anxiety-disorders. Accessed 15 June 2022. 

Bailey, Moya. “‘The Illest”: Disability as Metaphor in Hip Hop Music.” Blackness and 

Disability: Critical Examinations and Cultural Interventions, edited by Christopher M. Bell, Michigan UP, 1997, pp. 141-48. 

Baynton, Douglas C. “Disability and the Justification of Inequality in American History.” The 

New Disability History: American Perspectives, edited by Paul Longmore and Lauri Umansky, New York UP, 2001, pp. 33-57.

Bell, Chris. “Introducing White Disability Studies: A Modest Proposal.” The Disability Studies 

Reader, 2nd edition, edited by Lennard J. Davis, Routledge, 2006, pp. 275-82. 

Bell, Chris. “Introduction: Doing Representational Detective Work.” Blackness and 

Disability: Critical Examinations and Cultural Interventions, edited by Christopher M. Bell, Michigan UP, 1997, pp. 1-8. 

Bennett, Kristin C. “Prioritizing Access as a Social Justice Concern: Advocating for Ableism 

Studies and Disability Justice in Technical and Professional Communication.” IEEE Transactions on Professional Communication, vol. 65, no. 1, 2022, DOI: 10.1109/TPC.2022.3140570. Accessed 1 May 2022. 

Bennett, Kristin C. and Mark A. Hannah. “Transforming the Rights-Based Encounter: Disability 

Rights, Disability Justice, and the Ethics of Access.” Journal of Business and Technical Communication, vol. 36, no. 3, 2022, pp. 326-54, https://doi.org/10.1177/10506519221087960. Accessed 1 June 2022. 

Berne, Patricia, et al. “Ten Principles of Disability Justice.” WSQ: Women’s Studies Quarterly, vol. 46, no. 1, 2018, pp. 227-330, https://doi.org/10.1353/wsq.2018.0003. Accessed 1 May 2022. 

Birge, Sarah. “No Life Lessons Here: Comics, Autism, and Empathetic Scholarship.” Disability Studies Quarterly, vol. 30, no.1, 2010, n.p., https://dsq-sds.orgarticle/view/1067/1255. Accessed 1 May 2022. 

Browning, Ella R. and Lauren E. Cagle. “Teaching a ‘Critical Accessibility Case Study’: 

Developing Disability Studies Curricula for the Technical Communication Classroom.” Journal of Technical Writing and Communication, vol. 47, no. 4, 2017, pp. 440-63, https://doi.org/10.1177/0047281616646750. Accessed 1 May 2022. 

Cherney, James L. Ableist Rhetoric: How We Know, Value, and See Disability. The State UP, 2019. 

Collins, Patricia Hill and Sirma Bilge. Intersectionality. Polity Press, 2016. 

Colton, Jared and Rebecca Walton. “Disability as Insight into Social Justice Pedagogy in 

Technical Communication.” The Journal of Interactive Technology and Pedagogy, vol. 8, 2015, https://jitp.commons.gc.cuny.edu/disability-as-insight-into-social-justice-pedagogy-in-technical-communication/. Accessed 1 May 2022. 

Combahee River Collective. “A Black Feminist Statement.” Words of Fire: An Anthology of 

African-American Feminist Thought, edited by Beverly Guy-Sheftall, The New Press, 1995, pp. 231-40.

Crenshaw, Kimberlé. “Mapping the Margins: Intersectionality, Identity Politics, and Violence 

Against Women of Color.” Stanford Law Review, vol. 43, no. 6, 1999, pp. 1241-99, https://doi.org/10.2307/1229039. Accessed 10 November 2022. 

Czerwiec, M.K., et al. “Introduction.” Graphic Medicine Manifesto. The Pennsylvania State 

UP, 2015. 

Emmons, Kimberly K. Black Dogs and Blue Words: Depression and Gender in the Age of Self-

care. Rutgers UP, 2010. 

Erevelles, Nirmala. Disability and Difference in Global Contexts: Enabling a Transformative 

Body Politic. Palgrave Macmillan, 2011. 

Erevelles, Nirmala. “Educating Unruly Bodies: Critical Pedagogy, Disability Studies, and the 

Politics of Schooling.” Educational Theory, vol. 50, no.1, 2000, pp. 25-47, 

https://doi.org/10.1111/j.1741-5446.2000.00025.x. Accessed 1 November 2022. 

Fox, Ann. “Graphic Medicine in Disability Studies: Getting Started with Graphic Medicine in

Disability Studies.” Graphic Medicine. https://www.graphicmedicine.org/resources/liaison-program/disability-studies/. Accessed 1 May 2022. 

Gonzales, Laura et al. “Narratives from the Margins: Centering Women of Color in Technical 

Communication.” Equipping Technical Communicators for Social Justice Work: Theories, Methodologies, and Pedagogies, edited by Rebecca Walton and Godwin Y. Agboka. UP of Colorado, 2021, pp. 15-32. 

Gonzales, Laura and Rachel Bloom-Pojar. “A Dialogue with Medical Interpreters about 

Rhetoric, Culture, and Language.” Rhetoric of Health and Medicine, no.1, vol. 1-2, 2018, pp. 193-212, https://doi.org/10.5744/rhm.2018.1002. Accessed 30 October 2022. 

Gutsell, Margaret and Kathleen Hulgin. “Supercrips Don’t Fly: Technical Communication to Support Ordinary Lives of People with Disabilities.” Rhetorical Accessibility: At the Intersection of Technical Communication and Disability Studies, edited by Lisa Melonçon, Baywood Publishing Company, Inc., 2013, pp. 83-94.

Haas, Angela M. “Race, Rhetoric, and Technology: A Case Study of Decolonial Technical Communication Theory, Methodology, and Pedagogy.” Journal of Business and Technical Communication, vol. 26, no. 3, 2012, pp. 277-310. DOI: 10.1177/1050651912439539. Accessed 1 June 2022. 

Haas, Angela M. and Michelle F. Eble. “Introduction.” Key Theoretical Frameworks: Teaching Technical Communication in the Twenty-first Century, edited by A.M. Haas and M.F. Eble, U of Colorado P, 2018. pp. 212-40.

Hamraie, Aimee and Kelly Fritsch. “Crip Technoscience Manifesto.” Catalyst: Feminism, 

Theory, Technoscience, vol. 5, no.1, 2019, pp. 1-33. https://doi.org/10.28968/cftt.v5i1.29607. Accessed 15 May 2022. 

Harper, Kimberly. The Ethos of Black Motherhood in America: Only White Women Get 

Pregnant. Lexington Books, 2020. 

Hatfield, Charles. Alternative Comics: An Emerging Literature. UP of Mississippi, 2005. 

Hitt, Allison. “Access for All: The Role of Dis/ability in Multiliteracy Centers.” Praxis: A 

Writing Center Journal, vol. 9, no. 2, 2012. Accessed 1 May 2022. 

Jones, Natasha N. “The Technical Communicator as Advocate: Integrating a Social Justice 

Approach in Technical Communication.” Journal of Technical Writing and Communication, vol. 46, no. 3, 2016, pp. 342-61, https://doi.org/10.1177/0047281616639472. Accessed 3 June 2022. 

Jones, Natasha and Rebecca Walton. “Using Narratives to Foster Critical Thinking About 

Diversity and Social Justice.” Key Theoretical Frameworks: Teaching Technical Communication in the Twenty-first Century, edited by A.M. Haas and M.F. Eble. U of Colorado P, 2018, pp. 241-67.

Jones, Natasha N. et al. “Disrupting the Past to Disrupt the Future: An Antenarrative of Technical Communication.” Technical Communication Quarterly, vol. 25, no. 4, 2016, pp. 211-29. https://doi.org/10.1080/10572252.2016.1224655. Accessed 1 May 2022. 

Konrad, Annika. “Reimagining Work: Normative Commonplaces and Their Effects on Accessibility in Workplaces.” Business and Professional Communication Quarterly, vol. 81, no.1, 2018, pp. 123-41. https://doi.org/10.1177/232949061772577. Accessed 1 June 2022. 

Lakshmi Piepzna-Samarasinha, Leah. Care Work: Dreaming Disability Justice. Arsenal Pulp 

Press, 2018.

Lewis, Talila “TL.” “Updated Working Definition of Ableism.” Facebook, January 25, 2020, 

https://www.facebook.com/photo.php?fbid=10102728588169305&set=a.10101262893458255&type=3&theater. Accessed 1 November 2022. 

Licona, Adela C. “(B)orderlands’ Rhetorics and Representations: The Transformative Potential

of Feminist Third-Space Scholarship and Zines.” NWSA Journal, vol. 17, no. 2, 2005, pp. 104-29, https://www.jstor.org/stable/4317128. Accessed 1 November 2022. 

Oswal, Sushil K. and Lisa Melonçon. “Paying Attention to Accessibility When 

Designing Online Courses in Technical and Professional Communication.” 

Journal of Business and Technical Communication, vol. 28, no.3, 2014, pp. 271-300 https://doi.org/10.1177/1050651914524780. Accessed 17 May 2022. 

McAllister, Matthew P. “Comic Books and AIDS.” Journal of Popular Culture, vol. 26, 1992, pp. 1-24, https://doi.org/10.1111/j.0022-3840.1992.26021.x. Accessed 1 June 2022. 

McCloud, Scott. Understanding Comics. Harper Perennial, 1994.

Melonçon, Lisa. “Introduction.” Rhetorical Accessibility: At the Intersection of Technical 

Communication and Disability Studies, edited by Lisa Melonçon. Routledge, 2013, pp. 1-14. 

Melonçon, Lisa et al. “Introduction: The Rhetoric of Health and Medicine As/Is.” Rhetoric of 

Health and Medicine As/Is: Theories and Approaches for the Field, edited by Lisa Melonçon et al., The Ohio State UP, 2020, pp. 1-12. 

Moeller, Marie. “Pushing Boundaries of Normalcy: Employing Critical Disability 

Studies in Analyzing Medical Advocacy Websites.” Communication Design Quarterly, vol. 2, no. 4, 2014, pp. 52-80. https://doi.org/ 10.1145/2721874.2721877. Accessed 1 May 2022. 

Mollow, Anna. “‘When Black Women Start Going on Prozac:’ Race, Gender, and Mental Illness 

in Meri Nana-Ama Danquah’s Willow Weep for Me.MELUS, vol. 31, no.3, 2006, pp. 68-99, https://www.jstor.org/stable/30029652. Accessed 4 November 2022. 

Molloy, Cathryn and Lisa Melonçon. “Introduction: Interventions in Mental Health Rhetoric 

Research.” Strategic Interventions in Mental Health Rhetorics, edited by Lisa Melonçon and Cathryn Molloy, Routledge, 2022, pp. 1-12. 

Prayal, Katie Rose Guest. “The Genre of the Mood Memoir and the Ethos of Psychiatric Disability.” Rhetoric Society Quarterly, vol. 40, no.5, pp. 479-501, https://doi.org/10.1080/02773945.2010.516304. Accessed 1 May 2022. 

Prendergast, Catherine. “On the Rhetorics of Mental Disability.” Embodied Rhetorics: Disability in Language and Culture, Southern Illinois UP, 2001, pp. 45–60.

Price, Margaret. “The Bodymind and the Possibilities of Pain.” Hypatia, vol. 30, no. 1, 2015. pp. 

268-84. https://www.jstor.org/stable/24542071. Accessed 1 June 2022. 

Price, Margaret. Mad at School: Rhetorics of Mental Disability and Academic Life. U of Michigan P, 2011.

Puar, Jasbir K. The Right to Maim: Debility, Capacity, Disability. Duke UP, 2017.

Ramdarshan Bold, Melanie. “Why Diverse Zines Matter: A Case Study of the People of Color 

Zines Project.” Publishing Research Quarterly, vol. 33, pp. 215-28, https://doi.org/10.1007/s12109-017-9533-4. Accessed 30 October 2022. 

Roberts, Dorothy and Sujatha Jesudason. “Movement Intersectionality: The Case of Race, 

Gender, Disability, and Genetic Technologies.” Du Bois Review, vol. 10, no. 2, 2013, pp. 313-28, https://doi.org/10.1017/S1742058X13000210. Accessed 30 October 2022. 

Saldaña, Johnny. The Coding Manual for Qualitative Researchers. Sage, 2016.

Schuster, Susan. “If You’re an Introvert with Anxiety, These Comics are For You.” The Mighty. 

June 3, 2016, https://themighty.com/2016/06/introvert-doodles-marzi-draws-about-being-an-introvert-with-anxiety/. Accessed 1 June 2022. 

Schalk, Sami. Black Disability Politics. Duke UP, 2022. 

Schalk, Sami and Jina B. Kim. “Integrating Race, Transforming Feminist Disability Studies.” 

Signs: Journal of Women in Culture and Society, vol. 46, no. 11, 2020, pp. 31-55, https://doi.org/10.1086/709213. Accessed 30 October 2022. 

Sointu, Eeva. “The Rise of an Ideal: Tracing Changing Discourses of Wellbeing.” The 

Sociological Review, vol. 53, no.2, pp. 255-74. https://doi.org/10.1111/j.1467-954X.2005.00513.x. Accessed 3 June 2022. 

Taylor, Ashley. “The Discourse of Pathology: Reproducing the Able Mind through Bodies of 

Color.” Hypatia, vol. 30, no.1, 2015, pp. 181-98, https://doi.org/10.1111/hypa.12123. 

Accessed 1 November 2022. 

Walters, Shannon. “Autistic Ethos at Work: Writing on the Spectrum in Contexts of 

Professional and Technical Communication.” Disability Studies Quarterly, vol. 31, no.3, 2011, n.p. https://dsq-sds.org/article/view/1680. Accessed 16 May 2022. 

Walton, Rebecca, et al. Technical Communication After the Social Justice Turn: Building Coalitions for Action. Routledge, 2019. 

Wegner, Geisine. “Reflections on the Boom of Graphic Pathography: The Effects and Affects of Narrating Disability and Illness in Comics.” Journal of Literary and Cultural Disability Studies, vol. 14, no. 1, 2000, pp. 57-74, https://muse.jhu.edu/article/748214. Accessed 1 May 2022. 

Wheeler, Stephanie. “Harry Potter and the First Order of Business: Using Simulation to Teach 

Social Justice and Disability Ethics in Business Communication.” Business and 

Professional Communication Quarterly, vol. 81, no.1, 2018, pp. 85-99. https://doi.org/10.1177/2329490617748691. Accessed 1 June 2022. 

Yam, Shui-yin Sharon. “Visualizing Birth Stories from the Margin: Toward a Reproductive 

Justice Model of Rhetorical Analysis.” Rhetoric Society Quarterly, vol. 50, no. 1, 2020, 

pp, 19-34. https://doi.org/10.1080/02773945.2019.1682182. Accessed 30 October 2022. 

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