Asking for Accommodations as a Higher-Weight Person Part 1
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While places that serve the public (from transportation, to food service, to entertainment and especially healthcare) should be set up to accommodate everyone in the public, unfortunately, that is not always the case. This can create a situation where we may want/need to ask for access/accommodations. This can happen to people for any number of reasons - size, disability, neurodivergence and more. For those with multiple marginalized identities, this can occur more often and asking can be more difficult. For this piece, I’ll be focusing on accommodations for fat people, though these techniques can be helpful in any situation. I also want to acknowledge that, while the size at which someone may need to ask for accommodations can vary, lack of accommodation does the most harm to those at the highest weights and/or multiply marginalized fat people.
Asking for accommodations can bring up a lot of emotions – stress, embarrassment, shame, fear, anger, guilt. I think that one massive problem is that we’ve been told that asking for accommodations is asking for some kind of favor or special treatment above and beyond what everyone else gets. This stems from weight stigma. Unfortunately there are people who believe that fat people don’t deserve healthcare and, thus, that if a lack of accommodation is due to fatness, then inequality is acceptable. It can also stem from capitalism. If you can make the people you haven’t accommodated blame themselves (and/or get others to blame them) for the lack of accommodation, then you don’t have to invest resources to fix it.
In truth, there is plenty of evidence to show that people are a variety of sizes for a variety of reasons which are not necessarily within their control and that we have no proven method to change size over the long term. More importantly, it doesn’t matter why someone is fat or even if it was possible to be thin. We have every right to exist in our bodies as they are, and we deserve to be accommodated, including in healthcare. Fat people exist and they deserve to be accommodated in the bodies they have now, not at some hypothetical future date when they might look different.
Another issue with accommodation for fat people is some people believe , and we are often actually told, that we should simply get thin so that we don’t need the accommodations. Perhaps the most cruel version of this is when people suggest that we use someone else’s failure to accommodate us as “motivation” to change ourselves. Even if this was appropriate - and it’s not - and even if it was likely to work – and it’s not – it doesn’t help someone who needs to fit into an MRI and get the scan they need right now, nor does it help someone fit into a too-small chair with arms for the office meeting they’re required to attend, or into the too-small theater seat to watch their kid’s performance or the Broadway show they spent a ton of money on.
Also, asking a healthcare facility, business etc. for accommodation is not asking for special treatment, it’s asking for what everyone else is already getting. When the hospital opened to provide healthcare to the community they were aware that the community includes fat people; so they should have ordered armless chairs, large blood pressure cuffs, gowns, larger beds etc. so that all patients could have access to the same experience, and if they failed to do it when they opened, they should have done it at some point, and if they failed to do it at some point, they should do it now. Regardless, fat people who want a properly-sized blood pressure cuff (or a seat that accommodates them on a plane for a single fare, or a seat they can sit in to go with their expensive theater ticket) aren’t asking for something special, they are just asking for what thin people are already getting.
So what can you do about a failure to accommodate? First, realize that you shouldn’t have to ask for them and that if you do you aren’t doing anything wrong or asking for anything special, you’re doing the facility/business a favor by alerting them to a situation that they should have already been aware of and solved. They should be embarrassed, not you. Second, you get to decide how and if you want to ask, and that may vary depending on how you feel on any given day. That said, this can be a great chance to use any power/privilege/leverage you have. For some people, it can be helpful to think about it not as asking for accommodations just for yourself, but for the next fat person who may not be in a position to ask. This can also vary depending on who you are talking to.
Finally, remember that you can’t control the outcome of your request. The only thing you can do is make the request, if the person chooses to respond with fatphobia that sucks, and it can do real harm to you, but it’s not your fault.
Let’s look at some options for how to ask:
When to Ask
It may be a situation where you (or someone who is advocating for you) can ask ahead of time. So, when you schedule your procedure ask them to make sure to have a bed that is weight-rated for you. Or call ahead to make sure that the facility where you are getting your mammogram has robes that will fit you. Or ask for the weight rating and bore size of the MRI.
If the accommodation failure is happening in real-time, you might choose to say something as it’s happening, or you might choose to wait until it is over/you have what you need and then ask. You can ask in person, you could also call and/or send an email/text/DM later (or have someone who is willing to advocate for you reach out.)
Who to Ask
If it’s happening in real-time, the person you are talking to may not have had anything to do with the lack of accommodation that you are experiencing, and may not be empowered to solve the problem. (Or they may have, and be.) You can ask them if they can help and, if not, ask you you should talk to. You can also try a facilities website, or ask to speak to someone in patient management, or a medical advocate.
How to Ask
You can start by pointing out the lack of inclusion and letting them come up with the solution or ask for the solution you want:
There are no armless chairs in the waiting room, I can’t sit comfortably/at all…
Could you please bring me an armless chair so I can sit comfortably/at all?
You get to choose the tone that you use. The saying tells us that we can catch more flies with honey than vinegar. That may be true and you may try the honey approach. Or, you may not feel like catching flies. You might choose to express the anger and frustration you feel at your inability to access something you want/need, and that’s also valid.
If things don’t get resolved
If they fail to provide accommodations, you may consider filing a complaint with the facility, practice manager, government offices, and/or state medical boards. You might also go public with social media and review sites like Yelp, ZocDoc, HealthGrades, and Vitals.com
Remember that none of this should be necessary, and each person gets to choose how they handle it in each situation. How much privilege, power, and leverage we have will always come to bear in these situations. Whatever decision you make is the right one, as long as it’s the right decision for you.
In Part 2 we’ll learn more techniques from the amazing people at FLARE (Fat Legal Advocacy Rights and Education) Project!
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*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.
Thank you SO much for this. I'm fat and autistic, and when I do encounter bias or a lack of accommodations I have a really hard time advocating for myself because I get easily frustrated and end up melting down over struggles to communicate that leave me feeling unheard or condescended to.
My current healthcare system is nicer than some I've dealt with, but I've still had to bring my best friend with me to appointments for support, after previous visits were so awful that I did not want to return for care. And it's nice that this guide can apply to more than healthcare, because while my doctor's office only has one or two armless seats in each waiting area and that does make access harder for me, there's also only one movie theater in my city that has seats that fit me.
I would like to get better at being a force for change, not only for my sake but for the larger community, like you mention here. Because I'm white and people assume I'm cis, straight, and neurotypical, I know I have a lot of privilege--and sometimes I experience moments where I can tell that people are trying to accommodate me without visibly singling out my size, even as they're clearly having to rethink their usual ways of working. So this was a really useful breakdown for me to think about, and I'll hang onto it.