A Civil Rights Lawyer with Type 1 Diabetes Reflects on Barriers to and Benefits of Self-Advocacy

Guest Post written by Elise Cossart-Daly, panelist at Invisible Identities: A Conversation on Diabetes and Disability.

It can be challenging for people with diabetes to exercise their legal rights. Diabetes is often invisible and disabilities are stigmatized, so people are incentivized to not disclose their medical condition, explain what managing diabetes entails, or ask those in power to honor their legal rights as diabetics. People with diabetes also have to contend with others’ misconceptions about their disease. People who don’t have diabetes or intimately know someone with it may assume that diabetes is extremely limiting or, alternatively, that managing diabetes is as simple as taking medication each day.

This can be particularly challenging in the employment context. Unless an employee has a visible disability, most employers assume that employees do not contend with serious health issues. They do not expect that employees will need to treat low blood sugars, take time for a last-minute pump site change, frequently visit their healthcare providers, or otherwise take time off of work to care for themselves. In addition, identifying oneself as disabled and requiring accommodations cuts against cultural norms that glorify commitment to work above all else. Many diabetics also face bias and discrimination at work based on race, gender, national origin, gender identity or expression, sexual orientation, disabilities other than diabetes, or other protected characteristics. This compounds other barriers to self-advocacy around diabetes at work.

Though it is difficult to address, the reality remains that, at times, diabetes will come into conflict with diabetics’ aspirations and responsibilities in a professional context. As people with diabetes, we spend more time at doctors’ appointments than people who do not contend with serious physical or mental health conditions. We have to monitor and manage blood sugars, food intake, exercise, and hormonal changes each day. Our bodies often handle more physical stressors than people without major health concerns, and as a result, we may need more rest and care than others. We frequently have additional health conditions, which may require more treatment or lifestyle modifications. Some of us live with complications that have tangible impacts on our bodies. Yet, at the same time, we are extremely capable, and, if we care for ourselves, we can accomplish practically anything. As a result, we must advocate for ourselves so that we have every opportunity to care for our bodies, succeed at work, and provide for ourselves and our families.

I understand this struggle. I have long fought for equality and fairness along lines of gender, race, socio-economic status, disability, and sexual orientation. Yet, for many years, it was challenging and emotionally complicated to advocate for myself as a diabetic. For the first twenty-five years I had type 1 diabetes, I was reticent to ask schools, institutions, or employers for anything I didn’t absolutely need to survive. It took over a decade of working for others’ civil rights; attending a graduate school that wouldn’t permit me to wear my pump, test my blood sugar, or treat hypoglycemia during exams without official accommodations; managing a healthy pregnancy while working at a busy law firm; and developing additional autoimmune disorders to change that practice and perspective in my own life. Advocating for myself and my body is still a process, but I now approach self-advocacy as an essential component of my well-being and professional success.

In my own life, I have come to realize that self-advocacy is an act of acceptance, self-love, and service to others. To advocate for yourself, you must first accept that your body functions differently than others’ and that you must do things to keep yourself alive that those without diabetes do not. You must love yourself enough to believe that you are worthy of fair and equitable opportunities. You must care for your body enough to ask for the resources and accommodations you need to keep it safe. When you advocate for yourself, you remind employers, schools, and institutions that they must be responsive to the needs of people with disabilities. When you are honest about what you must do to care for your body or ask for accommodations, you make it easier for other diabetics and people with disabilities to be open about their own experiences and needs. When you challenge discrimination, you remind those in power of their responsibility to treat people fairly. Ultimately, in advocating for yourself, you create space for others to challenge inequality and injustice.

Elise Cossart-Daly is an anti-discrimination, civil rights, and environmental lawyer at Cossart-Daly Law. She has had type 1 diabetes for over thirty years, and lives with celiac disease, Hashimoto’s Thyroiditis, and an autoimmune arthritis. She practices law in California, where she lives with her husband and daughter. At the time of publication, Elise is pregnant with her second child.