On her left arm, Twitch streamer LittleNavi has a tattoo of WASD, the four keyboard keys PC gamers typically use to move their characters. “It’s ironic, though, because my left hand is the hand that has lost the most function over the years,” says Lorelei, who goes by LittleNavi online to preserve her anonymity. She was diagnosed in her 20s with relapsing remitting multiple sclerosis, a chronic condition that affects her central nervous system. “I remember thinking, ‘I can’t believe I got a tattoo of the WASD keys, and I don’t know if I’m ever going to be able to use the WASD keys again.’”

A digital accessibility specialist from Ontario, Canada, Lorelei is one of 15% of people in the world living with disability or chronic illness, according to the World Bank. However, 30% of US gamers identify as disabled, as do 20% of gamers in the United Kingdom, per research firm Newzoo. While much progress has been made in the gaming industry in recent years, there are still barriers preventing the most inclusive experience for those living with disabilities, from a lack of basic in-game features to a broader ignorance regarding the community. Disability means something unique to everyone, and no individual experience, even within the same diagnosis, is the same. In order to move the needle toward greater accessibility in gaming, we must continue to create (and play) games with assistive technology, dismantle stigmatized perceptions of disability, and challenge ableist beliefs surrounding gaming.

Accessibility starts with the development of games themselves, and thankfully certain studios from major and indie developers are prioritizing inclusive features today more than ever, often with the help of hired accessibility consultants. Ubisoft Toronto’s Far Cry 6 boasts an expansive accessibility menu of audio and interface options, from enabling closed captioning for all in-game sounds to outlining certain enemies and items in different colors for people with visual disabilities. Eidos-Montréal’s Marvel’s Guardians of The Galaxy offers a custom difficulty mode of gameplay, which allows players to tailor specific aspects of the game to their needs, from adjusting how much damage they deal to enabling auto-win events. These types of highly customizable settings are essential for meeting the needs of as many players as possible — and the more options, the better. “No one or two implementations will make anything accessible for everyone, because no one or two implementations would even make things accessible for one person,” says Lorelei, whose energy levels and accessibility needs fluctuate from day to day.

More recently, gaming equipment companies have also begun prioritizing accessibility in their device designs such as the Xbox Adaptive Controller and Logitech Adaptive Gaming Kit, which allow players to customize their gaming experience with programmable buttons and external peripherals. The QuadStick, a mouth-operated controller, gives gamers a hands-free way to play. Even packaging has become more accessible, as seen with the Xbox Adaptive Controller, which provides a seamless unboxing thanks to low-effort tear strips and tuggable loops. “When I first got my [Xbox Adaptive Controller],” Lorelei recalls, “my hands were barely functioning. Being able to open that box by myself was actually a big deal, and made me a bit emotional.” Other equipment, like a 3D rudder, which allows players to control their movement with their feet, weren’t specifically created for those with disabilities, but allowed disabled players to expand their game pools. “That’s one thing about us disabled folks,” says Lorelei, who re-binded her WASD keys to her 3D rudder, “we’re incredibly adaptive.”

But all that additional equipment comes at a literal cost. Accessibility peripherals, from controllers to switches, can cost hundreds or even thousands of dollars — or a “disability tax,” as it’s known within the community. That doesn’t include potentially having to hire someone to install the equipment if you are unable to do so yourself, or spending $60 on a new game only to discover upon initial playthrough that there is a mechanic you cannot perform in order to progress the story.

“Oftentimes, the people who most need accessible tech are the ones least able to access it,” says Lorelei. “If you have a disability that’s going to make it difficult for you to use a standard controller, that disability might also make it difficult for you to find regular employment. A lot of us in the disabled community are or have been on government assistance.” Organizations like AbleGamers and SpecialEffect, she mentions, are examples of charities helping provide adaptive equipment to those in need, making gaming more affordable for all.

Still, the steep cost of making gaming and streaming more accessible is worth the social connection and personal fulfilment to those living with disabilities, some streamers say. “Illness is isolating,” says Netherlands-based streamer Lauren Radford, or RaddersGaming, who spends most of her days at home ever since a case of tonsillitis during college sent her down a path of various illnesses, including myalgic encephalomyelitis (i.e. chronic fatigue syndrome) and fibromyalgia. After becoming sick, she started immersing herself in open-world games like The Elder Scrolls V: Skyrim, and eventually discovered a community of fellow gamers on Twitch. “I had lost everything. I was grieving my life, my education, my future. Then I fell into the gaming community, and I found a rope to cling onto,” says Radford, now a Twitch partner and full-time creator. “I’m not sure I would have been able to find such strong hope in any other industry. This was the most accessible thing I could have done, because I was doing it from my bedroom in my pajamas. I honestly don’t think I would have a career if I hadn’t found gaming.”

For Emma, a Netherlands-based Twitch streamer who goes by Emmagination, streaming allows her to create a safe space for fostering community and educating others. “Video games can be a facilitator into bigger conversations,” she says. Diagnosed with fibromyalgia and having recently accepted herself as a trans woman, Emma often speaks openly with her viewers about her personal struggles on stream, from her gender identity to mental health and disability support. In one particular instance, a regular chatter opened up to the community about accepting themselves as a trans woman, something they had not even expressed to their friends and family at the time. “That was a huge landmark moment for me in terms of what I wanted to do with streaming,” Emma says. “Growing up, gaming was always my chance to be the hero of the story, to be the person who can create change. Now, it’s become a very real power in which I can make a difference by helping other people and positively impacting their lives. It’s become a self-fulfilled prophecy.”

But life as a full-time streamer, especially for someone living with disabilities, can be mentally and physically draining, and for many, it’s not an entirely viable option. Ask most streamers how to grow viewership and you’ll hear the same advice: stream for long hours at a time, maintain a consistent schedule, and constantly put out content. “There is a lot of inherent ableism in the ways we tell people to become successful [in streaming],” says Florida-based writer and streamer Teona Studemire, or Tee_Spoonie. “I can’t stream for eight hours a day, I’m too sick. My illnesses are too inconsistent and unpredictable for me to be able to deliver in that way — and I shouldn’t have to.”

Putting your disability in front of a live audience that might not understand how to discuss or respond to disabilities can present challenges, as well. “There’s a barrier to the way that society perceives disability, in that they think it’s all or nothing. They think that someone who is in a wheelchair has to always be in a wheelchair a hundred percent of the time,” says Lorelei. “People will log into someone’s stream who is low-vision, see them read something with their eyes, and start saying others are ‘faking’ their disability or using it to get attention.”

On the flip side, some people will look at streamers with disabilities as “inspiration porn,” a term coined in 2012 by disability rights activist Stella Young, celebrating them solely on the basis of their disability in an objectifying manner. And that can be exhausting in other ways. “People will come into my stream and say it is inspiring that I play video games,” Lorelei says. “Is it? Tell me I am inspiring because I am talented at something, because I volunteer on boards and committees, because of the advocacy work I do — but don’t tell me I am inspiring for being in a wheelchair, for simply existing.”

As discourse around accessibility in gaming continues to grow, the vision of a more accessible gaming industry becomes clearer and clearer. “I want more legislation on accessibility,” says digital content producer Erin Hawley, or GeekyGimp, referring to protections like the Twenty-First Century Communications and Video Accessibility Act which requires accessible communication services in video games. “I want to see a director of accessibility on every staff that’s big enough to have one,” says Jay, a streamer, editor, and cosplayer who streams under the name ThatJayJustice. “If you are making triple-A games, where is your accessibility director? Who are they? What is their name?”

Intersectionality must be a guiding principle of every gaming company and corporation, as well, Lorelei says. “From square one, having a focus on diversity, equity, and inclusion — not only in hiring practices, but also in the ways that we design games and represent characters in games — will be a big first step that things will naturally build from.” What’s most needed though is a cultural shift in the larger gaming community that requires every gamer, disabled or not, to rally for change. “If an inclusive game with equal representation that is accessible to the vast majority of people is what most people want, that is the game we are going to get,” Emma says. “But we need to ask for it, and not just those who are affected by it.”

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