After I finished chemotherapy for stage 3 endometrial cancer in 2021, I had a lot of new side effects to get used to. A total hysterectomy meant early onset surgical menopause at 33, which meant compromised bone density, and also that I shrunk by half an inch (which I wasn’t totally thrilled about since my younger sister was already taller than me before that). Chemotherapy obviously meant I’d lost my hair, so I was rocking this very chic, avant garde “Anxious Mr. Clean” appearance. But the chemo also compromised my joints in my hips, knees, and for a while, in my hands. Gripping a controller became incredibly painful and I couldn’t sustain it for more than a few minutes at a time. Sitting upright at my PC felt like knives were sliding down my spine and digging into my hip bones over and over. Of course, this meant that not only was I unable to stream, but I couldn’t even kick back on the couch or in bed to play a game without feeling like my hands were going to fall off. I was, effectively, unable to engage in my favorite hobby because of a disability.
I’m very lucky. The extreme nature of the post chemotherapy arthritis I was afflicted with did ease up over time. I still have permanent damage to my knees and hips, but I eventually regained the use of my hands and fingers without issue. But the harsh reality of that situation was not just debilitating, it was demoralizing. Options existed for me to play games in a more accessible manner, such as foot pedals and buttons, or a larger control spread across my desk. There are even options for using your mouth as a controller. Finding the means to play games was not the challenge, at least for me. Feeling accepted for needing those options ended up being the challenge. And now I’m infinitely more aware of the stigma that many gamers face due to ableism in games, and the discriminatory opinions of those who would say that making games accessible, regardless of whether it’s via controller or in game settings, compromises the integrity of the game.
To be clear, I can’t speak for every disabled gamer, nor would I ever attempt to. What I can do, now that I’ve had a lens into how limited accessibility can be within games, is try to examine why that is and understand how it can be improved. And of course, highlight where we have seen success.
In the last decade alone, we’ve seen developers making strides in the accessibility of their games, but it has probably been most apparent in the last several years. From options for people affected by color blindness, to greater flexibility with control mapping, to even something as simple as controlling font size, these adjustments are making huge impacts for gamers who need them.
A lesser example: in recent years I’ve started to need glasses. I used to game for hours and hours on end without issue, but these days, even wearing glasses, it’s hard for me to read the text on the screen unless I am scooched very close to the TV. Something as simple as making an option to enlarge the text provides inclusivity for millions of people with compromised eyesight.
We’ve learned that accessibility often applies to the actual game itself, including the level of difficulty. This is where controversy began to bubble up more, since the very thought of being able to adjust the difficulty of a game to something like “Story Mode” almost entirely eliminates all of the challenges within the game.
I spoke to one streamer (who has chosen not to have their name shared) who emphasized how important the ability to play a game in “Story Mode” can be. They are affected by a disability that impacts their coordination, which makes combat encounters exceedingly difficult. The presence of a “Story Mode” provides “a more level playing field” for them, and allows them to experience the game and its story without having their immersion disrupted by circumstances that they are unable to overcome due to their disability.
“It’s not about me wanting to have an ‘easy’ experience, it’s about being able to have an ‘experience’ at all,” they said. “I don’t even tell people most of the time, I just hope no one notices and makes fun of me or calls me a cheater.”
This streamer is not alone in their feelings. A year ago when FromSoftware released Elden Ring, several gamers I know (including myself at one point) resigned themselves to the fact that they simply would not be able to play the game. Not because we don’t love a challenge or respect the difficulty and intended rewards of overcoming such encounters, but because that level of play is simply out of our reach. FromSoft games are notoriously difficult, and most anyone can respect the level of dedication it takes to complete the game as it was designed. But that doesn’t mean that non-competitive players, or disabled players who cannot, for whatever reason, play the game as intended, should be excluded from the experience of riding through The Lands Between and exploring its hidden caves, dungeons, and lore.
In that same vein, the increased addition of “trigger warnings” within games has generated a relatively positive response, with a few outliers. Virtually all games receive a maturity rating before going on the market, and those ratings provide a very high level overview of what aspects of the game are present to warrant the higher rating. For example, seeing a game rated M for Mature would detail reasons such as sexual content, alcohol use, violence, language, etc. While this does provide a surface level look at the type of content you’ll find in a game, it doesn’t necessarily indicate the specific level of content that exists, content that could upset a player who has PTSD or sensory processing disabilities.
While the argument could be made that players do, on some level, know what they’re getting themselves into when picking up a game (you shouldn’t be surprised at the level of violence you’ll find in Mortal Kombat 1, for example), it isn’t impossible to predict everything, or even really know what could be triggering without relevant context. So having the option to be shown a “warning” when starting a game, like is often the case nowadays with horror games that will explain more specifically what to expect in their games, is more than reasonable in an age that grants us the ability and the means to provide it.
No game is perfect, no developer is perfect, and not every studio or every game is going to get the combination just right. But we can look to the likes of studios like Naughty Dog which have created groundbreaking accessibility options that allow even blind players to enjoy their game, or Extremely Ok Games and their options to level the game’s difficulty for players with disabilities related to motor functions, to drive us forward amidst the noise. Once we can dismiss this mindset of labeling ableism as the mean upon which all games must live, we will see that path forward clearer than ever.