When clothes cause harm, innovation in adaptive fashion is the future of design

As admiration for British Vogue’s powerful May 2023 cover featuring prominent figures from the disability community continues to reverberate widely, we are reminded of the importance of visibility and representation. Vogue’s creative director Edward Enninful lives with a disability himself. People within our industry have a habit of dismissing fashion with statements like “It’s not as if we’re curing cancer,“ however fashion has the potential to heal. There is the psychological healing associated with seeing oneself reflected on the cover of the preeminent fashion magazine after a lifetime of feeling unseen by the luxury industry. But rarely discussed in the mainstream is how fashion has for decades been inflicting harm. Until recently the seemingly innocent decisions of a designer or pattern maker had the potential to be life-threatening.

“The Game Changer pant is the most important work I’ve ever done,” says Toronto-based Izzy Camilleri from IZ Adaptive, one of the earliest adaptive clothing ranges founded in 2009. The world appears to be in agreement as Camilleri received 2 awards in 2022 for her adaptive line: the Innovation Award at the Women’s Empowerment Awards and the Fashion Impact Award from the CAFA Awards.

Camilleri has dressed celebrities like Meryl Streep, Angelina Jolie and David Bowie, but when people from the disability community began asking for a pant without a crotch seam, Camilleri was at a loss. “I didn’t really understand what the big deal was, she tells FashionUnited. “I just kept explaining how that seam is so integral to pant design because it divides the right and left, and the curves contour and cup the rear.” Camilleri was merely echoing an industry standard that also formed the bedrock of fashion education. It was impossible to create a well-fitting pair of pants without a crotch seam. Fashion students who forgot to add it in their technical flat sketches routinely had their grade docked for carelessness.

Rethinking design for the adaptive market

But for wheelchair users the seam can lead to pressure sores on the sit bones when the spine presses down on it. Over an extended period it can penetrate the skin. The wound can take up to a year to heal and in some cases the individual might have to lie on their stomach for 3 months to aid recovery. The worse case scenario is that if can lead to fatal blood infection which is how Superman actor Christopher Reeve died. All because of the placement of a seam.

“It’s common, debilitating, and for the longest time I didn’t think I could do anything,” says Camilleri. “Then during first lockdown, with so little going on, I wondered if I could crack it. I called these pants the Game Changer because that’s really what they are.”

With patent pending, IZ’s Seamless Technology involves a seated cut with classic front, and additional length at the back to prevent gaping. Some styles boast faux stitching where seams would usually be to resemble conventional jeans and stitching also creates trompe l’oeil back pockets. Front pocket bags have been sewn down because even folded fabric can lead to sores. The technology has been applied to sweats, chinos, leggings and yoga pants for men and women.

Adaptive fashion, an exciting design frontier for creative thinkers

There are so many considerations that go into the development of adaptive fashion that it really is an exciting opportunity for designers and pattern makers who like to be challenged. A paralyzed person can start the day with a 30 inch waist but it can measure 32 inches as the day wears on due to organs dropping during extended periods of sitting. A well appointed elastic counters this.

Camilleri pioneered adaptive design when it wasn’t much discussed. “For the longest time I was alone.” Now she licenses her technology to other brands, and works closely with Runway of Dreams, Gamut Management and, most importantly, the disability community. Her initial foray into adaptive fashion in 2004 emerged from working on custom items for a client who used a wheelchair and learning of the challenges she faced. Statistics in Canada at the time showed that 84 percent of people that break their back were aged between 18-34, the result of either car accidents or sports. The remaining 16 percent were caused by falls among the elderly. The staggering gap between supply and demand motivated Camilleri to pivot her business to provide designs for people with disabilities, specializing in clothes for wheelchair users.

“There were only options for the elderly, nothing for the young accident victims who are rebuilding their lives and maybe returning to work,” she says. “If you’re a real goth girl you’re still the same person you were before the accident, and imagine having that stripped away from you through lack of options.”

IZ offers sleek wardrobe staples with stealthy innovations not always visible to the naked eye which is how Camilleri intends it. Traditionally designed coats can be a problem for people in wheelchairs or those who are unable to stand to tuck the hem underneath them. “Many wheelchair users wear short bombers for this reason to avoid that bunching sensation,” says Camilleri. “But in the Canadian cold your lap is going to be freezing, and you’re not moving your legs so it takes a long time for the body to generate the energy to warm up.” Hiring fit models in wheelchairs is critical during prototyping. IZ coats follow the line of a seated person with the back reaching the seat of the chair while the front extends over the knee so it can be put on without the need to stand.

Victoria Jenkins, garment technologist and founder of brand Unhidden whose February runway show created a stir during London Fashion Week, has had multiple surgeries for gastro-intestinal problems. She created her brand to provide inclusive and adaptive clothing for disabled people, such as tailored trousers for wheelchair users with vertical pockets so that the contents don’t fall out, and an elasticated waistband that isn’t restrictive or painful for seated wearers. There are also shirts with portals for stomas or feeding tubes, and arm openings for easy access for those undergoing chemo or radiotherapy. Clothing designed without these considerations “can compromise dignity,” says Jenkins. “Being able to thread tubes through openings is more comfortable and less risky.”

Slippery fabrics can be dangerous for chair users and some people with certain skin conditions can only wear natural fibers. If a person has trouble raising their arms to get into sleeves, detachable sleeves are helpful and capes have proven popular, says Camilleri. IZ pea coats and jackets have faux buttons covering magnetic closures while zippered styles also conceal a magnet so it simply pops together to ease dressing for those with dexterity issues.

When reviewing the many failings in traditional garment design it can seem as if society or, more specifically, the fashion industry is adding insult to injury for the disabled community. So I have to ask, is it fair to consider traditional design ableist? Jenkins argues that this line of thinking is counterproductive. “It is pure ignorance but that is not always a brand’s fault,” she says. “We are so segregated that it's simply a case of out of sight, out of mind. I do think it is exclusionary and I think any brand calling themselves sustainable needs to have a look at what excluding 25 percent of people means for them. We have finite resources and we need to make them work smarter and that means universal design practice must be baked in.”