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Six years ago, Maura Horton, a housewife in Raleigh, N.C., received a call from her husband, Don, the assistant football coach at North Carolina State. He was on the road for a game and having so much trouble buttoning his shirt, he had to ask a player (Russell Wilson, now the quarterback of the Seattle Seahawks) for help.
Mr. Horton had received a diagnosis of Parkinson’s disease four years before, and symptoms were starting to worsen.
So Mrs. Horton did what anyone would do these days when faced with such a problem: She searched Google for “easy-to-close shirt.” And found … not much.
“And then I looked at my iPad cover and saw it had these really small magnets, and thought, ‘Well, what about that?’” she says now — a patent, a company and 22 shirt styles later.
Mrs. Horton (who once designed children’s wear but stopped to start her family) and her company, MagnaReady, are part of a new sub-sector in fashion: what Chaitenya Razdan, the founder and chief executive of Care and Wear, has christened “healthwear.” The sector takes the tools and techniques (and trends) of fashion and applies them to the challenges created by illness and disability.
And healthwear is simply one part of a larger movement, in which classically trained designers (and those they work with) are rethinking the basic premise, and promise, of fashion itself. Call it solution-based design.
Though fashion is often dismissed as frivolous and self-indulgent, this growing niche suggests that rather than being part of the problem — and a symbol of the multiple divisions in society (political, personal, economic) — it can actually come up with some of the answers.
In May, for example, Angela Luna was named a designer of the year at Parsons the New School for Design for a graduate collection of convertible garments that used outerwear to address specific issues of the refugee crisis: shelter, flotation, visibility. So there was a hip utility coat that could become a tent, and a padded jacket that became a sleeping bag. One anorak had a built-in flotation device; another, a baby carrier.
And she followed Lucy Jones, who won designer of the year in 2015 for a collection that focused on minimal, elegant clothes for wheelchair users, taking into account both the altered proportions necessitated by being permanently seated, and the challenges of getting pieces on and off when one is physically impaired — or taking care of someone who is.
“It started when a professor of mine challenged us to do something that would change the world,” Ms. Jones said. “I thought: ‘How can I do that? This is fashion.’”
But then she began talking to a 14-year-old cousin who has a condition called hemiplegia, which means that one side of his body is significantly weaker than the other. He told her he was being teased at school for not being able to do up his pants by himself, and how embarrassed he was. “I couldn’t believe no one had tried to fix that,” she said. “But then I realized it was a much bigger problem.”
She met with United Cerebral Palsy of New York City and started conducting focus groups. “I couldn’t believe what I was hearing,” she said. “Something everyone does — get dressed and undressed — should not be a challenge.”
Mr. Razdan had a similar epiphany in 2014, while he was working at an internet start-up following a stint at Goldman Sachs. He noticed that some family members who were wrestling with cancer were walking around with what looked like the ankle section of tube socks on their upper arms.
The socks, it turned out, were being used as not particularly attractive covers for peripherally inserted central catheters, semi-permanent intravenous lines in the upper arm. Known as PICC lines, they allow easy vein access for chemotherapy and extended antibiotic administration, among other uses.
After his mother, an anesthesiologist, mentioned to a former colleague at Johns Hopkins that her son had an idea to improve the cover, Mr. Razdan teamed up with a friend’s wife who had been working at Kensie, a contemporary brand for girls.
Together they created what is effectively a brightly colored sleeve, not unlike a truncated version of what runners and basketball players now use, except that it is made with an antimicrobial treatment and comes with a mesh window to make dressings visible and let them breathe. It can be customized in a variety of ways, and makes the wearer look like LeBron James (kind of) instead of a patient.
This was followed by shirts — polo, baseball, plus a zippered blouse — that allow for the insertion and removal of central lines and ports, as well as a collaboration with Ms. Jones on gloves made specifically for wheelchair users. (Generally, wheelchair users adapt bicycle or batting gloves for their purposes.)
“What you wear has a profound impact on your psyche,” Mr. Razdan said. “It can make you feel like yourself again at a time when it’s easy to feel like things are out of your control.”
Though most of the people involved in solution-based design have a missionary zeal when they talk about what they do — not just what it means for the people they reach, but also what it means for their industry and its image in society — it has not escaped any of them that it is also a significant business opportunity.
According to a report from the Centers for Disease Control and Prevention, one out of every five adults in the United States has a disability. “We are all at risk of having a disability at some point in our lifetime,” Dr. Thomas R. Frieden, director of the agency, said in a news release.
“We think it is a $40 billion industry,” said Mr. Razdan, who is in talks with a “big name designer — I can’t tell you who” to redesign a hospital gown. More than 580 million people are admitted to hospitals worldwide every year, according to the World Medical Markets Factbook.
It all seems so obvious that it’s hard not to wonder: What took fashion so long?
After all, fashion, which was once a world defined by exclusivity — clothes for the very rich, or the very skinny; clothes for insiders, for people who knew where to shop — has, in recent years, undergone a democratic revolution.
If the doors first opened with Yves Saint Laurent’s popularization of high-fashion ready-to-wear in the 1960s, they were thrown wide to the masses at the turn of the millennium with the advent of fast fashion, and the idea that economics should not dictate who has access to cool clothes.
From there, it did not take long for the same idea to be applied to size, age, sexuality and religion. Yet solving for the disabled and the displaced has in many ways been the final frontier.
Though advances in medical technology and legislation have created situations in which people with long-term conditions are increasingly able to be part of the work force and quotidian life, the implications — they need clothes that allow them to do so while also accommodating their physical reality — have taken a while to sink in.
Manufacturing has similarly not caught up with reality, and Ms. Jones and Ms. Luna cite issues with nonstandard pattern-cutting and materials (people in wheelchairs for example, need tops with very truncated bodies but long arms) as roadblocks to wider production.
But beyond the practical, there’s also a more fundamental issue of what, exactly, fashion is for.
Escapism has long been considered by many the point of fashion. Talk to chief executives of catwalk brands and chances are they will go on and on about “the dream.” Even when fashion has wrestled with real-world issues, it was always in the context of either fund-raising (it has been active with issues like H.I.V./AIDS and breast cancer) or its own traditional forms: John Galliano’s controversial “Homeless” couture collection for Dior, for example, with newsprint gowns inspired by the men sleeping beside the Seine.
When Ms. Luna first became immersed in the refugee crisis, she considered transferring from Parsons to a school with a more traditional international relations program (she even applied to Sciences Po — the Paris Institute of Political Studies) because she couldn’t imagine how what she was learning could be relevant. She didn’t have a model to follow.
And when she realized that her skills may have a practical application, she had to overcome the stigma of refugee chic, the assumption that she was being “inspired” by the crisis to make expensive clothes. (You can understand why: Last year a Hungarian photographer did a widely criticized fashion shoot featuring a model in runway attire posing by a barbed wire fence.)
But this is not about exploiting an issue, or even bringing it to broader attention. It’s about seeing fashion as a tool to ameliorate it and creating a system to help.
“Fashion has created a lot of problems, but there is an opportunity for it to be a force for good,” Ms. Luna said. “We just have to realize it.”
So at Parsons, a new discipline called “systems and society” has been developed for Bachelor of Fine Arts students. It focuses on how to “utilize their education and learned skills within a broader context,” according to Burak Cakmak, dean of the fashion school at Parsons.
“This gives the young designers an opportunity to operate and succeed in areas that are traditionally outside the fashion industry, but also help define the future of fashion businesses by expanding its scope,” he said.
Likewise, in 2014 M.I.T. established the Open Style Lab in its International Design Center, a program that matches engineering, design and occupational therapy students with disabled clients to come up with adaptive clothing technologies.
PVH, the largest shirtmaker in the United States and the owner of Tommy Hilfiger and Calvin Klein, has partnered with Ms. Horton to incorporate her technology into its Van Heusen dress shirts. This followed a collaboration she did with Tommy Hilfiger for boys’ and girls’ shirts for Runway of Dreams, a nonprofit founded in 2013 by a former designer, Mindy Scheier, that works with fashion to create mainstream adaptive clothing.
And, though the designer of the year is normally a direct conduit to a job at a major fashion label, Ms. Luna (who had planned to go work at Abercrombie & Fitch before her conversion) and Ms. Jones (who is finishing a year’s residency at Eileen Fisher, which she took in part to better understand production concerns) have eschewed that path and are planning to work together to adapt their collections for commercial production. Ms. Luna has trademarked the name of her would-be brand: Adiff (Design for Difference).
“In today’s world, we are all asking ourselves how we can play a role in bringing change to problems around us as an individual,” Mr. Cakmak said. Designers are no longer exempt from that question.