This article draws on data collected in group interviews with six young, urban Aboriginal mothers whose lives have included substance use and Fetal Alcohol Syndrome/ Fetal Alcohol Effects (hereafter FAS/FAE) to highlight the multiple and often contradictory ways in which disability as a constituent of social relations is defined in public policy and experiences of people's everyday lives. The findings of this research demonstrate that the process of medicalization acts in both enabling and disabling ways to inform the women's experiences of substantive citizenship in their everyday lives and the lives of their children. Young Aboriginal mothers simultaneously reify and resist medicalization in diagnosis of and interventions for FAS/FAE, in order to support advocacy efforts on behalf of their children to access a range of educational, health, and social services. "Labeling" a child's struggles in medicalized terms through a diagnosis of FAS or FAE was useful for some mothers because it enabled access to supports that would otherwise have been unavailable and provided a way to resist racist, sexist, and classist representations of Aboriginal women as "bad mothers". At the same time, the women who participated in this research found that the processes of disclosing that a child's impairments were the result of prenatal alcohol exposure and of having her child labeled as a "special needs placement" could also frustrate attempts to advocate for supports and access some types of community services. Accordingly, I argue that medicalization acts as both a site of oppression when institutionalized through education, health, and welfare policies, and as a site for advancing claims to knowledge and social justice in a neo-colonial context. (Contains 7 notes.)