Stigma and the Way We View Disability

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A disability can refer to any condition of the mind or body that makes it more difficult for the affected person to perform certain activities and interact with society. These conditions may range from vision impairment to muscular dystrophy to diabetes. Some disabilities are more stigmatized than others—this involves the propagation of negative beliefs and stereotypes about people with a specific disability, often leading to discrimination and social exclusion. 

Stigmatization includes labelling, stereotyping, separation, loss of status, and discrimination–these occur due to ‘perceived differences between an individual or group and other members of society’ (Link & Phelan, 2001). Prejudice and discrimination are widespread for members of stigmatised groups and can range from subtle microaggressions to explicit hostility and rejection. 

There is a considerable variation in individual experiences of stigma (Daley & Rappolt-Schlichtmann, 2018). Different disabilities carry different levels of stigma, and the severity and visibility of the condition also contribute to this. Women, people with non-conventional gender identities and racial minorities are doubly disadvantaged. Intellectual disabilities, severe mental health conditions, albinism and sensory disabilities often have more stigma attached to them than physical disabilities. Socio-economic status and urbanisation can also affect attitudes toward disabilities. 

Stigma rarely, if ever, is backed by scientific data; it is usually a result of people with disabilities not conforming to societal expectations and ideals. More often than not, misconceptions about the causes of disabilities come from cultural or religious beliefs. They are believed to be punishments for mistakes on the part of ancestors, parents, or the person with disabilities. The superstition can go as far as to claim the disabilities as  curses made by supernatural beings such as demons, spirits or witches. A key factor responsible for stigma is the lack of understanding and awareness regarding the causes of disabilities and their characteristics.

Furthermore, it is important to remember that since the upheld ideals are social and cultural, they are likely to change over time and with geographic location. People with disabilities who can participate in their communities experience less stigma than those with more severe disabilities. ADHD (attention-deficit/hyperactivity disorder) was most likely an evolutionary asset (Eisenberg, Campbell, & Gray, 2008). Traits associated with ADHD support hunter-gatherer systems as opposed to settling. Modern environments, full of loud, bright stimuli, differ from times when ADHD traits would have evolved and been definite strengths. Environments that are the most hostile to people with ADHD  today, such as school classrooms and work conditions that do not involve much physical labour, did not necessarily exist a mere three or four centuries ago. Thus, many conditions that are considered disabilities may only even be disadvantageous in particular settings. 

Contrary to one’s expectations, medical and academic professionals are not exempt from having troubling attitudes about disabilities. The development of extreme medical procedures such as lobotomies, electroconvulsive therapy and trepanation was motivated by misguided notions about disabilities, especially mental disorders, and attitudes that regarded people with disabilities as subhuman that are still prevalent today. In early December 2020, a paper titled ‘Attend Less, Fear More: Elevated Distress to Social Threat in Toddlers With Autism Spectrum Disorder’ appeared in the Official Journal of the International Society for Autism Research. The study, conducted by researchers at Yale University, used 42 autistic children and 22 ‘regularly’ developing children, all around two years old, and exposed them to various stimuli such as adults in masks and mechanical spiders, only to conclude that autistic children showed more distress compared to regular children. The methodology involved exposing them to such stimuli and recording the children’s reactions, consisting of vocal and facial distress. According to the published paper, some trials were concluded only after parents interfered due to the children becoming extremely agitated and fearful. A statement made by Yale after online outcry claimed that none of the children experienced extreme negative emotions, and online users quickly pointed out that this contradicted the original paper which said some children were distressed enough for the parents to interfere. The article, and the subsequent response from Yale, have been criticized for the lack of ethics, and for displaying ‘traumatizing’ and ‘insensitive’ attitudes towards children on the spectrum. Autism organizations and other professionals from the same field have also criticized the methodology and  called for increased cultural competence and ethics discussions.

This case only shows that much work is to be done to erase stigma even in the present day. Both society at large and the scientific community champion vehicles for change. Physicians must be educated in cultural competence (Eddey, 2005), and methods of protest, education, and providing equal status, cooperative interaction, and institutional support (Corrigan and Penn, 1999) must be promoted. Research suggests that scientists and advocates must target stigma change and attempt to propagate positive attitudes and decrease stigmatizing attitudes to reduce discrimination. 

References

  1. Eisenberg, D.T., Campbell, B., Gray, P.B. et al. Dopamine receptor genetic polymorphisms and body composition in undernourished pastoralists: An exploration of nutrition indices among nomadic and recently settled Ariaal men of northern Kenya. BMC Evol Biol 8, 173 (2008).
    https://doi.org/10.1186/1471-2148-8-173
  2. Eddey, Gary E, and Kenneth L Robey. “Considering the culture of disability in cultural competence education.” Academic medicine : journal of the Association of American Medical Colleges vol. 80,7 (2005): 706-12.
    doi:10.1097/00001888-200507000-00019
  3. Corrigan, P.W., and Bink, A.B. The Stigma of Mental Illness. Elsevier Inc, 2016. 
  4. Daley, Samantha G., and Gabrielle Rappolt-Schlichtmann. “Stigma Consciousness Among Adolescents With Learning Disabilities: Considering Individual Experiences of Being Stereotyped.” Learning Disability Quarterly, vol. 41, no. 4, Nov. 2018, pp. 200–212, doi: 10.1177/0731948718785565.
  5. Jaarsma, Pier. Reflections on Autism: Ethical Perspectives on Autism Spectrum Disorder in Health Care and Education. Linkoping University, 2014.