Types of Stigma and Steps to Stamping It Out

Types of stigma

While people can stigmatize nearly any trait, the National Alliance on Mental Illness (NAMI) categorizes stigma into seven main types:

Public stigma

Public stigma describes the overarching sentiment society has about people with a certain trait. Societal attitudes toward these traits may show up in the media, often subtly encouraging negative perceptions or presenting stereotypes as facts.

Here’s an example:

You tell a friend you have dissociative identity disorder (DID), and they react by saying, “Whoa. That’s kinda scary. What if one of your ‘personalities’ tried to kill someone? Would you even know about it?”

Their (inaccurate) understanding of this mental health condition, of course, comes from the multiple media portrayals of people with DID who engage in acts of violence.

Self-stigma

Self-stigma happens when you accept public stigma. To put it simply, you may begin to consider your own traits or symptoms “shameful” and deserving of criticism, or believe you’ve earned negative judgment because of them.

Here’s an example:

You may consider yourself weak for having post-traumatic stress disorder (PTSD), especially when the people in your life suggest you’re overreacting to the trauma you experienced.

Perceived stigma

Perceived stigma happens when you believe (rightly or wrongly) the people around you, or society as a whole, would judge you negatively for having a certain trait.

Here’s an example:

You might hide your stuffed animal collection from your friends for fear they would perceive you as immature or wonder about your interest in children’s toys.

Label avoidance

Label avoidance happens when you distance yourself from a stigmatized group. You may, for instance, publicly deny having a specific trait or reject treatment to avoid getting a diagnosis.

Here’s an example:

You may avoid getting treatment for schizophrenia because you worry a diagnosis would cost you the custody of your kids.

Structural stigma

Structural stigma refers to institutional policies based on stigmatizing attitudes. The individuals who work for that institution may have no bias against you themselves, but the system operates in a way that puts you at a disadvantage.

Here’s an example:

You apply online to a new job after spending a year recovering from long COVID-19. The company’s hiring software shuffles your resume to the bottom of the digital pile, almost guaranteeing no one will ever review it, simply because the coders assumed anyone with a large employment gap would prove unreliable.

Health practitioner stigma

Health practitioner stigma happens when a healthcare professional’s belief in racial, gender, or other stereotypes gets in the way of their ability to provide effective care.

Here’s an example:

You reach out to a counselor to get support for avoidant personality disorder. But they believe people with personality disorders can’t change their behavior, so they refuse to work with you solely because of your diagnosis.

In reality, everyone is capable of change.

Associative stigma

Associative stigma targets people connected to someone with a specific trait. You may face criticism and judgment for choosing to stay in contact with a person who has done something “wrong,” by society’s standards.

Here’s an example:

Your friends may accuse you of “enabling” your sibling’s substance use disorder when you choose to support them through treatment and recovery instead of cutting off all contact.

What’s the impact?

Stigma can have long-term health and mental health consequences, including:

Lack of access to treatment

Some parents may resist having a child evaluated for mental health issues or neurodevelopmental disabilities or avoid telling a child about a diagnosis because:

• They believe a label will discourage their child.
• They want to protect their child from bullying.
• They think others will blame them for their child’s condition.

Research suggests parents who don’t want their child to be “labeled” are less likely to help their child get treatment for their symptoms.

Yet denying a child the care they need will likely worsen their mental health over time. What’s more, the child may still experience stigma due to their symptoms — and since they don’t understand why, they may blame themselves for their mistreatment.

Risks to personal safety

During infectious disease outbreaks, around 3 in 10 healthcare workers encounter stigma for their profession. Others may accuse them of spreading disease or treat them as perpetually “unclean.”

The SARS-CoV-2 pandemic has created more stigma than most previous outbreaks, with numerous reports of healthcare workers being shunned, denied public services, and even assaulted.

According to a 2022 report from the American Hospital Association, 44% of nurses have experienced physical violence, while 68% have endured verbal abuse.

Lower quality of care

Health practitioner stigma can cause treatment disparities like:

• Spending less time in appointments
• Offering less education about the person’s injury, disease, or other health condition
• Refusing diagnostic tests or requested medication

People with more body weight, for instance, often experience discrimination and lower-quality care from healthcare professionals who endorse weight stigma. Doctors may offer weight loss tips and criticism instead of actual treatment for their health symptoms.

Similarly, people living with substance use disorders may face discrimination from healthcare professionals who link substance use to a “character flaw” or “lack of willpower” instead of recognizing addiction as a serious mental health condition.

Why does it happen?

A number of theories have attempted to explain potential causes of stigma. These include:

Labeling theory

Social interactions are complicated, so your brain likes to take shortcuts when it can. Stigmatizing certain traits offers a quick way to categorize people as “good” or “bad” without learning their whole life story.

Here, the stigmatized traits typically depend on cultural values and the members who have the most power. For example, a society run by introverts might stigmatize people who talk excessively. Meanwhile, an extrovert-led society might stigmatize those who keep to themselves.

Social identity theory

According to social identity theory, people build their identities out of the groups they belong to. For example, someone who identifies as Gen Z or a Baby Boomer may draw specific traits, like work ethic, thriftiness, or independence, based on the generation they belong to.

As a general rule, people may perceive their own group more favorably and assign negative stereotypes toward rival groups. Stigmatizing outsiders serves three functions:

• The conviction of belonging to the “best” group can boost self-esteem.
• It helps justify hoarding resources like wealth, power, or social status.
• It offers an excuse to exploit stigmatized groups for additional resources.

Terror management theory

Terror management theory suggests people stigmatize signs of sickness or misfortune to soothe their own existential fears.

Say you leave an abusive relationship. Some people may try to blame you, though abuse can happen to anyone. They might ask if you provoked your ex-partner, or say you should have never started dating them.

This reaction may happen, in part, because they have trouble acknowledging the frightening possibility that their loved ones could one day hurt or betray them. Suggesting you somehow caused your own abuse allows them to create a comfortable fiction where they’ll never face the same risk.

How to overcome stigma

You can do a lot to help end stigma, though the path to stamping it out can depend on where it comes from.

If you encounter someone spreading stigma, it may help to:

• Find community: Shame often thrives in solitude. If you connect with others who’ve had a similar experience, you may find they can offer emotional support and validation.
• Call out bias: Stigma is often woven into cultural norms, and people may spread it without realizing the hurtful impact of their actions. Pointing out bias, however, often prompts people to rethink their assumptions. Not everyone may change their mind, but even one person’s rejection of stigma can weaken its cultural power.
• Disclose your own status: If you feel safe doing so, consider sharing your own experience with stigma. People who vilify or criticize abstract strangers might stop to think twice about statements that harm someone they know and care for. From there, they may go on to consider how their words affect others.

If you want to avoid spreading stigma yourself, it may help to:

• Consider your language: Words carry a lot of emotional nuance beyond their dictionary definition. For example, calling someone an “addict, an “alcoholic,” or “suicidal” may lead others to perceive them negatively. Instead, you might opt for neutral language, like “They have a substance use disorder” or “They’ve had thoughts of suicide.”
• Educate yourself: Research on mental health stigma suggests knowing more about a certain condition may help minimize stigmatizing beliefs. Reading firsthand narratives from real people can offer unique insight into living with specific conditions, such as bipolar disorder or bulimia nervosa. The same goes for stigmatized health conditions like genital herpes.

If you want to overcome stigmatizing attitudes you have about yourself, it may help to:

• Practice self-compassion: When you start criticizing yourself, try pushing back against that negativity by affirming yourself. For example, instead of scolding yourself for not getting married as quickly as your friends, remind yourself that your relationship status has nothing to do with your value as a person.
• Work with a therapist: A therapist can offer unconditional acceptance to help counter a narrative of shame and guilt. Self-kindness may come more easily when someone else treats you as worthy of kindness first.

Here’s how to find the right therapist for you.

The bottom line

Stigma is a metaphorical mark of shame society often assigns to people with certain traits. When stigma spreads unchecked, it can affect anything from your personal safety to the quality of your medical care.

When facing stigma, it can help to remember it’s nothing more than social judgment, not an objective fact. In short, stigma doesn’t define you, your worth, or the quality of your life.

Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.