Coping | Daily Life | Disability
Ableism–the intentional or unintentional bias against individuals with disabilities–has historically led to the oppression, marginalization, discrimination, and even the death of people with disabilities. This erroneous viewpoint permeates every aspect of society, from schools to doctor’s offices to public venues and media representation. Despite its menacing presence, ableism does not get much attention. In fact, many people have never heard the term before.
This blog will explore what ableism is, where it is seen, how it impacts people with disabilities, and what you can do about it.
As I write at the beginning of this article, ableism is the intentional or unintentional bias against people with disabilities. Ableism frames being nondisabled as the norm/desired state of being. In doing so, it regards disability as a deviation from normal, a flaw. Such a viewpoint leads to the false belief that people with disabilities are “less than” those without disabilities.
As with all forms of prejudice, ableism can be unintentional. People often exhibit ableist behavior without realizing it because such behavior or opinions are normalized in our culture. This is known as implicit bias. A study conducted by Medical News Today revealed that 76% of participants held unconscious bias in favor of people without disabilities. Unfortunately, this suggests that many people view disability in a negative light.
Institutional Ableism: Institutionalized ableism refers to ableism within the law and institutions such as schools and the healthcare system. An example of ableism in the healthcare industry is the lack of requirements for disability training in medical school. Many physicians enter the medical field with little to no knowledge of disability topics. Limited knowledge about disability can lead physicians to downplay the lived experience of individuals with disabilities or even withdrawal medical support when they do not believe they can help.
Infrastructural Ableism: Infrastructural ableism refers to the failure of people to consider human diversity when designing places, buildings, and tools. When thinking about problems with physical accessibility, broken ramps, malfunctioning elevators, and narrow hallways come to mind for most people. These are, indeed, serious problems that can pose both access challenges and physical danger to people with disabilities.
However, there are many other instances of ableism in design that might not immediately come to mind. The failure of healthcare providers to consider the diverse needs of patients impacts those with disabilities. For example, people with mobility impairments frequently encounter inaccessible diagnostic equipment, scales, and examination tables. Healthcare providers often lack training on how to lift and transport people with physical disabilities safely. Unfortunately, these oversights can lead to delayed diagnoses and sub-quality care for patients.
Interpersonal Ableism: Interpersonal ableism is ableism that takes place in social interactions. In the medical setting, this might take the form of undermining the autonomy of patients with intellectual or communication disabilities. Mary Doherty– founder of Autistic Doctors International– conducted a study revealing that 63% of people with autism have a serious physical health condition that is untreated. Study participants cited difficulty using the phone to book an appointment, not feeling understood, and difficulty communicating with their provider as the top barriers to care.
Another example of interpersonal ableism could be a friend or family member who is focused on ‘curing’ or ‘fixing’ a loved one’s disease instead of accepting them.
Cultural Ableism: Cultural ableism refers to the lack of a positive, realistic representation of people with disabilities and chronic illness in the mainstream media. The negative portrayal or absence of people with disabilities in the media exacerbates stereotypes and prejudices about people with disabilities. Cultural ableism also contributes to the sense of isolation faced by individuals with disabilities.
Internalized Ableism: Internalized ableism occurs when people with disabilities begin to believe the ableist ideas in our culture and think less of themselves as a result. Unfortunately, this can lead someone to accept mistreatment.
Ableist Micro-aggressions Ableist microaggressions are everyday subtle indirect comments, statements, or actions against people with disabilities. Ableist microaggressions often come in a misguided effort to ‘help.” For instance, it could take the form of someone asking if you have tried eating healthier or practicing yoga to cure a chronic illness like IBD.
While working to dismantle ableism, education is key. It is infuriating to see someone engage in behavior that is blatantly ableist to us. Nevertheless, ableism has received such sparse consideration from the mainstream media and education, that many people genuinely do not recognize it. Most small-scale instances of ableism can be addressed through awareness and education.
Emily Ladua suggests politely calling people out on ableism by saying, “I’m sure you didn’t have any bad intentions, but I just wanted to let you know that [word or phrase the person said] was actually pretty discriminatory towards people with disabilities, and that’s not okay.”
If a comment is made in public, it is often better to follow up privately (Ladau, 2021).
In other instances, you can help combat unintentional ableism by alerting people to accessibility issues with places or events. For example, you might suggest a virtual option for a book club meeting or asking people if they have dietary restrictions before planning a catered event.
Institutionalized ableism is much harder to address. It often requires us to fight and advocate for legal change. Since it is impossible to take on every ableist policy and law, you can focus your energy on the issues that are most important to you. Nevertheless, please remember your disability community when voting, making political decisions, or leading. You do not need to exert all of your energy into every disability-related policy, but please avoid shrugging off the issues that do not directly impact you.
Finally, it is important to note that having a disability does not prevent one from being ableist. Disability scholars often use the phrase “hierarchy of disability” to explain how people with less stigmatized disabilities have a tendency to separate themselves from those with more stigmatized disabilities. It is important to recognize when something we think, say or do is influenced by ableism. Take the time to learn about other types of disabilities and medication conditions, and admit when you have been ableist.
Center for Disease Control. (2020). “Common Barriers to Participation Experienced by People with Disabilities.” https://www.cdc.gov/ncbddd/disabilityandhealth/disability-barriers.html
Ladau, Emily. (2021). Demystifying Disability: What to Know, What to Say, and How to Be an Ally. Ten Speed Press.
McCarty, Niko. (2022). Healthcare Barriers Prevent Many Autistic People from Seeking Medical Treatment. Spectrum News. https://www.spectrumnews.org/news/health-care-barriers-prevent-many-autistic-people-from-seeking-medical-treatment/
Sullivan, Debra.(2021). “What is Ableism, and What is its Impact?” Medical News Today. https://www.medicalnewstoday.com/articles/ableism