The views expressed in this article are the author’s and are not necessarily the views of the partners.
Stigma: It Is All About Undesirable differentness
Stigma is about norms. A certain section of the society ascribes it, mandates it, and enforces it. In the literature on stigma, such groups of people who ascribe are the ‘normals’. Those that do not conform to the norm prescribed by the normals are the ‘deviants’.
The deviants encounter stigma from the normals. They possess an attribute that is different from the ones the so-called normals have or that which they prize. We see several examples of this around us. A dark-complexioned person faces stigma because fair complexion is an attribute that is prized by members of society. This is how society idealizes bodily beauty.
Similarly, a person from the northeast possesses an attribute that does not conform to the norm. She or he looks different and defies normative expectations of how an Indian looks or should look.
Differentness is potentially a ground for stigma and discrimination. If the differentness is undesirable, then the probability of occurrence of stigma only increases. Persons affected by disfigurement due to leprosy look ‘ugly’.
The ‘normals’ perceive their appearance as undesirable. Here, pleasing personality or physical attractiveness is the desirable attribute. A woman suffering from HIV is held responsible for her behaviour, even though she may have contracted the disease from her partner. So is a male who has HIV because of multiple partner sex.
In such cases, the person defies the norm of loyalty or faithfulness to the partner. Hence, such persons face stigma. Here responsibility to the partner is the desirable attribute. A doctor who treats Covid 19 patients is considered a threat to the general well-being of the community and is restrained from entering his or her own house. Fear or perceived peril leads the community to stigmatize the doctor. Here, self-preservation is the desirable attribute.
In all these instances, the affected person exhibits undesirable differentness. The notion of ‘undesirable differentness’ is important to understand because it marks out ‘the other’.
The case of the doctor or the paramedical staff treating Covid 19 person is a unique instance of stigma. It shows that proximity to a person exhibiting undesirable characteristic can also result in stigma.
So a doctor who treats persons with some sort of mental disorder is termed ‘pagaloan ka doctor’. Because the father (or mother) has cancer, their children often find it difficult to enter into wedlock. It is no different with parents having leukoderma (Vitiligo).
The police that deals with offences of a different kind and are found in close proximity of thieves and thugs face the same negative consequences. All these instances are what scholars call, ‘courtesy stigma’ – the transference of stigma on to those who are found or seen in close association with the already stigmatized.
A remarkable quality of stigma is that it only occurs during social interaction between the normal and the other. That is, the attribute or the undesired differentness itself does not bring any harm or risk on to its bearer.
Persons with HIV may not necessarily stigmatize each other (in fact, they could join hands and form an association – as they have); nor will two dark-complexioned persons or two persons from northeast share any negative attitude toward each other because of the attribute.
However, should these individuals interact with those who have assigned to themselves the power and privilege to define what is normal, then stigma would likely occur.
Discrimination becomes evident when stigma becomes visible. It shows itself in behaviours. Those who stigmatize do not behaviorally involve themselves with those whom they stigmatize. Social interaction between them would be awkward, unpredictable and may soon terminate. The absence or sudden termination of conversation can affect the stigmatized. This produces a rather peculiar situation, referred to as self-stigma. It is a mental state when the person blames himself or herself for the stigmatizing condition.
Stigma has little to do with knowledge. Campaigns built around information dissemination to tackle stigma may not be effective. It isn’t about cognition. It would be far better to create situations where the two can interact, hear out their stories, peel the thick layer of ‘patient-hood’ to reveal the person behind it and grow to treat each other as human beings. A Tabrez Khan donating plasma multiple times is more powerful than recorded messages instructing listeners not to discriminate.
About the author: Pradeep Krishnatray is former director, Research and Strategic Planning, Johns Hopkins Center for Communication Programs, New Delhi