Conceptualizing Stigma
Author(s): Bruce G. Link and Jo C. Phelan
Reviewed work(s):
Source: Annual Review of Sociology, Vol. 27 (2001), pp. 363-385
Published by: Annual Reviews
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Annu.Rev.Sociol. 2001. 27:363-85
Copyright
(? 2001 byAnnualReviews.All rightsreserved
CONCEPTUALIZING STIGMA
BruceG. Link1and JoC. Phelan2
andNewYorkStatePsychiatric
NewYork,
NY 10032;
Institute,
'ColumbiaUniversity
e-mail:[email protected]
NewYork,
NY 10021;
2Department
ofSociology,ColumbiaUniversity,
e-mail:[email protected]
deviance
discrimination,
exclusion,
Key Words labeling,
stereotype,
* Abstract Socialscienceresearch
overthepast
onstigma
hasgrown
dramatically
whereresearchers
haveelucidated
twodecades,particularly
insocialpsychology,
the
categories
andlinkthosecategories
tostereowaysinwhichpeopleconstruct
cognitive
thestigmaconcepthasbeencriticized
as
typedbeliefs.In themidstofthisgrowth,
andindividually
focused.In responseto thesecriticisms,
beingtoovaguelydefined
stereotyping,
sepwe define
stigma
as theco-occurrence
ofitscomponents-labeling,
to
statusloss,anddiscrimination-and
further
indicate
thatforstigmatization
aration,
Thestigma
weconstruct
hasimplications
for
concept
occur,powermustbe exercised.
ranging
fromthedefinition
of
understanding
severalcoreissuesin stigmaresearch,
represents
a verypersistent
predicament
theconcept
tothereasonsstigmasometimes
in thelivesofpersonsaffected
becausethereareso manystigmatized
byit.Finally,
circumstances
andbecausestigmatizing
canaffect
domains
ofpeomultiple
processes
on thedistribution
hasa dramatic
oflife
bearing
ple's lives,stigmatization
probably
chancesinsuchareasas earnings,
criminal
andlifeitself.
involvement,
health,
housing,
Itfollowsthatsocialscientists
inunderstanding
thedistribution
of
whoareinterested
suchlifechancesshouldalsobe interested
instigma.
INTRODUCTION
Erving Goffman's (1963) book Stigma: Notes on the Management of Spoiled
ofresearchon thenature,
sources,andconsequences
Identity
inspireda profusion
of
andMedlineshowdramatic
increasesinthenumber
ofstigma.BothPsychInfo
titlesorabstracts
from1980(PsychInfo
thewordstigmaintheir
articles
mentioning
14, Medline19) to 1990 (PsychInfo81, Medline48) to 1999 (PsychInfo161,
Medline114).
leadseminalessayhas beenincredibly
ResearchsinceGoffman's
productive,
of the
and repeateddemonstrations
ing to elaborations,
conceptualrefinements,
The stigmaconcept
negativeimpactof stigmaon thelives of the stigmatized.
is appliedto literally
incontinence
scoresofcircumstances
rangingfromurinary
(Sheldon& Caldwell1994) to exoticdancing(Lewis 1998) to leprosy(Opala &
0360-0572/01/0811-0363$14.00
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All use subject to JSTOR Terms and Conditions
363
364
LINK * PHELAN
Boillot1996),cancer(Fife& Wright2000), and mentalillness(Angermeyer
&
& Penn1999,Phelanetal 2000). Itis usedtoexplain
Matschinger
1994,Corrigan
someofthesocialvagariesofbeingunemployed
(Walsgrove1987),to showhow
welfarestigmacanleadtotheperpetuation
ofwelfareuse (Page 1984),andtoprovideanunderstanding
ofsituations
facedbywheelchair
users(Cahill& Eggleston
1995),stepparents
(Colemanet al 1996),debtors(Davis 1998),andmothers
who
arelesbian(Causey& Duran-Aydintug
1997).
A substantial
portion
oftheproductive
research
on stigmahasbeencontributed
bysocialpsychologists
whohaveusedtheinsights
ofthesocialcognitive
approach
tounderstand
howpeopleconstruct
andlinkthesecategories
to stereocategories
typedbeliefs.Thislineofresearch
a majoradvanceintheunderstanding
represents
ofstigmaprocesses,andsociologists
woulddo welltoattend
toitthoroughly
(fora
see Crockeretal 1998).Giventheseadvancesinthesocial
comprehensive
review,
of stigmaandgiventheaccumulated
psychology
scientific
impactofresearchon
we proposea return
tothestigmaconceptfroma distinctly
stigmamoregenerally,
We engageoursociologicalperspective
sociologicalperspective.
to
by attending
severalcorecriticisms
ofthestigmaconceptanditsapplication.
The first
ofthese
is directedtowardtheclarityof theconceptandfollowsfromtheobcriticisms
thatstigmais definedin different
servation
waysby different
The
investigators.
secondis a setof criticisms
thewayin whichthestigmaconcepthas
regarding
beenappliedby someresearchers.
We use thesecriticisms
bothas a stimulus
to
return
tothestigmaconceptandas a criticalanalytic
a revised
lensinconstructing
We followourexplication
conceptualization.
of thestigmaconceptwitha more
detaileddiscussionofeach ofitscomponent
parts.We endby applyingourcontoseveralcoreissuesinthestigmaliterature
withaneyetoassessing
ceptualization
whether
ourconceptualization
is helpfulin understanding
thoseissues.In doing
so, we attendmoreto thenatureandconsequencesof stigmathanto itssources.
(For a reviewof someideas abouttheoriginsof stigmasee Crocker& Lutsky
1986.)
VARIATIONSIN THE DEFINITION OF STIGMA
One of thecuriousfeatures
of literature
that
concerning
stigmais thevariability
existsin thedefinition
of theconcept(Stafford
& Scott1986). In manycircumstancesinvestigators
andseemtoreferto something
provideno explicitdefinition
likethedictionary
mark
of
definition
("a
disgrace")orto somerelatedaspectlike
orrejection(e.g.,a socialdistancescale). Whenstigmais explicitly
stereotyping
definition
ofstigmaas an "attribute
thatis
defined,
manyauthors
quoteGoffman's
andthatreducesthebearer"froma wholeandusualperson
deeplydiscrediting"
to a tainted,
discounted
one" (Goffman
1963,p. 3).
SinceGoffman,
alternative
orelaborateddefinitions
havevariedconsiderably.
Forexample,Stafford
& Scott(1986,p. 80) proposethatstigma"is a characteristic
ofpersonsthatis contrary
toa normofa socialunit"wherea "norm"is defined
as
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CONCEPTUALIZING STIGMA
365
a "sharedbeliefthata personoughtto behavein a certainwayat a certaintime"
individuals
possess
(p. 81). Crockeretal (1998,p. 505) indicatethat"stigmatized
orcharacteristic,
thatconveysa social
(or arebelievedtopossess)someattribute,
socialcontext."
An especiallyinfluential
identity
thatis devaluedin a particular
definition
is thatofJonesetal (1984),whouse Goffman's
(1963,p.4) observation
betweenan "attribute
and a stereotype"
thatstigmacan be seenas a relationship
thatlinksa personto
to producea definition
of stigmaas a "mark"(attribute)
In ourownreviewsofstigmaandmental
undesirable
characteristics
(stereotypes).
ofdiscrimination
illness(e.g.,Link& Phelan1999),we haveaddedthecomponent
totheJoneset al (1984) definition.
of stigmavary,two seem particularly
Of themanyreasonsthatdefinitions
prominent.
First,as indicatedabove,thestigmaconcepthas beenappliedto an
Each one of theseis unique,and each one is
enormousarrayof circumstances.
to conceptualize
different
way.
stigmain a somewhat
likelyto lead investigators
on stigmais clearlymultidisciplinary,
contributions
by
including
Second,research
andsocialgeograanthropologists,
politicalscientists,
psychologists,
sociologists,
thereis a greatdealofoverlapininterests
acrossthesedisciplines,
phers.Although
somedifferences
inemphasis.Evenwithin
peotherearenevertheless
disciplines,
theoretical
thatproorientations
ple approachthestigmaconceptfromdifferent
ducesomewhat
different
visionsofwhatshouldbe includedintheconcept.Thus,
different
framesofreference
haveled todifferent
conceptualizations.
itseemswisetocontinue
Becauseofthecomplexity
ofthestigmaphenomenon,
to allow variationin definition
so long as investigators
are clear as to whatis
meantby stigmawhenthetermis used. Havingsaid this,we shallalso attempt
to movematters
aheadby specifying
a conceptualization
of stigmathatincludes
in thisarea ofresearchshare.Before
manyof theconcernsthatpeopleworking
itis important
tonotethattheuse ofthestigmaconcepthas
proceeding,
however,
who havefocusedon theperspective
been challengedby some social scientists
ofpersonswhoarestigmatized
(Schneider1988,Fine& Asch 1988,Sayce 1998;
thesechallengesis important
forthefurther
Kleinmanetal 1995).Understanding
froma sociologicalperspective.
ofresearchon stigma,
particularly
development
CHALLENGESTO THE STIGMACONCEPT
is thatmanysocial
Therearetwomainchallengestothestigmaconcept.The first
whodo notbelongto stigmatized
scientists
groups,andwhostudystigma,do so
fromthevantagepointof theoriesthatare uninformed
by thelivedexperience
ofthepeopletheystudy(Kleinmanet al 1995,Schneider1988).Forexample,in
abouttheexperience
ofdisability,
Schneider
(1988) assertsthat"mostablewriting
"to theirscientific
theoriesandresearchtechniques
bodiedexperts"givepriority
ratherthanto thewordsandperceptions
of thepeopletheystudy."The resultis
andthe
of theexperienceofthepeoplewhoare stigmatized
a misunderstanding
Fine& Asch
aboutdisability,
ofunsubstantiated
assumptions.
Writing
perpetuation
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366
LINK * PHELAN
fiveassumptions:
is locatedsolelyin biology,
(1988) identify
(a) thatdisability
(b) thattheproblemsof thedisabledaredue to disability-produced
impairment,
(c) thatthedisabledpersonis a "victim,"(d) thatdisabilityis centralto the
disabledperson'sself-concept,
self-definition,
socialcomparisons,
andreference
withneedinghelpandsocial
is synonymous
groups,and(e) thathavinga disability
support.
The secondchallengeis thatresearchon stigmahas had a decidedlyindividutoOliver(1992),thecentralthrust
alisticfocus.Forexample,according
ofstigma
research
hasbeenfocusedon theperceptions
ofindividuals
andtheconsequences
of suchperceptions
formicro-level
interactions.
Accordingto Oliver(1992), researchexaminingthe sourcesand consequencesof pervasive,sociallyshaped
exclusionfromsocial and economiclifeare farless common.Interestingly,
this
is echoedbyatleastonerenowned
criticism
student
ofstereotyping,
and
prejudice,
In herreviewof thesetopics,SusanFiske(1998) concludesthat
discrimination.
theliterature
(at leastwithinsocialpsychology)
on discrimination
is farless extensivethanthaton stereotyping
and thatmoreattention
needsto be addressed
to structural
issues.In anothervein,eventhoughGoffman
(1963, p. 3) initially
advisedthatwe reallyneeded"a languageofrelationships,
notattributes,"
subseofpersons
quentpracticehas oftentransformed
stigmasor marksintoattributes
in theperson
(Fine & Asch 1988). The stigmaor markis seen as something
rather
thana designation
or tagthatothersaffixto theperson.In thisrespectthe
termstigmadirectsour attention
differently
thana termlike "discrimination."
In contrast
to "stigma,""discrimination"
focusestheattention
ofresearchon the
producersof rejectionand exclusion-thosewho do thediscriminating-rather
thanon thepeoplewhoaretherecipients
ofthesebehaviors(Sayce 1998).Thus,
thetermswe use couldlead to "different
understandings
ofwhereresponsibility
lies forthe'problem'andas a consequenceto different
foraction"
prescriptions
(Sayce 1998).
Researcherson stigmacould respondto thesechallengesby disputing
their
on stigma.
validityor pointingto exceptionsin thenow voluminousliterature
of the
We findthesecritiquesto providea usefulstimulusfora reassessment
of stigmaandrelatedconcepts.One wayin whichsomeofthe
conceptualization
issuesraisedbythecritiques
is toproposethatstigmabe described
canbe addressed
withreference
totherelationships
betweena setofinterrelated
concepts.
DEFINING STIGMAIN THE RELATIONSHIP
OF INTERRELATEDCOMPONENTS
tolocatingthemeaningofstigmaintherelationbetween
An important
precedent
conceptsis availablein Goffman'sobservation
thatstigmacan be seen as the
relationship
betweenan "attribute
and a stereotype."
We expandthenexusof
withtheintentof capturing
somewhat
a fullersetof meaningsfor
relationships
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CONCEPTUALIZING STIGMA
367
thetermbydoingso. We stateourconceptualization
as conciselyas we can and
thenelaboratethecomponents
itcontains.
In ourconceptualization,
stigmaexistswhenthefollowing
interrelated
componentsconverge.In thefirstcomponent,
people distinguish
and label human
In thesecond,dominant
differences.
cultural
beliefslinklabeledpersonstoundesirablecharacteristics-to
negativestereotypes.
In thethird,
labeledpersonsare
placedindistinct
categories
so as toaccomplish
somedegreeofseparation
of"us"
from"them."In thefourth,
labeledpersonsexperience
statusloss anddiscriminationthatlead to unequaloutcomes.Finally,stigmatization
is entirely
contingent
on access to social,economic,andpoliticalpowerthatallowstheidentification
ofdifferentness,
theconstruction
theseparation
ofstereotypes,
oflabeledpersons
intodistinct
andthefullexecution
categories,
ofdisapproval,
rejection,
exclusion,
and discrimination.
Thus,we applythetermstigmawhenelementsof labeling,
statusloss,anddiscrimination
co-occurin a powersitustereotyping,
separation,
ationthatallowsthecomponents
of stigmato unfold.Withthisbriefexplication
ofthestigmaconceptas background,
we turnto a moredetailedexamination
of
each component
we identified.
COMPONENT 1-ON DISTINGUISHING
AND LABELINGDIFFERENCES
The vastmajority
of humandifferences
are ignoredand are therefore
socially
irrelevant.
Some of these-such as thecolorof one's car,thelastthreedigitsof
one's social security
or whether
one has hairyears-are routinely
number,
(but
notalways)overlooked.
oreyecolor
Manyotherssuchas one's foodpreferences
arerelevant
inrelatively
fewsituations
andaretherefore
typically
inconsequential
in thelargeschemeofthings.Butotherdifferences,
suchas one's skincolor,IQ,
sexualpreferences,
or genderarehighlysalientin theUnitedStatesat thistime.
Thepointis thatthereis a socialselectionofhumandifferences
whenitcomesto
differences
thatwillmatter
identifying
socially.
is oftenoverlooked
Thefullweightofthisobservation
becauseoncedifferences
are identified
and labeled,theyare typically
takenforgrantedas beingjust the
are-thereareblackpeopleandwhitepeople,blindpeopleandsighted
waythings
andpeoplewhoarenot.Thetaken-for-granted
people,peoplewhoarehandicapped
natureof thesecategorizations
is one of thereasonsthatdesignations
likethese
someobservations
we canmakethatbring
carrysuchweight.Thereare,however,
tolightjusthowsocialthissocialselectionofhumandifferences
is.
is requiredto creategroups.One example
First,substantial
oversimplification
is theassignment
of individuals
to categoriesof "black"or "white"whenthere
is enormousvariability
withintheresulting
categoriesand no cleardemarcation
between
onalmostanycriterion
onecanthink
likeskin
categories
of,evenattributes
orfacialcharacteristics
thatarebelievedtodefinethecategories
color,parentage,
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368
LINK * PHELAN
likegayorstraight,
(Fullilove1998).Thesamecanbe saidforothercategorizations
ornot.
blindorsighted,
handicapped
is revealed
roleofthesocialselectionofhumandifferences
Second,thecentral
deemedsalientdiffer
dramatically
accordingto time
bynotingthattheattributes
century,
humanphysicalcharacand place. For example,in thelatenineteenth
salient-these
andlargefaceswereparticularly
teristics
suchas smallforeheads
tobe ape-like-andwerebelievedtorevealthecrimcharacteristics
werethought
inalnatureofthepeoplepossessingthem(Gould 1981).And,ofcourse,cultures
deemedsociallysignificant.
Forexample,anvaryextensively
in characteristics
andsoughtto
to beingcross-eyed
cientMayanculturegaveunusualsignificance
bainchildren
through
devicesthatencouraged
createthisdesirablecharacteristic
biestofocusonobjectsinwaysthatforcedtheireyestocross.Sociologicalstudies
arealso goodexamples(Conrad1992).
ofsocialconstruction
andmedicalization
ofa disorder,
thanitused
is muchmoresalientnow,as an indicator
Hyperactivity
is part
deficit
hyperactivity
disorder)
tobe,andthemedicaltermADHD (attention
ofcommonparlance.
aresociallyselectedforsalience,wehavechosento
Becausehumandifferences
or"mark."Each ofthese
than"attribute,"
"condition"
use theword"label"rather
to in thestigmatized
person
lattertermslocatesthethingthatis beingreferred
is
and electionforsocial significance
and risksobscuringthatits identification
a label is something
thatis affixed.
theproductof social processes.In contrast,
termslike"attribute,"
or
Moreoverin theabsenceofqualifications,
"condition,"
hasvalidity.
In contrast
theword"label"leaves
"mark"implythatthedesignation
thevalidityofthedesignation
an openquestion-an optionthathas greatutility
as, forexample,whenonewishestodiscussthestigmasomewomenexperienced
as a consequenceofbeinglabeledwitches.
Withregardto thisaspectofthestigmaprocess,thecriticalsociologicalissue
ariseandhowtheyaresustained.
is todetermine
howculturally
createdcategories
aresingledoutanddeemedsalientbyhuman
Whyis itthatsomehumandifferences
forces
Whatarethesocial,economic,andcultural
areignored?
groupswhileothers
thefocuson a particular
humandifference?
thatmaintain
COMPONENT 2-ON ASSOCIATINGHUMAN
DIFFERENCESWITH NEGATIVEATTRIBUTES
are linkedto
of stigmaoccurswhenlabeleddifferences
The secondcomponent
was
in
Goffman's
This
of
(1963) workand
stereotypes. aspect stigma highlighted
ever
It is theaspect
central
to
the
of
since.
conceptualization
stigma
has been
aboutstigma,
has
salient
in
the
literature
of stigmathat beenmost
psychological
aboutthe
it
of
a
nature
because
critical
questions
psychological
perhaps
poses
connections
betweenlabelsandstereotypes.
Conthought
processesthatfacilitate
is thecentrality
of thisdimensionin
sistentwiththisemphasisin psychology
ofstigma.Forexample,Crockerandcolleagues(1998)
definitions
psychologists'
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CONCEPTUALIZING STIGMA
369
thatconveysa social
orcharacteristic
definestigma,
as notedabove,as an"attribute
context."
identity
thatis devaluedin a particular
withthelabel
thisaspectofstigmainvolvesa labelanda stereotype,
Inourterms,
An
characteristics
thatformthestereotype.
linking
a persontoa setofundesirable
byLink
conducted
experiment
is evidentin a vignette
exampleofthiscomponent
labeling,tagginga random
manipulated
et al (1987). The studyexperimentally
back-pain
andtheotherhalf"former
halfofthevignettes
"former
mentalpatients"
believed
It also includeda measureoftheextentto whichrespondents
patients."
describeda
Whenthevignette
thatmentalpatientsingeneralwere"dangerous."
ofpeoplewithmental
former
beliefsaboutthedangerousness
back-painpatient,
illnessplayedno partin rejectingresponsestowardthevignettesubject.When
thesebeliefswerepotent
however,
thevignette
describeda former
mentalpatient,
were
whobelievedmentalpatients
responses:Respondents
predictors
ofrejecting
mentalpatient
to thepersondescribedas a former
dangerousreactednegatively
in thevignette.
formanypeople,the"mentalpatient"label linked
Apparently,
beliefsaboutthedangerousness
of people
thedescribedpersonto stereotyped
withmentalillness,whichin turnled themto desireforsocialdistancefromthe
person.
has beena
betweenlabelsandstereotypes
above,thisconnection
As indicated
the
studyof stigmain recentyears,following
majoraspectofthepsychological
bodyof
andveryfruitful
socialcognitive
approach(Fiske 1998).Thisintriguing
theuseofcategories
research
seekstoelucidatethecognitive
processesunderlying
to stereotypes
andthelinkingofthosecategories
(Crockeret al 1998).We focus
on someselectedaspectsofthisextensive
bodyofresearch.
briefly
are often"automatic"
categoriesand stereotypes
Accordingto thisliterature,
The automatic
natureis revealedin experiand facilitate
"cognitive
efficiency."
andstereotypes
areusedinmakingsplit-second
mentsthatindicatethatcategories
Forexample,Gaertner
preconsciously.
andthusappeartobe operating
judgments
inwhichonegroupofwhitesubanexperiment
& McLaughlin(1983) conducted
jects was primedby theword"whites"and anotherby theword"blacks,"and
thenbothgroupsweretestedas tothespeedwithwhichtheywereabletoidentify
whether
twostringsof letterswerebothwords.Bothhigh-and low-prejudiced
and
morerapidlytopositivewordslike"smart,"
"ambitious,"
subjectsresponded
bytheword"blacks."
"clean"whenprimed
bytheword"whites"thanwhenprimed
ina preconcious,
automatic
tooperating
In addition
way,somestudiessuggestthat
resources.
usepreserves
Thus,forexample,ifsubjectsareprocognitive
category
orrealestateagentwhenaskedto
videdwithlabelslikedoctor,artist,
skinhead,
of a vignette,
forman impression
perform
theyarebetterable to simultaneously
thanare subjectswho are not
anothertasklike turning
offa beepingcomputer
standpoint,
providedtheselabels(Macraeetal 1994).Thus,froma psychological
culturally
givencategoriesare presenteven at a preconciouslevel and provide
decisionsthatfreethemto attendto
peoplewitha meansof makingshorthand
revealsconAt thesametime,otherresearchin socialpsychology
othermatters.
suchthatverydifferent
siderablelatitudein thecognitive
processesthattranspire
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370
LINK * PHELAN
peopleemployand
onthenatureofthecognitions
outcomesmayoccurdepending
thecontexts
inwhichpeopleareembedded(Crockeretal 1998).
COMPONENT 3-ON SEPARATING"US" FROM "THEM"
A thirdfeatureof thestigmaprocessoccurswhensocial labels connotea separationof "us" from"them"(Morone1997,Devine et al 1999). UnitedStates
deold-order
Americans
andpoliticsoffermanyexamplesas established
history
Indians,andsuccessivewavesofimmifinedAfrican-American
slaves,American
from"us." Few groups
grantsas outgroups-the"them"whowereverydifferent
spared.Forexample,Morone(1997) providesquotesfromBenjamin
wereentirely
("them")on theEnof theimpactof Dutchimmigrants
Franklin'sobservations
neighborhoods,
theEnglishbegintoquitparticular
glishcolonists("us"). "Already
ofdissonant
bytheDutch,beingmadeuneasybythedisagreeableness
surrounded
enabledtounder-work
andarethereby
... Besides,theDutchunder-live,
manners
and conseincommoded
theEnglishwho are thereby
extremely
and under-sell
1752).Andofcourse,whilethegroupsrepresenting
(Franklin
quentlydisgusted"
is stillprominent
today."They"are
"us" and"them"havechanged,thisseparation
(Morone1997).
lazy,andpredatory
a menaceto "us" becausetheyareimmoral,
of thestigmaprocess-thelinkingof labelsto undesirThus,othercomponents
labeledpersons
forbelievingthatnegatively
therationale
ableattributes-become
types
fromthosewhodon'tsharethelabel-different
different
arefundamentally
of people.At thesametime,whenlabeledpersonsare believedto be distinctly
becausethereis littleharm
can be smoothly
accomplished
stereotyping
different,
thestigto"them."In theextreme,
in attributing
ofbad characteristics
all manner
to be so different
from"us" as to be notreallyhuman.
matizedpersonis thought
of "them"becomes
all mannerof horrific
treatment
And again,in theextreme,
possible.
available
directly
to separateus fromthemare sometimes
Evidenceofefforts
to "be" the
Incumbents
are thought
in theverynatureof thelabels conferred.
1989).Forexample,somepeoplespeakofpersons
thingtheyarelabeled(Estroff
themas having
ratherthandescribing
as being"epileptics"or "schizophrenics"
of
thiscomponent
Thispracticeis revealing
regarding
epilepsyor schizophrenia.
forotherdiseases.A personhas cancer,heartdisease,
stigmabecauseitis different
ortheflu-sucha personis one of"us,"a personwhojusthappenstobe besetby
a seriousillness.Buta personis a "schizophrenic."
COMPONENT 4-STATUS LOSS AND DISCRIMINATION
statusloss
In thiscomponent
ofthestigmaprocess,thelabeledpersonexperiences
but
ofstigmado notincludethiscomponent,
anddiscrimination.
Mostdefinitions
assignto
as we shallsee,thetermstigmacannotholdthemeaningwe commonly
whenpeoplearelabeled,setapart,
itwhenthisaspectis leftout.In ourreasoning,
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CONCEPTUALIZING STIGMA
371
a rationaleis constructed
fordevaluing,
characteristics,
andlinkedtoundesirable
whenthefactthat
rejecting,
and excludingthem.Thus,people are stigmatized
characteristics
leadsthemto
theyarelabeled,setapart,andlinkedto undesirable
experience
statusloss anddiscrimination.
whenitcomesto a
groupsaredisadvantaged
Consistent
withthis,stigmatized
psychological
well-being,
generalprofileoflifechanceslikeincome,education,
andhealth(e.g. Drusset al 2000,Link 1987).
housingstatus,medicaltreatment,
ofsomedisadvantaged
outcomessomeWhilesomegroupsescapetheexperience
regarding
self-esteem-seeCrocker1999),when
times(e.g.,AfricanAmericans
one considerstheprofileof all possibleoutcomes,thegeneralprincipleclearly
groups.How does thishappen?
holdsformoststigmatized
StatusLoss
ofsuccessful
Analmostimmediate
labelingandstereotyping
consequence
negative
ofa personin a statushierarchy.
The personis
is a generaldownward
placement
thatreducehis or herstatusin theeyes
characteristics
connectedto undesirable
The factthathumanbeingscreatehierarchies
of thestigmatizer.
is, of course,
whositswhereinmeetings,
whodefersto whom
charts,
evidentin organizational
and so on. One strandof sociologicalresearchon
in conversational
turn-taking,
is particularly
theso-calledexpectation-states
tradition,
relevant
socialhierarchies,
to thestudyof stigmaand statusloss (Cohen 1982,Driskell& Mullen 1990).
of evenunacquainted
a reliabletendency
indivdiualsto form
Based on finding
setout
whenplacedingroupsituations,
researchers
fairlystablestatushierarchies
to understand
theprocessesthatproducedthisstateof affairs.
Whattheyhave
foundis relevantto researchon stigmain manyways,two of whichwe shall
emphasizehere.First,thisresearchshowsthatexternalstatuses,like race and
within
smallgroupsofunacquainted
personseven
gender,
shapestatushierarchies
at a taskthegroupis
thoughtheexternalstatushas no bearingon proficiency
askedto perform.
Men and whitesare morelikelythanwomenand blacksto
havetheirideas
talkmorefrequently,
attainpositionsofpowerandprestige-they
morereadilyacceptedby others,and are morelikelyto be votedgroupleader
areimportant
to researchon stigmabecause
(Mullenet al 1989). Thesefindings
theyshowhowhavinga statusthatis devaluedin thewidersocietycan lead to
withinsmall
inthecontext
ofsocialinteractions
formsofinequality
veryconcrete
in status-related
occur
outcomesdefinitely
inequalities
groups.Second,although
ofdiscrimination
thatwouldbe readily
inthegroups,theydo notresultfromforms
use externalstatuses(like
Insteadgroupmembers
to a casual observer.
apparent
of
thatthenleadtoa labyrinth
raceandgender)tocreateperformance
expectations
tothecontributions
referring
detailsthatinvolvetakingthefloor,
keepingthefloor,
and thelike.Thisis important
to research
of others,
headnodding,interrupting,
inoutcomecanoccureven
on stigmabecauseitshowsthatsubstantial
differences
to specifya singleeventthatproducedthe
forparticipants
whenit is difficult
unequaloutcome.
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372
LINK * PHELAN
Discrimination
INDIVIDUAL DISCRIMINATION The standard
wayofconceptualizing
theconnectionbetweenlabeling,stereotyping,
and discrimination
in thestigmaliterature
followsa relatively
simplistic
formulation.
In thisapproach,theimportance
of
andbeliefsarethought
attitudes
to lie in whether
personA's labelingandstereotypingof personB leads personA to engagein some obviousformsof overt
discrimination
directedat personB, suchas rejecting
a job application,
refusing
torentan apartment,
andso on. Thereis no doubtthatthisrather
straightforward
processoccurswithconsiderable
regularity,
althoughsomesocialpsychologists
withinterests
instigmahaverecently
bemoanedthefactthatdocumenting
discrimbehaviorhas notbeentheirstrongsuit(Fiske1998).Connecting
inatory
attitudes
to behaviorsis, therefore,
as something
thearea of researchon
conceptualized
needs(Fiske 1998). In thisregardAjzen & Fishbein's
stigmaand stereotyping
ofreasonedaction"hasbeensuccessfully
(1980) "theory
appliedtotheprediction
ofmanybehaviors
andmight
alsobe usefulinpredicting
behaviors.
discriminatory
The approachtheyproposeis effective
becauseit asksus to narrowourfocusto
a veryspecificbehaviorand to be attentive
to theintricacies
of thebeliefsand
attitudes
towardperforming
thespecificactinquestion.Buttheareaofstigmaresearchneedstoexpanditsconception
oftheprocessesthrough
whichlabelingand
leadtosocialinequalities
inlifecircumstances.
stereotyping
By itselfthestandard
modelthatasks"what-makes-person-A-discriminate-against-person-B"
is inadequateforexplainingthefullconsequencesof stigmaprocesses.In fact,getting
ofexplaining
a specificactfromknowledge
tangledup in thenarrowintricacies
of a specificset of attitudes
and beliefscould cloud ratherthanilluminate
our
ofwhystigmatized
understanding
groupsexperience
so manydisadvantages.
STRUCTURALDISCRIMINATION Theconcept
ofinstitutional
racismsensitizes
usto
thefactthatall manner
ofdisadvantage
canresultoutsideofa modelinwhichone
bad to another.
Institutional
racismrefersto accumulated
persondoes something
institutional
thatworktothedisadvantage
ofracialminority
practices
groupseven
in theabsenceofindividual
prejudiceordiscrimination
(Hamilton& Carmichael
1967). For example,employers
(moreoftenwhite)relyon thepersonalrecommendations
ofcolleaguesor acquaintances
(moreoftenwhiteandmorelikelyto
knowandrecommend
whitejob candidates)forhiringdecisions.The samekind
ofstructural
discrimination
forotherstigmatized
is,ofcourse,present
groups.For
example,disabledpersonsmaybe limitedin theirabilityto worknotso much
becauseof theirinherent
limitations
butbecausetheyareexposedto whatHahn
createdbythebarriers
toparticipation
that
(1983) calls"a disablingenvironment"
residein architecture
we humanshave constructed
(Fine & Asch 1988). Considersomepossibleexamplesofstructural
discrimination
fora mentalillnesslike
lessfunding
is dedschizophrenia.
Supposethatbecausetheillnessis stigmatized,
icatedto researchaboutit thanforotherillnessesand less moneyis allocated
to adequatecareandmanagement.
considerthat,becauseofhistorical
Moreover,
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CONCEPTUALIZING
STIGMA
373
processesinfluenced
by stigma,treatment
facilitiestendto be eitherisolatedin
settings
awayfromotherpeople(Rothman1971) orconfined
to someofthemost
in urbansettings
in communities
disadvantaged
neighborhoods
thatdo nothave
enoughcloutto excludethisstigmatized
groupfromtheirmidst(Dear & Lewis
1986). At thesame time,themostsuccessfuland accomplishedmentalhealth
tendto accruemorestatusandmoneybytreating
personnel
less seriousillnesses
in privateofficesin affluent
areas,leavingthecareofpeoplewithschizophrenia
to a generally
less accomplished
group(Link1983).To theextentthatthestigma
ofschizophrenia
hascreatedsucha situation,
a personwhodevelopsthisdisorder
willbe therecipient
of structural
discrimination
or notanyonehappens
whether
to treathimor herin a discriminatory
way because of some stereotype
about
schizophrenia.
thestructure
Stigmahas affected
aroundtheperson,leadingthe
personto be exposedto a hostofuntoward
circumstances.
In keepingwithobservations
abouttherole of stigmain theloss of status,it is important
to notethatlower
in a statushierarchy
can beginto haveeffects
placement
ofitsownon a person's
lifechances.Itis notnecessary
torevisit
thelabelingandstereotyping
thatinitially
ledtothelowerstatus,
becausethelowerstatusitselfbecomesthebasisofdiscrimination.Forexample,low statusmightmakea personless attractive
to socialize
orto includein a businessventure
with,to involvein community
activities,
that
whohavepoliticalinfluence
requirespartners
withlocal politicians.
In thisway,
a lowerpositionin thestatushierarchy
can havea cascadeofnegativeeffects
on
all mannerofopportunities.
Becausethediscrimination
thatoccursis one stepremovedfromthelabelingandstereotyping,
itis easytomissthemoredistaleffects
ofthesefactors
in anyaccounting
oftheeffects
ofthesestigmacomponents.
STATUS LOSS AS A SOURCE OF DISCRIMINATION
SOCIAL PSYCHOLOGICAL PROCESSES OPERATING THROUGH THE STIGMATIZED
is in place, it can affectlabeledpersons
PERSON Once theculturalstereotype
inimportant
ofdiscriminatory
behavioron
waysthatdo notinvolveobviousforms
thepartofpeopleintheimmediate
presenceofthestigmatized
person.Forexamtoa modified
abouttheeffects
ofstigmaon people
ple , according
labelingtheory
withmentalillnesses(Link1982,Linketal 1989),peopledevelopconceptions
of
mentalillnessearlyinlifeas partofsocialization
intoourculture(Angermeyer
&
Matschinger
1996,Scheff1966,Wahl1995).Onceinplace,people'sconceptions
becomea lay theoryaboutwhatit meansto havea mentalillness(Angermeyer
as to
& Matschinger
1994,Furnham& Bower1992). People formexpectations
emwhether
mostpeoplewillrejectan individual
withmentalillnessas a friend,
orintimate
mostpeoplewilldevaluea person
andwhether
ployee,neighbor,
partner
withmentalillnessas less trustworthy,
andcompetent.
Thesebeliefs
intelligent,
havean especiallypoignant
relevancefora personwhodevelopsa seriousmental
ofdevaluation
anddiscrimination
becomespersonillness,becausethepossibility
Ifonebelievesthatotherswilldevalueandrejectpeoplewithmental
allyrelevant.
Thepersonmay
illnesses,onemustnowfearthatthisrejection
appliespersonally.
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374
LINK * PHELAN
wonder,"Willotherslook downon me,rejectme, simplybecauseI havebeen
identified
as havinga mentalillness?"Thento theextentthatit becomesa part
ofa person'sworldview,thatperception
canhaveseriousnegative
consequences.
Expectingand fearingrejection,
peoplewho havebeenhospitalizedformental
illnessesmayactless confidently
andmoredefensively,
ortheymaysimplyavoid
a potentially
threatening
contactaltogether.
The resultmaybe strained
and uncomfortable
social interactions
withpotentialstigmatizers
(Farinaet al 1968),
moreconstricted
social networks
(Link et al 1989), a compromised
qualityof
life(Rosenfield
1997),low self-esteem
etal 2000),depressive
(Wright
symptoms
(Linket al 1997),unemployment
andincomeloss (Link1982,1987).Whilethis
theory
has beenmostthoroughly
examinedwithrespectto mentalillnesses,the
processis probablymuchmoregeneral.In keepingwiththispossibility,
Pinel
(1999) hasrecently
calledtheexpectation
ofstereotyping
"stigmaconsciousness"
andhasproposeditsapplication
to otherstigmatized
statuses.
A relatedbutslightly
different
to
theeffect
of stereoapproach understanding
typesis Steele& Aronson's(1995)conceptof"stereotype
threat."
tothis
According
idea,peopleknowaboutthestereotypes
thatmightbe appliedto them-African
Americans
knowtheyaretaggedwithattributes
ofviolenceandintellectual
infeandpromiscuous,
riority,
gaymenknowtheyare seenas flamboyant
andpeople
withmentalillnessesknowthattheyarebelievedtobe unpredictable
anddangerous. The insightthatSteele& Aronsonprovideis thatthestereotype
becomesa
threat
or challengeeitherbecauseone mightbe evaluatedin accordancewiththe
orbecauseonemightconfirm
stereotype
thestereotype
through
one'sbehavior.
In
keepingwiththisidea,Steele& Aronsonhaveshownthat,controlling
forinitial
on SAT scores,African-American
differences
students
worsethanwhite
perform
students
on a testwhenstudyparticipants
areled tobelievethatthetestmeasures
intellectual
In contrast,
ability.
whenthesametestis notlabeledas beingdiagnosticofability,
African
Americans
scoreas wellas whites.Thisresearch
tellsus that
theexistenceofa stereotype
andtheadministration
ofa testof"ability"can lead
to an invalidassessment
oftheacademicpotential
ofAfrican-American
students
and thereby
to discrimination
on thebasis of a seemingly
againstsuchstudents
"objective"test.
Notethatinboththemodified
andtheory
aboutstereotype
labelingtheory
threat,
no one in theimmediate
contextofthepersonneedsto haveengagedin obvious
formsofdiscrimination.
thediscrimination
lies anterior
to theimmediate
Rather,
situation
andrestsinsteadin theformation
andsustenance
ofstereotypes
andlay
theories.
Stilltheconsequencesaresometimes
severeandundoubtedly
contribute
todifferences
inthelifechancesofpeoplein stigmatized
greatly
groups.
The problemof stigmahas beendescribedas
a predicament
or a dilemmaby Goffman
and others(Ainlayet al 1986,Crocker
et al 1998). One reasonforthisis brought
to lightby thesociologicalobservationthatmechanisms
liketheones we have describedare bothinterchangeable
and mutually
in achievingendsthatdiscrimnate
reinforcing
againststigmatized
INTERCHANGEABLEMECHANISMS
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CONCEPTUALIZING STIGMA
375
against
todiscriminate
groupsaremotivated
groups(Lieberson1985).Ifpowerful
can be
"them,"therearemanywaysin whichsuchdiscrimination
a stigmatized
accepttheir
personscannotbe persuadedto voluntarily
achieved.If stigmatized
can be used to accomrewards,directdiscrimination
lowerstatusand inferior
becomesideologicallydifficult,
plishthesameoutcome.If directdiscrimination
as teststhatinducestereoformsofstructural
discrimination-such
sophisticated
are mutually
typethreat-canachievesomeof thesameends.The mechanisms
groupsacceptthedominant
as well. To theextentthatstigmatized
reinforcing
formsof
view of theirlowerstatus,theyare less likelyto challengestructural
directdiscrimination
theydesire.Further,
discrimination
thatblockopportunities
in accorgroupsthattheywillbe treated
thebeliefamongstigmatized
reinforces
processeslikethoseexplicatedin
andtherefore
reinforces
dancewithstereotypes
concept.From
labelingtheoryand thestereotype-threat
thecontextof modified
in thefollowingsense-as longas
thisvantagepoint,stigmais a predicament
theuse of
dominant
persons,decreasing
groupssustaintheirviewof stigmatized
simultaneously
whichdisadvantage
canbe accomplished
through
onemechanism
Thislatterobservation
bringsus
toincreasetheuse ofanother.
createstheimpetus
on powerdifferences.
tothefinalaspectofourstigmaconcept-itsdependence
THE DEPENDENCE OF STIGMAON POWER
on social,economic,and politicalpower-it takes
dependent
Stigmais entirely
In someinstancestherole of poweris obvious.However,
powerto stigmatize.
becausein manyinstances
theroleof powerin stigmais frequently
overlooked
Whenpeople
areso takenforgranted
as toseemunproblematic.
powerdifferences
thinkofmentalillness,obesity,
andhavingoneleginsteadoftwo,there
deafness,
associatedwiththeseconditionsrather
is a tendency
to focuson theattributes
thanonpowerdifferences
betweenpeoplewhohavethemandpeoplewhodo not.
of
is essentialto thesocial production
But power,evenin thesecircumstances,
stigma.
In orderto reasonabouttheroleof powerin stigma,firstconsiderinstances
To begin,taketheexample
in whichit is clearthatsocial poweris important.
century
EnglishcoloniststaggedtheDutch
providedearlierin whicheighteenth
andlow-living.
ofdisagreeableness
withattributes
Alongthesamelines,peopleof
as "temperamental,
Irishbackground
werestereotyped
quarrelsome,
dangerous,
The Irish
Americansin thenineteenth
century.
idle and reckless"by old-order
as suchin cartoonsof the
at thetimewerelikenedto apes and wereportrayed
itis clearthat
circumstances,
day(Feagin& Feagin1996).In thelightofcurrent
and theold-order
Americansof the
century
Englishcolonistsof theeighteenth
theDutchand Irishbecauseof their
wereable to stigmatize
nineteenth
century
positionsofpoweroverthesegroupsatthetime.And,ofcourse,itwas thepower
ofJewish
anddevastating
oftheNazis thatallowedtheirthorough
stigmatization
people.
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376
LINK * PHELAN
Buthowcanwe thinkoftheroleofpowerincircumstances
likementalillness,
obesity,
deafness,
and one leggedness?One wayis to recognizethatstigmatized
groupsoftenengageinthesamekindsofstigma-related
processesintheirthinking
aboutindividuals
who are notin theirstigmatized
group.Considerforexample
in a treatment
forpeoplewithseriousmentalillness.Patientsin
patients
program
sucha setting
arelikelytoidentify
andlabelhumandifferences
in staff
members.
Forinstance,
theymighttagsomeclinicianswiththelabel"pillpusher"andapply
stereotypes
connectedwiththelabels theycreatesuch as thatpill pushersare
cold,paternalistic,
andarrogant.
Finallytheymighttreatthepeopletheyidentify
as pill pushersdifferently
in accordancewiththeconclusionstheyhave drawn
aboutthemby avoidingor minimizing
withthem,exchanging
communication
andjokesaboutthem,andso on.Thusalthough
thepatients
derogatory
comments
mightengagein everycomponent
of stigmawe identified,
thestaffwouldnot
endup beinga stigmatized
group.The patientssimplydo notpossessthesocial,
cultural,
economic,andpoliticalpowerto imbuetheircognitions
aboutstaff
with
seriousdiscriminatory
consequences.
Considerfurther
thatscenariossimilarto theone just describedexistforall
inwhichrelatively
sortsofothercircumstances
powerlessgroupscreatelabelsand
aboutmorepowerful
ofthemorepowerful
stereotypes
groupsandtreatmembers
a
in
accordance
with
those
Such
realizationclarifies
group
stereotypes.
whythe
of stigmamustinvolvereference
definition
topowerdifferences.
Without
sucha
andmuchbroaderconceptthatmight
reference,
stigmabecomesa verydifferent
be appliedtolawyers,
WallStreetinvestors,
politicians,
andwhitepeople.Stigma
is dependent
on power.
Because of theimportance
of powerin stigmatization,
it is criticalto ask the
havethepower
followingsetof questions:Do thepeoplewho mightstigmatize
to ensurethatthehumandifference
theyrecognizeandlabelis broadlyidentified
in theculture?Do thepeoplewhomightconferstigmahavethepowerto ensure
thattheculturerecognizesanddeeplyacceptsthestereotypes
theyconnectto the
labeleddifferences?
Do thepeoplewhomight
havethepowertoseparate
stigmatize
"us" from"them"and to have thedesignation
stick?And do thosewho might
conferstigmacontrolaccess to majorlifedomainslikeeducationalinstitutions,
teethintothe
-jobs,housing,and healthcarein orderto putreallyconsequential
we
distinctions
thatwe canansweryestothesequestions,
theydraw?To theextent
canexpectstigmatoresult.To theextent
thatwe answerno,someofthecognitive
of stigmamightbe in place,butwhatwe generally
meanby stigma
components
wouldnotexist.
IMPLICATIONSOF THE STIGMACONCEPT
Thestigmaconceptwe havearticulated
hasimplications
forhowonemight
reason
aboutseveralpersistent
ofstigma,
questionsincluding:
(a) thedefinition
(b) stigma
as a matter
ofdegree,(c) theoriginsof stigma,(d) theimageofthestigmatized
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CONCEPTUALIZING
STIGMA
377
personas a passivevictimversusan activechallenger,
(e) theconsequencesof
stigma,
dilemma,
(g) whatwe shoulddo tochangestigma
(f) stigmaas a persistent
processes,and (h) theimportance
of stigmain understanding
thedistribution
of
lifechances.
The Definition
ofStigma
of thestigmaconceptis revealingwithregardto whyso many
Our explication
definitions
of stigmaare extantin theliterature-there
are severalcomponents,
each one of whichhas been describedas stigma.We chose to definestigmain
ofinterrelated
theconvergence
components.
Thus,stigmaexistswhenelements
of
labeling,stereotyping,
separation,
statusloss,anddiscrimination
occurtogether
in
a powersituation
thatallowsthem.Thisis a definition
thatwe derived,
notonethat
existsin someindependent
existential
way.As such,itsvaluerestsin itsutility.
is thatthetermstigmais inverywideuse,andsomedegree
Onereasonitis helpful
ofclarity
willhelpus communicate
abouttheconcept.Second,therearewordsthat
likelabel(ormarkorstatus),stereotyping,
aptlydescribeeachofthecomponents
so thattheuse of thewordstigmato
exclusion,statusloss, and discrimination
describeanyparticular
cohereswith
aspectis notnecessary.
Third,thedefinition
thecurrent
usageofthetermas itis appliedtogroupsthatarecommonly
referred
to as stigmatized
of
groups.Recallthatifwe onlyusedthecognitive
components
to definestigma,groupslikelawyers,politicians,
and
labelingand stereotyping
whitepeoplewouldhavetobe considered
stigmatized
groups.Ourincorporation
ofpower,statusloss,,anddiscrimination
we derived
allowstheformaldefinition
ofwhata stigmatized
to coherewithcurrent
we
understandings
groupis. Fourth,
believethatthedefinition
morefullyunderstand
helpsus envisionand thereby
as describedbelow.
severalimportant
issuesin thestigmaliterature
Stigmaas a MatterofDegree
leads to theconclusionthatstigmaexistsas a matterof
Our conceptualization
canbe moreorlessprominent.
A label
degree.Thelabelingofhumandifferences
canconnecta persontomanystereotypes,
tojusta fewortononeatall. Moreover,
of theconnection
can be
thestrength
betweenlabels and undesirable
attributes
orrelatively
weak.The degreeof separation
intogroupsof "us"
relatively
strong
and"them"canbe moreorless complete,
andfinally
theextentofstatusloss and
discrimination
can vary.Thismeansthatsomegroupsaremorestigmatized
than
othersandthatsomeofthecomponents
wehavedescribed
canbe usedanalytically
tothink
aboutwhydifferences
intheextent
ofstigmaexperienced
varyfromgroup
togroup.
The OriginsofStigma
than
Ourpaperhasbeenfocusedon thenatureandconsequencesofstigmarather
its sources.Nevertheless
ourconceptualization
providessomeideas abouthow
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378
LINK * PHELAN
to thinkabouttheoriginsof stigma.As we indicatedat theoutsetof thispaper,
a greatdeal of attention
in theliterature
on stigmahas beendirectedtowardthe
cognitive
processing
ofstigma-relevant
information.
As crucialas theknowledge
gainedfromthisliterature
is, it is not a sufficient
basis forunderstanding
the
originsof stigma.As we havepointedout,groupsbothwithand without
power
labelandformstereotypes
abouttheothergroup-members
ofeachgroupengage
in thekindsofcognitive
processesthatare studiedin thenowvoluminous
social
is whosecognitions
psychological
literature.
But whatmatters
prevail-whose
cognitions
carrysufficient
cloutinsocial,cultural,
economic,andpoliticalspheres
toleadtoimportant
consequencesforthegroupthathasbeenlabeledas different.
Hereis wherethesociologicalstudyofstigmaisbadlyneeded-forwhilecognitive
of stigma,theyare not
processesmaybe necessarycauses fortheproduction
sufficient
causes.We needto further
understand
thesocial processesthatallow
one group'sviewsto dominateso as toproducerealandimportant
consequences
fortheothergroup.
PassiveVictimVersusActiveChallenger
One of themosttroublesome
issuesin thestudyof stigmaemergeswhensocial
scientists
seek to articulate
thereal constraints
thatstigmacreatesin people's
lives,andin doingso theyendup portraying
membersof thestigmatized
group
as helplessvictims(Fine & Asch 1988). Ironically,
thisproducesmorelinesin
thelistof undesirable
attributes
thatformthestereotype
aboutthestigmatized
group-theyareadditionally
"passive,""helpless,"or "acquiescent."
Because of
this,therearefromtimetotimearticlesthatremind
us thatpeopleartfully
dodgeor
constructively
challengestigmatizing
processes(e.g. Reissman2000). Theseare
veryimportant
reminders,
andthemessagetheydeliverneedstobe incorporated
intoourunderstanding
ofstigma.
Atthesametime,thesimplefactthattheseforms
ofresistance
existsuggests
thereis something
outtheretoavoidandthatthereare
forcesat work.How can we reasonaboutthesecontrasting
powerful
constraining
constraint
andresistance
inresearchaboutstigma?Here,our
imagesandportray
ofpowerdifferences
in stigmaand ourobservation
emphasison theimportance
thatstigmais a matter
of degreeare helpful.Specifically,
theseallow us to see
issues of constraint
and resistancein thecontextof a powerstruggle.
We can
see thatpeoplein stigmatized
groupsactivelyuse availableresourcestoresistthe
ofthemorepowerful
stigmatizing
tendencies
thatthey
groupandthat,totheextent
toportray
do,itis inappropriate
themas passiverecipients
ofstigma.Atthesame
time,to theextentthatpowerdifferences
cannotfullyovercome
exist,resistence
constraint.
Theamountofstigmathatpeopleexperience
willbe profoundly
shaped
bytherelative
andthestigmatizer.
powerofthestigmatized
The OutcomesofStigma
Our conceptualization
of stigmademandstheassessment
of multipleoutcomes,
notjustoneortwo.We cannotassesstheextentofstigmatization
whenwe assess
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CONCEPTUALIZING
STIGMA
379
housingstatus,or
justone outcome,whether
thatsingleoutcomebe self-esteem,
toimpose
accesstomedicalcare.Fromonevantagepoint,thisis an odd stricture
conceptualization
ofstigma,
forexamonthestudyofstigma.
Ifwe adopta narrow
we mightexpectspecificity
in theoutcomes.
ple as a labellinkedto a stereotype,
theelementsof thestereotype
and then,based on whatthe
We mightidentify
If thestereotype
is
stereotype
entails,predictwhichoutcomesmightbe affected.
mathincompetence,
thenwe mightexpectthepersontobe excludedfromendeavas thiskindof theorizing
orswheremathcompetence
is required.As important
mightbe forunderstanding
someaspectsofstigma,itwillcloudourvisionofthe
fullconsequencesifitis theonlyapproachwe employ.
of stigmacalls forthescrutiny
of
Amongthereasonsourconceptualization
manyoutcomesare threewe considerhere.First,stigmainvolvesstatuslossa downwardplacementin the statushierarchy.
To theextentthatthisoccurs,
groupsto accrueall mannerofuntoward
we can expectmembers
of stigmatized
in a statushierarchy,
ranging
fromthe
outcomesassociatedwithlowerplacement
discrimination
can
selectionof sexualpartners
to longevity.
Second,structural
beliefsthat
producenegativeoutcomesthathavelittleto do withthestereotyped
Forexample,theNotIn MyBack
motivated
thestructural
discrimination.
initially
Yard(NIMBY) phenomenon
resulted
intreatment
facilities
forpeoplewithmental
illnessbeinglocatedinrelatively
poorandpowerlessareasofthecitythatwerealso
peoplewith
crimeriddenanddangerous
(Dear & Lewis 1986).As a consequence,
mentalillnessare muchmorelikelyto be victimizedthanotherpeople.Third,
to cope withstigmamayhaveuntoward
consequencesthatare
people's efforts
seemingly
unrelated
to thestereotype
(Jameset al 1984,Smart& Wegner1999).
theconceptof
For example,socialepidemiologist
ShermanJamesputsforward
towork
whathecalls"John
forsomeAfrican
Americans
tendency
Henryism"-the
and
with
to
the
of
laziness
and
hard
extremely
greatpressure disprove stereotype
this
toJamesetal (1984),undersomeconditions copingeffort
inability.
According
bearscostsin theformofhypertension.
In short,a comprehensive
of
exploration
thestigmaconceptmakesitclearthatstigmacaninvolvemanyoutcomesandthat
mustlookto a broadrangeofsuchoutcomes.
anyfullassessment
Predicament
Stigmaas a Persistent
to stigmaas a predicaAs previously
theliterature
makesreference
mentioned,
draws
attention
to one way in which
mentor dilemma.Our conceptualization
is
a
the
stigma persistent
predicament-why negativeconsequencesofstigmaare
to
label and extensively
so difficult eradicate.Whenpowerful
groupsforcefully
forachievingdisa
less
the
of
mechanisms
stereotype
powerfulgroup, range
threegeneric
outcomesis bothflexibleandextensive.
We mentioned
criminatory
and
of
structural
discrimination,
discrimination,
types mechanisms-individual
beliefs
and
behavthestigmatized
discrimination
thatoperatesthrough
person's
of
are a wholemultitude
iors.But lyingbelow thesebroad-band
designations
aremanywaysto achievestructural
discrimination,
specificmechanisms-there
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380
LINK * PHELAN
manywaystodirectly
discriminate,
andmanywaysin whichstigmatized
persons
canbe encouraged
tobelievethattheyshouldnotenjoyfullandequalparticipation
ifthemechanisms
inplace
insocialandeconomiclife.Moreover,
thatarecurrently
areblockedorbecomeembarrassing
touse,newonescanalwaysbe created.This
is themainreasonthatstigmais sucha persistent
predicament.
Whenpeoplein
a stigmatized
grouptakeactionto avoida negativeconsequence,
theyfrequently
do so bycounteracting
oravoiding)thespecificmechanism
that
(e.g. confronting
leadstotheundesirable
outcometheyseektoescape.Butwhentherangeofposis broad,thebenefit
is onlytemporary
siblemechanisms
becausethemechanism
thathas beenblockedoravoidedcanbe easilyreplacedbyanother.
is thatthere
A secondandrelatedreasonthatstigmais a persistent
predicament
to avoidone
of associatedoutcomes.One can exertgreateffort
are a multitude
inmedicalinsurance
orinjury
to selflikediscrimination
stigma-related
outcome,
thecopingeffort
canbe stressful,
esteem,
butdoingso cancarrycosts.Forinstance,
andhypertension
Americans
as inthecase ofJohnHenryism
levelsamongAfrican
(Jameset al 1984). In thatexample,theeffort
to eliminateone bad outcome
attention
ironically
producesstrainthatleadstoanother.
Also,focusing
particular
on oneoutcomemeansthatless attention
is availabletodeal withotheraspectsof
harmsmay
life.As a result,
whilebenefits
mayaccrueinonedomain,concomitant
and multiple
resultin others.It is theexistenceof multiplestigmamechanisms
stigmaoutcomesthathelpsexplainwhystigmais a persistent
predicament-why,
on average,members
ofstigmatized
groupsaredisadvantaged
in a broadrangeof
lifedomains(e.g. employment,
socialrelationships,
housing,andpsychological
well-being).
We end ourdiscussionof stigmaas a persistent
witha pointof
predicament
clarification.
is notto say
First,to say thatstigmais a persistent
predicament
thateveryindividual
in a groupsuffers
thesameoutcome.Individualdifferences
in personal,social,andeconomicresourcesalso shapethelifecircumstances
of
in
substantial
variation
within
persons stigmatized
groups,
thereby
producing
stigmatizedgroupsin anyoutcomeonemightconsider.Thus,no one is fullytrapped
of persons
in a uniform
disadvantaged
position.All of theothercharacteristics
outcomesforpersonswho
influence
an outcomein thesamewaytheyinfluence
arenotmembers
ofthestigmatized
groupinquestion.Thepersistent
predicament
thatis connected
tostigmaprocessesof
refers
toa generalpattern
ofdisadvantage
statusloss,anddiscrimination.
labeling,stereotyping,
ChangingStigma
If stigmais a persistent
how can it be changed?One approachis
predicament,
to focuson a particular
behaviorin a particular
group.For example,one might
theemployment
chancesfora
targethiringpracticeswiththeaim of increasing
stigmatized
groupsuchas people withmentalillnesses.One could thentryto
towardhiringpersonswithsuch
changeemployers'beliefsaboutand attitudes
illnesses.Thisapproachis veryappealingbecauseit breaksdownthemorassof
intoa moretractable
Ifoneweretodevelop
interconnecting
stigma-facets
problem.
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CONCEPTUALIZING STIGMA
381
tothespecificbeliefs,attitudes,
one couldtarget
theintervention
an intervention,
thelikelihoodof an apparently
thereby
increasing
and behaviorsof employers,
researchstudy.But whatis appealing
successfuloutcomefortheintervention
aboutthisapproachis also whatmakesit such an inadequateresponseto the
broaderproblemof stigma.The intensefocuson one specificbehaviorin one
and as a consequenceeven
specificgroupleavesthebroadercontextuntouched
theverypositiveoutcomesof an unusuallysuccessfulprogramwill erodewith
time.Thiswilloccurforreasonswe havestated:Thereexistsa flexiblepackage
andbeliefsofdominant
ofmutually
mechanisms
linkingtheattitudes
reinforcing
persons.
outcomesforstigmatized
groupsto an arrayofuntoward
in considering
how
Ourconceptualization
leads us to focuson twoprinciples
and
to reallychangestigma.The first
is thatanyapproachmustbe multifaceted
the
It
to
be
multifaceted
to
address
mechanisms
that
can
many
multilevel. needs
to addressissuesof
outcomes,
anditneedstobe multilevel
lead todisadvantaged
Butsecond,andmostimportant,
an
bothindividual
andstructural
discrimination.
of
the
cause
stigma-it
address fundamental
approachto changemustultimately
and beliefsofpowerful
groupsthat
musteitherchangethedeeplyheldattitudes
or it
and discriminating,
settingapart,devaluing,
lead to labeling,stereotyping,
so as to limitthepowerof suchgroupsto maketheir
mustchangecircumstances
thedominant
changes,intervenones.In theabsenceof fundamental
cognitions
at onlyone mechanism
at a timewillultimately
fail,becausetheir
tionstargeted
by
willbe undermined
factors
thatareleftuntouched
bycontextual
effectiveness
a multifaceted
mulThus,in considering
sucha narrowly
conceivedintervention.
thateitherproduce
tilevelresponseto stigma,one shouldchooseinterventions
changesin attitudes
and beliefsor changethepowerrelationsthat
fundamental
andbeliefs.
underlietheabilityofdominant
groupsto acton theirattitudes
ofStigmaProcesses
theInfluence
Understanding
ofLifeChances
on theDistribution
thedistribution
of lifechances,
A core concernof sociologyis to understand
tocareers,
socialties,housing,
criminal
involvement,
whether
thoserefer
earnings,
andprobably
orlifeitself.Webelievethatstigmaprocesseshavea dramatic
health,
a highlyunderestimated
impacton suchlifechances.Mostresearchproceedsby
at a time(e.g. AIDS,
examiningthestigmaassociatedwithone circumstance
racialstatus,femalegender,
homosexuality,
etc),
mentalillness,minority
obesity,
and mostalso assessesonlyone outcomeat a time(e.g. earnings,
self-esteem,
oftenfindsome
etc.).Whenthisoccurs,researchers
housing,socialinteractions,
outcome.However,
levelofeffect
fora particular
stigmatized
groupona particular
otherthanthestigmaprocessesinquestion
itis also usuallytruethatmanyfactors
influence
theoutcome,leavingstigmaas just one factoramongmany.This can
modest
butthatitseffectis relatively
lead to theconclusionthatstigmamatters
is misguidedfortworeasons.First,
comparedto otherfactors.This accounting
one
theimpactof stigmafora particular
in seekingto understand
circumstance,
mustkeepin mindthatitcan affect
manylifechances,notjustone. Thus,a full
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382
LINK * PHELAN
ofoutcomes.Second,
on a multitude
accounting
mustconsidertheoveralleffect
instudying
circumstances
thatneedtobeconsidered
therearea hostofstigmatizing
outcome.A fullassessment
oftheimpactofstigmaonsuchanoutcome
a particular
to thatoutcome
mustrecognizethatmanystigmatizing
circumstances
contribute
studyin question.Whenviewed
and notjusttheone selectedfortheparticular
broadly,stigmaprocesseslikelyplay a majorrole in lifechancesand deserve
whohappento be interested
notjustbyinvestigators
in stigmabutbya
scrutiny
who are interested
in thedistribution
of lifechances
varietyof social scientists
moregenerally.
CONCLUSION
thepublication
ofGoffman's
bookon stigma,
werevisited
Almostforty
yearsafter
intheinterim.
theconceptinlightofresearch
thathasbeenundertaken
Attending
of theconceptand its applicationby researchers
fromGoffman
to
to criticisms
we constructed
of theterm.In ourdefthepresent,
a revisedconceptualization
status
separating,
inition,stigmaexistswhenelementsof labeling,stereotyping,
co-occurin a powersituation
thatallowstheseprocesses
loss,anddiscrimination
thisdefinition
itscomponent
tounfold.After
andexplicating
parts,we
developing
founditusefulinproviding
a substantially
different
on severalcrucial
perspective
ourconceptualization
issuesin theliterature
on stigma.Moreover,
suggeststhat
of manyof thelifechancesthatsocistigmais likelyto be a keydeterminant
well-beingto employment,
housing,and life
ologistsstudy,frompsychological
researchwouldinvolvetheincorporation
itself.A propitious
avenueforfuture
ofstigmaconceptsandmeasuresin community-based
surveyresearchthatseeks
of a broadarrayof lifechances.Such an
to understand
thesocial determinants
wouldgreatly
on stigmabecauseitwouldassessthe
advanceresearch
undertaking
inpeople'slives,thereby
linkagebetweenstigmaandoutcomesthatclearlymatter
theoveremphasis
thecriticism
we alludedtoearlierregarding
on miovercoming
of
crolevelinteractions
in stigmaresearch.At thesame time,theincorporation
stigmaconceptsandmeasuresin researchfocusedon lifechanceswouldprovide
in manyareasof sociologicalresearchwithadditionalpossibilities
investigators
forunderstanding
thesocial distributions
of theparticular
outcomesthatarethe
suchan endeavorwouldtell
focusof theirattention.
Mostimportantly,
however,
underwhichstigmais
us muchmorethanwe alreadyknowabouttheconditions
relatedtountoward
outcomesinreallifesituations.
Knowledgeofthissortshould
interventions
thatrepresent
formthebasisforthekindsofmultifaceted
multilevel
ourbesthopeforproducing
realchangein stigma-related
processes.
ACKNOWLEDGMENTS
BruceDohrenwend,
WethankPatrick
DavidPenn,andElmerStruening
Corrigan,
forvaluablecomments
on an earlierversionofthispaper.
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CONCEPTUALIZING STIGMA
383
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