Ableism refers to bias, prejudice, and discrimination against people with disabilities. It hinges on the idea that people with disabilities are less valuable than nondisabled people.
Differences in ability are a normal part of human experience. Just under 1 in 5 people in the United States lives with a disability, and worldwide, people with disabilities represent the largest marginalized group, making up
To understand ableism, a person needs to understand what disability is.
There are two models of disability: the medical model and the social model. The medical model treats disability as a health condition. The social model views disability as a concept created by humans.
However, this does not mean that impairments do not exist. The social model argues that that the definition of “disability” depends on context. For example, autism spectrum disorder (ASD) may be a disability in a world that values a neurotypical way of thinking, but in a world that values and understands neurodiversity, it might not be.
There is no single set of characteristics that makes someone disabled in every situation. This highlights the reality that the society a person lives in often informs what they think of as “disability.”
Ableism perpetuates a negative view of disability. It frames being nondisabled as the ideal and disability as a flaw or abnormality. It is a form of systemic oppression that affects people who identify as disabled, as well as anyone who others perceive to be disabled. Ableism can also indirectly affect caregivers.
As with other forms of oppression, people do not always know they are thinking or behaving in an ableist way. This is because people learn ableism from others, consciously or unconsciously. Bias that a person is unaware they have is known as implicit bias.
Implicit bias against people with disabilities is extremely common. An older study found that 76% of respondents had an implicit bias in favor of people without disabilities. This included respondents who had disabilities themselves.
In the study, ableism was among the most common and strongest forms of implicit and explicit bias out of the ones the researchers tested for, surpassing gender, race, weight, and sexuality. It was second only to ageism.
Ableism manifests in many ways. It exists on different levels of society, including the following:
- Institutional level: This form of ableism affects institutions. An example is medical ableism, which is rooted in the idea that disability of any kind is a problem that needs fixing. When this is part of medical teaching and health policy, it affects the entire healthcare system and the well-being of patients.
- Interpersonal level: This is ableism that takes place in social interactions and relationships. For example, a parent of a child with a disability might try to “cure” the disability rather than accept it.
- Internal level: Internalized ableism is when a person consciously or unconsciously believes in the harmful messages they hear about disability and applies them to themselves. For example, a person may feel that disability accommodations are a privilege and not a right.
Ableism also takes on different forms,
- Hostile ableism: This includes openly aggressive behaviors or policies, such as bullying, abuse, and violence.
- Benevolent ableism: This form of ableism views people with disabilities as weak, vulnerable, or in need of rescuing. This is patronizing and undermines the person’s individuality and autonomy, reinforcing an unequal power dynamic.
- Ambivalent ableism: This is a combination of both hostile and benevolent ableism. For example, a person might start a social interaction by treating someone in a patronizing way, and then switch to being hostile if the person objects to their behavior.
An important thing to note about ableism is that it affects people differently depending on how others perceive their disability. For example, how people discriminate against those with visible impairments is different from how they treat those with invisible impairments.
Other factors that can influence this include:
- whether an impairment is physical or cognitive
- whether or not a condition is well known to the general public
- whether it has a history of being stigmatized, as this can lead to the development of specific myths, stereotypes, or slurs
Examples of ableism range from blatant hostility and aggression to less obvious everyday interactions. Some examples of these include:
- asking someone what is “wrong” with them
- saying, “You do not look disabled,” as though this is a compliment
- viewing a person with a disability as inspirational for doing typical things, such as having a career
- assuming a physical disability is a product of laziness or lack of exercise
- using public facilities that are for people with disabilities, such as parking spaces or toilets
- questioning whether a person’s disability is real
On a larger scale, some examples of ableism include:
- Ableist language: There are many examples of ableism in everyday language. Terms such as “dumb” and “lame” were originally used to describe disabilities, but today, people use them as synonyms for “stupid” or “bad.” People also misuse words in a way that trivializes conditions. For example, a person may say, “I am so OCD.”
- Inaccessible design: Designing buildings, public spaces, products, and technology that only caters to nondisabled people is an example of ableism. This includes websites that have no text enlargement feature, buildings that have no ramp for wheelchairs, and sidewalks with obstacles that make walking more difficult.
- Education discrimination: Schools refusing to make disability accommodations, failing to understand a disability, or trying to “teach” a child not to have their impairment are all examples of ableism in education. For example, a teacher might punish a child for their dyslexia rather than adapt how they teach.
- Employment discrimination: Employers may be biased against those with disabilities, believing they make less productive workers. They may also refuse disability accommodations to existing employees or allow workplace bullying to go unpunished.
Here are some of the ways ableism affects health and healthcare.
Barriers to care
Some doctors assume that having a disability inevitably leads to a low quality of life. This is based on the idea that someone can only have a high quality of life if they are nondisabled. It can also tie in to a belief that being nondisabled makes someone’s life more worthwhile.
This bias has serious consequences. It can cause medical professionals to ignore the lived experiences of their patients, incorrectly blame new symptoms on a person’s disability, or withdraw medical support in the belief that nothing they do will help. It can lead to barriers to getting healthcare, as well as avoidable illness and death.
Disregard for peoples’ lives
Ableism can cause people to prioritize the health and independence of nondisabled people at the expense of those with disabilities.
For example, during the COVID-19 pandemic, some people refused to wear masks to prevent the spread of the disease, despite knowing that older adults and people with certain long-term conditions were at a higher risk.
This shows a clear disregard for the lives of people most vulnerable to COVID-19, and for those with disabilities, as older adults and people with chronic illnesses are more likely to have one.
Failure to control the spread of COVID-19 has also led to people with disabilities spending prolonged time indoors. Some have postponed medical appointments, been unable to access caregiver services, or have been
It is well known that historically, doctors used force to restrain the movements of patients with mental health conditions and developmental differences. However, physical restraint still takes place in U.S. education and healthcare settings.
The aim of restraint is often to stop people from harming themselves or others, but some institutions also use it to stop damage to property, control behavior, or as punishment for rule-breaking. Its use is disproportionately high among people with neurological or developmental conditions, particularly children.
According to a report, dozens of people in the United States died in the 1990s and 2000s due to physical restraint. Many were children with disabilities.
Eugenics is the practice of, or belief in, eradicating “undesirable” traits from humans via selective breeding. It was a popular concept among scientists in the early 20th century, and it was responsible for many mass sterilization programs across the United States. It also informed similar policies in Nazi Germany and, ultimately, the Holocaust.
The impact of eugenics is still present in healthcare. In some cases, programs lasted into the 21st century, and many survivors are still alive. The mental and physical impact of the programs continues to affect the survivors and their families.
There are also new technologies, such as genetic testing and engineering, that make it possible to avoid or “edit out” genetic conditions that can cause disability. Some argue this can enable a modern version of eugenics.
Ableism affects everyone. It shapes how people think about physical or mental differences, which anyone can acquire during their lifetime. It also damages society as a whole by:
- reducing access to transport, education, and the internet
- increasing levels of unemployment
- increasing poverty
- fueling bullying, harassment, and violence
- causing unnecessary institutionalization
Anti-ableism means actively working to dismantle ableism. It begins with recognizing that ableism exists, that it causes serious harm, and that nondisabled people benefit from this system. This is known as privilege.
Nondisabled people do not need to think about accessibility or worry about facing ableist discrimination. Others may be more likely to respect nondisabled people or promote them to positions of power. A person, or group of people, can use this privilege to help others.
Some ways to begin practicing anti-ableism include:
- learning about disability — what it means and how it affects people
- learning about ableism, ableist stereotypes, and the history of disability rights activism
- listening to people with disabilities share their experiences
- challenging ableism as it happens, for example, by correcting a myth or stopping bullying
- giving people with disabilities a platform, or “passing the mic,” instead of speaking for them
- advocating for accessibility and inclusivity
- enacting policies or laws that counter ableism
Ableism is prejudice and discrimination against people with disabilities. It is based on the idea that being nondisabled is the default, and anything outside that is abnormal or undesirable. It manifests in many different ways, from subtle comments to open hostility.
In healthcare, ableism can affect interactions with doctors and other professionals, healthcare policies, and health outcomes. The idea that disabled people have less value or lower-quality lives contributes to damaging practices that persist today.
Anti-ableism is a way for anyone to work against ableism.