Bullying of disabled people is extensive. According to a Columbia University study, 1 in 3 disabled children have globally experienced violence. It is not only children who are the target of bullying; bias against disabled adults is also common.
In my almost 30 years of treating people with disabilities, I have seen the intense emotional and physical toll that bullying and discrimination have on these marginalized groups. Bullying can affect all aspects of life, including mental and physical health, schooling, employment, and social relationships. And it can significantly increase risk for suicide.
There really is no judgment-free zone for those with disabilities. This is particularly true for those who have a nonvisible disability. One such patient had alopecia, which is often caused by an autoimmune disease. This patient entered a new school and was being bullied by classmates who made jokes comparing the patient with actors or movie characters who were bald or had shaved heads.
While my patient’s peers passed this off as jokes, it was no joke to my patient. My patient started to refuse school and finally revealed the bullying to me. The pain of this reveal caused my patient to stop looking at me. The school felt that the comments were “just jokes” and did not consider them as bullying. My patient’s family finally decided to move away to start fresh.
Bullying of adults is also common. I have an autistic adult patient who was trying to fit in and tell jokes, but co-workers shunned this person. My patient, who couldn’t tolerate the negative comments or jokes about “odd” social interactions, needed to quit and is now afraid to work.
Some of my disabled patients tell me that they wish they were never born or they want to die. Some tell me it doesn’t matter, but I see the changes in their demeanor, how they speak, and the decline in their eye contact. I can see the slow eating away of who they once were.
Hearing loss is another “invisible” disability that is often overlooked. The struggles that people with hearing impairment have are significant. So much of work and school requires adjustments for hearing impairments. COVID-19 and the wearing of masks has particularly affected people with hearing loss because they cannot see people’s mouths to more easily understand what someone is saying.
According to the Centers for Disease Control and Prevention, more than 1 in 4 adults and 1 in 6 children in the United States — 61 million adults and 3 million children — have a disability. It is difficult to estimate how many US persons have a disability that is not readily visible.
Nonvisible disabilities include autoimmune diseases, such as alopecia; chronic pain; cognitive impairments; sensory impairments; autism; and neurological disorders. Disability World estimated that 10% of the US population have an invisible disability, but a study published in 2017 by the Center for Talent Innovation (CTI) found that only 3% reported their disability.
The Equal Employment Opportunity Commission recently reported that the majority of COVID-related cases of discrimination filed between April 2020 and December 2021 were related to persons with disabilities. More than 66% of the more than 6200 total discrimination cases in that timeframe, or 4125 cases, were violations of the Americans With Disabilities Act of 1990.
A recent study showed that passive bystanders (those not engaging or supporting the victim) increased the negative impact of the bullying, while active bystanders (those who intervened to stop the bullying) mitigated the effects.
In my view, silence is not an option; it is important to help deter bullying. Microinsults and microaggressions — everyday statements or slights — often don’t appear to be significant, but they act as ways to invalidate people.
A 2019 study of Black women experiencing microaggressions who did not report the aggression found that their DNA changed, which led them to be more susceptible to illness and early death. Numerous other studies show the physical consequences of enduring bullying or microaggressions. The term microaggression is often used to connote racist statements, but it should be understood in the broader context of invalidating anyone is different.
There are ways to deal with microaggressions.
A 2020 study offers strategies to deal with bias and bullying, using the acronym PEARLS (partnership, empathy, apology/acknowledgment, respect, legitimation, support). Resources such as the toolkit for interrupting oppression are also available.
A simpler technique is the call-out/call-in method. Calling out addresses at the moment, in front of others; calling in means taking the person aside to discuss this. Calling out allows for at-the-moment correction and may be a more powerful means of enlightening the person committing the indiscretion.
Also, calling out at the moment allows the people who will witness the microaggression to see the response. Calling out includes interruptions — that is, attempts to stop the harmful behavior.
When advocating for those dominated by words or behaviors, it is important to use respectful words and actions, create a safer space for everyone involved, and support those being harmed.
Individuals can adopt different strategies to deal with disability bias and bullying, but much work needs to be done on a larger systemic level. Disability is not a joke, and no one should have their identity or physicality used against them. There are real-world ways for all of us to make a difference.
Lisa Yeh, MD, is medical director of the Autism Assessment Resource Treatment Services Center at Rush University Medical Center in Chicago, Illinois. She also is a Public Voices Fellow with The OpEd Project.