“Stigma” is NOT the Problem . . .
It’s time we moved past using the word “stigma” to describe what happens time and again to those we love who are living with HIV. Let’s be more direct with our language and see if we can get better results from words that are clearer and closer to the truth than “stigma”.
"Stigma". It's the buzzword de jour in the world of HIV these days. My last blog post was about stigma, so you should realize that the topic has been in the forefront of my thoughts recently. Sadly, the topic of stigma has also been painfully present in many of my weekly HIV clinical encounters with rural Tennesseans living with HIV. It seems that I am surrounded by stigma, wherever I turn. While not directly impacted by stigma, I am acutely aware of the cruelty and unnecessary pain inflicted on so many of those I have focused my life's energy to assist.
The Oxford English Dictionary defines stigma as "a mark of disgrace associated with a particular circumstance, quality, of person." Full stop. Please re-read the definition. "A mark of disgrace"? There's no mark of disgrace that appears on a person living with HIV. There's no mark of disgrace on the bodies of men who love men and women who love women. None of us, in fact, bear any marks of disgrace for whomever we love and however we choose to enjoy our sexuality and express our love to each other.
Several of my academic colleagues published a paper in 2013 that defined stigma as an action that "occurs when a person is identified as "tainted" or "less desirable" and results in the individual being devalued in the eyes of society." (PLoS One 2013 Aug 8;8(8):e69564.
doi: 10.1371/journal.pone.0069564. eCollection 2013.). That's a good working definition of how those of us working in academia have defined stigma over the years. This definition makes two critical points. First, the definition says makes it clear that stigma is an act, a choice, made by the stigmatizer, not the stigmatized. "Stigma occurs when a person is identified" makes it clear that the violation called stigma only occurs when a "person is identified".
I don't see it as a stretch to suggest that there's not a lot of light between identifying persons and targeting persons. Were the issue here policing, for example, what the definition above describes would be called "profiling." So, I'm going to ask that we agree that, in practical terms, stigma occurs when people are targeted for a characteristic that is beyond their control, such as skin color or sexual identity.
The second critical point brought to light by this definition is that the act of "identifying", or targeting people leads directly to those people being "devalued in the eyes of society." This is an issue that gets far too little attention in the public marketplace of ideas. Over the past 50 years, our society has increasingly tolerated and sometimes even rewarded people and groups who feel free to act on whatever it is that they believe. There's a fundamental difference between the right to think a thing, no matter how odious, and the right to act without consequences on those thoughts. We have smashed that distinction, and are clearly the worse for it.
Picture yourself stuck in traffic on the interstate, either running late to work or exhausted and late home. Frustrated, sitting in your car and yelling at other drivers - we've all been there. Thankfully, very few of use our cars to target drivers who frustrate us. Very few of us get out of our cars and stop traffic to confront another driver. Society is like the interstate. Society works when everybody stays in their car. Turning your car into a weapon, or getting out of your car to act on how you believe others should be driving is dangerous for everyone. Targeting and devaluing people over their sexual identity, excluding them from their families and churches of origin, following them around at family gatherings with cans of disinfectant, refusing to let them in the pool with others, shunning their businesses and costing them their livelihoods and self-esteem - these are the equivalent of getting out of your car in traffic.
So far, so good. However, what current definitions of stigma fail to do is place appropriate blame for intolerance on the stigmatizer. The person being stigmatized bears no blame here. No blame. The issue is with the stigmatizer, and the best way to lay that bare would be to stop calling this shameful process "stigma" and start calling it what it is - intolerance. People who stigmatize others are intolerant of them. End of discussion. For me, that's a lot clearer use of language that highlights the inadequacies of the stigmatizer and makes it crystal clear that the stigmatized has done NOTHING to trigger being excluded from his or her community, which is the end result of intolerance.
As I wrote in my last blog, a friend recently said to me that "haters gonna hate." Sadly, that's very true. I can't change that, and neither can you, dear reader. But we do those we love a profound disservice when we fail to shine a bright light on the injustices they bear for no reason than another person's opinion. Calling intolerance "stigma" whitewashes the pain that intolerance causes and leaves open the door to the vile suggestion that the stigmatized person is in any was deserving of their treatment.
The profound, deep-seated, unrelenting, and often ferocious intolerance heaped on people living with HIV is the rural South is appalling. The intolerance of rural Southerners is appalling. If we are truly committed to addressing sexual intolerance in the South, we have to find ways to call out injustice yet also invite both the violated and the violators into community with us. Humanity only grows, humanity only works when everyone is moving in the same direction. Let's call stigma what it is - intolerance. I truly believe that is a step forward. Once that is done, let's work to make sure that we are not making the mistake of turning the intolerant into intolerated people, as well. We can do better, together.
