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Social Stigma and its Consequences for the Socially Stigmatized

Article in Social and Personality Psychology Compass · November 2011

DOI: 10.1111/j.1751-9004.2011.00394.x

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 Social Stigma - 1

Running Head: SOCIAL STIGMA

Social Stigma and its Consequences for the Socially Stigmatized

David M. Frost

San Francisco State University

Citation:

Frost, D. M. (2011). Social stigma and its consequences for the socially stigmatized. Social and
Personality Psychology Compass, 5(11), 824-839. DOI: 10.1111/j.1751-
9004.2011.00394.x
 Social Stigma - 2

Abstract

This paper presents an integrative review of current and classic theory and research on

social stigma and its consequences for the socially stigmatized. Specific attention is paid to

stigma-related processes surrounding race/ethnicity, gender, and sexual orientation. The

origins and perpetration of social stigma are discussed alongside perspectives on how

stigmatized groups and individuals experience stigma-related stress. Consideration is

given to responses to stigma in the form of coping, social support, and meaning-making

processes. Both the potential negative and positive consequences of social stigma are

highlighted in this review through the integration of predominant social psychological

theory with emerging critical and feminist theories of positive marginality and resistance.

The paper culminates in a theoretical process model designed to provoke future theory and

research that share its integrative aims.

Keywords: Stigma; Prejudice; Discrimination; Stigma-Related Stress; Coping; Meaning;

Positive Marginality; Race; Gender; Sexual Orientation

 Social Stigma - 3

Social Stigma and its Consequences for the Socially Stigmatized

Overview

This article presents an integrative theoretical overview of classic and current

perspectives on social stigma from psychology and related disciplines. Drawing mainly on

current theories of stigma across race/ethnicity, gender, and sexual orientation, I attempt

to join together models of the perpetration of stigma with models of the target’s experience

of stigma. I also aim to integrate findings from research on the negative consequences of

stigma with work stemming from critical psychological and feminist perspectives on

positive marginality. Going forward, I aim to distinguish between processes that

stigmatize and the experiences of the stigmatized, all the while recognizing that these

experiences are deeply embedded within one another and not entirely separable. Doing so

gives rise to a critical social psychological perspective on social stigma and its many and

varied consequences for the socially stigmatized.

The Perpetration of Social Stigma

Stigma

Goffman (1963) defined stigma as an attribute that can be deeply discrediting,

which reduces whole persons to tainted and discounted others. Goffman’s classic

definition begins with the attribute as the source of discreditation; however, more recent

definitions of stigma explicitly adopt a social constructivist frame. For example, Herek

defines stigma as “the negative regard, inferior status, and relative powerlessness that

society collectively accords to people who possess a particular characteristic or belong to a

particular group or category” (Herek, 2009; p. 441). This shift moves the source of stigma

out of the bodies and identities of the stigmatized and places the origins of stigma at the
 Social Stigma - 4

societal level (Fine & Asch, 1988). Meanings inherent to social stigmas are nested within

historical contexts, and their meanings can change over time (e.g., Cross, 1991; Savin-

Williams, 2005). Stigma is not limited to numerical minorities; yet stigma originates and is

perpetuated by those with power against others with less power (Link & Phelan, 2001).

Once established, social stigma manifests in a myriad of conceptually distinct stigma-

related processes, which are outlined below.

Structural Inequalities

Laws, policies, religions, and other institutional structures are constructed in ways

that reflect the negative meanings attached to stigmatized groups and individuals. The

rights, freedoms, and resources of the stigmatized are limited compared to the non-

stigmatized. Structural inequalities both stem from and perpetuate social stigma by

reinforcing negative connotations of stigmatized groups via limiting their participation in

society. If certain groups are prevented from fully participating in society, their social

status will remain “less than” non stigmatized groups, which is often perceived as

legitimizing prevailing social stigma. Those who are allowed full participation in society

become established as normal, and those who do not are othered and marginalized (Herek,

2007).

Stereotypes and Prejudice

Stereotypes and prejudice exist at the psychological level and are often the product

of social stigma. Stereotypes represent commonly held generalizations about qualities of

people based on their membership in stigmatized groups or possession of a stigmatized

attribute (Allport, 1954; Devine, 1989). Stereotypes are known by most people within a

given culture due to the underlying stigma from which they stem. Although most people
 Social Stigma - 5

may be aware of a given stereotype, they may not necessarily personally believe the

stereotype to be true (Devine, 1989). Prejudice occurs when people believe a stereotype to

be true and apply its corresponding generalizations in their attitudes and judgments of

others to whom the stereotype corresponds (Allport, 1954; Devine, 1989). Thus,

stereotypes and prejudice are interrelated, though distinct, psychological processes

stemming from social stigma. Prejudice is complex: It does not always operate at the

conscious level (Greenwald & Banaji, 1995). Given stigma is ingrained within multiple

aspects of societies, implicit forms of prejudice operate outside of people’s awareness that

can shape their behavior towards the stigmatized in unintended ways.

Discrimination

Prejudice can, though not always, result in discrimination. Discrimination refers to

instances when people or groups are denied equality and treated differently because of

their stigmatized status (Allport, 1954; Major & O’Brien, 2005). Discrimination can occur

at the institutional level, as described above, as well as at the interpersonal level (Frost,

2011b; Major & O’Brien, 2005). Furthermore, As it becomes increasing socially

unacceptable to act in overtly discriminatory ways, “modern” racism and sexism persist in

which stigmatized people are avoided or excluded in the absence of an individual’s or

institution’s explicit endorsement of racist or sexist attitudes (McConahay, 1983; Swim et

al., 1995; Swim & Cohen, 1997). Discrimination brings the current discussion closest to the

experiences of those people and groups who are targets of stigma.

Experiences of Stigma

Although the first wave of social psychological work on stigma focused mainly on the

perpetration of stigma, there has been an increase in research on how people and groups
 Social Stigma - 6

that are stigmatized experience the effects of stigma (Swim & Stangor, 1998). Recent

efforts have focused on how experiences of stigma confer excess social stress for

stigmatized people, which can produce a myriad of negative consequences. Social stressors

are factors or conditions that require an individual to adapt to changes intrapersonally,

interpersonally, or in his or her environment (Meyer, 2003a, Pearlin, 1999).

Stigma-Related Stress

Much of the work on stigma-related stress has been done with regard to

racial/ethnic minorities’ experiences of racial discrimination stress (Clark, Anderson, Clark,

& Williams, 1999) and sexual minorities’ experiences of sexual minority stress (Meyer,

2003a; b). I draw mainly from Meyer’s model of minority stress (Meyer, 2003a; b) in the

sections that follow in an attempt to extend this model of stigma-related stress to account

for the experiences of multiple and varied stigmatized experiences. Although experiences

of racial, gender, and sexual minority stigmas are discussed separately below, they are not

always mutually exclusive, and many experience stigma at the intersections of multiple

stigmatized identities (cf. Bowleg, 2008; Collins, von Unger, & Armbrister, 2008; Meyer,

2010; Meyer et al., 2008).

Stressful Life Events. Stigma-related stressors can take the form of event-based

experiences of discrimination (Meyer, 2003a). Stigma-related stressful life events are

acute stressors in that they occur relatively infrequently (compared to other stressors) and

tend to stem from an isolated event. These manifest in direct experiences discrimination or

other events brought on by prejudice. Hate crimes are a prime example of stigma-related

stressful life events, and occur when a person or group is targeted, usually for assault or

harassment, because of a stigmatized status or identity (Herek, 2009b; King et al., 2009).
 Social Stigma - 7

Other stigma-related stressful life events include being fired from a job because of one’s

race/ethnicity, gender, and/or sexual orientation. Stigma-related stressful life events,

when they occur repeatedly over an extended period of time (e.g., bullying), can produce

chronic stigma-related stress. Although laws exist prohibiting many kinds of

discriminatory life events related to some stigmatized statuses (e.g., race/ethnicity, gender,

age), many stigmatized individuals (e.g., sexual minorities) are not protected from multiple

forms of discriminatory life events by policies, furthering social inequality (e.g., Herek,

2005; 2007).

Everyday Discrimination. Stigma-related stress also exists in everyday forms of

discrimination (Meyer, 2003a). These include receiving poorer services in restaurants or

stores, being treated as threatening, and/or being assumed to be unintelligent as a result of

one’s stigmatized status (Williams et al., 1997). Although forms of everyday discrimination

may be of smaller magnitude than stigma-related life events, their chronicity produces a

cumulative stress effect that can potentially be equally distressing.

Expectations of Rejection. Not all forms of stigma-related stress involve identifiable

forms of discrimination or even contact with a perpetrator of stigma. Because stigmatized

individuals and groups live within societies structured in ways that perpetuate social

stigma, people who are stigmatized may enter into social interactions with an expectation

that they will be rejected by others because of their stigmatized social status (Link, 1987;

Meyer, 2003a). This expectation of rejection, regardless of whether or not rejection

actually occurs, produces a cognitive burden that constitutes stigma-related stress.

Stigma Management. In response to the potential for rejection and discrimination,

people who are stigmatized face an additional chronic stressor with regard to their
 Social Stigma - 8

management of how and whether a stigmatized identity or characteristic is made visible to

or concealed from others (Frost & Bastone, 2007; Goffman, 1963; Meyer, 2003a; Smart &

Wegner, 1999). People with concealable stigmas (e.g., sexual minorities, people with

mental health disorders), are constantly faced with the decision to conceal or make visible

their stigmatized statuses. Although concealing one’s stigmatized status from others can be

protective, in that it may allow one to avoid discrimination, stigma concealment is stressful

because produces cognitive burden resulting from fear of discovery. People with visible

stigmas (e.g., racial/ethnic minorities, women) do not have an option to conceal their

stigmatized social status. However, they may manage others’ reactions to their stigmatized

status through various stigma management techniques. For example, Cross (in press)

described the strategy of code switching whereby racial/ethnic minority individuals switch

between patterns of speech, behavior, and dress when interacting with in-group members

(i.e., other racial/ethnic minorities) and members of the dominant majority (Whites). This

is sometimes necessary in order to advance one’s needs and desires within dominant social

structures (e.g., employment, education), which are heavily shaped by stigma-related

processes. Thus, demonstrating “bicultural competence” (Cross, in press) within

mainstream or dominant social contexts is a way of managing characteristics of a

stigmatized status, thereby potentially reducing the likelihood of rejection. However, the

cognitive burden of determining when and how to implement code switching, like stigma

concealment, may produce additional stigma-related stress.

Internalized Stigma. The previous stigma-related stressors have been discussed along

Meyer’s (2003a) continuum of proximity to the self, starting with the stigma-related

stressor most distal to the self (i.e., life events) and now ending with the stressor most
 Social Stigma - 9

proximal to the self: internalized stigma. Internalized stigma refers to the application of

negative social meanings of stigma to one’s self-concept. Internalized stigma manifests as

internalized homophobia for sexual minorities (Frost & Meyer, 2009; Russell & Bohan,

2006), internalized racism (Wester et al., 2006) or racialized self-hatred (Cross, 1991) for

racial/ethnic minorities, and internalized sexism for women (Bearman, Korobov, & Thorne,

2009; Szymanski & Kashubeck-West, 2008). As discussed above, stigma is socially

constructed; not an inherently negative characteristic of individuals. However, given

people who are stigmatized live their daily lives within societies that are shaped by social

stigma, the socially generated negative meanings surrounding stigmatized characteristics

and identities can easily be internalized and attached to the self. The result is socially

generated but internally perpetuated self-devaluation. Internalized stigma can persist even

in the absence of direct perpetrators of stigma, and is thought by some to never completely

subside (e.g., Gonsiorek, 1988).

Consequences of Stigma-Related Stress

The negative consequences of stigma-related stress on women, racial/ethnic

minorities, and sexual minorities have been well documented across various social

scientific bodies of research (see Chan et al., 2008; Meyer & Frost, forthcoming; Williams,

Neighbors, & Jackson, 2008 for reviews). However, the types of negative consequences of

stigma depend largely on the stigmatized population under investigation; suggesting that

the negative consequences of stigma are contextually-dependant and often domain-

specific. Below, I briefly highlight some of the primary domains and outcomes in which

stigma-related stressors have consequences for the stigmatized, emphasizing important

population variability when appropriate.

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Health and Well-Being Outcomes

Mental health. Perhaps one of the most consistent findings in examinations of

consequences of stigma-related stress is that increased exposure to stigma-related stress

results in poorer mental health across a variety of outcomes. This is true for sexual

minorities with regard to mental health disorders, suicide, and subthreshold symptoms

(e.g., Frost et al., 2007; Frost & Meyer, 2009; Hatzenbuehler, 2009; Mays & Cochran, 2001;

Meyer et al., 2008). The negative association between stigma-related stress and mental

health has also been well demonstrated among women and racial/ethnic minority groups,

especially with regard to perceived discrimination and depression (Brown et al., 2000;

Corning, 2002; Fischer & Holz, 2007; Moradi & Subich, 2004; Paradies, 2006; Williams, Yu,

& Jackson, 1997). Some studies have further demonstrated that stigma-related stressors

largely account for disparities in mental health between sexual minorities and

heterosexuals (Mays & Cochran, 2001). This has not been demonstrated in other

stigmatized populations, and is not entirely relevant for racial/ethnic minorities given

research has rarely documented race-based disparities in mental health (Schwartz &

Meyer, 2010).

Physical health. Racial/ethnic disparities have been documented in physical health

outcomes. Much of the research in this area has demonstrated that increased exposure to

stigma-related stressors results in poorer cardiovascular health (Friedman, Williams,

Singer, and Ryff, 2009; Harris et al., 2006; Smart Richman, Pek, Pascoe, & Bauer, 2010).

Experiences of stigma-related stressors are also associated with decreased access to

medical care and thus poorer physical health outcomes, particularly among racial/ethnic

minorities (Piette et al., 2006). Similarly, stigma-related stressors are associated with
 Social Stigma - 11

decreased access to and quality of medical care among sexual minorities (e.g., Makadon,

Mayer, & Garafolo, 2006; Steele, Tinmouth, & Lu, 2006). Among HIV positive gay men,

stigma concealment is associated with accelerated disease progression (Cole et al., 1996).

Risk behaviors. Research has established connections between stigma-related stress

and health risk behaviors via decreased self-efficacy and maladaptive coping strategies

(e.g., Ramirez-Valles et al., 2010). For example, recent studies have demonstrated links

between increased experiences of stigma-related stress and smoking (e.g., Borrell et al.,

2010; Todorova et al., 2010). Also, among diverse sexual minority populations, several

studies have demonstrated links between a variety of stigma-related stressors and sexual

health/HIV risk behavior (Bruce, Ramirez-Valles, & Campbell, 2008; Nakamura & Zea,

2010; Ryan, Huebner, Diaz, & Sanchez, 2009; Simoni ,Walters, Balsam, & Meyers, 2006;

Preston, D’Augelli, Kassab, & Starks, 2007; Sugano, Nemoto, & Operario, 2006). Thus, not

only is stigma-related stress directly connected to mental and physical health outcomes,

but it also produces increased health risk, which strengthens connections between social

stigma and negative health outcomes for a variety of stigmatized individuals and groups.

Performance Outcomes

In addition to health and well-being, the last few decades of research have

demonstrated links between stigma-related stressors and performance outcomes across a

variety of domains.

Academic performance. Perhaps one of the most significant social psychological

advancements in the study of stigma’s consequences has been research on stereotype

threat (Steele, 1997; Steele & Aronson, 1995). Stereotype threat occurs when an individual

becomes aware of a negative stereotype and his/her performance in that domain is

 Social Stigma - 12

diminished as a result of the interrupting cognitions produced from stereotype awareness.

For Black and Latino individuals, stereotype threat has been consistently demonstrated to

have a negative effect on performance across a variety of diagnostic standardized testing

situations. Stereotype threat also negatively impacts women’s performance on arithmetic

performance in diagnostic situations (Spencer, Steele, & Quinn, 1999). For sexual minority

students, increased perceived stigma-related stress in the form of stigma concealment is

associated with more absences in high school (Frost & Bastone, 2008).

Job performance. Discrimination often occurs in the hiring and interviewing of

stigmatized individuals based on race/ethnicity, gender, and sexual orientation (Horvath &

Ryan, 2003; Pager & Shepherd, 2008; Phalen & Rudman, 2010). However, the negative

effects of stigma-related stressors persist beyond the hiring process. Three decades of

research on sexual harassment in the workplace have consistently demonstrated the

negative effects of stigma-related stress on women’s job satisfaction and performance

(Gutek, 1985; Schnieder et al., 1997; 2001; Woodzicka & Lefrance, 2005). Further, sexual

minorities also face the challenge of negotiating stigma-related stressors in the workplace

(e.g., Fassinger, 2008; Ragins, Singh, & Cornwell, 2007; Huffman, Watrous-Rodriguez, &

King, 2008). Stigma-related stressors have been negatively linked to a variety of job

performance indicators among sexual minorities (Ragins, Singh, & Cornwell, 2007) as well

as their satisfaction with and perceived fit within the workplace (Lyons, Brenner, &

Fassinger, 2005).

Relational Outcomes

Sexual minorities in same-sex relationships are stigmatized as a result of their sexual

minority identity as well as their romantic involvement with a partner of the same gender.
 Social Stigma - 13

Stigma-related stressors have been demonstrated to negatively impact multiple indicators

of relationship quality among same-sex couples (e.g., Frost & Meyer, 2009; Rostosky,

Riggle, Gray, & Halton, 2007; Peplau & Fingerhut, 2007; Todosijevic et al., 2005). The

stigma-related stressors experienced by same-sex couples stem from both interpersonal

sources of prejudice and discrimination, as well as structural inequities in the form lack of

equal relationship recognition in the majority of counties world-wide (e.g., Hatzenbuehler

et al., 2010; Rostosky et al., 2009). Same-sex couples are not the only couples that

experience relational stigmatization. There are many types of couples that are stigmatized,

including but not limited to interracial couples and age discrepant couples. Members of

these marginalized relationships (Lehmiller & Agnew, 2006) experience the gamut of

stigma-related stressors discussed above. Some members of marginalized relationships

are not stigmatized as individuals, but take on stigmatized statuses relationally, via their

membership in a marginalized couple. For example, a white heterosexual man may not

experience any stigma-related stressors as an individual. However, after marrying a Black

women, he, and his wife, may experience discrimination and expectations of rejection as a

result of their being in an interracial relationship.

Members of marginalized relationships have some experiences in common due to

their stigmatized statuses (Lehmiller & Agnew, 2006). Marginalized couples typically

experience more stigma-related stressors than non-marginalized relationships (Diamond,

2006; Frost, 2011b; Knox et al., 1997; Lehmiller & Agnew, 2006; McNamara, Tempenis &

Walton, 1999; Rosenblatt, Karis & Powell, 1995). In other words, even though these three

types of marginalized relationships all undergo unique stressors, there are some issues that

transcend all types of marginalized couples. Although limited research exists on

 Social Stigma - 14

overarching processes of stigma-related stress in marginalized couples, there is some

evidence that stigma-related stressors can have a substantial impact on their relationship

satisfaction and stability (Felmlee, 2001; Lehmiller & Agnew, 2006).

Responses to Stigma

The connections between social stigma and its consequences are not universal.

There is a tremendous amount of variability in the ways stigmatized individuals and

groups respond to experiences of stigma-related stress (Frost, 2011a). Understanding the

ways people and groups respond to stigma-related stress is an important endeavor in the

psychological study of stigma. Not only is it necessary to understand the damaging effects

of social stigma, it is equally, if not more important to understand how the stigmatized are

able to cope with, resist, and overcome the limiting consequences of stigma.

Coping & Social Support

Individual-level coping. Much of the existing research on coping with stigma-related

stress has focused on individual-level coping strategies and support seeking. In many

ways, this body of research draws heavily from classic stress and coping models (Lazarus &

Folkman, 1984). Individual-level coping strategies and support often focus on dealing with

emotional aspects of the stress experience (e.g., meditation, expressive writing) or focus on

changing the circumstances of the source of the stress (e.g., spending less time at work,

asking a sibling to help with the care of a sick parent) (see the following for reviews: Carver

& Connor-Smith, 2010; Coyne & Downy, 1991; Thoits, 1995). Some coping strategies can

be effective in preventing the negative effects of stigma-related stress in one domain, while

magnifying damage in another. Jackson and colleagues (2010) have demonstrated that

Blacks may engage in passive/avoidant coping strategies, such as smoking, drinking, and
 Social Stigma - 15

unhealthy eating, which buffer the negative effects of stigma-related stress on mental

health, but increase physical health problems. This potentially accounts for frequently

observed disparities between Blacks and Whites in physical health problems and lack of

consistent differences based on race/ethnicity in mental health (Schwartz & Meyer, 2010).

Group-level coping. Meyer’s minority stress model (2003a) highlights important

distinctions between individual-level and group-level coping processes. Specifically, sexual

and other numerical minority stigmatized populations often rely on minority communities

to provide safe and supportive physical and psychological environments. Not only do

minority communities provide spaces safe from aspects of prevailing social stigma, but

feelings of psychological connectedness also have the potential to be stress-ameliorative.

Having and perceiving support from similar others have been shown to reduce the

negative effects of stigma on health and well-being across a variety of stigmatized groups

and individuals (e.g., Frable, 1998). Although less research has been conducted on group-

level coping compared to individual-level coping with stigma-related stress, some studies

have shown positive associations between connectedness to minority communities and

mental health and well-being (Kertzner, Meyer, Frost, & Stirratt, 2009; Ramirez-Valles,

Fegus, Reisen, Poppen, & Zea, 2005) and risk behaviors (Ramirez-Valles & Brown, 2003).

Additionally, perceived support within one’s own racial/ethnic community has been found

to moderate the effect of perceived discrimination on depression (Noh & Kaspar, 2003).

Beyond Stress and Coping: Making Meaning of Stigma-Related Stress

Thus far, stigma has been portrayed as having a unidirectional and negative effect on

the lives of the stigmatized. In cases where individuals or groups are able to cope with

their experiences of stigma-related stress, the negative effects of stigma can be diminished
 Social Stigma - 16

or neutralized. By examining the many ways in which experiences of stigma-related stress

are made more or less meaningful in the lives of stigmatized individuals, a more nuanced

person-centered understanding of the effects of stigma can be achieved.

Insight into how stigmatized individuals make meaning of stigma-related stress can

be found in the early formulations of stress perceptions. The foundational work of Lazarus

and Folkman (1984) articulated how people perceive stressors as either threats or

challenges, and that this attribution of meaning to the stressor determines how the stressor

will affect the individual. If stigmatized individuals are able to engage in meaning-making

processes that reduce the threat of stigma to their lives, they may be able to diminish

and/or overcome its delimiting effects. Evidence for this hypothesis can be seen in the

classic analysis of stigma and self-esteem by Crocker and Major (1989). Specifically, they

show that stigmatized individuals may attribute the cause of stigma to a fault of society

(i.e., the out-group; perpetrators of stigma), not of themselves or other members of their in-

group. They also discuss how people may selectively make domains in which they are

limited by stigma-related stressors less meaningful than domains in which they are not as

limited by stigma-related stress. These meaning-making processes of reframing causes and

the (de)valuation of life domains lead to a great degree of individual variability in the

consequences of stigma-related stress, including gains in self-esteem (see also Shih, 2004).

Additional work from a critical social psychological perspective has identified other

meaning-making processes though which stigmatized individuals are able to make

meaning of stigma in ways that allow them to not simply cope with, but overcome and even

thrive in the face of stigma-related stress. Unger’s (2000) work on positive marginality

provides a critical framework from which to evaluate predominant models of social

 Social Stigma - 17

scientific research on stigma and its consequences. Unger argues that laboratory-based

experimental and quantitative survey methods provide a limited picture of how social

stigma affects the lives of the stigmatized. Critical feminist and qualitative methods have

since been applied in emerging theory and research on the lived experiences of

marginalized individuals and groups (Fine, 2006; Frost & Ouellette, 2004; in press;

Ouellette, 2009; Ouellette & Frost, 2006). These approaches reveal agency and resiliency

by highlighting the processes through which marginalized individuals make meaning of

and respond to their experiences of stigma-related stress. Additional perspectives,

drawing from community psychology emphasize further how those at the margins can

thrive and achieve well-being in life through active resistance of stigma-related stress (e.g.,

Campbell & Deacon, 2006; Nikora, Rua, & Awekotuku, 2006).

One example of such an approach can be seen in the application of narrative analyses

to the meaning making processes that same-sex couples employ in negotiating stigma-

related stress within romantic relationships (Frost, 2011a). Such an approach emphasizes

the meanings that the stigma-related stressors themselves take on in individuals’ lived

experiences. Frost (2011a) showed that members of same-sex couples utilize multiple

meaning making strategies to negotiate the potential effects that stigma-related stressors

can have on their experiences of intimacy. Some strategies emphasized a negative,

delimiting, and contaminating effect of stigma on their relationships, as is common in

existing research. However, other strategies emphasized how stigma can be made sense of

in ways that allow individuals to overcome its negative effects. For example, some

constructed meanings of stigma-related stressors as challenges that reaffirmed their

commitment to and bond with their partners. These narrative strategies for making
 Social Stigma - 18

meaning of stigma-related stressors represent more than coping (Shih, 2005). They

represent agentic attempts to reclaim experiences of being marginalized in ways that allow

individuals to resist and even thrive in the face of social stigma. Thus, through individual

and group-level meaning (re)making processes of stigma-related stressors, social stigma

can, indirectly, result in positive outcomes.

These positive outcomes include social creativity that manifests as activism and

attempts at social change (Hall & Fine, 2005; Frost, 2011a; Jewkes, 2006; Riggle et al.,

2008). Theories of positive marginality predict that, by reclaiming one’s position as

marginal as an advantage instead of a disadvantage, marginalized groups and individuals

are able to reframe experiences of stigma-related stress as opportunities for activism and

social change to improve their social positions. In this regard – aided by enhanced

community connectedness – marginalized communities become spaces for affirmation of

stigmatized identities and characteristics. Furthermore, it is this kind of social creativity

that may lead to policy reform efforts, which, if successful, can potentially alter

discriminatory social structures and diminish the underlying negative meanings of social

stigma.

Summary: An Integrative Model of Social Stigma

This paper aimed to provide an integrative overview of existing social scientific

perspectives on social stigma and its consequences for the socially stigmatized. In

accomplishing this task, the predominant literatures portraying the negative effects of

stigma on the lives of stigmatized individuals was positioned in relation to emerging

perspectives on positive marginality. These discourses, that emphasize damage and

resistance, respectively, are rarely discussed in relation to one another. What follows is a
 Social Stigma - 19

theoretical model (Figure 1) designed to integrate these two perspectives and provide a

holistic perspective on the perpetration and experience of social stigma.

Social stigma occupies the majority of the left side of the model, as it is the

foundation for stereotyping, prejudice, and discrimination. Stigma, stereotypes, and

prejudice are represented as partially nested within one another given the extent to which

they are often inseparable from one another. Stigma further results in structural

inequalities that prevent stigmatized groups from full participation in society. This is

represented by the dotted box surrounding all processes in the model. All elements of the

perpetration of, experience of, and response to stigma are embedded within the ways

societies are structured. Structural manifestations of stigma shape the life opportunities of

stigmatized individuals (for better or worse), even in the absence of others who are

prejudiced or act in discriminatory ways towards them.

Experiences of stigma for stigmatized groups and individuals can be usefully framed

in terms of stigma-related stress. Stigma-related stress exists as acute and chronic

discrimination, expectations of rejection, management and concealment of stigma, and

internalized stigma. These processes range from very distal to the self and perpetrated by

outside social sources (e.g., discrimination) to internalized forms of stigma that are

proximal to the self and persist outside of the presence of a direct source of discrimination.

These proximal sources of stigma-related stress still stem from the prevailing culture of

social stigma, and should not be reduced to personality traits or internally generated

processes (Frost & Meyer, 2009; Russell & Bohan, 2006).

The extent to which experiences of stigma-related stressors impact important

positive and negative outcomes is dependent on a number of intervening and moderating

 Social Stigma - 20

factors. Generally, stigma-related stress is a negative force in the lives of stigmatized

groups and individuals, and can result in a number of negative mental health, physical

health, performance, and relational outcomes. However, individual and group-level coping

and support mechanisms can moderate the negative effect of stigma, buffering the overall

impact of stigma-related stress on these negative outcomes. Further, meaning making

processes that focus on attributions of the source of stigma-related stress can buffer

stigma’s negative affects by attributing the source to a fault in society instead of one’s self

or group membership. Meaning making strategies that focus on (re)defining the meaning of

stigma-related stressors themselves can potentially result in positive outcomes for

marginalized individuals in various forms of positive marginality, such as social creativity,

social change, and thriving in the face of stigma. Just as negative outcomes can perpetuate

negative social stigma via self-fulfilling prophecies, positive outcomes may have the

potential to change social stigma and structural inequalities for the better through social

policy reform and collective action.

Conclusions and Suggestions for Future Research

This paper constructed an integrative review of classic and current theory and

research on social stigma and its consequences for the socially stigmatized. Careful

attention was paid to both the origins and perpetration of social stigma alongside how

stigmatized groups and individuals experience and respond to social stigma. Both the

potential negative and positive consequences of social stigma were highlighted in this

review through the integration of predominant social psychological theory and findings

with emerging critical and feminist theories of positive marginality and resistance. Many

nuances of the theories and studies reviewed have been omitted in favor of theoretical
 Social Stigma - 21

parsimony. Furthermore, much of the work reviewed stems from research on stigma as it

applies to race/ethnicity, gender, and sexual orientation; leaving out other important axes

of social stigma (e.g., weight, social class, mental illness).

The resulting process model is intended to provoke future theory and research that

share its integrative aims. Social scientific efforts are often divided in terms of a focus on

either the damage that stigma can have on the stigmatized or the ways in which socially

stigmatized groups and individuals resist marginalizing conditions. Critical steps need to

be taken to design approaches that can holistically – and in the same study – examine the

conditions under which stigma leads to positive and/or negative outcomes. Current

directions in the social scientific study of stigma are undoubtedly important and must

continue. However, the kind of integrative approach put forth in the preceding discussion

is necessary to build a useful science of stigma that is responsive to both the basic scientific

questions at stake in academia, as well as the pressing needs of those most affected by the

consequences of social stigma.

 Social Stigma - 22

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Figure 1. Process model of social stigma and its consequences.

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