Ableism: What It Is, What It Looks Like and How To Shut It Down

Are you familiar with the word “ableism”? If not, you’re not alone. Approximately 1.3 billion people around the world have a significant disability. That’s 16% of the global population. But few people know what ableism means and how it works. It’s ironic because most of us join the disability community at some point in our lives.

“I was unaware of ableism until it impacted me personally,” says Carolyn Deming, who works in communications and chaired an employee resource group for people with disabilities. “I have a disease that’s degenerative and unpredictable. It also affects my mobility. These challenges opened my eyes to the inequalities people with disabilities face every day.”

Marvin Natowicz, MD, PhD, is a physician who specializes in genetics and pathology. He’s also a caregiver for an adult child with a disability. He and Deming explain what ableism is, why it’s harmful and how you can help.

What is ableism?

Ableism is the belief that bodies that don’t look or work the same as others are less important or less valuable. It also suggests that our abilities and appearance determine our social worth. That perception shapes every aspect of our lives because it makes it OK to discriminate against people with disabilities, as well as deprioritize their rights and needs.

Of course, all human bodies look different. And we all have different functional abilities. So, what counts as a disability is often arbitrary. The label tells us more about our culture than it does about the person it describes. Ditto for the emotional response many people have to seeing or talking about the topic.

Dr. Natowicz uses the example of mobility impairment to explain this concept: “Using a wheelchair can limit a person’s ability to be a part of day-to-day life. But it only limits you if there aren’t curb cuts, elevators and ramps. Using a wheelchair isn't disabling if we make those types of accommodations. In fact, the opposite is true. For many people using them, wheelchairs and mobility aids are enabling. They can symbolize freedom and independence.”

In other words, having a mobility impairment isn’t the problem. The problem is society not prioritizing accessibility for people with disabilities.

“The experience of ableism involves a lack of respect. Both for the person with the disability and for their families or caregivers,” he adds. Being anti-ableist starts with understanding disability as a social issue — not a medical problem.

What ableism looks like

Dr. Natowicz and Deming agree that ableism pops up in a lot of different ways, in a lot of different places, for a lot of different reasons.

In your history classes, you may have learned about the mass murder of people with disabilities during the Holocaust. Or the eugenics movement’s forcible sterilization of thousands of people with intellectual disabilities. But most discrimination is quieter than that. Oftentimes, it’s an honest mistake made out of ignorance.

You may have the best intentions when you speak loudly and slowly to a person using a wheelchair, for example. But if they haven’t told you they have cognitive or hearing issues, that behavior is ableist. That’s because you’re assuming their mobility issues impact their ability to communicate.

Other times, ableism takes the form of microaggressions or hostility. Mocking or bullying people with disabilities is obviously wrong. But many of us say and do ableist things without realizing it. Common examples include:

Insults

Using terms like “blind,” “dumb,” “schizophrenic,” “lame” or “spastic” as insults suggests having a disability is a bad thing or something to be ashamed of.

“Special” is acceptable in certain contexts, but it’s offensive when you use it to insult or mock somebody.

Outdated language

It’s no longer socially acceptable to call people with disabilities “handicapped,” “touched” or “challenged.” Some members of the disability pride movement have reclaimed slurs like “cripple.” But if you don’t have a disability, they’re not your words to use.

The “R-word” is a euphemism many use to get around the words “retard,” “retarded” and other slurs ending in “-tard.” We’ve spelled these words out here for educational purposes. But the R-word and all its variations are hate speech. It’s never OK to use those words to describe people.

Invasive questions

You do not have a right to another person’s medical history.

“I’ve had strangers guess at my diagnosis, asking the question as if they had a right to know the answer,” Deming shares. “At the end of the day, it’s no one’s business.”

Conflation

Ableist conflation is when you equate disability with pain and suffering. When nondisabled people say things like, “I’d rather be dead than disabled,” they’re assuming that people who have impairments can’t live happy, meaningful lives. In other words, their differences make their lives less valuable than yours.

Condescension

Speaking to an adult with a disability like they’re a child is dehumanizing. So is speaking to their caregiver instead of them. It’s similarly patronizing to use phrases like “differently-abled” or “handi-capable.”

Exploitation entertainment

Exploitation entertainment is also known as “disability porn.” It refers to media that treat people with disabilities as curiosities. It may also describe them as inspiring or brave for doing ordinary activities.

Stigma

Blaming people for their medical condition is ableist. So is stereotyping a person on the basis of their disability.

Legal and institutional discrimination

So far, we’ve focused on the ways ableism appears in our everyday lives. But it’s important to recognize that it’s also embedded in our politics, economy and culture.

Ableism is as much a legal and governmental issue as it is an interpersonal one. That’s because — like racism, sexism and other types of discrimination — it’s often reflected in our institutions. Take, for example, the following two U.S. policies:

• Subminimum wage laws. These laws allow some employers to pay workers with specific disabilities less than the federal minimum wage.
• Marriage inequality. Many people living with disabilities can’t marry their partner. If they do, they risk losing the federal benefits they rely on for medical care.

Most U.S. citizens don’t realize these policies exist, even though they impact hundreds of thousands of people.

Failure to provide accommodations

Of course, not all ableism happens at a policy level. Dr. Natowicz points to the lack of widespread accommodations for people with disabilities as another example of institutional ableism. These failures may be accidental. But people and organizations often violate disability rights laws on purpose, too.

Here are a few examples of intentional and unintentional discrimination around accommodations:

• Parking in a spot reserved for people with disability placards. Or blocking that spot or van access with a grocery cart.
• Not repairing damaged sidewalks and curb cuts or malfunctioning automatic doors, which poses a safety risk to people who use mobility aids.
• Turning away a restaurant patron who uses a guide dog for vision support.
• Making up an excuse to fire someone with cancer who’s using the Family and Medical Leave Act (FMLA) to take time off work.
• Not providing an interpreter or captioning service at an event with Deaf attendees.
• Refusing to follow an Individualized Education Program (IEP) for a student with a developmental or learning disability.
• Not equipping doors with push plates for easy entry.
• Restricting bathroom breaks for an employee with inflammatory bowel disease (IBD).
• Serving cafeteria food with peanuts in it, even though a student has a life-threatening allergy.

Medical ableism

It’s sad but true: Ableism is also common in medical settings. It shows up in four main areas:

1. Healthcare access. One in four U.S. adults with disabilities between the ages of 18 and 44 didn’t get medical help in 2023 because they couldn’t afford it.
2. Transportation access. Twelve percent of people with disabilities struggle to access transportation services, compared to 3% of nondisabled people.
3. Facilities and training. Once people with disabilities arrive at medical facilities, they often encounter more obstacles. The building itself might be inaccessible. Or the providers lack important equipment (like adjustable exam tables or wheelchair-accessible scales). On top of that, support staff are often inadequately trained to do things like transfer patients.
4. Provider prejudice. A 2021 study polled over 700 practicing doctors. It found that over 80% believed people with significant disabilities have a lower quality of life than nondisabled people.

Providers rarely mean to treat patients with disabilities differently. Dr. Natowicz says one reason that it happens is that most medical schools offer minimal instruction on many important aspects of disability. For example, students rarely learn what ableism is or how to prevent it.

Their practical education is incomplete, too. Instructors tend not to focus on factors like adaptive exams or communicating with nonspeaking patients. The medical students who learn these skills often pick them up themselves.

The impact is clear. Only 40.7% of physicians polled in the 2021 study on provider prejudice felt “very confident” they could provide the same quality of care to patients with disabilities they give nondisabled patients.

Internalized ableism

Have you heard of internalization? It’s the idea that being steeped in prejudice day in and day out is corrosive. Over time — often without realizing it — you start to believe that your differences do make you less.

Internalized ableism is a big problem, too. Deming recounts her first-hand experience with it:

“I resisted using a mobility aid because I wanted to appear normal. I probably could have kept my mobility longer if I had used assistive devices sooner. Instead, I adjusted my life to be what I thought everyone expected me to be, at great expense to my own energy and function. The physical, mental and psychological impacts of internalized ableism are devastating.”

Why ableism is damaging

Ableism is like a self-fulfilling prophecy. When society devalues the lives and contributions of people with disabilities, it actually does make it harder to get by. The statistics tell the story:

• Employment: The U.S. Department of Labor says unemployment rates are higher for people with a disability than for people without disabilities, regardless of education level.
• Socioeconomic status: The poverty rate for adults with disabilities is 27%. That’s compared to 12% for nondisabled adults, according to the National Disability Institute.
• Victimization: From 2017 to 2019, people with disabilities were four times more likely to be the victims of violent crime than nondisabled people, per the U.S. Bureau of Justice Statistics.
• Police brutality: Up to 50% of people killed by police in the U.S. have disabilities or are Deaf, according to a 2024 study.
• Overall health: People with disabilities have more functional limitations and chronic health issues than nondisabled people, according to a WHO report. That is one of the many reasons the National Institutes of Health (NIH) officially designated people with disabilities as a population experiencing health disparities in 2023.
• Inequitable treatment: In 2022, The Urban Institute reported that 40% of adults with disabilities experienced unfair treatment or judgment in healthcare settings, at work or when applying for public benefits in the past year. That’s double the rate reported by people without disabilities.

The statistics are striking. And so are the physical and psychological impacts of ableism.

“Everyday tasks like cooking and cleaning are harder for me, but not impossible. I make decisions every moment of every day about how and where I spend my energy,” Deming explains. “When people question the validity of my struggles or decisions, or when I have to spend precious time and energy fighting to be seen as equal to someone without a disability, that has serious health ramifications.”

The physical, mental and emotional effort Deming puts into addressing ableism is a big investment, too. “It means I’m not doing other things,” she says. “When people or institutions are ableist, they take something from my life. I choose to help others through education and advocacy. But that choice has a personal cost. In a less ableist world, I wouldn’t have to make those choices and sacrifices.”

Being an ally to people with disabilities means proactively standing up for them. That way, they can devote less time to addressing injustice and more time to living their lives.

How to speak up about ableism

Now you know how pervasive and damaging ableism is. So, you may be wondering: What can I do about it? Deming says the motto, “If you see something, say something” is a great place to start.

Here are some tips to help you be an ally in the movement against ableism:

• Educate yourself. The best way to combat ignorance is by learning all you can about what living with a disability is like. “We all need a basic education about disability, starting from when we’re little kids,” Dr. Natowicz says. “But learning is a lifelong experience, so if you haven’t had the benefit of learning about it yet, now is a fine time.”
• Learn respectfully. Deming welcomes questions about disability that aren’t invasive or accusatory. She appreciates it when nondisabled people show a desire to learn and grow. But everyone’s different. Ask the person you’re speaking with if they’re comfortable discussing the topic. And don’t feel bad if they say no. Those conversations can be draining and should only happen on their terms.”
• Assume everybody has a disability. Curb cuts were originally designed to help people with disabilities. But they also make it easier for people using strollers, rolling suitcases and scooters. So, keep accessibility top of mind at all times. Dr. Natowicz offers the example of planning an event. “Think hard about all the different types of disabilities the human body can encounter. Then ask: Is this event accessible?” If not, do something about it.
• Make it safe to disclose disabilities. If you’re a manager, learn about the resources your company makes available for people with disabilities without sharing anyone’s ability status. If you’re a teacher, use universal design principles to build your courses, and include lessons about disability where possible. If you’re a romantic partner or friend, don’t make assumptions about last-minute cancellations or sudden changes in behavior. Ask questions and listen carefully.
• Encourage accommodations. If your child missed school due to an illness, they get to take a make-up test, right? Well, guess what? That’s an accommodation! Accommodations are a part of life, no matter who you are. But when people with disabilities request them, they’re often met with suspicion. Deming reminds us that accommodations level the playing field. They don’t give anybody an unfair advantage. So, respect these accessibility requests, and use your creativity to find solutions. A good ally errs on the side of inclusivity and fairness.
• Create space for people with disabilities. One of the main slogans of the Disability Rights Movement is “Nothing about us without us.” As you go through your daily life, keep that in mind. And look for opportunities to make space for, and amplify the voices of, people with disabilities. “Not only do we need a seat at the table, we need decision-making capabilities,” Deming says.
• Don’t tolerate intolerance. If you hear somebody make a joke about or bully a person with disabilities, intervene. If you hear a coworker express skepticism about a colleague’s disability, let them know that behavior is unacceptable. If your curious child asks a stranger with a prosthetic limb what happened, don’t yell or scold. Instead, gently explain what privacy is, and why it’s impolite to ask personal questions or comment on other people’s bodies.

The bottom line

Like racism and sexism, ableism is a form of discrimination that labels and treats a group of people as less than. It does this by suggesting that human bodies can be either “normal” (good) or “abnormal” (bad). In reality, all bodies are different, and all people are worthy of respect.

Ableism is both a way of thinking and a systemic process. In other words, it’s a pattern of thinking and behavior that shapes our world — sometimes, literally. It’s enshrined in laws, present in popular culture, and shapes everything from our history and our healthcare to our own self-image.

You can be an ally by recognizing that it isn’t OK to define people by how their body looks or what it can do. Then, you need to act accordingly. That means educating yourself, practicing good disability etiquette, advocating for accessibility, and making sure people with disabilities have a place in every conversation and at every table.