Sickness and Shame
As if being sick weren't bad enough, some diseases come with a social stigma that can make sufferers hide their illness.
Colorectal cancers are very curable in the early stages, according to the National Institutes of Health. Unfortunately, colon cancer often sneaks up without symptoms, and even if symptoms do show up, patients may be embarrassed to talk about diarrhea and abnormal bowel movements with their doctors. The best way to diagnose colon cancer is early screening, including colonoscopies.
Journalist Katie Couric tackled the stigma surrounding this bowel cancer straight on in March 2000 by televising her colonoscopy. Along the way, she proved that talking about hidden diseases can help people seek medical care. According to a 2003 study in the journal Archives of Internal Medicine, colonoscopy rates went up after Couric's TV special. Before the campaign, a physician could expect to conduct 15 colonoscopies a month. For 9 months after Couric's on-air procedure, that number jumped to 18 colonoscopies per physician per month.
The stigma surrounding erectile dysfunction has lessened in recent years, thanks to hours of commercials depicting happy, wholesome couples dancing to the soundtrack of an announcer talking about pharmaceutical side effects. But it can still be tough for men to admit to sexual dysfunction. According to a 2010 review of sexual dysfunction treatments published in the journal Primary Care: Clinics in Office Practice, only half of men with erectile dysfunction get treatment.
Men with erectile problems shouldn't feel alone, however. According to the same report, 10 to 20 million American men have erectile dysfunction, and by age 70, about two-thirds of men have trouble achieving or keeping an erection.
If erectile dysfunction is surrounded by a stigma of unmanliness, some female disorders come with symptoms that challenge our cultural definitions of femininity. Polycystic Ovary Syndrome, a hormone disorder that can cause infertility and diabetes, among other medical problem, is often marked by excessive facial hair. That symptom can leave women struggling to shave, wax or otherwise hide their hirsutism.
Disorders like hyperhidrosis, or excessive sweating, can be stigmatizing to both genders. But the disorder comes with extra baggage for women.
"You know, with women, you don't want to be someone who is sweaty," Sophia Wastler, a 36-year-old Virginia woman with hyperhidrosis, told LiveScience. "It's kind of more of a male characteristic than a female characteristic, so it's quite embarrassing."
Psoriasis is a chronic immune disorder that causes patches of cracked, scaly skin. These outbreaks can be hard to hide and understandably embarrassing. The embarrassment is multiplied by people who see psoriasis and shy away, mistakenly believing the disorder is contagious.
According to a 2008 survey by the National Psoriasis Foundation, 63 percent reported feeling self-conscious about their skin. More than half, 58 percent, said they felt embarrassed, and one-third said they limited their social interactions and dating because of psoriasis flare-ups.
Irritable and Inflamed Bowels
Any disease related to excretion is bound to come tied in some sort of stigma. Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) aren't exceptions. IBD is actually a cluster of syndromes, all marked by the inflammation of the intestines. IBS is a vaguer diagnosis, but the disorder is marked by intestinal pain, cramping and constipation or diarrhea without the inflammation that marks IBD.
In general, IBS patients feel more stigmatized by their disease than IBD patients, according to a study published online March 2011 in the journal Quality of Life Research. Among more than 200 IBS patients surveyed, 27 percent said they felt moderately or extremely stigmatized, compared with 8 percent of the more than 200 IBD patients surveyed. The difference may be because without a clear physical cause, IBS sufferers feel their disease is not taken as seriously.
Fat stigma has gone global. According to a 2011 study in the journal Current Anthropology, there are almost no cultures that don't associate obesity with laziness and gluttony, despite the fact that many of these same cultures once saw heftiness as a sign of wealth.
Those who would shame the overweight often say they're concerned about the person's health. If that's the case, shame is likely to backfire? A 2011 study in the journal Social Psychology Quarterly found that shame and stigma hasten physical decline in people who are obese.
Leprosy, or Hansen's Disease, looms large in the public imagination. The disease is thought to be extremely contagious and believed to result in body parts falling off.
Wrong on both counts. More than 90 percent of people who come in contact with the bacteria that cause leprosy will fight the disease off without symptoms and without becoming contagious (though humans may be able to catch the disease from close contact with armadillos).
The disease is also curable with antibiotics. And while the skin lesions caused by the infection can be disfiguring without treatment, fingers and toes don't just fall off. This myth likely got its start because nerve damage to digits can cause numbness, putting people with leprosy at more risk of accidental injury or amputation.
Like obesity, lung cancer is a condition that people tend to blame on the victim. The link between smoking cigarettes and lung cancer leads people to believe that sufferers bring cancer upon themselves. But in fact, thousands of people who have never smoked get lung cancer every year.
Besides, as Jamie Ostroff of Memorial Sloan-Kettering Cancer Center pointed out at the 2009 World Conference on Lung Cancer in San Francisco, people who have smoked are no less worthy of lung cancer treatment than those who have never lit up. According to LungCancer.org, the disease is the leading cause of cancer deaths in men and women, killing more than 158,000 people each year in the United States.
Human papillomavirus (HPV) infects the skin or mucous membranes, often asymptomatically. But some strains of the virus can cause cervical cancer in women, making them dangerous sexually transmitted infections (STIs). HPV can also cause genital warts.
HPV became a flashpoint in the GOP primary elections in September 2011, when Republican candidates criticized Texas Governor and frontrunner Rick Perry for issuing an executive order in Texas that would have made vaccination against HPV mandatory for girls attending school in the state. Many other vaccines are already mandatory in Texas, but the HPV vaccine is controversial because the virus is spread through sexual contact. Medical experts say that the vaccine is most effective when administered before a person becomes sexually active and potentially exposes themselves to the virus. But Perry's attempt to make the vaccine mandatory was shot down by social conservatives, who argue that getting vaccinated may spur teens into early sexual activity.
Perhaps one of the most famously stigmatized diseases ever, HIV/AIDS first appeared as a mysterious syndrome in mostly gay men in the early 1980s. Anti-gay activists blamed gay men's "immoral" behavior for the spread of the disease, setting up a persistent victim-blaming attitude.
According to a 1999 study published in the journal American Behavioral Scientist, 52 percent of Americans still associated HIV with homosexuality, despite the fact that by that time, only about a third of new HIV cases were contracted by gay men. In 1997, the same study found, 55 percent of Americans believed that most people with AIDS were responsible for their illness, and 28 percent went as far to say that most of them deserved it.
As late as 2006, a Kaiser Family Foundation report found significant confusion among Americans about HIV. According to the report, 37 percent of Americans erroneously believed that HIV could be spread by kissing, while 32 percent thought it could spread via shared drinking glasses.
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Stephanie Pappas is a contributing writer for Live Science, covering topics ranging from geoscience to archaeology to the human brain and behavior. She was previously a senior writer for Live Science but is now a freelancer based in Denver, Colorado, and regularly contributes to Scientific American and The Monitor, the monthly magazine of the American Psychological Association. Stephanie received a bachelor's degree in psychology from the University of South Carolina and a graduate certificate in science communication from the University of California, Santa Cruz.