Consequences of Confronting Patronizing Help for People with Disabilities: Do Target Gender and Disability Type Matter?

Abstract

People with disabilities face a dilemma in dealing with patronizing help: Although accepting unsolicited assistance can incur psychological costs, confronting the helper has been shown to incur interpersonal penalties. The present research explored whether the consequences of confronting patronizing help vary across target gender and disability type. A vignette paradigm introduced participants to various interactions between adults with and without disabilities. Study 1 (N = 137) showed that, when blind targets confronted help that was clearly patronizing, they were rated as ruder and less warm after (vs. before) confronting regardless of their gender. Study 2 (N = 368) showed that, although both blind and wheelchair-using targets were rated as less warm and ruder after (vs. before) confronting, blind targets were penalized more, and patronizing behavior toward blind targets was perceived as more appropriate. These results highlight the importance of considering intersectionality and cross-disability heterogeneity when examining the multifaceted experience of ableism.

Defined as a physical or mental impairment that substantially limits major life activities (U.S. Department of Justice, 1990), disability affects a large segment of the U.S. population: One in five adults report having a disability (CDC, 2015), and even individuals who are currently nondisabled might acquire a disability at any time through various circumstances, including illness, injury, and aging. Despite this high prevalence of disability and its potential to affect all people at some point in their lives, those with physical or psychological limitations continue to experience pervasive ableism (i.e., stereotyping, prejudice, discrimination, and social oppression toward people with disabilities; Bogart & Dunn, 2019; Harder, Keller, & Chopik, 2019).

Like prejudice and discrimination directed toward other socially disadvantaged groups (e.g., racism, sexism), ableism is a multifaceted construct that operates across different levels of analysis. On the structural level, it may manifest as access barriers to physical spaces or information, such as lack of ramps, elevators, and Braille signage in public facilities as well as policies that restrict access to housing, healthcare, and education benefits (National Council on Disability, 2008; Nielsen, 2012). On the interpersonal level, it may manifest as hostility and violence, patronizing behaviors such as unwanted help, and awkward interactions fraught with anxiety and discomfort (Hebl & Kleck, 2000; Nario-Redmond, Kemerling, & Silverman, 2019; Olkin, Hayward, Abbene, & VanHeel, 2019). Taken together, these forms of ableism place people with disabilities at a significant disadvantage across a wide range of life domains, including employment, higher education, and healthcare, thus hindering their full participation in society (Bogart & Dunn, 2019).

The present research focused on unsolicited, inappropriate offers of help, an interpersonal manifestation of ableism, and the consequences facing people with disabilities when they actively resist this form of ableism. According to a number of qualitative studies (Braithwaite & Eckstein, 2003; Nario-Redmond et al., 2019; Olkin et al., 2019), encounters with unsolicited help represent one of the most common forms of ableism experienced by individuals with visible physical or sensory disabilities. Though often well-intentioned, such imposed assistance can incur significant psychological costs because it implies that the recipients lack the ability to take responsibility for their own welfare. This theorizing is well-supported by social psychological research on patronizing treatment directed toward other disadvantaged groups. For example, benevolently sexist behaviors have been shown to impair women’s cognitive performance by triggering self-doubt and intrusive thoughts (Dardenne, Dumont, & Bollier, 2007). Similarly, when Black students received unsolicited help from a White peer on an intelligence test, they saw themselves as less competent than those who did not receive such help (Schneider, Major, Luhtanen, & Crocker, 1996).

In light of these findings, it is not surprising that people with disabilities tend to find patronizing help to be highly disturbing and inappropriate, even though nondisabled individuals might perceive such behaviors as innocuous and even charitable (Dunn, 2019; Wang, Silverman, Gwinn, & Dovidio, 2015). This discrepancy in perspectives presents a dilemma for people with disabilities: Although accepting unwanted help may undermine their self-esteem and sense of autonomy, refusing such help might have significant interpersonal repercussions, as highlighted by recent studies in the ableism literature. Specifically, individual interviews and focus groups with disabled individuals revealed that they are often accused of being ungrateful, rude, and hyper-sensitive when declining patronizing help and that attitudes toward people with disabilities tend to become more negative when they violate the stereotype of incompetence and dependency (Braithwaite & Eckstein, 2003; Nario-Redmond et al., 2019; Olkin et al., 2019). Additionally, Wang et al. (2015) showed that a blind, female target was perceived as less warm, ruder, and generally less likable when she declined patronizing help from a sighted pedestrian than when she accepted such assistance. It is worth noting that this backlash associated with refusing patronizing help is not limited to people with disabilities. For example, Becker, Glick, Ilic, and Bohner (2011) found that a female target was perceived as less warm when she refused, rather than accepted, patronizing help from a male colleague.

Building on this evidence base, the current studies sought to provide a more nuanced understanding of the interpersonal backlash faced by people with disabilities when they decline patronizing help by engaging in direct confrontation. Specifically, we extended the experimental work of Wang et al. (2015) in two important ways. First, recognizing that, like all individuals, people with disabilities possess multiple identities, we examined how gender might interact with disability to shape the perceptions of both male and female blind targets who confronted patronizing treatment (Study 1). Second, we examined whether the interpersonal penalty associated with confronting patronizing help might generalize to targets with physical disabilities other than blindness, such as individuals who use wheelchairs. Taken together, these two studies aimed to illuminate the consequences of confronting patronizing treatment for different segments of the disability community through the lens of an intersectionality perspective. Given that a majority of the studies on the experience of patronizing help as a form of ableism have been qualitative in nature, the present research contributes to the existing literature by providing a much-needed quantitative investigation of the consequences facing people with disabilities when they resist this subtle yet pernicious form of ableism.

Study 1

Although the concept of intersectionality has gained significant traction in the field of psychology over the past decade (Cole, 2009), little research has considered the intersection of disability and other social identities. This limitation is noteworthy given that, contrary to popular belief, disability is far from a unitary construct, nor does it necessarily eclipse the other dimensions of social experience; rather, it represents only one facet of people’s lives and interacts with other facets of their identities to shape their experiences and perceptions by others (Fine & Asch, 1988; Olkin et al., 2019). As an initial attempt to address this gap in the literature, we examined the role of gender in potentially shaping observers’ perceptions of blind individuals who declined patronizing help through direct confrontation.

At the beginning of the study, participants were presented with some background information about a 22-year-old blind man or woman, who was portrayed as a competent working adult and a confident cane traveler and indicated their perceptions of this individual with respect to both warmth and competence. Participants then read a hypothetical vignette, which was taken from Wang et al. (2015) and developed in consultation with members of the blindness community. In this vignette, the blind individual asked for directions from a sighted pedestrian, who responded in a patronizing manner and was subsequently confronted by the blind individual. After reading the scenario, participants were asked to indicate their perceptions of the blind individual a second time. They also indicated the extent to which they believed the pedestrian’s behavior to be appropriate.

Consistent with the findings of Wang et al. (2015), we hypothesized that the blind individual would be perceived as less warm after (vs. before) he/she confronted patronizing help. Our examination of target gender was more exploratory in light of competing perspectives in the intersectionality literature. Because women, who are stereotyped as warm and penalized for demonstrating assertiveness and dominance (Rudman & Glick, 2001), have been shown to be particularly vulnerable to backlash when they confront patronizing treatment (Becker et al., 2011), we might expect that the interpersonal penalty would be stronger for the female (vs. male) blind target and that this effect would be mediated by perceptions of the pedestrian’s behavior. In other words, it could be that participants would penalize the female target more than the male target, in part because they perceive patronizing help as more acceptable when the recipient is a woman rather than a man. Such findings would be consistent with the double jeopardy hypothesis (Berdahl & Moore, 2006), which suggests that people with multiple stigmatized identities experience increased discrimination with each additional devalued status. As preliminary support for this hypothesis, previous research has shown that women with disabilities tend to experience higher rates of poverty, social isolation, and victimization than men with disabilities (Palombi, 2012).

It is worth noting, however, that the double jeopardy hypothesis does not represent the only plausible account of intersectionality. Indeed, for many people who hold multiple marginalized identities, one identity may emerge as the primary source of stigma. For example, rather than obtaining support for the double jeopardy hypothesis, Levin, Sinclair, Veniegas, and Taylor (2002) found no differences between ethnic minority (specifically, Latinx and Black) men and women in self-reported discrimination expectations. Furthermore, for Black women and Latinas, perceived ethnicity-based discrimination accounted for a significant portion of the variance in self-reported general discrimination, whereas perceived gender-based discrimination did not. Collectively, these findings lend support for a primary stigmatized identity perspective (termed ethnic prominence by Levin et al., 2002, given their focus on ethnic minorities). Also consistent with a primary stigmatized identity perspective, research on disability stereotypes suggests that men and women with disabilities are perceived as more similar and less “gendered” than their nondisabled counterparts; in other words, people with disabilities tend to be viewed as dependent, incompetent, and asexual regardless of their gender (Nario-Redmond, 2010). In light of these findings, it is possible that targets in the present research will be viewed primarily through the lens of their disability rather than their gender.

As a result, we made no specific predictions with regard to target gender but instead explored the possibility that either of these intersectionality perspectives could be supported. Relatedly, although women are, in some contexts, perceived as less competent than men (Eagly & Mladinic, 1994), we followed the methods of Wang et al. (2015) very closely, explicitly indicating the blind target’s comfort level with navigating their environment independently. Thus, similar to Wang et al., we examined perceived competence for exploratory purposes, but did not have a strong reason to expect a significant difference in perceived competence before versus after confrontation.

Methods

Participants.

Using the Wang et al. (2015) effect size (${\eta }_p^2=.06$) for the interaction and G*Power software (Faul, Erdfelder, Lang, & Buchner, 2007), we estimated requiring at least 128 participants to find a significant effect (p < .05) at 80% power.

We recruited 169 undergraduate students from a university located in the Midwestern United States, who participated in exchange for course credit. Thirty-two participants (19%) failed an attention check to correctly identify that Matt (or Mary) was blind, and to correctly identify what directions Matt or Mary requested (i.e., to find the bus stop) and were thus excluded from analyses. These 32 excluded participants did not differ significantly across gender condition, χ² (1, N = 169) = 1.30, p = .254. The final sample included 137 participants (88 female, 48 male, 1 other) between the ages of 18 and 43 years (M = 20.26, SD = 3.49). The majority (71.5%) identified as White; the remainder identified as Black (11.7%), Latinx (4.4%), South Asian (4.4%), Southeast Asian (4.4%), Middle Eastern (2%), Native American/Alaska Native (.007%), and other (1.5%).

Procedure.

All study vignettes and measures were adapted from Wang et al. (2015). Participants first read background information about a blind adult who was either male or female (Mary or Matt). This background information indicated that Matt/Mary worked for a radio station and took the bus to get to work. Moreover, this information emphasized that Matt/Mary was comfortable taking the bus and was familiar with bus stop location and bus route (see Appendix A for the complete background information). After reading this background information, participants indicated the extent to which they agreed (1 = strongly disagree, 5 = strongly agree) that Matt/Mary was warm (i.e., warm, good natured, rude [R], and arrogant [R]), and that Matt/Mary was competent (i.e., competent, intelligent, independent). We created mean scores of participants’ responses to the items, with higher scores indicating perceptions of greater warmth and competence.

Participants then read a vignette in which Matt/Mary confronted a pedestrian for insisting on providing patronizing help. In particular, Matt/Mary was described as taking a detour to the bus stop because his/her regular route was blocked by construction. Matt/Mary stopped a pedestrian to confirm that the bus stop was one block from where he/she was standing. Instead of answering Matt/Mary’s question, the pedestrian asserted that the street was very busy, and tried to grab Matt/Mary by the arm to direct him/her to the bus stop. Matt/Mary then confronted this patronizing help by saying “Excuse me, I can handle myself just fine and was only trying to get some simple directions. Can you please just answer my question?!” (See Appendix A for the complete vignette).

Participants then rated the target’s perceived warmth and competence, using the same scales employed before the vignette. Finally, participants rated the extent to which they agreed (1 = strongly disagree, 5 = strongly agree) that the pedestrian’s behavior was appropriate (i.e., helpful, compassionate, overbearing [R], and condescending [R]). We averaged participants’ responses to these four items; higher scores represented perceiving the behavior as more appropriate.

Results

The means and standard deviations across time and target gender conditions are presented in Table 1, and correlations between outcome variables, as well as the means, standard deviations, and reliabilities for the outcome variables are available in Table 2.

Table 1.

Means and (Standard Deviations) by Condition in Study 1

	Time 1		Time 2
Measure	Mary (N = 71)	Matt (N = 66)	Mary	Matt
Warmth	3.81 (0.70)	3.72 (0.70)	3.12 (0.84)	3.00 (0.81)
Competence	4.24 (0.73)	4.26 (0.59)	4.23 (0.60)	4.16 (0.58)
Response appropriate	3.30 (0.99)	–	–	3.52(0.81)

Table 2.

Correlations between Outcome Variables in Study 1

Measure	M	SD	1	2	3	4	5
1. Warmth (before confrontation)	3.77	.69	.86	–	–	–	–
2. Warmth (after confrontation)	3.06	.82	.20*	.79	–	–	–
3. Competence (before confrontation)	4.25	.66	.30***	.15+	.64	–	–
4. Competence (after confrontation)	4.20	.59	.03	.30***	.47***	.62	–
5. Perceptions of pedestrian’s behavior	3.41	.91	.10	−.32***	.11	−.09	.77

^*Note. Cronbach’s alphas are on the diagonal.

⁺p < .10,

^*p < .05,

^**p < .01,

^***p < .001

We analyzed perceived warmth and competence separately, using a mixed model ANOVA with time (ratings before vs. after the confrontation) as the within-subjects variable and target gender as the between-subjects variable. We initially also included participant gender as a between-subject variable; however, it did not significantly moderate our results (all two- and three-way interactions were nonsignificant, ps > .258). Thus, we report the more parsimonious analyses not including participant gender.

With respect to warmth, replicating previous research (i.e., Wang et al., 2015) and in line with our predictions, there was a significant main effect of time such that the blind target was perceived as less warm after versus before confronting patronizing help, F (1, 135) = 72.45, p < .001, ${\eta }_p^2=.349$, and d = .73 (see Table 1). The main effect of gender and interaction between time and gender were both nonsignificant, ps > .892. In other words, consistent with the primary stigmatized identity perspective, participants did not perceive the female blind target as less warm than the male blind target after the confrontation, and the female blind target did not incur more of a warmth penalty for confronting. With respect to competence, there were no significant effects of time, gender, or interaction between time and gender, ps > .299. This finding is consistent with past work (i.e., Wang et al., 2015).

To supplement our analyses with respect to target perceptions, we also ran a between-subjects t-test with respect to perceived appropriateness of the pedestrian’s behaviors. We found no significant difference between appropriateness for Mary and Matt, t(135) = 1.42, p = .159, providing further support for the primary stigmatized identity perspective (see Table 1).

Discussion

Replicating Wang et al. (2015), we found that the blind target was viewed as less warm after confronting the patronizing help, whereas confrontation did not influence participants’ perceptions of the target’s competence. Importantly, extending previous research, this pattern did not differ across target gender. Moreover, target gender did not influence the perceived appropriateness of the pedestrian’s behavior. Thus, these findings are more consistent with the primary stigmatized identity perspective than with the double jeopardy hypothesis.

Study 2

In our second study, we sought to extend the findings of Study 1 in two important ways. First, although people with disabilities are often considered as a single stigmatized group in social psychological research, the composition of this group is far from homogeneous. Indeed, while people with visual, hearing, and mobility impairments share the common experience of ableism tied to their physical differences, they also have diverse access needs, self-advocacy preferences, roles in the larger disability rights movement, and views on how disability fits within their multifaceted identities (Fine & Asch, 1988). As such, a nuanced understanding of the consequences associated with confronting patronizing treatment should also consider the heterogeneity of the disability experience. Toward this end, we examined whether the findings from Study 1 might generalize to people who use wheelchairs, who constitute an important segment of the physical disability community and are frequent targets of patronizing help (Braithwaite & Eckstein, 2003; Nario-Redmond et al., 2019; Olkin et al., 2019).

Additionally, in Study 1, we utilized vignettes in which the blind target initiated a conversation requesting information from a sighted pedestrian. It is possible that participants used this request as a cue that legitimized patronizing help. Indeed, because people tend to perceive those who seek assistance as having an acknowledged need for help (Dovidio & Penner, 2001), participants might be more likely to recognize patronizing help as inappropriate when assistance is completely unsolicited. To address this possibility, we modified our vignettes for Study 2 so that they featured targets with disabilities who receive patronizing help without first initiating an interaction.

As in Study 1, participants were first presented with background information on a man or woman with a visible disability, who was portrayed as blind or using a wheelchair. Participants then indicated their perceptions of the disabled individual with respect to both perceived warmth and competence. Next, they read a hypothetical vignette depicting an interaction between the disabled target and a nondisabled pedestrian, in which the target who was blind or used a wheelchair confronted completely unsolicited, patronizing help from the pedestrian. After reading the scenario, participants indicated their perceptions of the disabled target for a second time as well as the extent to which they perceived the pedestrian’s behavior as appropriate. Overall, we expected to replicate the findings from Study 1 such that the disabled target would be penalized for confronting regardless of target gender. Given the dearth of research on the impact of different disability types on interpersonal perceptions, we did not have specific expectations regarding the extent to which this interpersonal penalty might vary across disability types.

Methods

Participants.

To assess the generalizability of our findings from Study 1 to a more diverse sample outside a university setting, we recruited 455 U.S. residents from Amazon’s Mechanical Turk (Mturk), which provides a valid source of data for social and behavioral science researchers (Buhrmester, Kwang, & Gosling, 2011; Mason & Sufi, 2010). In line with the suggested payment structure for MTurk (Buhrmester, 2018), each participant was paid $1.00, and the study took approximately 10 minutes. Eighty-seven participants (19%) failed to correctly identify Matt or Mary’s disability (either as blind or as in a wheelchair), and to correctly identify why Matt or Mary was waiting to cross the street (i.e., to get to his/her bus stop). These 87 excluded participants did not differ significantly by gender, χ² (1, N = 455) = 0.06, p = .807, or disability condition, χ² (1, N = 455) = 1.30, p = .254, and the 19% exclusion rate was comparable to the undergraduate sample in Study 1. The final analytic sample consisted of 368 participants (168 female, 200 male) between the ages of 19 and 74 years (M = 36.35, SD = 11.38). The majority (70.1%) identified as White; the remainder identified as Black (7.1%), Latinx (6.3%), East Asian (6.5%), South Asian (1.1%), Southeast Asian (1.9%), Middle Eastern (0.3%), Native American/Alaskan Native (1.1%), and other (3.0%).

Procedure.

Study 2 was a replication of Study 1 with two modifications. First, we included two additional conditions featuring a male and a female target who uses a wheelchair, with adapted vignettes that, informed by consultation with wheelchair users, appropriately reflected their experiences of patronizing help. Second, we removed any mention of requests for directions across all conditions, making the patronizing help offered completely unsolicited. In particular, in the revised vignette, Matt/Mary was described as waiting to cross a busy street to reach his/her bus stop. A pedestrian approached Matt/Mary and insisted that the street was too busy for him/her to cross. The pedestrian then proceeded to either grab onto Matt’s/Mary’s arm or wheelchair and help him/her cross the street. At this point, Matt/Mary confronted this patronizing help, saying “Excuse me, I can handle myself just fine! I’m comfortable crossing the street on my own.” (The complete vignette is available in Appendix B.)

As in Study 1, participants indicated their perceptions of the disabled target with respect to warmth and competence before and after reading the confrontation vignette. Participants also rated how appropriate they perceived the pedestrian’s behavior.

Results

The means and standard deviations across time and conditions are presented in Table 3, and correlations between outcome variables, as well as the means, standard deviations, and reliabilities for the outcome variables are available in Table 4.

Table 3.

Means and (Standard Deviations) by Condition in Study 2

Blind targets
	Time 1		Time 2
Measure	Mary (N = 92)	Matt (N = 98)	Mary	Matt
Warmth	4.14 (0.76)	4.00 (0.70)	3.19 (0.96)	3.16(0.93)
Competence	4.41 (0.59)	4.28 (0.69)	4.40 (0.60)	4.25 (0.73)
Targets who were in wheelchair
	Time 1		Time 2
Measure	Mary (N = 91)	Matt (N = 87)	Mary	Matt
Warmth	4.05 (0.72)	4.10(0.69)	3.32 (0.95)	3.43 (0.86)
Competence	4.29 (0.64)	4.39 (0.61)	4.39 (0.62)	4.39 (0.64)
	Blind targets		Targets who were in wheelchair
Measure	Mary	Matt	Mary	Matt
Perceptions of pedestrian’s behavior	3.65 (0.92)	3.58 (0.94)	3.40 (0.88)	3.33 (0.96)

Table 4.

Correlations between Outcome Variables in Study 2

Measure	M	SD	1	2	3	4	5
1. Warmth (before confrontation)	4.07	.72	.84	–	–	–	–
2. Warmth (after confrontation)	3.27	.93	.25*	.87	–	–	–
3. Competence (before confrontation)	4.34	.63	.45***	.16+*	.72	–	–
4. Competence (after confrontation)	4.35	.65	.35***	.24***	.74***	.74	–
5. Perceptions of pedestrian	3.50	.93	.21***	−.31***	.03	−.05	.79

^*Note. Cronbach’s alphas are on the diagonal.

⁺p < .10,

^*p < .05,

^**p < .01,

^***p < .001.

We analyzed perceived warmth and competence separately in mixed model ANOVAs, with time as the within-subjects variable and both target gender and disability type as between-subjects variables. As in the first study, we ran initial analyses including participant gender as a between-subjects factor and did not find that participant gender moderated our results (all two-, three-, and four-way interactions were nonsignificant, ps > .311). We therefore report the more parsimonious analyses not including gender.

Consistent with Study 1, a significant main effect of time indicated that the target with a disability was perceived as less warm after versus before confronting patronizing help, F (1, 364) = 224.56, p < .001, ${\eta }_p^2=.382$, and d = .77 (see Table 3). Interestingly, there was a marginally significant interaction between time and disability type, F (1, 364) = 3.53, p = .061, and ${\eta }_p^2=.010$. Specifically, although both the blind target, d = .85, p < .001, and the target who used a wheelchair, d=.76, p<.001, were perceived as less warm after the confrontation, the blind target (M = 3.17, SD = .94) was perceived as significantly less warm than the target using a wheelchair (M= 3.38, SD = .91) after confronting, d = .23, p = .029. There was no difference between the blind target (M = 4.07, SD = .73) and the target using a wheelchair (M= 4.08, SD = .70) before the confrontation, d =.01, p=.875, suggesting that the blind target received more of a warmth penalty for confronting than did the target using a wheelchair. All other main effects and interactions were nonsignificant, ps > .125. With respect to competence, there were no significant main effects or interactions, ps > .128, replicating Study 1 as well as prior research (i.e., Wang et al., 2015).

As in Study 1, we also ran a between-subjects ANOVA on participants’ judgments of the appropriateness of the pedestrian’s behavior, with target gender and target disability type as between-subject variables. The only significant effect that emerged was for target disability, F(1, 360) = 6.71, p .010, and ${\eta }_p^2=.018$; neither the main effect of target gender nor its interaction with target disability was significant, ps > .455. Participants thought the pedestrian’s behavior was more appropriate for the targets who were blind (M = 3.62, SD = .93) than for the targets who used a wheelchair (M = 3.37, SD = .92), d = .27, and p = .007.

Discussion

As expected, the interpersonal penalty for confronting remained robust even in the context of completely unsolicited patronizing help, and it did generalize to individuals who use wheelchairs. However, the blind target was penalized more for confronting relative to the target using a wheelchair. In particular, although perceptions of warmth did not differ between the targets before confrontation, after confrontation, participants perceived the target who was blind as less warm than the target using a wheelchair. Moreover, the pedestrian’s behavior was viewed as significantly more appropriate when the target was blind than when the target was in a wheelchair. One possible explanation for these findings is that participants regarded blind individuals as more in need of help than those who use wheelchairs, especially in the specific context of independent travel; indeed, in comparison with other physical disabilities, blindness is often considered as particularly debilitating by members of the general public (Ferguson, 2001). Another possible explanation is related to the specific ways we depicted patronizing help toward blind versus wheelchair-using targets, despite our efforts to keep these vignettes as similar to each other as possible. Specifically, participants might have perceived the pedestrian’s actions toward the target using a wheelchair (i.e., grabbing onto the person’s wheelchair and trying to steer him/her across the street) as less appropriate because it directly interferes with the target’s freedom of movement; in contrast, grabbing onto a blind person’s arm might be seen as relatively innocuous (i.e., the blind person could simply pull away if he/she does not want to be helped).

General Discussion

To date, precious little social psychological research has examined the significance of the heterogeneity among people with disabilities. The present research addressed this limitation by examining how people with disabilities are perceived when they confront unsolicited, patronizing help that they so often experience in daily life (Braithwaite & Eckstein, 2003; Nario-Redmond et al., 2019; Olkin et al., 2019). Specifically, we examined the role of disability and gender intersectionality, as well as cross-disability heterogeneity, in an effort to provide a nuanced quantitative investigation of the consequences facing people with disabilities when they choose to resist this subtle yet pervasive form of ableism. Our findings demonstrate that although men and women with disabilities experience similar levels of backlash for confronting patronizing help, blind people evoke greater backlash than people who use wheelchairs. Our research underscores the fact that people with disabilities are not a monolithic group, and we call for other researchers to further consider their within-group variability in future work.

Theoretical and Policy Implications

The present research contributes to the extant literature on disability stigma in several important ways. First, by conceptually replicating the work of Wang et al. (2015), we again demonstrate the social backlash people with disabilities experience for confronting inappropriate, unsolicited offers of help and further highlight the misconceptions many people have about ableism. Across the present and previous studies, the fact that people with disabilities who confronted perpetrators’ patronizing treatment incurred significant warmth penalties suggests that many nondisabled individuals do not recognize such treatment as inappropriate. This lack of awareness is remarkable, given that across studies, efforts were made to communicate the target’s competence clearly (indeed, there were no differences in terms of perceived target competence, and all ratings were near the ceiling of the scale). Moreover, despite numerous studies demonstrating adverse reactions to violations of personal space (e.g., Evans & Wener, 2007; Perry, Rubinsten, Peled, & Shamay-Tsoory, 2013), many participants failed to recognize grabbing a person with a disability by the arm or by their wheelchair as inappropriate, overbearing, or condescending. Such findings underscore the importance of educational interventions that highlight the multifaceted, subtle nature of ableism. After all, if people do not recognize patronizing help as prejudice or as serious enough to warrant intervention, they will be unlikely to change their own behaviors or confront others for engaging in such behaviors (Ashburn-Nardo, Morris, & Goodwin, 2008), making it more likely for patronizing help to persist in our society.

Relatedly, our results speak to the important role that nondisabled allies may play in combating patronizing help as a pervasive form of ableism. Previous research on confronting racism and sexism has shown that nontarget confronters are perceived as more persuasive and encounter less social backlash than stigmatized targets who engage in confrontation (Czopp & Monteith, 2003; Eliezer & Major, 2012; Rasinski & Czopp, 2010). In light of the robust interpersonal penalty that people with disabilities have been shown to incur when they confront patronizing help, intervention efforts should focus on providing nondisabled individuals with the necessary tools and resources so that they can advocate on behalf of members of the disability community. Indeed, as revealed by in-depth interviews with people with physical and sensory disabilities (Ostrove, Kornfeld, & Ibrahim, 2019), the ability to provide appropriate help that supports the autonomy of people with disabilities without patronization or presuming incompetence was identified as one of the most important qualities of effective allies.

The current studies also extend previous work on disability stereotypes and identity (Fine & Asch, 1988; Nario-Redmond, 2010) by demonstrating that people with disabilities encounter similar levels of backlash for confronting patronizing help regardless of their gender. These results are also consistent with the ethnic-prominence perspective, which showed that, among individuals with multiple stigmatized identities (i.e., women of color), one devalued identity (i.e., racial/ethnic minority status) can play a more prominent role in shaping discrimination experiences than another devalued identity (i.e., female gender; Levin et al., 2002). Given that little empirical attention has been devoted to the intersection of disability and gender, these findings contribute to the general intersectionality literature and advance our understanding of the multifaceted experience of disability.

Additionally, our findings point to the varied lived experiences of people with different disabilities. Specifically, preliminary evidence from Study 2 indicated that blind people experienced greater interpersonal backlash than wheelchair users for confronting the same type of patronizing help and that nondisabled individuals perceived patronizing help as more appropriate when the target was blind versus using a wheelchair. As noted earlier, these results might have reflected participants’ perceptions of the specific ways we depicted patronizing help and should therefore be interpreted with caution. Nevertheless, they point to the possibility that members of the general public might view people who are blind as more dependent on others than people who use wheelchairs, which could have important psychosocial implications for blind people across various life domains (e.g., self-esteem, employment).

Taken together, the present research highlights the need for policymakers to incorporate people with diverse disabilities as key stakeholders when designing programs and services geared toward the disability community. Given that nondisabled individuals often fail to recognize subtle forms of ableism such as patronizing help (Dunn, 2019; Wang et al., 2015), programs and services based only on nondisabled perspectives may overlook such biases and inadvertently undermine the autonomy and agency of people with disabilities. Policies that lack disability community input may also underestimate the heterogeneous challenges faced by people with different disabilities, in light of the common misperception of people with disabilities as a homogeneous group (Fine & Asch, 1988; Nario-Redmond, 2010). Because the pervasiveness of patronizing help, and the significant backlash people with disabilities encounter when confronting such inappropriate treatment, is largely driven by stereotypes of people with disabilities as incompetent (Hebl & Kleck, 2000), individual-level interventions that disrupt such stereotypes and provide information about how to interact with people with disabilities (e.g., educational videos, positive equal-status contact with people with disabilities; see Lindsay & Edwards, 2013, for a systematic review on individual-level disability awareness interventions) are likely to be best suited to address these subtle yet pernicious forms of ableism. Nevertheless, considering that structural changes can often mitigate interpersonal expressions of prejudice (Cook, Purdie-Vaughns, Meyer, & Busch, 2014), we believe that a more disability-centered, inclusive policy climate can also play an important role in combating the pervasiveness and social acceptability of patronizing help.

Limitations and Future Directions

The present research is not without limitations. First, despite our efforts to recruit a more diverse sample in our second study than in our first by utilizing Amazon’s Mechanical Turk, both samples were predominantly White samples of convenience. Although we do not have compelling theoretical reasons to suspect that participant race/ethnicity would have a bearing on our findings, it is nonetheless important for future research to examine the generalizability of our results using more diverse samples.

Second, the present research was guided by the assumption that patronizing help, when directed toward people with disabilities, would be deemed more socially acceptable than if it were directed toward nondisabled individuals. This assumption was informed by previous research demonstrating that people with disabilities are often treated like helpless children. For example, when asking for directions on a college campus, confederates using a wheelchair received more concrete, redundant answers than did their nondisabled counterparts (Gouvier, Coon, Todd, & Fuller, 1994). Similarly, college students gave directions that resembled those they would give to a 12-year-old child (e.g., using more words, speaking louder and in a higher pitched voice) when under the impression that the recipient was an adult using a wheelchair, even when the adult was clearly identified as a working professional (Liesener & Mills, 1999). Nevertheless, future research could productively examine the perceptions of patronizing help toward nondisabled men and women, thus extending our test of the primary stigmatized identity perspective.

Another limitation of the present work concerns the utilization of hypothetical scenarios rather than real-time social interactions. Although it may be difficult for some participants to predict their real-life reactions with accuracy, the advantage, of course, of using scenarios is that they afford far greater control than do everyday social interactions. Furthermore, our repeated measures approach allowed participants to serve as their own controls, thereby minimizing the influence of noisy individual differences that may be relevant in real-world contexts. However, considering that people tend to be more receptive to confrontation in actual situations than when asked to predict their responses (Mallett & Wagner, 2011), it is possible that individuals who are presented with more realistic versions of the situations featured in the current scenarios might react less negatively to the confronting disabled target. Future research could assess this possibility using simulated or videotaped interactions.

Conclusions

People with disabilities represent a large segment of the general population (CDC, 2015), yet research investigating disability stigma and ableism remains underdeveloped. The present research provided a nuanced examination of the consequences of confronting unsolicited, inappropriate offers of help, one common form of ableism directed toward people with visible disabilities. Across two studies, we demonstrated that both men and women with physical and sensory disabilities encounter significant backlash when advocating for themselves in the face of patronizing help, suggesting that, from an intersectionality perspective, disability might play a larger role than gender in shaping the lived experience of people with disabilities. We also showed that, when confronting patronizing help, blind individuals might experience a greater backlash than individuals who used wheelchairs, though the extent of such cross-disability heterogeneity requires further exploration. Taken together, these findings underscore the importance of identifying effective interventions, both on the individual level and policy level, to combat interpersonal forms of ableism and to improve the quality of interactions between people with and without disabilities.

Biography

KATIE WANG, PhD, is an assistant professor in the Department of Social and Behavioral Sciences at the Yale School of Public Health. She received her PhD in Social Psychology at Yale University and completed a postdoctoral fellowship at the Center for Interdisciplinary Research on AIDS affiliated with the Yale School of Public Health. Dr. Wang’s research focuses on the role of stigma as a psychosocial determinant of health disparities across various marginalized populations, including people with physical disabilities and mental illnesses. She is also interested in developing interventions to mitigate the adverse impact of stigma on health by fostering adaptive coping and resilience among members of socially disadvantaged groups.

KESHIA WALKER is an undergraduate student at Indiana University – Purdue University of Indianapolis (IUPUI). Currently, Keshia is pursuing a degree in Psychology with a minor in Biology. This aligns with her Pre Medical academic ambitions. Keshia is a research assistant for Dr. Pietri and has worked in her Social Intervention and Attitudes lab since 2016. Her interests in gender biases and disability discrimination inspired her to also work on an Honor’s Capstone Thesis with Dr. Pietri and Dr. Ashburn-Nardo. Her general research interests include gender bias intervention, disability awareness and inclusion, and the promotion of diversity.

EVAVA PIETRI, PhD, is an Assistant Professor of Psychology at Indiana University – Purdue University Indianapolis (IUPUI). She received her PhD in Psychology at the Ohio State University. After receiving her PhD, Dr. Pietri completed a postdoctoral position at Yale University, during which she worked in the Psychology department and in the Center for Scientific Teaching. An overarching goal of her work is to investigate how basic processes in social cognition and attitudes influence a variety of domains that are pertinent to real-world issues. She aims to use theories and research from social psychology to guide the development of interventions, and much of her current research focuses on reducing biases and promoting diversity in science, technology, engineering, and mathematics (STEM) fields.

LESLIE ASHBURN-NARDO, PhD, is an Associate Professor of Psychology at Indiana University – Purdue University Indianapolis (IUPUI). She is also Director of IUPUI’s Applied Social and Organizational Psychology doctoral program and the Industrial/Organizational Psychology master’s program. Her work focuses on documenting the various ways that women, African Americans, and other under-represented groups are stigmatized; as well as individual strategies that stigmatized targets and their allies can use to reduce prejudice and foster inclusivity. Dr. Ashburn-Nardo is a Fellow of the Society of Experimental Social Psychology, the Midwestern Psychological Association, and the Society for the Psychological Study of Social Issues. Currently, she is a Consulting Editor for the journals Cultural Diversity and Ethnic Minority Psychology and Sex Roles.

Appendix A

Study 1 Vignette

Background information.

[Mary/Matt] is a 22-year-old college graduate. [She/he] lives on [her/his] own and has been working full-time at a local radio station for the past few months. [Mary/Matt] is blind and gets around by swinging a long white cane from side to side in front of [her/him]. To get to work, [she/he] has to walk about five blocks to the bus stop from home, but the route is pretty familiar and routine by now.

Confrontation vignette.

Although [Mary/Matt] is familiar with [her/his] route to work, one day [she/he] has to take a detour to the bus stop as [his/her] usual route is blocked by construction. As [he/she] approaches an unfamiliar street corner, [he/she] stops to confirm with a passerby that [his/her] bearings are correct and that the bus stop is located just one block from where [he/she] is standing. [Mary/Matt] addresses a nearby pedestrian: “Excuse me, can you see the bus stop for the 22? I think it’s over that way (points).” The pedestrian says, “Oh, this is a really busy street! It’s not safe for you to walk by yourself. Let me take you to the bus stop,” then grabs onto [Mary’s/Matt’s] arm and tries to steer [her/her] across the crosswalk. [Mary/Matt] then says, “Excuse me, I can handle myself just fine and was only trying to get some simple directions. Can you please just answer my question?!”

Appendix B

Study 2 Vignettes

Target who was blind.

Background.

[Mary/Matt] is a 22-year-old college graduate. [He/She] lives on [his/her] own and has been working full-time at a local radio station for the past few months. [Mary/Matt] is blind and gets around by swinging a long white cane from side to side in front of [him/her]. To get to work, [he/she] has to cross a busy multilane intersection. However, this is part of [Mary’s/Matt’s] regular work route, and [he/she] has to do this every day.

Confrontation Vignette.

“[Mary/Matt] is waiting to cross the street. A pedestrian approaches [him/her] and states “Oh, this is a really busy street! It’s not safe for you to cross by yourself. Here let me help you.” The pedestrian then grabs onto [Mary/Matt] arm and tries to steer her/him across the crosswalk. [Mary/Matt] then says, “Excuse me, I can handle myself just fine! I’m comfortable crossing the street on my own.”

Target who was in a wheelchair.

Background.

“[Mary/Matt] is a 22-year-old college graduate. [He/She] lives on [his/her] own and has been working full-time at a local radio station for the past few months. [Mary/Matt] is paralyzed from the waist down and gets around by using a manual wheelchair. To get to work, [he/she] has to cross a busy multilane intersection. However, this is part of [Mary’s/Matt’s] regular work route, and [he/she] has to do this every day.”

Confrontation Vignette.

“[Mary/Matt] is waiting to cross the street. A pedestrian approaches [him/her] and states “Oh, this is a really busy street! It’s not safe for you to cross by yourself. Here let me help you.” The pedestrian then grabs [Mary/Matt] wheelchair and tries to steer her/him across the crosswalk. [Mary/Matt] then says, “Excuse me, I can handle myself just fine! I’m comfortable crossing the street on my own.”