Structural Injustice: Reflections on Social Groups, Identity and Intersectionality

The Special Issue "Structural Injustice: Reflections on Social Groups, Identity and Intersectionality", co-authored by Ingrid Salvatore and me, was published in the journal Phenomenology and Mind at the end of 2024. The volume investigates the ways in which oppression, marginalization, and misrecognition are determined and/or fostered by practices, social standards, and attitudes concerning intersectional identities and how we should conceptualize social groups against these circumstances. 

The various contributions, from different perspectives, tackle how forms of oppression can be directed toward individuals qua members of a specific group and can involve systemic forms of misrecognition often coupled with unwarranted biases regarding the epistemic credibility of these individuals (Dotson 2011; Fricker 2007). Many contributions reason upon how social discrimination against members of racialized, sexualized, or otherwise stigmatized and oppressed groups must be understood as institutional, structural, or systemic phenomena deeply embedded in the social system of our political societies. 

From this normative framework it follows that addressing injustices related to identity groups requires clarifying the self-reinforcing dynamics between structural disadvantages and identity-based prejudices. These forms of injustice take stock of the constrained position in which members of disadvantaged groups find themselves given the “unintended consequences of the combination of the actions of many people” (Young 2011, p. 53).

Not just bad luck;
disadvantaged groups often face the consequences
 of actions within unjust social structures.

The special issue illustrates the social dynamics impacting agents in making fundamental life decisions within the constraints of unjust social structures that restrict their options and capacity for critical reflection. The attempt by some of the contributions, then, is to outline a paradigm of social justice that aims to provide normative guidance for actual people, situated within their complex lives and interacting with societal structures and imperfect political institutions. From the perspective of disadvantaged social groups, multiple belonging invites intersectional philosophical and sociological investigation into how individuals can be victims of multiple injustices (Crenshaw 1989). But it also requires deeper philosophical research on personal identity and group belonging (Appiah 2006).

Specifically on the topic of epistemic injustice in healthcare, I think that the last section of the volume, Power, Social Oppression and Recognition, is of most interest. The section has a double goal: on the one hand, it is interested in laying out concrete instances of group discrimination related to specific ascriptive characteristics possessed by groups’ members and in proposing some justice-oriented remedies; on the other hand, this section delves into the notion of recognition, illustrating how helpful the recognition framework (Honneth 1996) is in identify instances of social injustice in contemporary societies.

In the context of mental illness and disabilities that impact the collective perception of agents’ epistemic capacities, it is essential to promote epistemic justice that improves relationships between speakers with mental disorders and people who care for them in society. On this specific topic, the volume presents two relevant contributions. 

First, the article by Christian Tewes, “Reconsidering the Double Empathy Problem”, addresses the exclusionary mechanisms directed towards autistic individuals, showing the deeply discriminating side-effects of neurotypical individuals and institutions projecting their implicit normative rules of behavior and assumptions onto autistic individuals. In so doing, Tewes argues that neurotypical individuals and institutions inaccurately ascribe a lack of empathetic understanding to autistic individuals, resulting in their exclusion, stigmatisation, and even traumatisation (Milton 2012). This analysis, employing a range of embodied-phenomenological perspectives, is illuminating in showing the often-overlooked exclusionary mechanisms activated, sometimes even involuntarily, by social norms and social conventions that are established mirroring the preferences, costumes, and ascriptive characteristics of members of the cultural majority (Galeotti 2017). 

On similar lines, a second contribution, by Donata Chiricò and Maria Tagarelli De Monte, “Hearing perspectives on deafness: a century-long form of power” illustrates the kind of structural exclusion and discrimination historically suffered by deaf and hear-impaired individuals. Through the powerful example of Charles-Michel L’Épée (1776), who founded a school where deaf individuals were treated equally to hearing individuals, the authors problematize the exclusionary dimension of spoken language for subjects precluded from it and the enduring implicit stigmatization that characterizes the historically established notion of “physical and cognitive normality”.

Federica Liveriero is associate professor of political philosophy at the Department of Political and Social Sciences of the University of Pavia. Liveriero's main areas of interest are normative theories of justice and legitimacy; democratic theory; social epistemology and oppression studies. She is interested in understanding what we owe to each other as fellow citizens in democratic settings, both practically and epistemically. You can see more about her publications and published monographs here.

Stigma as a Barrier to Self-Understanding

This blogpost is written by Alexander Edlich and Alfred Archer, writing about their recent paper in Social Epistemology entitled 'Rejecting Identities: Stigma and Hermeneutical Injustice'.

To seek, and accept, medical help, it is often necessary to realize that one needs it. Sometimes, however, people refuse to accept they need help, and this disables them from accessing medical resources. This refusal need not be due to stubbornness but can be the result of unjust social factors. In particular, we suggest that stigma can unjustly prevent people from making sense of their situation, including stigmatized illnesses. 

Take, for instance, the American writer Caroline Knapp’s account of her struggle to accept the idea that she was an alcoholic in her memoir Drinking: A Love Story. She describes how at times she was so drunk that she would ‘drive home with one eye shut, to avoid double vision’ (p. 54). 

After being advised by her therapist that she should stop drinking, she decided to attend an Alcoholics Anonymous meeting. Once in the meeting though, she felt a strong revulsion to accepting that she belonged there. As she describes it, she “looked around at the dingy room with the old men sipping coffee from foam cups and I thought, No way. No way in hell I’m doing this. This is not me. I do not belong here’ (pp. 190–191).

For Knapp to accept that she was an alcoholic would mean ‘owning up to flaws and imperfections and depths of confusion I was too ashamed to reveal’. This shame that she felt about her alcoholism was a response to the social stigma attached to it. Even when she had accepted her alcoholism and stopped drinking, Knapp continued to be very careful about which people she would discuss it with ‘for fear of being judged’ (p. 244). 

What prevented Knapp first from accepting and even longer from communicating about her situation was the stigma attached to alcoholism, and thus a social factor burdening those suffering from it. This made it harder for her to seek help.

The cover of Knapp's book

Knapp is far from alone in struggling with this, the stigma attached to alcoholism is a significant barrier to people seeking out medical assistance. This difficulty in accepting one’s addiction is a major problem, given that this acceptance is crucial for overcoming the addiction and also for seeking help in the first place.

While medical professionals are aware of the importance of reducing the stigma attached to medical conditions like addiction, the impact of stigma on self-understanding is not only practical, but, we argue, also creates a particular type of hermeneutical injustice: those whose experiences are stigmatized are unjustly made to reject helpful descriptions of their situation.

Hermeneutical injustice is the label philosophers use, coined by Miranda Fricker, to describe cases where the social practices of knowing, learning, and communicating are unjust so that persons in particular social positions are deprived of the means to make sense of their experiences. In paradigmatic cases, this occurs because dominant discourses do not include concepts that are needed to make sense of the experiences of marginally situated agents.  

For example, Fricker argues that before the development of the concept ‘sexual harassment’ people who experienced unwanted sexual attention in the workplace were not able to properly name their experiences. In this case, they were unfairly prevented from fully understanding the situation they were in because they lacked the concepts needed to articulate what it is they were experiencing, which, consequently, also disabled them from sharing their experiences. 

The stigma related to addiction (and other stigmatized experiences, like homosexuality or suffering intimate partner violence) also unfairly prevents people from making sense of their experiences but does so in a subtly different way. Here the conceptual resources are available to people. The concept of an alcoholic or an addict was available to Knapp and once she accepted that it applied to her, she was able to access the resources she needed to manage her addiction, including a supportive community of people struggling with the same problem. 

What prevented Knapp from accessing these resources was not the absence of a concept but the stigma that was attached to it. Knapp denied herself access to the hermeneutic resources that go with the label ‘alcoholic’ because of the stigma attached to this identity, which led her to refuse to accept that the label applied to her. In this way, stigma can unjustly cause people to reject helpful descriptions of their situation or identity.

To come to terms with a condition like addiction and to seek help about it, it is important to understand one’s situation and to accept it. Some people refuse such acceptance, and they can suffer gravely from it. This is a problem for medical practice, but, importantly, it can also be a problem of justice: to offer help, but also to treat people justly, we must make sure that stigma does not stand in the way of self-understanding.

Alexander Edlich completed his PhD at Ludwig-Maximilians-Universität Munich in 2023, where he then was a postdoctoral researcher. He works on moral responsibility (specifically blame, protest, and apology), the philosophy of emotions, and feminist and LGBTQ ethics.

Alfred Archer is Associate Professor of Philosophy at Tilburg University. He is interested in ethics, social philosophy, philosophy of sport, and moral psychology. He is the co-author of Honouring and Admiring the Immoral: An Ethical Guide (Routledge 2021), Why It’s OK to be a Sports Fan (Routledge 2024) and Extravagance and Misery: The Emotional Regime of Market Societies (OUP 2024).

Jodie Russell joins EPIC!

Welcome to Jodie Russell who will be joining project EPIC, working in Birmingham with Matthew Broome and Lisa Bortolotti. Here Jodie replies to some questions about her research.

Jodie Russell

Hi Jodie! What are your main research interests?

Hello there! I’m interested in the ways in which talking about and researching mental disorder shapes the very experience of mental disorder itself. I would describe myself as part philosopher of mind, philosopher of psychiatry and phenomenologist. 

Early in my PhD I was strongly inspired by Ian Hacking’s work in looping effects; he describes how the act of labelling a person can influence their behaviour, which in turn can change the meaning of the label. This also applies in the case of mental disorder categories, and I used my PhD project to try and get at the bottom of why and how this happens. 

My hypothesis is that looping effects are as a result of people trying to understand one another, where labelling is a way of learning about other people. When we label, I suggest, we (intentionally or unintentionally) encourage another’s behaviour to conform to certain norms and expectations about that label. 

For example, by labelling someone as a friend, that might come with expectations that they should do me certain favours (like keeping a secret). They could refuse, of course, but that might challenge the legitimacy of the label ‘friend’ and whether I actually understand the nature of our relationship! This is how social cognition works, according to the mind-shaping hypothesis; we understand each other’s minds through the norms and expectations we conform to. My contribution, however, is to describe how scientists and patients themselves ‘shape’ the minds of those with mental disorder, for good or for bad.

Why do you think it is important to study epistemic injustice in healthcare?

My research thus far has led me to the conclusion that the kinds of concepts and labels someone has access to can greatly influence how they behave. This can have good and bad effects; a mental disorder concept that implies that one must suffer if one has a mental disorder might lead to a person expecting a poor quality of life, which may itself lead to experiences of suffering and despondency. However, a concept of a particular mental disorder that captures a significant aspect of how it feels might make people feel understood and less alienated in society.

Identifying cases of epistemic injustice, I think, helps us steer away from the negative effects of social labelling and understanding, and steer our cognitive tools towards those concepts which not only help reduce the suffering of people with mental disorder but are also informed by their experiences directly. 

Studying epistemic injustice in healthcare not only helps us identify where particular concepts have been overlooked and where testimony has been excluded in cases of mental health, but the principle of epistemic justice can help rectify some of the historic harms of an overly narrow approach to healthcare where patients traditionally did not have much say in how they were treated and understood.

What are you working on right now?

Now I have completed my PhD, I’m developing its insights further in my current work to consider how mental disorder concepts overlap with other facets of our identity (such as race, gender, and age) where concepts may similarly apply in order to shape someone’s behaviour. My goal is to establish an intersectional, feminist approach to psychiatry that highlights how other aspects of one’s identity impact disorder experience, and vice versa.

I feel that in order to effectively tackle cases of epistemic injustice we should also consider the nuances of people’s identity; two people with psychosis, for example, will never have the exact same experience as they take up different roles and positions in the world. A young person with psychosis will face different kinds of challenges and may require different tools for understanding their experience than someone middle-aged, for instance. My goal is to capture these nuances and to make a case for this more intersectional approach.