Microaggressions have big impacts for disabled users online

Originally published by Cornell University Cornell Ann S. Bowers College of Computing and Information Science

By Patricia Waldron

In person, people with disabilities often experience microaggressions – comments or subtle insults based on stereotypes – but similar interactions, as well as new types of microaggressions, play out online as well.

A new study by researchers at Cornell and Michigan State University finds that those constant online slights add up. Interviews revealed that microaggressions affect their self-esteem and change how people with disabilities use social media. Ideally, digital tools will one day reduce the burden for marginalized users, but due to their subtlety, microaggressions can be hard for algorithms to detect.

“This paper brings a new perspective on how social interactions shape what equitable access means online and in the digital world,” said Sharon Heung, a doctoral student in information science. Heung presented the study, “Nothing Micro About It: Examining Ableist Microaggressions on Social Media,” Oct. 26 at ASSETS 2022, the Association for Computing Machinery SIGACCESS Conference on Computers and Accessibility.

Previously, little was known about online microaggressions. “If you look at the discourse around harms emanating from social media use by communities that are vulnerable, there is almost no work that focuses on people with disabilities,” said co-author Aditya Vashistha, assistant professor of information science in the Cornell Ann S. Bowers College of Computing and Information Science. “It’s surprising because about one in seven people in the world has a disability.”

When microaggressions occur in live settings, they are often ephemeral, with few bystanders. In contrast, “when they happen on social media platforms, it’s happening in front of a large audience – the scale is completely different,” said Vashistha, “and then they live on, for people to see forever.”

Additionally, social media platforms can amplify microaggressions, potentially spreading misinformation. “Online microaggressions have the ability to shape the understandings of disability for a lot of people who are not even involved in the situation,” said co-author Megh Marathe, assistant professor of media, information, bioethics, and social justice at Michigan State. “We’re very concerned about how it’s shaping the way the broader audience thinks about disability and disabled people.”

Heung and co-author Mahika Phutane, a doctoral student in computer science, interviewed 20 volunteers who self-identified as having various disabilities, and who were active on social media platforms. They asked the participants to describe subtle discrimination and microaggressions they had experienced, and the impact on their lives.

Patronizing comments like, “You’re so inspiring,” were the most common, along with infantilizing posts, like “Oh, you live by yourself?” People also asked inappropriate questions about users’ personal lives and made assumptions about what the person could do or wear based on their disability. Some users were told they were lying about their disability, or that they didn’t have one, especially if that disability was invisible, such as a mental health condition.

The researchers categorized the responses into 12 types of microaggressions. Most fit into categories previously recognized in offline interactions, but two were unique to social media. The first was “ghosting,” or ignored posts. The second was ways that the platform was inaccessible for people with various disabilities. For example, some users said they felt unwelcome when people did not add alt text to photos or used text colors they couldn’t discern. One person with dwarfism said her posts were continually removed because she kept getting flagged as a minor.

After experiencing a microaggression, users had to make the tough choice of how to respond. Regardless of whether they ignored the comment, reported it, or used the opportunity to educate the other person, participants said it took an emotional toll and damaged their self esteem. Many took breaks from social media or limited the information they shared online to protect themselves.

“Addressing this problem is really hard,” said Phutane. “Social media is driven to promote engagement, right? If they educate the perpetrator, then that original post will just get more and more promoted.”

Most social media platforms already have moderation tools, but reporting systems are sometimes flawed, lack transparency, and can misidentify harassment. The participants proposed that platforms should automatically detect and delete microaggressions, or a bot could pop up with information about disabilities. 

However, microaggressions can be hard for automated systems to detect. Unlike hate speech, where algorithms can search for specific words, microaggressions are more nuanced and context-dependent.

Once the scope and types of microaggressions experienced by people from various marginalized groups are better understood, the researchers think tools can be developed to limit the burden of dealing with them. These issues are important to address, especially with the potential expansion of virtual reality and the “metaverse.”

“We need to be especially vigilant and conscious of how these real-world interactions get transferred over to online settings,” said co-author Shiri Azenkot, associate professor of information science at the Jacobs Technion-Cornell Institute at Cornell Tech and Cornell Bowers CIS. “It’s not just social media interactions – we’re also going to see more interactions in virtual spaces.”

This work was partially supported by the National Science Foundation Graduate Research Fellowship and the University of California President’s Postdoctoral Fellowship.

Patricia Waldron is a writer for the Cornell Ann S. Bowers College of Computing and Information Science.

Dr. Cabrera co-authors commentary in ‘AJOB Neuroscience’ neuroethics issue

Laura Cabrera photoCenter Assistant Professor Dr. Laura Cabrera and Dr. Robyn Bluhm, Associate Professor in the Department of Philosophy and Lyman Briggs College, are co-authors of a commentary published in the latest issue of AJOB Neuroscience.

In “Fostering Neuroethics Integration: Disciplines, Methods, and Frameworks,” Drs. Cabrera and Bluhm comment on two papers that are part of the journal’s special issue on the BRAIN 2.0 Neuroethics roadmap.

Drs. Cabrera and Bluhm are co-investigators on an ongoing NIH BRAIN Initiative project,
“Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions.”

The full text is available online via Taylor & Francis Online (MSU Library or other institutional access may be required to view this article).

Brittany Ajegba presents at Diversity in Medicine Conference

In early March, College of Human Medicine student Brittany Ajegba presented at the second annual Diversity in Medicine Conference at the University of Michigan in Ann Arbor. Ajegba presented a poster titled “Rationales for expanding minority physician representation in the workforce: a scoping review.” The poster presented the work of a multi-institution research team comprised of Karen Kelly-Blake (MSU), Libby Bogdan-Lovis (MSU), Nanibaa’ Garrison (UCLA), Faith Fletcher (University of Alabama at Birmingham), Brittany Ajegba (MSU), Nichole Smith (University of Chicago), and Morgan Brafford (Walden University). The team’s scoping review of the same name was published in the September 2018 issue of Medical Education.

Ajegba shared her experience on attending: “I was so happy I was able to attend and present at the [conference]. While I got to present on our physician-patient racial/ethnic concordance research, it was great to see what researchers from around the country are doing to address underrepresentation in medicine. Being from the area, it was nice to reconnect with future colleagues and to see what work was being done around various topics of diversity in medicine that included but was not limited to: unconscious bias projects, pipeline programs, LGBTQ+ healthcare, and much more.”

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Image description: Brittany Ajegba smiles next to her poster that is pinned on a display board at the Diversity in Medicine Conference. Photo courtesy of Brittany Ajegba.

The team’s poster presented findings of their scoping review of the 2000-2015 literature on strategies for and approaches to expanding underrepresented minority (URM) representation in medicine, “which reveals a repetitive, amplifying message of URM physician service commitment to vulnerable populations in medically underserved communities. Such message repetition reinforces policies and practices that might limit the full scope of URM practice, research and leadership opportunities in medicine. Cross-nationally, service commitment and patient-physician concordance benefits admittedly respond to recognized societal need, yet there is an associated risk for instrumentally singling out members of URMs to fulfill that need. Additionally, the proceedings of a 2001 US Institute of Medicine symposium warned against creating a deterministic expectation that URM physicians provide care to minority populations.”

Listen to Episode 6 of our podcast series No Easy Answers in Bioethics, featuring Libby Bogdan-Lovis and Dr. Karen Kelly-Blake, to learn more about this ongoing research.

Dr. Cabrera gives community talk on psychiatric neurosurgery

Laura Cabrera photoOn February 18, Center Assistant Professor Dr. Laura Cabrera presented a talk entitled “The ethics of psychiatric neurosurgery” at Schuler Books & Music in Okemos. The event was part of the Cafe Scientifique series presented by the Lansing Community College Science Department.

In her presentation Dr. Cabrera shared results from her Science and Society at State grant with the audience, and discussed how the insights from that project led to her current NIH-funded project, “Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions.” The presentation also highlighted the role of neuroethics in examining and addressing public perceptions and values around psychiatric neurosurgery.

Visit the Lansing Community College website for information on future Cafe Scientifique events, which are free to attend and open to the public.

Dr. Laura Cabrera presents at 1st International Bioethics Congress

Laura Cabrera photoCenter for Ethics Assistant Professor Dr. Laura Cabrera traveled to Mexico City earlier this month to give a keynote presentation at the 1st International Bioethics Congress: Knowledge, Law and New Technologies in Health.

Dr. Cabrera’s presentation, “Neuroethical Aspects of Psychiatric Neurosurgery,” gave an overview of her work as part of the NEURON Consortium with Dr. Judy Illes (University of British Columbia) on media and public perceptions around psychiatric neurosurgery. The congress had several parallel tracks touching on a variety of important bioethics topics, including neuroethics, nanomedicine, clinical ethics, research ethics, biolaw, medical devices regulation, and translational medicine.

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Image description: Dr. Laura Cabrera stands while presenting her talk to attendees at the 1st International Bioethics Congress in Mexico City. Photo courtesy of Laura Cabrera.

Dr. Cabrera presents at International Neuroscience Society annual meeting

Laura Cabrera photoLast month Center Assistant Professor Dr. Laura Cabrera presented at the International Neuroethics Society (INS) Annual Meeting in Chicago. The meeting theme, “Mapping Neuroethics: An Expanded Vision” resulted in a gathering of a truly diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science.

Dr. Cabrera participated in the panel “Incapable Patients and Psychiatric Neurosurgery: What do Law and Ethics Have to Say?”, discussing the regulatory and ethical landscape around psychiatric neurosurgery. Additionally, Dr. Cabrera had two posters discussing results from her NEURON collaboration with Dr. Judy Illes (University of British Columbia), and two posters discussing results from her NIH BRAIN Initiative grant on psychiatric electroceutical interventions. Undergraduate research assistants Emily Castillo and Marissa Cortright were there to present the posters discussing results from the developmental stage of the ongoing NIH BRAIN project. They are pictured below with the posters “Public Views About Treating Depression Across Four Treatment Modalities” and “Perceived Invasiveness of Psychiatric Electroceutical Interventions as Treatment for Clinical Depression.”

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Marissa Cortright with the poster “Public Views About Treating Depression Across Four Treatment Modalities.” Photo courtesy of Emily Castillo.

Emily Castillo with poster at INS 2019
Emily Castillo with the poster “Perceived Invasiveness of Psychiatric Electroceutical Interventions as Treatment for Clinical Depression.” Photo courtesy of Emily Castillo.

Students present research findings at 9th annual Mid-Michigan Symposium for Undergraduate Research Experiences

Michigan State University students Marissa Cortright and Emily Castillo presented a poster at the 9th annual Mid-Michigan Symposium for Undergraduate Research Experiences (Mid-SURE), held July 24 at Spartan Stadium. Their poster, “Perceived Invasiveness of Psychiatric Electroceutical Interventions as Treatment for Clinical Depression,” presented research from an ongoing NIH BRAIN Initiative grant related to the ethical concerns and attitudes toward the use of psychiatric electroceutical interventions (PEIs) in treatment resistant depression.

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Image description: Emily Castillo (left) and Marissa Cortright (right) pose for a photo with their poster at Mid-SURE on July 24. Photo courtesy of Peggy Anderson.

Cortright and Castillo, who are both majoring in neuroscience, have been working with MSU faculty mentors Laura Cabrera, Robyn Bluhm, Aaron McCright, and Eric Achytes. Their poster specifically addressed the invasiveness of multiple PEIs­—electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and adaptive brain implants (ABI)—based on the analysis of semi-structured interviews with Michigan-based psychiatrists. Cortright and Castillo concluded that the results of the interview analysis “suggest that while physical features are key for assessments of invasiveness, psychological, emotional, and lifestyle effects also play an important role.”

Cortright and Castillo both enjoyed the experience of presenting at Mid-SURE. “It provided a positive and engaging environment to share my work on the project as well as develop my professional skills,” said Castillo, adding, “I left the day feeling inspired and excited to keep working on a topic that is not only important me, but relevant and meaningful to many others.”

With attendees and presenters from many institutions and disciplines, Mid-SURE provided an opportunity to share research and network with a wide variety of individuals. “Many people were excited to learn about the PEIs and the potential to help lots of patients with treatment resistant depression,” said Cortright. “I learned that many people were interested in other segments of our project, and were anticipating the further research and results. I also learned that many people had no idea that PEIs even existed, and were extremely interested in the psychiatrist perspective on these therapies.”

“By sharing the research findings, I learned how different backgrounds can influence how data is interpreted across different disciplines,” said Castillo. “For example, I had an interesting conversation with a chemist who was curious about how the use of magnets or electrical stimulation can alter the chemical balance of the brain and how that relates to invasiveness. I thought this was an interesting question and enjoyed learning about how he interpreted the data coming from a chemistry background.”

Castillo continued: “My interactions with the other students and professors sparked great conversations about the stigma surrounding PEIs and mental illness. It reminded me how critical this research is in educating the public and informing future guidelines and policies surrounding these treatments.”

As the second year of the project approaches, Cortright and Castillo look forward to continuing the research and analysis. “I’m looking forward to looking deeper into the other neuroethical considerations and understanding how these topics vary between psychiatrists, patients, and the general public,” shared Castillo.

Please visit the project webpage to learn more about the NIH BRAIN Initiative grant “Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions,” led by Center Assistant Professor Dr. Laura Cabrera.

Listen: Activating and Empowering Patients

No Easy Answers in Bioethics logoNo Easy Answers in Bioethics Episode 15

How can shared decision-making tools and evidence-based guidelines be used to ensure that every patient receives the best care possible? How can patients be activated and equipped to interact with their provider and manage their health condition? In this episode, three Michigan State University researchers—Dr. Bill Hart-Davidson, Professor in the Department of Writing, Rhetoric, and American Cultures, Dr. Karen Kelly-Blake, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Medicine, and Dr. Ade Olomu, Professor of Medicine in the Department of Medicine—discuss a shared decision-making tool they developed called Office-GAP, Office-Guidelines Applied to Practice. Together they discuss the origins of the project, and the results so far in improving outcomes for patients managing chronic illness by using a simple checklist to get patients and providers on the same page.

Ways to Listen

This episode was produced and edited by Liz McDaniel in the Center for Ethics. Music: “While We Walk (2004)” by Antony Raijekov via Free Music Archive, licensed under a Attribution-NonCommercial-ShareAlike License. Full episode transcript available.

About: No Easy Answers in Bioethics is a podcast series from the Center for Ethics and Humanities in the Life Sciences in the Michigan State University College of Human Medicine. Each month Center for Ethics faculty and their collaborators discuss their ongoing work and research across many areas of bioethics. Episodes are hosted by H-Net: Humanities and Social Sciences Online.

Assistant Director Libby Bogdan-Lovis a co-investigator on breastfeeding project

Libby Bogdan-Lovis photoCenter for Ethics Assistant Director Libby Bogdan-Lovis is a co-investigator on the project “Buffers, Barriers, and Resiliency in Breastfeeding Behaviors of Asian American Mothers.” The project is funded by the Trifecta Initiative for Interdisciplinary Health Research, a collaboration between the Colleges of Communication Arts & Sciences, Engineering, and Nursing at Michigan State University.

The interdisciplinary research team includes principal investigator Joanne Goldbort of the College of Nursing, Mary Bresnahan of the College of Communication Arts & Sciences, and Jie Zhuang of the Bob Schieffer College of Communication at Texas Christian University.

Project Summary: While Asian American (AA) mothers are described as high initiators of breastfeeding, no previous studies have conducted a randomized trial of AA mothers’ breastfeeding and formula use behaviors and whether these mothers continue to breastfeed exclusively for the recommended six months. Using an online Qualtrics customized panel, we will conduct a systematic investigation of the breastfeeding behaviors and timing of the introduction of complementary foods, and use of formula of AA mothers over a one-year period. We will recruit 1200 women between the ages of 18 and 35, as follows: 400 AA mothers with children one-year or younger; 400 pregnant AA women; and 400 American mothers from all race/ethnic groups will serve as the control group. This longitudinal study will track pregnant AA women through the birth of their babies, and will assess breastfeeding support and behaviors after the initial data collection, at 3-months, 6-months, and at one-year.

Visit our website to learn more about current research projects in the Center for Ethics and Humanities in the Life Sciences.

Dr. Kelly-Blake a co-author of new article in ‘Health Services Research and Managerial Epidemiology’

Karen Kelly-Blake photoCenter Assistant Professor Dr. Karen Kelly-Blake is co-author of an article published in Health Services Research and Managerial Epidemiology, “Sex Differences in Statin Prescribing in Diabetic and Heart Disease Patients in FQHCs: A Comparison of the ATPIII and 2013 ACC/AHA Cholesterol Guidelines.”

The team of Michigan State University College of Human Medicine researchers, Nazia Naz S. Khan, Karen Kelly-Blake, Zhehui Luo, and Adesuwa Olomu, found statin underprescribing for both men and women with atherosclerotic cardiovascular disease and diabetes mellitus in Federally Qualified Health Centers.

The full text is available online with open access via Sage Journals.