Prejudice is a preconceived opinion or judgment formed without adequate knowledge or examination of the facts. It often relies on stereotypes—oversimplified generalizations about groups of people. For example, assuming that all women are overly emotional or that all older adults are technologically incompetent represents prejudicial thinking. Prejudice can operate both consciously and unconsciously, meaning people may hold and act on prejudicial beliefs without realizing they're doing so.
Prejudice and discrimination represent complex social problems that have led to systemic oppression, violence, and profound suffering throughout history. Working with a mental health professional can help individuals recognize and overcome their own prejudices, understand how discrimination affects their loved ones, and develop coping strategies for managing the psychological impact of living in a world where prejudice remains pervasive.
Table of Contents
- Understanding Prejudice and Its Mechanisms
- Discrimination: When Prejudice Becomes Action
- Types of Prejudice and Discrimination
- The Mental Health Impact
- Prejudice and Discrimination in Healthcare
- Addressing Prejudice in Therapy
- Frequently Asked Questions
- How Therapy Can Help
Understanding Prejudice and Its Mechanisms
Prejudice differs from discrimination and other forms of oppression like racism or sexism. While discrimination and oppression describe behaviors by dominant groups directed toward marginalized communities, prejudice can be held by anyone, regardless of their social position.
Prejudice shapes perception through a psychological process called confirmation bias—the tendency to notice and remember information that confirms existing beliefs while ignoring contradictory evidence. Contact's beneficial effects were at least as strong among individuals high (r = .19) as among individuals low (r = .18) in perceived threat. For instance, someone who believes that teenagers are irresponsible might focus on examples of teen recklessness while overlooking countless instances of responsible teenage behavior.
The Role of Social Context
Contact was associated with decreased prejudice and increased out-group positivity, in cross-sectional and longitudinal designs, among advantaged and disadvantaged group members, and in both Western, Educated, Industrialized, Rich, and Democratic (WEIRD) and non-WEIRD contexts. Social norms and cultural contexts significantly influence the types of prejudice people develop. In the United States, centuries of structural racism have created conditions where prejudicial attitudes against people of color are far more prevalent than prejudice against white people.
Research consistently demonstrates that increased exposure to diverse groups serves as a powerful antidote to prejudice. Two meta-analyses of correlational data from 34 studies (totaling 63,945 respondents drawn from 67 subsamples across 19 countries) showed that contact was associated with decreased prejudice, highlighting the importance of creating opportunities for meaningful intergroup contact.
Discrimination: When Prejudice Becomes Action
Discrimination refers to the unfair treatment of individuals or groups based on characteristics such as race, gender, age, sexual orientation, or disability status. Discrimination is the unfair or prejudicial treatment of people and groups based on characteristics such as race, gender, age, or sexual orientation, as well as things like disability status. While prejudice represents attitudes and beliefs, discrimination manifests as concrete actions or behaviors that disadvantage certain groups.
The Prejudice-Discrimination Connection
Although prejudice often leads to discrimination, the relationship isn't automatic or inevitable. Past research has identified many instances where intergroup behaviors can change without corresponding attitude change (e.g., Mousa, 2020; Scacco & Warren, 2018), illustrating that attitude change is not a requirement for reducing discriminatory behavior. Some individuals harbor prejudicial attitudes but consciously work to prevent these beliefs from influencing their behavior. Conversely, people may engage in discriminatory practices due to institutional policies or social pressures, even without holding strong personal prejudices.
When prejudicial beliefs become widespread within institutions, they can create patterns of systemic discrimination. For example, if hiring managers across an industry share age-based stereotypes about older workers being less adaptable, this can lead to widespread employment discrimination against older job seekers, regardless of their actual capabilities or qualifications.
Types of Prejudice and Discrimination
Racial Prejudice and Discrimination
Racial prejudice has deep historical roots in American society, with beliefs about racial inferiority used to justify slavery, colonization, and ongoing systemic oppression. Racism is an aspect of race, but it is really the application of racial prejudice with the use of power directed against those who are deemed inferior by individuals, institutional members, and leaders with the intentional and unintentional support and participation of the entire dominant racial-cultural group.
Contemporary manifestations include:
- There were 824 complaints based on color reported last year; this represents an increase of 35.30 percent
- There was a noticeably steep increase in the number of harassment complaints, particularly harassment based on color or race, which skyrocketed by 470.59 percent and 114.97 percent respectively
- A 2021 report on racial discrimination in the rental market from the National Bureau of Economic Research used more than 25,000 interactions with rental property managers across the 50 largest U.S. cities and found that Black and Hispanic renters continue to face discrimination in most of the cities
Gender-Based Prejudice and Healthcare Disparities
Gender bias significantly impacts healthcare delivery, particularly in pain management. Female patients are less likely than males to be prescribed pain-relief medications for the same complaints. A 2024 study demonstrated that female patients presenting to emergency departments were significantly less likely than male patients to receive analgesic medications—both opioid and non-opioid—even when reporting equivalent pain scores.
This disparity stems from deeply rooted stereotypes. Women exaggerate, men downplay: Gendered endorsement of emotional dramatization stereotypes contributes to gender bias in pain expectations. Healthcare providers may unconsciously believe that women's pain is psychological rather than physical, leading to:
- Longer wait times in emergency departments
- Prescription of sedatives instead of appropriate pain medication
- Dismissal of legitimate health concerns as "emotional" responses
LGBTQ+ Discrimination
The LGBTQ+ community faces substantial discrimination across multiple domains of life. In 2024, only 10 percent of LGBTQI+ people reported having excellent mental health, and only 11 percent reported being in excellent physical health. Recent data reveals:
- 23% of LGBTQ+ young people reported that they have been physically threatened or harmed in the past year due to either their sexual orientation or gender identity
- Discrimination affected the mental well-being of 52 percent of LGBTQI+ adults "significantly or more." This jumps to 61 percent for disabled LGBTQI+ adults and 74 percent for transgender adults
- LGBT adults face higher rates of discrimination and unfair treatment in their daily lives compared to non-LGBT adults, including in health care settings
Age Discrimination
Ageism affects people across the lifespan but particularly impacts older adults. More than 40% of workers over the age of 40 say they've experienced age discrimination at work in the last three years, according to a recent AARP survey. And nearly 40% cite ageism as their top concern when trying to look for work.
Research shows:
- Those who were older (57% of studies), with less education (64%), and of lower socioeconomic status (100%) reported higher rates of ageism
- Odds of negative health outcomes increased 59.0% to 110.5% with 1 SD increase in everyday ageism
- Age discrimination to be a "significant predictor of women's depressive symptoms and life satisfaction over the long term"
Disability Discrimination (Ableism)
Ableism refers to the presence of stereotypes, prejudices, and discrimination against older adults based on their age. In healthcare settings, it negatively impacts opportunities for treatment, rehabilitation, and cure opportunities. Recent research indicates:
- Ableism manifests differently depending on the nature of the individual's disability, their gender, and the social context
- Four in ten adults with disabilities experienced discrimination in healthcare settings, workplaces, or when applying for public benefits
- Mental healthcare providers often made assumptions that any mental health concerns stemmed directly from their disability rather than from life circumstances, trauma, or other factors unrelated to disability status
The Mental Health Impact
Direct Effects on Mental Health
The experience of discrimination has profound psychological consequences. They documented, with empirical evidence, that there were mental health effects as a consequence of discrimination. Mental health disparities have been magnified by recent acts of racism and discrimination and converging public health crises (for example, COVID-19 and youth mental health) that disproportionately affect populations that experience health disparities.
For marginalized communities, discrimination creates chronic stress that manifests as:
- Increased rates of depression and anxiety
- Post-traumatic stress symptoms
- Substance use as a coping mechanism
- Suicidal ideation and attempts
- Overall decreased life satisfaction
Intersectional Impacts
People with multiple marginalized identities face compounded discrimination effects. LGBTQ+ university students who identified as multiracial or other race were more likely to experience severe psychological distress compared to non-Hispanic White LGBTQ+ university students. This may be related to their unique intersectional experiences of discrimination and racism.
Protective Factors and Resilience
Despite these challenges, research identifies several protective factors:
- Strong social support networks
- Cultural identity and pride
- Shift-and-persist coping (reappraising and accepting an uncontrollable stressor while remaining optimistic about the future) has been shown to reduce depression and anxiety symptoms
- Access to culturally responsive mental health services
- Community activism and collective action
Prejudice and Discrimination in Healthcare
Healthcare settings, despite their mission to help and heal, often perpetuate discrimination. This creates particularly harmful dynamics because healthcare is essential for well-being, and discrimination in these settings can have life-threatening consequences.
Gender Bias in Medical Treatment
This discursive paper focuses on undergraduate medical education's role in tackling gender bias in clinical practice, specifically preventing and managing from a non-biomedical perspective chronic pain in women. A preliminary web search of medical schools' curricula was performed to identify program content related to gender bias in pain management. The web search, and the lack of response from the deans, highlighted that relevant curriculum components on gender bias and chronic pain needed to be implemented.
The consequences of gender bias in healthcare include:
- Misdiagnosis or delayed diagnosis
- Inadequate pain management
- Dismissal of symptoms as psychological
- Increased morbidity and mortality
Racial Disparities in Healthcare Access
Even taking into account different levels of mental health issues across racial/ethnic groups, existing evidence demonstrates glaring racial/ethnic disparities in mental health care use. One estimate found that rates of mental health care utilization among Black and Hispanic adults are less than half the rates of White adults and even lower among Asian Americans.
Barriers include:
- Financial, geographic, cultural, and linguistic obstacles
- Racial/ethnic minoritized people are more likely to experience discrimination by mental health care professionals as evidenced by audit studies showing major difficulties among Black and Hispanic adults in even securing mental health appointments
- Cultural misunderstandings and lack of culturally competent care
- Historical trauma and mistrust of medical institutions
LGBTQ+ Healthcare Discrimination
LGBTQ+ adults were more likely than their peers to postpone or not try to access medical care due to factors such as cost, discrimination, and insurance challenges in 2024. A higher proportion of LGBTQ+ adults postponed care when sick or injured because they could not afford it: 33 percent, compared with 15 percent of non-LGBTQ+ adults.
Additional challenges include:
- Nearly 80% of LGBTQ+ adults report that these gender-affirming care bans make them feel less safe and 43% of LGBTQ+ adults reported that gender-affirming care bans impact the physical and/or mental health of themselves or their loved ones. The impact of this legislation combined with a history of discrimination in healthcare settings has the potential to cause even more LGBTQ+ people to delay or avoid healthcare settings
- Lack of provider training on LGBTQ+ health needs
- Refusal of services based on religious or personal beliefs
- Misgendering and use of incorrect names/pronouns
Addressing Prejudice in Therapy
Recognizing Therapist Bias
Mental health professionals are not immune to prejudicial attitudes. Psychological therapists often lack sufficient knowledge, training, and confidence to sensitively manage conversations about racism. Common manifestations include:
- Minimizing experiences: Underestimating the impact of discrimination on clients' mental health
- Cultural incompetence: Lack of understanding about how cultural factors influence mental health and help-seeking
- Microaggressions: Subtle discriminatory comments or behaviors that harm the therapeutic relationship
- Diagnostic bias: Over-pathologizing normal responses to discrimination or attributing all problems to identity-related factors
Creating Inclusive Therapeutic Spaces
Effective therapy for clients experiencing discrimination requires:
- Cultural humility and ongoing self-reflection
- Understanding of how systemic oppression impacts mental health
- Validation of discrimination experiences
- Psychoeducation, skill development, and ethnoracial identity-based exercises to promote healthy coping, self-advocacy, and empowerment
- Collaborative treatment planning that addresses both individual and systemic factors
Addressing Internalized Prejudice
Clients may also seek therapy to address their own prejudicial attitudes. This work involves:
- Exploring the origins of prejudicial beliefs
- Examining how these beliefs impact relationships and behavior
- Developing empathy and perspective-taking skills
- Creating opportunities for positive intergroup contact
- Building accountability and commitment to change
Frequently Asked Questions
Q: What's the difference between prejudice and discrimination? A: Prejudice refers to attitudes, beliefs, and judgments about groups of people, often based on stereotypes. Discrimination is the behavioral manifestation—treating people unfairly based on their group membership. You can hold prejudices without discriminating, and discrimination can occur due to institutional policies even without personal prejudice.
Q: Can anyone experience prejudice? A: Yes, anyone can be the target of prejudicial attitudes. However, the impact varies significantly based on social power dynamics. Prejudice against historically marginalized groups is more likely to translate into systemic discrimination with serious life consequences.
Q: How does unconscious bias differ from conscious prejudice? A: Conscious prejudice involves awareness of one's negative attitudes toward certain groups. Unconscious or implicit bias operates outside of conscious awareness—people may genuinely believe they're unprejudiced while still showing biased behaviors in their actions, decisions, or physiological responses.
Q: What is intersectionality and why does it matter? A: Intersectionality recognizes that people have multiple, overlapping identities (race, gender, sexuality, disability status, etc.) that interact to shape their experiences. Someone who is both Black and LGBTQ+, for example, doesn't simply experience racism plus homophobia, but a unique form of discrimination that emerges from the intersection of these identities.
Q: How can I address my own prejudices? A: Start with self-reflection and education about different groups' experiences. Seek out positive contact with diverse people, consume media created by marginalized communities, examine your assumptions when they arise, and consider working with a therapist who specializes in diversity and inclusion issues. Remember that addressing prejudice is an ongoing process, not a destination.
Q: What should I do if I experience discrimination in healthcare? A: Document the incident with dates, times, and specific details. File a complaint with the healthcare facility's patient advocate or ombudsperson. You can also file complaints with state medical boards, insurance companies, or civil rights organizations. Consider finding a new provider and seeking support for any trauma resulting from the discrimination.
How Therapy Can Help
Mental health professionals can provide crucial support for both those experiencing discrimination and those working to overcome their own prejudices. Find a therapist who specializes in multicultural counseling, trauma-informed care, or specific identity-related concerns.
Therapy can help with:
- Processing experiences of discrimination and their impact
- Developing coping strategies for managing minority stress
- Building resilience and self-advocacy skills
- Healing from discrimination-related trauma
- Strengthening cultural identity and pride
- Addressing internalized oppression
- Creating action plans for systemic change
Remember that finding the right therapist is crucial—look for someone who demonstrates cultural competence, validates your experiences, and understands the role of systemic oppression in mental health.
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