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An invisible problem: stigma and FASD diagnosis in the health and justice professions

Katharine Dunbar Winsor (Department of Sociology and Anthropology, Concordia University, Montreal, Canada)

Advances in Dual Diagnosis

ISSN: 1757-0972

Article publication date: 11 November 2020

Issue publication date: 16 February 2021




Fetal alcohol spectrum disorder (FASD) is a complex lifelong disorder impacting the brain and body. Individuals with FASD may require lifelong supports and are at a higher risk of experiencing adverse outcomes, including incarceration. Individuals with FASD face stigma related to FASD that impacts disclosure of the diagnosis and access to supports. The prevalence of FASD exceeds that of other developmental disabilities, yet it remains less visible and stigmatized.


Interviews conducted with health-care and justice professionals in a Canadian province explore their experiences attending to FASD and challenges of stigma.


While difficult to access, diagnosis provides a pathway to supports and is crucial in the criminal justice process. Visibility and invisibility in health and justice systems highlight the lack of understanding of FASD and surrounding stigma. When unaddressed, individuals with FASD face additional challenges stemming from a lack of information and strategies by professionals involved in their lives.


Stigma represents a significant and complex issue intertwined in understandings of FASD. This research explores this relationship and the mechanisms through which FASD stigma has impacts in health-care and justice settings.



Funding information: Katherine Dunbar Winsor was funded by Memorial University at the time of data collection and initial writing.Declaration of conflicting interests: Katharine Dunbar Winsor declares no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.Katharine Dunbar Winsor thanks Adrienne Peters for her feedback on a previous version of this paper.Author contributions: Katharine Dunbar Winsor conceptualized, wrote and prepared this paper for publication.


Dunbar Winsor, K. (2021), "An invisible problem: stigma and FASD diagnosis in the health and justice professions", Advances in Dual Diagnosis, Vol. 14 No. 1, pp. 8-19.



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