title: Stigma experiences in youth with facial differences: a multi-site study of adolescents and their mothers.
abstract: OBJECTIVE
  To describe stigma experiences of adolescents with congenital and acquired facial differences.
  
  
  METHODS
  Used baseline cross-sectional stigma-related responses from a four site (Seattle WA, Galveston TX, Chicago IL and Chapel Hill NC) US study enrolling 185 English speaking, US participants ages 1118 years old with facial differences (60% male; 80% congenital conditions). Closed-ended, self-administered questions drawn from the Youth Quality of Life Instrument Facial Differences Module (YQOL-FD) determined perceptions of stigmatization. Mothers (n=153) were independently asked seven matching questions.
  
  
  RESULTS
  Frequencies report combined responses of 'sometimes,' 'fairly often,' and 'very often.' Mother's responses are in parentheses. *35% (47%) noticed people staring at their face in the past week. * 28% (43%) talked with others about how their face looks in the past month. * 29% (31%) heard others say something about their face in the past month. * 32% (32%) told peers about their facial difference in the past month. * 12% (12%) felt left out of doing things with peers because of how their face looks in the past month. * 11% (8%) got into a fight because of how their face looks in the past month. * 20% (18%) were teased about how their face looks in the past month.
  
  
  CONCLUSIONS
  Stigma experiences were frequently reported by youth with facial differences and were correlated with independent parental report. This level of stigma suggests that media and public health interventions may be warranted to reduce discrimination, prejudice and negative adolescent social experiences related to facial difference.
authors.affiliation: Department of Dental Ecology, University of North Carolina, Chapel Hill, NC 27599-7450, USA. ron_strauss@unc.edu
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Strauss
authors.forename: Barry L
authors.initials: BL
authors.lastname: Ramsey
authors.forename: Todd C
authors.initials: TC
authors.lastname: Edwards
authors.forename: Tari D
authors.initials: TD
authors.lastname: Topolski
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Kapp-Simon
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Thomas
authors.forename: Carla
authors.initials: C
authors.lastname: Fenson
authors.forename: Donald L
authors.initials: DL
authors.lastname: Patrick
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D019465:Craniofacial Abnormalities / Q000523:psychology*; D003430:Cross-Sectional Studies; D005151:Facial Injuries / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009035:Mothers / Q000523:psychology; D011287:Prejudice; D011788:Quality of Life; D012649:Self Concept; D012934:Social Isolation; D013240:Stereotyping; D011795:Surveys and Questionnaires