It can be argued that all research on stigma and stigmatisation is a footnote to the sociologist Erving Goffman. In a few short, elegantly written books (e.g. Goffman, 1968), he provided a wealth of ideas and insights, giving much inspiration to work on this topic. Goffman defined a ‘stigma’ as a mark or sign that not only sets a person apart from others but also leads to their devaluation. He distinguished between three types of stigma: ‘tribal identity’ (such as race, gender or religion); ‘character blemishes’ (such as mental illness or addiction); and what he called ‘abominations of the body’. Although today we would not wish to use such terms as ‘defects’, ‘abnormalities’ or ‘flaws’ to describe the bodies of people with physical differences, Goffman quite sensitively discussed the issues faced by people whose appearance or function has been compromised in some way.

One of Goffman's central ideas was that the mark or sign comes to take on ‘master’ status, becoming the most important characteristic of the affected individual. This is illustrated by the following description, given by a person with psoriasis. He is recalling a time when his psoriasis took on more importance in the eyes of others than his more relevant sporting skills and efforts: