Content note: Healthcare discrimination; involuntary treatment; general medical stuff.
The idea that someone is weak or irresponsible, or that they deserve to have medical or other related problems, because they decide not to get medical treatment is a great big bucket of nope. Here’s a number of valid reasons for why people might not seek treatment, and why not to shame people over it:
Lack of money. Because at least in the U.S., medical treatment is still not free for the most part. It’s not even necessarily affordable for a lot of reasons, including the cost of insurance premiums, high deductibles that often come with more affordable health care plans, lack of coverage for certain forms of treatment, and specialists who refuse to take (a particular type of) insurance.
Circumstances that make taking the time or effort to get medical treatment unfeasible, which often comes down to a lack of money. This includes having a job that doesn’t allow a person to take sick leave; not having access to childcare; and not having access to transportation that would get a person to a facility that provides the sort of treatment they need.
Medical anxiety, including phobias and post-traumatic stress disorder. There may be some things that are not serious or urgent enough to be worth endangering a person’s mental health over if certain people, devices, procedures or environments are triggers for them. This applies especially in cases where violations of someone’s boundaries or bodily autonomy in a medical context is the source of their anxiety.
Experiencing disrespectful treatment or discrimination in medical contexts. Doctors and therapists can be and frequently are hostile to people who belong to certain groups, including but not limited to transgender people, fat people, asexual people, people with disabilities and women. People may also have (repeatedly) experienced poor treatment in specific medical situations, such as having doctors refuse to alter a procedure to be less painful or anxiety-inducing because it’s inconvenient, or being dismissed as drug seeking when trying to get medication.
Having reason to believe that they will be subject to coercive treatment or otherwise lose control over their circumstances if they seek out care. This especially applies to people with psychiatric disabilities, who risk being institutionalized if they seek out care during a mental health crisis. Another example is how some states still have laws allowing parents to lose custody of their children if they have a (certain kind of) disability, which may be a deterrent to getting diagnosed or otherwise identified as having a certain condition.
Knowing through research or experience that the recommended, or only, treatments available are ineffective or unfeasible. There’s a lot of reasons for why this could be, including having atypical reactions to medication or having another condition that makes a certain form of treatment dangerous or impossible. Unfortunately, doctors aren’t always open to hearing this. In some cases, there just aren’t any options (yet), or at least any that have a high likelihood of success.
Not experiencing the “problem” as a problem at all when it’s just something that’s unusual or stigmatized enough that it makes other people uncomfortable. For instance, a person can have an unusual appearance but not want plastic surgery, or engage in unusual but harmless behavior such as tics or stimming* that they don’t want to take medication or undergo therapy for.
Having a low pain tolerance. The necessity of a certain procedure or treatment regimen might or might not be worth it to a given person relative to the discomfort it might cause them, and they’re in the best position to do that cost-benefit analysis. Which leads me to the last point, which is…
It’s a person’s own goddamned body and brain (and none of your business). The only one who really knows what a person needs or can handle is that person themselves. In the end, they’ll be the one most affected by their decisions, for better or for worse.
I’m sure there’s reasons I’ve left out here. There’s probably a similar list of reasons for seeking out medical care that other people don’t approve of or believe is necessary, which would include the last point on this list. In either case, the overall point is the same: A person’s medical decisions are their own to make, and shame is not recognized as an effective form of treatment for any medical condition.
* Stimming comes from the term “self-stimulating behaviors,” which refers to things that autistic people do to seek or regulate sensory input. This includes but is not limited to flapping one’s hands, rocking back and forth, making certain sounds and chewing on things.