[Twice disadvantaged? - Structural stigmatisation of those affected by SED injustice in health care]

Many of those who were politically persecuted in the GDR still suffer from the health, economic and psychosocial consequences to this day. Little research has been carried out into the after-effects of the state's deliberate stigmatization, through which people were assigned negative stereotypes, socially excluded and politically delegitimized. It can be assumed that structural stigmatization processes in particular continue to exist in institutional practices after the system change. Discrimination and different treatment of those affected can have far-reaching consequences, particularly in healthcare. In addition to a theoretical introduction to stigma research, the question of the extent to which those affected are still exposed to structural disadvantages in the healthcare system, what hurdles they experience and how they perceive them will be explored.As part of the qualitative study, 20 guided interviews with a high narrative component were conducted, transcribed in terms of content and semantics and then analysed using MAXQDA software and grounded theory methodology.The results make it clear that those affected by GDR injustice anticipate or experience structural stigmatization in the context of healthcare. In addition to the perception of general care problems, specific hurdles and requirements resulting from the experience of injustice in the GDR were described. In particular, competence barriers are mentioned in contact with professionals. Individual consequences for those affected can be seen on a psychological, emotional and behavioral level.The results make it clear that the health burdens experienced by those affected cannot be attributed solely to the injustice experienced in the GDR, but can also be exacerbated by the structural stigmatisation processes currently experienced in healthcare. Limitations and practical implications are discussed.There is an urgent need to sensitize professionals to these connections, also with regard to intersectional attributions of characteristics.