Civil rights experiences.

In alignment with the ADA, we defined civil rights experiences as experiences affecting the equal rights of service dog partners to access the same spaces, entities, and services as non-disabled individuals. Civil rights experiences were discussed in 35% of empirical articles [20,21,38–47] (Table 3). Of 12 eligible articles (published between 1993 and 2023), none used a standardized or validated measure to evaluate civil rights experiences. Instead, they relied on unstandardized survey questions or qualitative data collection.

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Table 3. Empirical article social experience findings.

https://doi.org/10.1371/journal.pone.0313864.t003

In 100% of cases, reported civil rights experiences linked to service dog partnerships were self-reported access denials or service refusals; no articles noted improvements or benefits in this domain. Most of these articles (83%; 10/12) specified the percentage of participants who encountered civil rights issues, ranging from 11% to 100% of study participants. Across the cumulative sample of these ten studies, we calculated that 37% of the total participants (102/276) reported experiencing access denials or service refusals. The wide range in the number of participants reporting access denials may be partially attributable to the varied methodology employed in each study: while some studies explicitly inquired about access denials, others only recorded instances where participants brought up access issues spontaneously. Access denials were reported by participants in a broad range of settings, including business entities, air and ground transportation, schools, and workplaces [e.g., 38,40,42,43,46].

A Pearson correlation identified no significant relationship between publication year and the percentage of participants reporting civil rights issues (r = 0.30, [95% CI: –0.41, 0.78], p = .399). However, the wide confidence interval (likely due to the small sample of 10 articles) reflects high uncertainty in the estimate.

Perceived stigma & discrimination.

We defined stigma and discrimination as negative attitudes [48] or treatment [49] of service dog partners due to their disability or – by extension – due to their status as a service dog partner. Slightly more than half of empirical articles (56%; published between 1993 and 2023) measured or discussed experiences of perceived stigma and discrimination other than (or in addition to) access or service denials (Table 3). One article used a modified version of a standardized measure, the Everyday Discrimination Scale, to measure self-reported discrimination [19]. No other studies employ standardized, validated measures to assess experiences of perceived stigma or discrimination. Instead, these reports were captured through open-ended surveys or qualitative surveys and interviews.

Among the 19 articles with stigma and discrimination-related findings, five studies (26%) reported service dog partners experiencing decreased stigma or discrimination compared to their experiences before service dog partnership [39,44,50–52]. After service dog partnership, these study participants felt more accepted and less judged or stigmatized by members of the public. For example, in one study, participants reported that service dog partnership shifted others’ attention toward the service dog and away from their disabilities or adaptive equipment (50). Similarly, two studies of service dogs for children with autism found that participants experienced less judgment and stigma from members of the public during service dog partnerships than they had previously [51,52].

An additional four studies (21%) reported mixed findings regarding experiences of stigma and discrimination [43,45,46,53]. For example, although one study’s participants described how their guide dogs could elicit stigma, they experienced guide dog partnership as less stigmatizing than using a white cane [45]. In another study, service dog partners reported barriers to public access requiring self-advocacy and education; on the other hand, they also reported a greater sense of belonging and more friendliness from strangers [46].

Finally, ten articles (53%) noted service dog partners reporting more stigma and discrimination following service dog partnership [19,20,38,41,42,54–56]. This included questioning the service dog’s legitimacy, skepticism about the individual’s disability, intrusive questions, insensitive comments, staring, perceived microaggressions (e.g., telling the person they are “lucky” or that it is “cool” that they can bring their dog with them), and other customers or coworkers not wanting a dog present. Individuals seeking service dog partnerships may not always be prepared for these types of adverse experiences. For example, in one study, 44% of participants with a service dog reported adverse experiences in public, while only 22% of participants on the waitlist to receive a service dog expected to face problems [21]. Most concerningly, participants in several studies described overtly aggressive behavior from members of the public or business employees, including verbal threats and violence towards the service dog partner or their service dog [47,54]. Finally, intersectional identities may compound experiences of stigma and discrimination. For example, one study identified that younger participants and participants self-identifying as female were more likely to experience questioned legitimacy [19].

While it seems that most instances of stigma and discrimination towards service dog partnerships came from non-disabled people, this was not always the case. Stigma against service dogs can also exist within disabled communities themselves. For example, some Deaf and blind people may hold cultural stigmas against hearing or guide dog partnerships due to concerns that (1) the partnership might make them appear “disabled,” whereas not all members of these communities identify as disabled in the first place, and (2) service dog partnerships could potentially generate further barriers to equal societal participation for those individuals both with and without dogs [57,58].

There was no significant association between experiences of stigma (positive, mixed, or negative) and the publication year (F(1,17) = 3.13, p = .095).

Broader social experiences.

We defined broader social experiences as any outcome related to service dog partners’ social integration, participation, support, or functioning within their communities (other than experiences of access denials, stigma, and discrimination). Most empirical articles (88%; 30/34, published between 1987 and 2023) reported findings in this domain (Table 3). Out of the 16 studies with quantitative components reporting broader social experiences, 7 (44%) employed standardized, validated measures when assessing social experiences. One measure, the Craig Handicap Assessment Reporting Technique (CHART) Social Integration Subscale, was used in two studies (13%). All other measures were only used in one study and included: the Community Integration Questionnaire (CIQ), the Survey of Social Behavior Patterns – Friend and Social Participation Subscales, the Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Activities, the PROMIS Social Isolation, the Work Productivity and Activity Impairment (WPAI) Questionnaire, the revised Social Connectedness Scale (SCS-R), the Pediatric Quality of Life (PedsQL) Social Functioning and Work/School Functioning scales, and the Adaptive Behavior Assessment System – Second Edition (ABAS-II).

Of these 30 articles, one (3%) reported worse social outcomes for service dog partners [56]; three (10%) reported null findings [59–61]; and 15 (50%) reported mixed findings [16,17,20,21,38,40,42–46,51,54,55,62]. Finally, 11 articles (37%) reported positive social outcomes [39,47,50,52,63–69].

Specifically, 60% of articles found that service dog partners had more social interactions or approaches, attributed to the dog’s functioning as a “social bridge” promoting positive connection. However, more interaction was not always equated with a positive outcome; 33% of articles found that the extra attention due to a service dog could be inconvenient, overwhelming, or even a nuisance, requiring additional time management, planning, and anticipatory problem-solving from the service dog partner. Half of the articles assessed social interaction quality in some way, finding that interactions were generally positive, with people being nicer and service dog partners receiving more smiles and friendly glances. However, again, interactions were not universally experienced as positive by service dog partners. Some articles (23%) highlighted challenges, such as others wanting to pet, feed, or distract the service dog. Additionally, in 10% of articles, some service dog partners reported feeling overshadowed by the dog, as others would greet only the dog or know the dog’s name better than the human partner’s name. Finally, there were mixed findings surrounding social participation. Some articles (23%) found service dog partnerships were related to more social participation, including more days of school attendance, leaving home more, and greater activity participation. In contrast, some articles reported mixed (10%), null (3%), or even negative (7%) findings, such as problems with fraudulent service dog encounters and lower occupational self-sufficiency, more travel-related challenges, and lower odds of leaving home compared to those without service dogs.

Adverse social experiences.

As discussed, while service dog partnership was associated with increased quantity and quality of the human partners’ social interactions in some respects, concerns for the social well-being of service dog partners were also noted. Some service dog partners reported routinely encountering inconvenience, unwanted attention, and rude or poor behavior from others when with their service dogs in public settings. Moreover, there were numerous reports of service dog partners experiencing stigma, discrimination, and access denials in public settings – so much so that these are suggested to be defining experiences for members of an “assistance dog sub-culture” within the broader disability community [57]. This sub-culture – the service dog community – offers empathy and essential support to its members who have faced various challenges, from microaggressions and intrusive questioning to outright access denials or service refusals [54]. Beyond community support, legal cases have also arisen from access issues in various settings, with varying outcomes [e.g., 11,70].

Importantly, while service dog partners were often disadvantaged and minoritized in these situations, they were certainly not helpless victims. Service dog partners reported that advocating for themselves, often through educating themselves and others about their rights, enabled them to work through potential access denials in some instances [45,46,50]. Many participants also reported feeling a responsibility – for some, an intense pressure – to be good advocates and representatives for the service dog community more broadly [21,41,43]; engaging in this type of advocacy can be empowering for service dog partners and foster community advocacy [57].

However, advocacy alone may not always be sufficient to prevent access denials. For some participants, the continual experience of stereotype threat, frequent need for self-advocacy, and ongoing attention surrounding the service dog (and, by extension, the person’s disability) was linked to burnout and advocacy fatigue [53,54]. In fact, service dog partners in several studies described finding negative experiences in public so unpleasant that they avoided going out in public or preferred to leave the service dog home rather than deal with these challenges, potentially compromising their health and safety [19,39,51,53]. These experiences may, at least in part, provide some explanation for the mixed social participation findings reported by empirical articles.

Contributing factors.

Proposed solutions.

Based on the reviewed articles, several solutions have been recommended to address concerns about the rights and well-being of service dog teams and suggested that a multi-faceted approach was likely needed [74].

The lived experiences of service dog partners.

The findings from this review support qualitative reports from service dog partners, who have shared their lived experiences of discrimination and marginalization [22]. In the absence of uniform construct measurement across the articles in this review, it is difficult to know the true magnitude of the aforementioned problems; however, there are clear patterns and consistent reports of adverse social experiences across a wide range of service dog placement types.

Undoubtedly, service dog partnership offers a multitude of biopsychosocial benefits that should not be disregarded: some participants in these studies reported decreased stigma, improved social interaction quantity and quality, and increased social participation, while the broader service dog literature has also identified benefits to physical and psychosocial well-being [e.g., 32,34,76]. However, service dog partnerships can also involve challenges and adverse experiences in public settings, ranging from inconvenience to overt civil rights violations, which may diminish the overall benefits. We must not simply view these challenges as inevitable consequences or “side effects” to service dog partnerships, nor rely solely on the training and preparedness of service dog partners to self-advocate. While empowering those whose well-being is at the heart of this issue is undeniably critical, the onus cannot rest solely on service dog partners – nor on service dog organizations – to solve this problem. There is no need for adverse social experiences to remain a defining experience for members of the service dog community; we can and should do better. Societally, we must take collective responsibility for facilitating access and inclusion in the first place.

Our research has uncovered a troubling trend of negative social experiences for service dog partners across the United States, consistent with reports from within the service dog community [e.g., 77,78]. A 2022 survey of 1,503 service dog partners worldwide found that a substantial majority (93%) had encountered suspected service dog fraud, resulting in a diminished quality of life and independence for 80% of respondents [77]. Additionally, 59% of those surveyed had experienced access denials, while 7% reported having to retire or limit their service dog’s working role due to these challenges. The participants also shared that fear, anxiety, and frustration with past negative experiences had led them to limit their public outings [77]. These issues are particularly concerning and align with our findings that negative public experiences may lead to an increase, rather than a decrease, in social isolation and marginalization for some service dog partners – a stark contradiction to the spirit and goals of the ADA. Additionally, our findings appear consistent with the experiences of service dog partners in some countries outside the United States [e.g., 79,80]. Researching the social experiences of service dog partners worldwide could help identify countries that are succeeding in mitigating adverse experiences, informing legislation and policies in countries with worse outcomes.

Health consequences.

We should also be concerned that service dog partners may be at risk for adverse health consequences as a direct result of experiencing stigma and discrimination. For one thing, some participants in the included studies reported challenges to accessing employment, housing, healthcare, and education, all of which can directly impact a person’s overall well-being. Moreover, research has found that discriminatory and stigmatizing experiences can lead to compromised psychosocial well-being, social isolation, lower quality of life, and chronic stress [81,82]. Further research emphasizes the social and institutional impacts of intersectional identity [83], as individuals with multiply minoritized identities often face additional barriers, which may include nuanced negative impacts [82–84]. While one article in this review identified age and gender identity as potential factors that could contribute to experiences of multiple discrimination, most articles did not address the effects of intersectionality or other facets of identity; this will, therefore, be an essential area for future research to explore, including capturing detailed demographics regarding the service dog partners. Additional adverse experiences could also affect disabled people whose symptoms may include disabling anxiety and distress in public spaces, such as some individuals diagnosed with posttraumatic stress disorder. For these service dog handlers, adverse experiences in public may be particularly harmful as these may exacerbate symptoms.

The need for policy alignment and reform.

There is a clear need for policy alignments and reforms at all levels of government - federal, state, and local. We note here that current legislation is reactionary by nature; it relies on the person with a disability to make entities aware of the need for access and accommodation rather than expecting entities to be accessible and accommodating to begin with. As identified in this review, entities and their employees are placed in the position of assessing whether the need for a service dog is valid, even while lacking the necessary expertise to make this determination. Ideally, reformed legislation should place the assessment of the need for a service dog exclusively in the hands of the disabled individual (or their caretaker, in the case of children), their healthcare provider, and (where applicable) the service dog team’s organization or trainer. Further, mechanisms are needed to reliably differentiate legitimate service dogs from pets, leaving gatekeeper entities responsible solely for welcoming service dog partners and ensuring equal and equitable access. Additionally, while appropriate behavior by the service dog is certainly essential at a minimum, legislation should further emphasize the dog’s working role and welfare alongside consideration of the needs of other people with and without disabilities, from those who may be inconvenienced to those who may experience adverse impacts due to disability (e.g., disabling phobias, allergies). Finally, legislation should empower public and private entities to welcome appropriately behaved service dogs in training, allowing these puppies to receive critical socialization and training in the contexts where they may work in the future [22,25]. Ultimately, once agreement is achieved at the legislative level (admittedly a monumental task in and of itself), a public awareness campaign should follow to disseminate information back to gatekeeper entities and provide training, templates, and suggestions for bringing their policies and procedures into alignment.

Addressing and understanding service dog fraud.

Any intervention must also tackle the complex problem of service dog fraud in the United States. Based on our findings, service dog fraud is widespread and a key contributor to the adverse experiences that service dog partners face. This finding aligns with related research; for example, a 2023 survey of 77 individuals with emotional support animals in the United States found that 60% of participants had falsely presented their emotional support dog as a service dog at least once, and 18% did so frequently or almost always; this, despite the fact that emotional support dogs do not meet the defining and qualifying criteria for service dogs [85]. State legislators are actively strengthening laws around fraud; as of 2022, 33 states had enacted bans on the fraudulent representation of companion animals (i.e., pets) as service animals [86]. However, as noted, state-level efforts can lead to inconsistencies that compound problems for service dog partners rather than protect their rights and may even encourage unscrupulous businesses to take advantage of this confusion by offering fraudulent dog “certification” and equipment services [26].

While legislative efforts may be part of the solution, something currently missing from much of the conversation around service dog fraud is understanding why people commit service dog fraud in the first place. If fraud originates in part from the lack of an identified victim [8], shifting business signage away from “no pets allowed”-type language towards language that connects people to the “victims” who are adversely impacted may be helpful. For example, certain businesses in Arizona employ signage that states: “Please DON’T try to pass off your pet as a service animal. FAKE service animals may hurt the reputation and acceptance of valid service animals” [87]. Conversely, if service dog fraud originates partly from a desire to spend more time with one’s companion animal, fraud could be disincentivized through legal and appropriate means for increased pet-owner companionship. This could be achieved through improved opportunities for pet-friendly housing, affordable and safe pet transport options, climate-controlled and secure crates for companion animals to wait for their owners outside of businesses and other similar initiatives. In summary, to more effectively address service dog fraud, it is necessary to understand underlying motives and develop responsive strategies while protecting the rights of legitimate service dog partners.

Mechanisms for education and advocacy.

Education and advocacy are critical interventions to mitigate adverse experiences facing service dog partners. Targeted audiences should include members of the public with and without disabilities, gatekeeper entities, medical professionals, and current and prospective service dog partners. However, few articles proposed specific mechanisms for education to occur. Beyond the concerted efforts toward policy alignment and reform described above, one potential pathway for education is integrating service dog regulations and disability etiquette into state-mandated curricula. For example, nine states currently mandate that K-12 curricula include humane treatment towards animals [88]. In Oregon, this education is provided in partnership with the Oregon Humane Society; a similar model could be employed in collaboration with global service dog coalitions such as Assistance Dogs International, the International Guide Dog Federation, or the International Association of Assistance Dog Partners. For medical and mental health professionals, service dog-related education should be built directly into cultural competency training as a key component of delivering culturally congruent care to people with disabilities partnered with service dogs [89]. Additionally, service dog partners themselves should receive education and training during their partnering process to prepare them to address adverse social experiences and enable them to self-advocate. This education and training should include education surrounding relevant laws and regulations, provision of sample dialogue scripts, and role-playing of various social scenarios in a controlled setting. The service dog community will surely also continue to play a vital role as a source of support, information, and group advocacy around these challenging experiences.

Thoughtful approaches to a certification system.

Finally, developing and implementing a service dog certification, registration, or permitting system should be carefully considered in parallel with existing or potential policy, education, and advocacy-related reforms. Although such a solution could offer many advantages, significant concerns should be anticipated and addressed. For example, a standardized verification of service dog legitimacy could drastically reduce the number of access denials, privacy impingements, and instances of fraud; however, any such system should avoid further stigmatizing or inadvertently harming service dog partners [15]. Problems with the implementation of similar systems illustrate some of these concerns; for example, voter identification laws can introduce barriers that disproportionately harm voters who are low-income, have disabilities, are racial and ethnic minorities, and the elderly [90].

In the absence of a national standard for service dog validation, some industry entities have stepped in to develop and introduce their own systems [e.g., 91,92]; however, their efficacy, impact, and scope of use are still unclear. Amidst the limited documentation requirements for service dog teams in most contexts, voluntary registry systems may confuse the public, hold little sway, and see inconsistent uptake unless and until a standardized system is implemented. Worse, they could increase public confusion, skepticism, and questioning of service dog partners who do not carry such identification.

One possible avenue to consider may be certification of service dog training processes, rather than the service dog teams themselves. Under this system, service dogs in the United States would be required to wear equipment identifying that the dog was trained through an accredited training process. If such a system were implemented in an accessible and equitable manner, it could shift some of the added burden onto organizations and private trainers rather than individuals with disabilities themselves. This approach could contribute to high training and behavioral standards for service dogs and reduce issues of access denials, questioned legitimacy, and fraud. However, nuanced challenges would need to be addressed, such as consideration for owner-trained service dogs, visiting international service dog partners, and service dogs in training. Ultimately, further discussion among stakeholders is necessary to inform any decisions regarding the development and implementation of such systems.

Intentionally measuring adverse social experiences.

The methodological rigor of articles was significantly positively associated with publication year, indicating that the quality of studies has improved over time – a promising trend for the field of human-animal interaction more broadly. That said, very few of the empirical studies in this review – particularly quantitative studies – intentionally measured adverse social experiences such as stigma, discrimination, or access denials. The lack of routine measurement of these constructs makes it difficult to accurately assess the true scope of these adverse experiences. It also underscores the value of conducting community-based participatory research to identify key issues in need of investigation [e.g., 93]. Moving forward, researchers should begin operationalizing the challenges associated with service dog partnerships, routinely include measures to capture these outcomes, and include effect sizes when reporting outcomes. This will not only enable us to develop a more nuanced understanding of the magnitude of these problems, but it will also allow us to track and measure changes over time that result from implementing any solutions addressing these concerns.

One option is to incorporate standardized, validated self-report measures into research, such as the Everyday Discrimination Scale [94], used in one of the studies in this review. However, this scale includes both general items (i.e., perceived respect) and context-specific items (i.e., “treated worse in a restaurant or store”; “considered less smart”), whereas ideally, a scale would only have items that can apply to all contexts. Moreover, there is a need to continually develop appropriately normed measures and bring study recruitment and assessments in line with best practices and recommendations for the inclusion of people with disabilities [95,96]. Therefore, a possible future direction includes the development and validation of a standardized scale to assess adverse social experiences faced by service animal partners. Additionally, given the call for greater use of ecological momentary assessment and similar methodologies in human-animal interaction research [e.g., 97], researchers examining social outcomes for service dog partners may consider asking questions about adverse social experiences via ecological momentary assessments, daily diaries, or as part of day reconstruction methods [98,99]. Finally, researchers can help by pilot testing and empirically investigating potential solutions; for example, it would be helpful to study whether different types of wording on storefront signage are more or less effective in mitigating service dog fraud. International and cross-cultural studies spanning nations with different legislation or education around service dogs may also help to identify strengths and limitations of particular legal or policy approaches in this area.

Impacts to service dogs.

While not the focus of the present review, it is also crucial to recognize that adverse experiences in public affect not only human service dog partners but also the service dogs themselves. As mentioned, encounters with stressed and possibly aggressive companion animals being fraudulently misrepresented as service dogs can pose serious safety risks for legitimate service dogs. More subtly, service dogs may also perceive and be affected by their human partners’ and other humans’ and animals’ stress [e.g., 100] and may be at greater risk for adverse health outcomes if frequently left at home without their human partners [39]. Service dogs are typically carefully screened and selected for their working roles [101]; if it is the case that they experience benefits when performing their work, it is plausible that they are also negatively impacted when prevented from performing their job. However, none of the articles in this review measured the impacts of adverse social experiences on the service dogs themselves. We, therefore, echo calls from the field of human-animal interaction [e.g., 102] for future studies to include measures of both human and animal well-being as part of the outcomes assessed.

Challenging ableism.

Lastly, we emphasize that the stigma, discrimination, and access denials that service dog partners encounter do not occur in a vacuum; in many ways, these are likely manifestations of individual and institutional ableism and the systemic marginalization of people with disabilities. Ongoing work is needed to systematically identify and address the root causes and consequences of ableism. Indeed, the findings from this review are somewhat aligned with research suggesting that the use of assistive devices (to which service dogs are legally equivalent) may engender experiences of perceived stigmatization and increased barriers, potentially even facilitating their disuse altogether [103–105]. However, there is no mention in these studies of experiences of access denials, questioned legitimacy, or others trying to distract or “pet” the assistive device. This implies that service dog partnerships and service dogs differ from assistive devices in important and unique ways. This said, the researchers of these articles emphasize the importance of design “for social acceptability” [105]. In this regard, there may be reason for optimism regarding service dog partnerships: despite adverse social experiences, research has found that most people hold positive implicit and explicit attitudes and perceptions towards both service dogs themselves and people with disabilities accompanied by service dogs [106–109]. With growth in society’s understanding of the relationship between people with disabilities and their service dogs, there is tremendous potential to challenge misconceptions and effect powerful change. While facilitating empathy, education, and inclusive policies, we can collectively nourish a culture that celebrates diversity and plurality, embracing the fuller spectrum of human ability.