“If Black women are free, it would mean that everyone else would have to be free since our freedom would necessitate the destruction of all the systems of oppression.” – Combahee River Collective
Betsey, Lucy, and Anarcha. The names of three enslaved women were memorialized on screen during the third episode of the first season of HBO’s Lovecraft Country. These names symbolize three women who were stripped further of any sense of human dignity during their time held captive and surgically experimented on without anesthesia for years by a prominent, white physician, J Marion Sims, to preserve one of the earliest engines of capitalism: the Black woman’s womb.
Dr. Sims has been considered the ‘father of gynecology’ — he invented the vaginal speculum still used today, and in 1875, he was elected President of the American Medical Association (AMA), the oldest, largest, and considered the most powerful organized body of medicine in the country. In reality, Sims’ presidency despite his gross use of power and disturbing legacy is not an isolated moment of racist norms within the AMA. This troubling history of medical experimentation is deeply connected to the health inequities Black women still experience to this day — a heartbreaking reminder of how systemic racism and health care have been intertwined for centuries.
In recent years, AMA has begun to reckon with not only its own racist past, but also the racist past of the larger field of medicine, in which it has been highly influential.
And this past Monday marked an historic day for the entire of community of medicine and the broader society at large: the American Medical Association and its House of Delegates for the first time in its history passed and adopted policy that sheds light on the harms and tragedies of racism for all of society and medicine to see. The 600+ delegates from across the nation voted overwhelming to adopt policies that name and act on racism as a threat to the public’s health, rid our healthcare system of racial essentialism, and support the elimination of race as a proxy for ancestry, genetics, and biology in medical education, research, and clinical practice.
It is racism, not race that produces higher death rates among Black women during childbirth, and of the babies that they bear. Years of institutional and structural racism has produced the highest rates of heart disease and high blood pressure for Blacks. Racism has produced the highest rates of getting and dying from COVID-19. How powerful it is that one of this nation’s founding tenets is now a recognized threat to its existence and the existence of the most targeted and harmed by the profession whose code of ethics demands that we “do no harm.” But we know that racism in medicine has created and perpetuated generations of harm.
While not exactly known, a confluence of events pushed the AMA to this critical juncture in history – the presidency of the first Black woman to be named AMA president, the leadership of the Black Lives Matter movement, resurgence of white supremacist action and terror, previous efforts of AMA’s Commission to End Health Disparities, recent AMA policy for the establishment of the AMA’s Center for Health Equity, the exposure of long-standing inequities by COVID-19, and the countless public murders of Black women and men at the hands of police, to name a few.
As a matter of time, most would say AMA’s recent actions are long overdue. We cannot go back. However, we can and must now better understand the harms of racism and work to dismantle and redesign injustice out of our culture and systems.
A core strategy to ensure justice in our systems is centering the voices of those most marginalized. Many of our brave leaders of the reproductive justice movement have long said, “listen to Black women.” Black women bring their minds and their hearts, as well as their lived experiences to justice work – it is personal in every way. The toll racism takes upon Black women, whether advocating inside or outside of organizations, is often underappreciated.
This Tuesday, as the deliberations of the AMA’s House of Delegates ensued, Black women physicians shared their stories experiencing and witnessing discrimination and racism at the hands of medicine and of police. Their stories, along with other AMA voices of student and physicians, changed hearts and minds and moved the house of medicine toward a brighter day.
As Black women leading justice work – formally and in our everyday lives, exhaustion permeates our minds and hearts. Black women have fought in body and voice, in silence and with great stir. And the cost to our health has been great and unjust exemplified by the extraordinary lives of Betsey, Lucy, and Anarcha – our ‘mothers of modern gynecology.’
The way forward for the AMA and other historically white institutions in our nation necessitates meaningful and deliberate action from many more accomplices, not only those of us most marginalized historically, operating in coalition and with great urgency.
Our collective freedom demands it.
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Aletha Maybank, MD, MPH, recently joined the American Medical Association (AMA) in April 2019 as their inaugural chief health equity officer and group vice president. Her role is to embed health equity in all the work of the AMA and to launch a Health Equity Center.