Updated: Sep 26, 2020
By: India Ciánna Stevenson
A painting of Dr. James Marion Sims, by American artist Robert Thom from the 1950s.
(Photo Credit: Today.com)
The global protests that arose in response to the death of George Floyd have brought racism to the forefront of conversation. As a nation, we are in the process of examining the ways in which White supremacy is upheld in our country, as well as the systems and institutions that support it. These are conversations that should have been highlighted and acted upon a long time ago, but the attention that they are receiving now has helped elucidate these systemic issues for the greater population. The medical field of gynecology is a prime example of this, and understanding the racist medical history behind gynecology is important when contextualizing the ways in which Black people experience healthcare today.
“Father of Gynecology”
Dr. James Marion Sims is considered “the father of modern gynecology,” which is a branch of medicine that deals with female functions and illnesses, particularly in regards to female reproductive health. In 1844, Sims began his experimentation on several enslaved women in Alabama. Their names were Anarcha, Lucy, and Betsy. Despite his status as a doctor and apparent healer, Dr. Sims repeatedly and invasively experimented on these women without any anesthesia. This brutal and unjust experimentation created his reputation as the country's preeminent gynecological surgeon, and resulted in his presidency in the American Medical Association in 1875 and the American Gynecological Society in 1879. Unfortunately, his medical experiments serve as the foundational bedrock for many practices that are still widely embraced in gynecology today.
Historians have found that there were many motivations underlying Dr. Sims’ work and egregious experimentation. For one, women, in general, were neglected in the field of medicine, and were often subject to medical trials because scientists and doctors needed a medium by which they could explore reproductive health. Additionally, the 1808 federal ban on importing slaves served as another motivation for Dr. Sims’ experiments, as slave owners were forced to derive additional labor from domestic slave births. Conditions that affected an enslaved woman’s ability to perform hard labor or that affected her reproductive ability appeared to be fiscal fiascos in the eyes of slave owners. Vesicovaginal fistula, commonly referred to as VVF, is a condition that threatens such abilities, and resulted in Sims experimenting on 14 different enslaved women with VVF, including Anarcha. This experimentation resulted in the development of an extremely invasive VVF treatment with the use of a silver wire. Thus, these trials, which at the time were being lauded as a way to promote scientific knowledge, were actually masquerading as a thinly-veiled exploitation of enslaved women for economic gain.
Racialized Fictions in Medicine
Deirdre Cooper Ownes, author of Medical Bondage: Race, Gender, and the Origins of American Gynecology, talks about how the use of enslaved women in medical experimentation resulted in the characterization of Black women as subhuman in the eyes of the medical world. She coined the term “medical superbodies” in order to describe the various racialized fictions that Black women were subjected to. For example, it was thought that Black women were more hypersexual, that they didn’t experience pain, and that they were immodest. These racist beliefs were then used as justification for the invasive experiments that Sims performed from 1844 to 1849. Thus, in this horrific worldview, Black women were viewed as acceptable trial subjects to operate on without anesthesia because of the widely-circulated belief that Black women did not experience pain.
Medical Racism Today
Many of the foundational principles of gynecology and other areas in medicine were grounded in racism, gender oppression, and classism. The effects of this origin can still be viewed in contemporary medicine. For example, in American medical practices today, there is still the false belief that there are significant biological differences in pain tolerance between Black and White patients. In a recent 2016 poll, it was found that around half of White medical students and residents who took the survey had false beliefs about biological differences underlying pain tolerance in Black and White patients. Furthermore, around 25% of medical residents reported that they believed Black people have thicker skin than other races. These racist beliefs are what enable racial disparities in health outcomes, which are particularly apparent in areas such as maternal health. For example, Black women are three to four times as likely to die from pregnancy-related causes than White women. There are many factors that contribute to this statistic, including the racialized fictions that stem from the early gynecology work of Dr. Sims.
The future of medicine is dependent upon our ability to acknowledge its instances of racist histories and to abolish these residual effects at their root. Thus, it is imperative that we continue to educate ourselves and to use this knowledge to challenge these systemic issues.
For further education about the history of gynecology and its impact on modern medicine, I suggest listening to this episode of the Natal Podcast: The Roots of the Black Birthing Crisis.
Bachynski, K. (2018, June 04). Perspective | American medicine was built on the backs of slaves. And it still affects how doctors treat patients today. Retrieved July 18, 2020, from https://www.washingtonpost.com/news/made-by-history/wp/2018/06/04/american-medicine-was-built-on-the-backs-of-slaves-and-it-still-affects-how-doctors-treat-patients-today/
Kara Manke| February 17, 2., & Manke, K. (2020, March 04). Historian uncovers gynecology's brutal roots in slavery. Retrieved July 18, 2020, from https://news.berkeley.edu/2020/02/17/historian-uncovers-gynecologys-brutal-roots-in-slavery/
Zellars, R. (2018, October 25). Black Subjectivity and the Origins of American Gynecology. Retrieved from https://www.aaihs.org/black-subjectivity-and-the-origins-of-american-gynecology/