The country is in chaos. People around the world are peacefully protesting the murder of George Floyd at the hands of the Minneapolis Police Department. But the protests represent so much more than a reaction to Mr. Floyd’s senseless murder.
The world is expressing its rage and despair. We are crying out for accountability for the countless state-sanctioned killings of unarmed Black individuals.
Many people recognize the racial inequalities that exist in the U.S. and around the world, while others still struggle to understand the meaning behind the protests.
Living in Different Worlds
These protests represent the individual and collective racial trauma that’s been perpetuated over hundreds of years, as Kareem Abdul-Jabbar penned in a recent article in the Los Angeles Times.
Navigating racism has been a large part of my experience. As a nine-year-old, I learned code-switching (the not-so-subtle art of changing your speaking style to adapt to different social environments) and other tactics Black Americans have learned to use when living in different worlds.
I write this article as a Black woman, a Black female therapist, and a Black female who is a member of the infertility and grief communities. Being part of these different communities has often left me feeling disjointed.
I can speak about my experiences of racism with my black community, and I can talk about my pregnancy losses with my infertility community. But I struggle to find ways to marry the two worlds.
Years ago, in a conversation I had with a friend who was also a professor of social justice issues, I shared how my experience of racism impacted my fertility. But without sound scientific evidence, the discussion ended there.
I could never fully process this with the members of my infertility community. The overwhelming majority of professionals, therapists, and coaches couldn’t comprehend the depths of my racial experience, which created another barrier.
The Intersection Where Infertility Trauma and Racial Trauma Meet
Being a part of the infertility community can bring about feelings of isolation in its own way, much like my experience within the racial community. However, I never fully conceptualized or owned the impact that racism and racial injustices have had on my reproductive health until recently.
I know the trauma of infertility. I’ve suffered four pregnancy losses, and I endured five mini-IVF rounds with only a chemical pregnancy to show for it. The hormones and repeated losses threw me into a world of grief and isolation.
When I began seeing social media posts about infertility trauma without any reference to what’s happening within the Black community, I became even more triggered.
Infertility and other fertility issues have long been considered something that only impacted white people. Stereotypes around Black female fertility portray us as hyperfertile, thus having no problem procreating. It’s one of the reasons that discussing fertility issues is so challenging within the Black community. Assuming the validity of these stereotypes delays many within our community from seeking help, while some choose not to access services at all.
If you’re working with people of color, particularly Black women and men, you need to understand the intersection between racial trauma and fertility trauma.
Discussing issues of race is already a challenge. But discussing intersectionality is even harder. Understanding the connections between racial trauma and fertility trauma is essential to understanding this country’s history with slavery and discrimination.
Infertility and Racism: A Complicated History
Born in 1813 in Lancaster County, South Carolina, Dr. James Marion Sims is considered a pioneer in women’s reproductive health, having developed tools and surgical techniques used today. He is regarded as the “father of modern gynecology.”
Dr. Sims was also a slaveholder, and he conducted research and experimental procedures on enslaved women – without anesthesia. Since they were viewed as property and devoid of human rights, these women could not give consent or take ownership of their bodies. His decision to operate on enslaved women was informed by his assumption that they did not feel pain. This concept still exists in the medical community, as confirmed in a 2016 study conducted at the University of Virginia.
His work is part of a long history of medical apartheid, which includes the Tuskegee syphilis experiment and the stolen cells of Henrietta Lacks that have generated millions of dollars for the medical community without any compensation to her or her family.
Racism in the Research
In 2019, the American Society for Reproductive Medicine noted that racial disparities in fertility care continue to exist. Their findings are compelling and validating:
“The success rate, measured as the ratio of live births per ART (Assisted Reproductive Technology) cycle, was lower for Black women, and the miscarriage rate was higher. Using statistical methods, the researchers found that race was an independent factor related to a live birth, even when controlling for age, BMI (Body Mass Index), previous pregnancy, and etiology of the infertility.”
Subtleties around race and white privilege extend into how a diagnosis is made. The difference in the rates at which African-American women were misdiagnosed with pelvic inflammatory disease (PID) and sexually transmitted infections (instead of fibroids or endometriosis) underscores the assumption that reproductive health issues are related to sexual behavior instead of reproductive ones.
Quinlan and Johnson (2017) suggested that gynecologists didn’t even believe that Black women could contract endometriosis, which had long been characterized as a “white woman’s disease” until 1960. But evidence suggests that African-American women can suffer from higher rates of endometriosis and fibroids.
Biases Around Diagnosis and Treatment
Biases within the medical community exist, and our experiences early on teach us, as people of color, to expect it.
While in graduate school, I experienced persistent pelvic pain. During my exam, my gynecologist dismissed my concerns and diagnosed me with PID. After conducting research on my own and enduring several more months of pain, I went back to the doctor. Eventually, I received an ultrasound where two large fibroids (the sizes of a grapefruit and lemon) were found protruding from my uterus.
Years later, when I sought help for fertility issues with therapists and coaches, I hardly felt seen or validated in terms of my racial experience and its impact on my fertility. One practitioner even told me that “Africans are having babies later in life” as a misguided way to soothe my anxious spirit.
With the existence of mistrust for the medical community amongst the African American community around basic medical care, can you imagine what it’s like to try to access specialized treatment for infertility?
Representing the Black Experience
The lack of representation and understanding of racial experiences within the fertility world is another barrier to accessing care.
It’s easy for people to dismiss the argument of racism when racial issues have never negatively impacted them. When you’ve seen your story represented everywhere all your life, it can be hard to accept that a person of color experiences it through a different lens.
Being Black in the infertility world means not seeing your story represented in the very communities it’s designed to support.
It means not being guaranteed to see a doctor that looks like you and or who will approach your case with racial sensitivity. It’s one of the reasons my communities fight so hard for representation because it matters.
Racial trauma and infertility trauma are interconnected. But for Black women who experience both, the intersection is rarely discussed or even acknowledged in either community.
For the Black people who face these challenges every day, what has been your experience with race and infertility? I’d love to hear your story.
Use the hashtag #infertilitytraumaisracialtrauma and tag me so that we can begin representing our experience for the world to see.
Resources to Learn More
I’ve compiled a list of resources to help you explore this topic even further:
- Peggy Mcintosh’s Unpacking the Invisible Knapsack of Privilege
- Resources on Fertility: A Race and Racism Conscious Guide for Friends, Family and Practioners
- The Broken Brown Egg: An Awareness and Service Organization for African American Infertility
- Robin DiAngelo’s White Fragility
Also, the following are social justice activists can provide additional information and support along your journey:
- Rachel Cargle – An activist dedicated to unpacking systemic racism to support the Black community and its allies.
- Alishia McCullough – Licensed Mental Health Therapist and Social Justice Warrior
- Tamika Mallory – An activist and initial organizer for the Women’s March
American Society for Reproductive Medicine. (2019). Philadelphia, PA. Racial disparities in fertility care persist. https://www.asrm.org/news-and-publications/news-and-research/press-releases-and-bulletins/racial-disparities-in-fertility-care-persist/
Hoffman, K.M, Trawalter, S., Axt, J.R., & Oliver, M.N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences Apr 2016, 113 (16) 4296-4301; https://doi.org/10.1073/pnas.1516047113
Holland, B. (2018, Dec 4). The “Father of Modern Gynecology’ performed shocking experiments on slaves: He was a medical trailblazer but at what cost? https://www.history.com/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves
Johnson, B. & Quinlan, M (2017, Nov 10). Race, racism, and infertility. Vital. https://the-vital.com/2017/11/10/racism-infertility/
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