The Intersection of Black History, Queer Studies, and Medicine
For Black History Month, we’re covering issues in health equity and ways that the medical field is turning inwards to address them. Up next: the importance of intersectionality.
This past January, Florida’s department of education rejected course materials and topics for a new AP African American Studies course, writing to the College Board that the subject matter “significantly lacks educational value.” This has concerning implications for the next generation’s understanding of the world around them – and how they conceptualize the impacts of social determinants of health, bioethics, and the history of this country.
Black History and Health
Why is learning Black history in the US necessary for our nation’s health? Closing racial health gaps is a key concern, but we don’t give our health professionals the historical context they need to do the best job of closing these gaps. Myths about physiological differences based on race (such as Black people feel less pain or have worse lung function) were created centuries ago to justify slavery and discrimination. But some of these myths are still present in the medical community, furthering unequal care.
The de facto segregation in hospitals also needs a historical context to be understood and dismantled by medical educators, clinicians, and hospital leaders alike. In the AMA Journal of Ethics, Dr. Emily Cleveland Manchanda and colleagues explain how current segregation in medicine stems from our history of racist policies like redlining, exclusionary zoning, and the bifurcation of publicly and privately insured patients. Without knowing the history, Manchanda et al. write, it’s easy for the medical system to assume that segregation is normal, and to keep the cycle going.
And as medical schools strive to include more students from underrepresented backgrounds, we need to have an understanding of the policies that led to the closure of most Black medical schools in the 1900s.
Queer Studies and Intersectionality are also Black History
Two of the target topics rejected by the Florida Department of Education were queer studies and intersectionality. “Intersectionality” was coined by Kimberlé Crenshaw over 30 years ago as a way to conceptualize and describe the various ways a person’s social identities, like race, gender, and class, overlap. Examining the world through this lens allows for a more complete, nuanced understanding of how these determinants play out in a person’s life. By cutting the reading requirements of queer and feminist scholars, this move is an attempt to sever the connection between queer studies, intersectionality, and Black history. But these are not, and never have been, fully separate topics.
Consider the gay rights movement, for example. The Stonewall Riots are largely seen as the catalyst for the movement. The most prominent figure and activist from the Stonewall Riots is Marsha P. Johnson, a Black gay and transgender rights advocate who herself had experienced the impacts of intersectional marginalization. She was on the front lines of the Riots, galvanizing a nationwide fight for equality.
Discrimination, especially as experienced by Black trans and gender non-conforming individuals, has an impact on both short- and long-term health. A well-known example is the AIDS crisis, in which homophobia both from the government and community members isolated LGBTQ+ individuals and treated them as disease vectors, not people. Activists have fought the dual damage of racism and homophobia for decades. Even today, Black Americans count for 40% of the 1.2 million Americans living with HIV despite only constituting 12% of the nationwide population.
The impacts of intersectional marginalization are still obvious in our society today. There is an ongoing public health crisis of violence against Black transgender and gender non-conforming individuals. It is impossible to conceptualize this crisis without having a foundational understanding of the history of harm these groups have endured.
There is no understanding the gay rights movement without understanding the intersection of race, sexuality, and gender, and how that affected individuals’ lived experiences. To exclude even one is to have only partial comprehension.
Looking at our healthcare system, it’s easy to see how racism is baked into the structures and policies to create disparate outcomes. Acknowledging the systemic nature of racism is the first step toward reaching the equitable system of health we all want and need — we should embrace it, not fear it.