ARCHIVES
EDUCATION | COVID-19 | TECH | SOCIAL | WORK | ENVIRONMENT | POLITICS | CRIMINAL JUSTICE
Don’t forget to subscribe ›
Reject racial gaslighting.
It's Friday! And we're introducing a new term to the newsletter: racial gaslighting.
This plays a major part in the systemic medical violence we've unpacked over the past week. And it's playing out in politics. When people and systems minimize the pain and trauma that people of color experience, they shield themselves from accountability and allow that harm to continue. Jami offers some specific examples of how this plays out in various spaces, and particularly how it impacts women of color.
Tomorrow is Saturday, where we host our weekly Study Hall. Reply to this email with any questions or insights from the content we covered this past week and I'll do my best to get to them!
Thank you for all your support! You can give one-time on our website, PayPal or Venmo (@nicoleacardoza), or subscribe for $5/mo on our Patreon.
– Nicole
TAKE ACTION
Watch how you and your friends/colleagues respond to the experiences of people of color. Consider how they may be gaslighting based on their comments, and inform them on why their approach is harmful.
If you’re considering two sides to a story, make sure you think about the power dynamics between the parties (in race, gender, age, position, etc.)
Don’t support businesses or organizations that deny or undermine the experiences of people of color.
Consider how racial gaslighting may play a part of the rhetoric of the upcoming election.
GET EDUCATED
By Jami Nakamura Lin (she/her)
In March, Margot Gage Witvliet developed coronavirus symptoms after a trip to Europe. Four months later, many of those symptoms still remain, putting her in the camp of what are known as “long-haulers”--coronavirus patients whose symptoms persist for months, deviating from the typically understood trajectory of the illness (read more about her experience at The Conversation). The experience of long-haulers is finally receiving more attention, but for many sufferers, it’s too little, too late.
“Employers have told long-haulers that they couldn’t possibly be sick for that long. Friends and family members accused them of being lazy. Doctors refused to believe they had COVID-19… This ‘medical gaslighting,’ whereby physiological suffering is downplayed as a psychological problem such as stress or anxiety, is especially bad for women, and even worse for women of color,” writes Ed Yong in his thorough examination of long-haulers, whose numbers could potentially be in the hundreds of thousands (The Atlantic).
Most of our popular understanding of the term gaslighting is within the context of abusive relationships, as that is the context of the term’s origin (BBC). Gaslighting is a psychological method of manipulation used to deny the victim’s experience and make them question their reality, judgment, and sanity (Britannica). The goal is to make the victim dependent on the deceiver.
But gaslighting can also happen on a structural level. Instead of an individual abuser, the gaslighter is an abusive system denying the reality of entire groups and communities in order to perpetuate power imbalances. “Gaslighting is a structural phenomenon… It is a technique of violence that produces asymmetric harms for different populations,” writes Elena Ruiz, a professor of philosophy and American Indian and Indigenous Studies (PhilArchive).
Women as a whole are often targets of gaslighting (read the American Sociological Review for how gaslighting relates to gender-based stereotypes and inequality), and articles warning women about gaslighting techniques abound. Less is said in popular media about racial gaslighting, which specifically refers to “the political, social, economic and cultural process that perpetuates and normalizes a white supremacist reality through pathologizing those who resist” (Politics, Groups, and Identities Journal). Racial gaslighting says: the system is not broken, you are broken.
These are things that most readers versed in anti-racism work will already know (that the system blames people of color instead of itself), but looking at them as forms of gaslighting can help understand how such psychological manipulation is intertwined at the individual and structural levels. Interpersonal gaslighting (within relationships) is usually successful because of systemic gaslighting because the relationship is “rooted in social inequalities” (American Sociological Association). The framework can help us understand how white supremacy remains entrenched in our society.
Such racial gaslighting appears in many different areas. An academic study on a police force in Hamilton, Ontario, found that the way the police explained away their ID and carding tactics was a form of gaslighting. In their media appearances, the police used “obfuscation techniques” (lies, misrepresentations) to undermine local people of color, who had been arguing that the police’s carding techniques were discriminatory. They used gaslighting to deny their own structural racism (SAGE Publishing).
In the field of medicine, gaslighting happens when health professionals minimize, ignore, or disbelieve patients’ symptoms and experiences (Health). Examples of this include doctors blaming physical symptoms on mental illness without justification, or providers refusing to request follow-up tests because they don’t believe their patients. Medical gaslighting is especially pernicious because of the inherent power differential between doctors and their patients, even before adding in the intersections of gender and race. Doctors have been socialized to take female patients (NY Times) and patients of color less seriously, and medical professionals still hold many racial biases (National Institute of Health). While practitioners usually participate in medical gaslighting without meaning to harm their patients, individual intent doesn’t mitigate the systemic impact. Their disregard has dire health outcomes, as explained in our recent newsletters on Black maternal health and Black mental health.
“Missteps and misunderstandings, even by well-seasoned medical professionals, are human, but medical gaslighting is not. Normal test results in patients with chronic pain, unexplained sensitivities to the world, or fatigue should provoke more investigation, rather than a weak handoff.”
Dr. Anne Maitland for Op Med
A 2016 study by patient safety experts suggests that medical error is the third-leading cause of death in America, resulting in over 250,000 deaths per year (Johns Hopkins). But medical error is not nearly as widely researched as other causes of deaths, and we don’t know how many deaths per year can be attributed to medical gaslighting.
What we do know is that medical gaslighting especially affects patients of color. One doctor described the stereotypes patients of color with myalgic encephalomyelitis (a mostly invisible illness with symptoms similar to those of COVID long-haulers) faced: Black and South Asian patients were suspected of faking their symptoms to avoid work, while East Asian patients’ symptoms were thought to be the result of working too much (ME Action). In other words, their actual medical conditions were dismissed and attributed instead to racist stereotypes.
Think about the words of Canadian policy expert Emily Riddle: “To be an Indigenous woman in this country is to intimately understand both interpersonal and systemic gaslighting… Any Indigenous woman who questions anyone who demeans her or a system that perpetuates violence against her is bound to be called difficult.” (The Globe and Mail). To effectively combat the effects of systemic gaslighting in our own thinking, we need to question not just what we believe, but who we believe.
Key Takeaways
A whistleblower filed a complaint against ICE for “medical neglect" at the detention camp she worked at, including mass hysterectomies without detainees' content
Forced sterilization was a state-sanctioned practice, often funded by the federal government, that disproportionately impacted women and women of color during the 19th century
Forced sterilizations procedures are sexist, xenophobic, racist, and ableist, and often homophobic
Unwanted sterilizations are still happening today
RELATED ISSUES
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza
Abolish ICE.
This is the third time I've referenced forced sterilizations in our newsletters over the past two weeks. And this time it's with a new and harrowing story. It's heartbreaking to see how our history keeps repeating itself, and the lasting implications of generations of violence against communities of color. This story is still developing, but our persistent action will ensure this conversation doesn't fade away. The violence that's been happening at these camps are an act of genocide.
If you're enjoying these newsletters, consider making a contribution to support our work. You can give one-time on our website, PayPal or Venmo (@nicoleacardoza), or subscribe for $5/mo on our Patreon.
– Nicole
TAKE ACTION
Sign United We Dream’s petition to release immigrants and asylum‐seekers at detention centers.
Support the GoFundMe of Dawn Wooten, a Black single mother of five who risked her job and safety as a whistleblower.
Call your senators and urge them to defund ICE, which operates under DHS.
Follow and support the voices that have been telling us about the atrocities happening at detention centers: Project South, Georgia Detention Watch, Georgia Latino Alliance for Human Rights, and South Georgia Immigrant Support Network
GET EDUCATED
By Nicole Cardoza (she/her)
This week, a whistleblower filed a complaint with the Department of Homeland Security’s Office of the Inspector General about “medical neglect” practiced at an ICE facility in Georgia. Dawn Wooten, a nurse at the Irwin County Detention Center (ICDC), reported that the facility was underreporting COVID-19 cases and not correctly testing or protecting staff and detainees (The Intercept). She also reported that the immigrants are being subjected to a high rate of hysterectomies without “proper informed consent” (The Intercept).
“I became a whistleblower; now I’m a target. But I’ll take a target any day to do what’s right and just, than sit and be a part of what’s inhumane.”
Dawn Wooten
Before we continue, I think it needs to be made clear that the allegations of medical neglect during a global pandemic alone should be enough for us to call for change. The forced separations of families are enough to call for change. In fact, the fact that these detention centers even exist is more than enough for me. We need to abolish ICE for the system itself, not just because we're hearing more allegations about forced sterilizations.
The latter allegation in particular has spurred lawmakers and advocacy groups into action. Organizers of the complaint, along with Wooten, include Project South, Georgia Detention Watch, Georgia Latino Alliance for Human Rights, and South Georgia Immigrant Support Network, and consists of the voices of detained immigrants that have “reported human rights abuses including lack of medical and mental health care, due process violations, unsanitary living conditions” since 2017 (Project South). They've been rallying to close this facility – and others – for years, and detainees have specifically complained about the rough treatment from the same gynecologist that's accused (AJC).
168 members of Congress sent a letter urging DHS Inspector General Joseph Cuffari to investigate the allegations (Congresswoman Jayapal website). They're demanding to know the status of the investigation by September 25th (NPR).
These allegations are horrifying. And, these allegations are nothing new. As we discussed in two newsletters over the past two weeks, our country has a history of medical violence, particularly against women and women of color. These procedures are sexist, xenophobic, racist, and ableist, and often homophobic. And they’re an act of violence against marginalized people, many of whom rely on the same institutions for their protection.
To understand this, we have to start with eugenics, the practice of improving the human species by “breeding out” disease, disabilities, and other characteristics from the human population (History). The concept gained traction in the U.S. in the early 1900s with the creation of the Race Betterment Foundation, led by John Harvey Kellogg – yes, that Kellogg (History). Through their “registry” of “pedigree” status and a series of national conferences, they promoted the idea that to improve the country, we needed to preserve the racial status of those that inhabit it (History). This meant that people that did not fit this category – including immigrants, Black people, Indigenous people, poor white people, and people with disabilities – needed to be maintained.
Via CNN: Eugenics had won such mainstream acceptance that Americans competed in "fitter families" contests at state fairs during the 1920s.
From this, 31 states sanctioned sterilizations. Many were presented to individuals as “protective” measures to prevent their “undesirable” traits from passing to others. But many more were nonconsensual, performed when patients believed they were receiving other forms of care (The Conversation). And although the programs initially targeted men, they quickly evolved to focus on women and women of color – particularly as the country began to desegregate.
From 1950 to 1966, Black women were 3x more likely to be sterilized than white women, and more than 12x the rate of white men (The Conversation). Hospitals in the South let medical students practice unnecessary hysterectomies on Black women, a practice so common it was given the euphemism “Mississippi appendectomies” (The Cut).
The U.S. Indian Health Service (IHS) applied forced sterilized over 3,000 Indigenous women in the U.S. in 1973 and 1976. A study from two years earlier found that at least one in four Indigenous women had been sterilized without consent (Minn Post).
In California alone, over 20,000 people were sterilized, and were disproportionately Latinx, primarily individuals from Mexico (Smithsonian). During that time, anti-Mexican sentiment was spurred by theories that Mexican immigrants and Mexican-Americans were at a “lower racial level” than white people (Internet Archives).
Via The Conversation: A pamphlet extolling the benefit of selective sterilization published by the Human Betterment League of North Carolina, 1950. North Carolina State Documents Collection/State Library of North Carolina
By 1976, over 60,000 people were recorded sterilized in 32 states during the 20th century (Huffington Post).
Although the Supreme Court moved to end these practices in 1974, these practices are still happening. Between 1997 and 2010, unwanted sterilizations were performed on approximately 1,400 women in California prisons, which primarily targeted women of color (Fox News). A judge in Tennessee offered those incarcerated thirty days off jail time if they volunteered for vasectomies or contraceptive implants, saying that he hoped repeat offenders would “make something of themselves” (Washington Post). Ten states still require transgender people to obtain proof of surgery, a court order, or an amended birth certificate to update their driver’s licenses – and 17 states require sex reassignment surgery to update birth certificate gender markers (The Daily Beast). And there are still terrifying stories of forcible sterilizations happening on people with disabilities deemed constitutional by the courts (Rewire News).
There’s been jokes and memes floating around that we’re “officially” living in the dystopian Handmaid’s Tale. But we’re not. We’re living in the reality of the United States. And when we distance ourselves from this painful reality, we allow it to persist. As investigators race to verify these allegations, we cannot continue to allow any injustices to continue in these spaces. We must keep listening and supporting to the voices that have been shouting this to us for years – that these institutions must be dismantled. The costs are far too great.
Key Takeaways
A whistleblower filed a complaint against ICE for “medical neglect" at the detention camp she worked at, including mass hysterectomies without detainees' content
Forced sterilization was a state-sanctioned practice, often funded by the federal government, that disproportionately impacted women and women of color during the 19th century
Forced sterilizations procedures are sexist, xenophobic, racist, and ableist, and often homophobic
Unwanted sterilizations are still happening today
RELATED ISSUES
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza
Understand representation in vaccine trials.
Happy Sunday!
Today marks our weekly review of the racial disparities of COVID-19. It's important to remember that this virus doesn't discriminate. But our systems do. And we're trying to respond swiftly to its catastrophic impact while reckoning with our deep history of oppression and harm. Today's topic – the fight for representation in vaccine trials – is a good example of this. As you read, consider how much our mistakes from the past affect our ability to respond equitably in the present – and its implications for the future.
Thank you all for your contributions. To support our work, you can give one-time on our website, PayPal or Venmo (@nicoleacardoza), or subscribe for $5/mo on our Patreon.
Nicole
TAKE ACTION
Support the Black Doctors COVID19 Consortium, which is building trust in their community by offering free COVID-19 testing in Philadelphia, New Jersey and New York
Respect the racial and historical context that may make people wary of a vaccine
Consider: how may your racial identity influence your perception of vaccine trials? What privilege(s) may have helped you build trust in the healthcare system?
GET EDUCATED
The U.S. is moving at an unprecedented pace to create a vaccine to respond to COVID-19. The Trump administration has dubbed these efforts “Operation Warp Speed,” with the hopes to deliver “initial doses of a safe and effective vaccine” by January 2021 — shortening the development time from years to months (NPR). More recently, Trump has hinted that a vaccine may be ready by the election (what a coincidence), which is highly unlikely. And part of that is because of a lack of representation in testing groups.
350,000 people have registered online for a coronavirus clinical trial, but only 10% are Black or Latino, according to Dr. Jim Kublin, executive director of operations for the Covid-19 Prevention Network (CNN). An additional 8% represent Indigenous communities. This isn’t nearly enough, considering over half the COVID-19 in the U.S. have been in the Black and Latino communities (CNN). And beyond that, 1.3% of reported cases are from Indigenous groups, despite only representing .7% of the population (CDC).
In fact, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, expressed his desire to see non-white communities enrolled in coronavirus vaccine trials at levels at least double their percentages in the population, which would mean 66.4% of participants need to identify as "Black or African American, Latin, American Indian, and Alaskan Native” (CNN). Scientists, doctors, and advocates are urging both pharmaceutical companies and the government to increase their efforts to enroll a diverse group of volunteers.
As we discussed in last week’s newsletter, communities of color have a deep distrust of the U.S. health care system, and for good reason.
📰 Read more about the history of medical violence against communities of color >
Also, the U.S. (and other parts of the world) have a long history of using people of color as trial subjects for vaccines. Thomas Jefferson tested what would become a successful smallpox vaccine on enslaved people before extending it to his family (Smithsonian). A British doctor serving as a plantation physician in rural Jamaica subjected enslaved people to trial tests without consent (Futurist).
As a result, people of color are historically underrepresented in clinical trials of new drugs, even when the treatment is aimed at an ailment that disproportionately affects them (ProPublica). Data from the FDA shows that Black people are the least likely to participate in drug trials – and that participation by people of color decreased between 2018 and 2019 (Outsourcing-Pharma).
“The absence of significant participation by Black patients creates not only a hole in the data, but can contribute to less effective treatments with little data on the impact on that specific population.”
Dr. Valerie Montgomery Rice, president and dean of the Morehouse School of Medicine, via Governing
One outreach effort includes reaching out to historically Black colleges and universities, encouraging students to participate in the trials, and engage medical staff and students in the process. Advocates believe this can grow trust in the community and encourage more Black people to join (NYTimes). Here’s an example of a letter from Xavier University. But this initiative, paired with efforts to increase testing across campuses, is garnering mixed feedback (Twitter).
📰 Read why it’s essential to have more representation of people of color in research >
Also, the COVID-19 Prevention Network, a group created by the National Institute of Allergy and Infectious Diseases, created an advertising campaign urging Black and Latino people to get involved. The ads center the voices of essential workers, grandparents, food industry workers, and other groups within communities of color that have been disproportionately impacted by COVID-19 (NBC News).
📰 Read more about the impact of COVID-19 on essential workers, the elderly, and workers in the food industry.
And leaders from the communities are doing their part to build trust. A group of faith-based leaders has joined together to enhance trust and engagement with people of color (Newswise). And the Navajo Nation has announced its participation in a Pfizer-BioNTech COVID-19 vaccine trial on a patient-volunteer basis (Indian Country Today).
“I would encourage people, but I know everybody won’t. It’s like ingrained in the mindset of Black people when you consider the syphilis injections. Black folks don’t want to be guinea pigs and we have been. Even in light of that, if the data is transparent, if the information makes sense, if the research is credible, then I think we can overcome that particular fear.”
Rev. Kenneth L. Samuel, senior pastor of Victory for the World Church in Stone Mountain, via Governing
Regardless of the accelerated timeline for finding a vaccine, there’s “no shortcut” to authentically engaging communities of color for trials, emphasizes Dr. Dominic Mack of Morehouse School of Medicine in Atlanta (NPR). It will take a long time to repair a history of discrimination and harm, but that work has to start now.
RELATED ISSUES
8/29/2020 | Study Hall! The trauma of police brutality videos, active bystander trainings.
8/15/2020 | Study Hall! Affirmative action, sliding scale pricing, and the right intentions.
8/8/2020 | Study Hall! Emoji blackface, the "family card," and starting conversations.
8/1/2020 | Study Hall! Racist actions, doulas, and intersectional change.
7/25/2020 | Study Hall! How to be a better ally, petitions, and plastics.
7/18/2020 | Study Hall! Ebonics, capitalizations and cultural appropriation.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza