“D.N.A”- Blackness and Health/Medical Antiblackness
“You know what DNA stands for? Dead N*gger Association.”
“Ensconced in a chair, I eagerly began to describe my work [to the white medical professor], only to be cut off before I had completed the first sentence. Bolting upright in her chair, she vehemently informed me that the topic of this book was taboo. “It’s a terrible thing that you are doing. You are going to make African Americans afraid of medical research and physicians! You cannot write this book!”… Was it indeed my work that would make African Americans wary of health care and medical research? Or had the work of those whose abused I proposed to chronicle already achieved this? The answer was all too obvious… Black Americans did not need me or anyone else to inculcate a fear of medicine. Medical history and practices had long since done so.” - Harriet A. Washington, Medical Apartheid
Black people have a fraught history with racism when it comes to medicine and healthcare. Is it true that medicine benefits us? Yes. Is it true that if we participated in more studies, more would be understood about the effects of medicine on the Black body? Yes. Should we fear the benefits of medicine and science? No.
“Not painful enough to justify the risk [of better care]”
If you had a painful tear in your bladder, and your doctor decided to operate on you without anesthesia over 30 times in order to perfect his operation (Anarcha, Lucy, and Betsey), would you still want to be treated?
If you knew you could go to the doctor to be treated for syphilis and rather than being saved, would unknowingly become a guinea pig for decades (Tuskegee), would you go?
If you went in to have an appendix removed, or to get birth control, and knew you could unwillingly wake up with no uterus (the Mississippi Appendectomy) would you go?
If you knew that you went in for cancer treatment, didn’t receive it, would die and then your cells were stolen (Henrietta Lacks) to make billions off of new and expansive cancer treatment, would you go?
If you were mortally injured in a car accident and expected to be healed, and instead, assuming you would die, they injected you with plutonium and stole your bone fragments to test under the Manhattan Project (Ebb Cade) would you go?
If you knew you went in pregnant and were 3x more likely to die in childbirth than the white woman next to you, and your partner would plead for over 10 hours while you bled to death, would you want to go (Kira Johnson)?
If you went in for bad headaches, knew you could be ignored, DIE, and be used as a human incubator for your unborn child (Adriana Smith), would you still want to go?
Do I really need to ask you anymore? Is this not enough? Because these are just high-profile ones- I can find you more! People treat Black suspicion of medical care, and by extension Black pain, as superstitious, as overexaggerated, despite the infinite, visceral examples throughout history of real and purposeful mistreatment! There is a history of using our bodies as tools, as experiments. We’re human enough to be experimented on, but not human enough to be treated! Let’s talk about some reasons why that is.
“Ableism is a set of beliefs or practices that devalue and discriminate against people with physical, intellectual, or psychiatric disabilities and often rests on the assumption that disabled people need to be ‘fixed’ in one form or the other.”
Now, let’s consider this: if the Black body was never intended to be seen as human, as less than… that is based in ableism! That belief that I am inherently intellectually lesser and physically inhuman in comparison to white people, is an ableist sentiment! Black disability activist Imani Barbarin, host of Crutches and Spice, goes deep into detail on this topic that is far better than anything I could say. I would highly recommend following her!
When I say ‘physically inhuman’, this goes all the way back to the reason why Black bodies were enslaved. There was a (made up) belief and consensus that the Black body was brutish, stronger, but not smart enough to direct itself. I “feel less pain” (and therefore can bear more) means that you don’t have to feel as bad because I “can take it and need the guidance”. It validates the conditions and the treatment of the enslaved, from overwork to forced starvation to cruel and unusual punishment. Slavery might be “over”, but that mindset didn’t vanish from the world. To this day, ideas of Black ‘strength’ persist.
How can I trust that I’m getting the right amount of medicine to treat me when they historically treat amounts on white bodies? If they think that I’m drug-seeking and not actually suffering because the amount of medication I’m receiving is in response to how much it’s believed I’m suffering? This idea manifested, and continues to manifest, as seeing us as either threatening beasts (a Black body not under control) or beasts of burden (a Black body under control), both physically and metaphorically.
Physical example: how police find Black boys larger and older than they are (Tamir Rice), that Black girls are older and more promiscuous.
Psychological example: the ongoing manifestation of the Mammy in “if you’re scared, find a Black woman.” Why? Why would it be any easier for me to handle what you’re going through? Why do you expect that I can do so, or that I even want to? Why would you do that, why put me up as a shield against your fears? Why do you believe a stranger of a Black woman is the one equipped to fight your demons for you? I don’t deal with things because I’m inherently stronger, I deal with them because I don’t have a choice! I help because I’m a decent person, not because I feel like it’s mandatory!
Innate? Or Socioeconomics?
Socioeconomic: “relating to, or involving a combination of social and economic factors”
This is where we get into terms like environmental racism, which means that the location where someone is often determines the quality of life they are “allowed” to experience, and how that often has to do with the race of the group living there (redlining, for example). Asthma, diabetes, high blood pressure, high cholesterol, all things usually diagnosed in Black people, but why? What access to adequate healthy food is there, if I live in a food desert? If my neighborhoods have no public resources or barely any sidewalks (or I don’t feel safe going outside) where am I supposed to exercise?
We are more likely put in spaces that aren’t meant for people- near or on top of landfills, or next to levees that they know are going to break, or with pipes full of lead for undrinkable water. They build AI centers that take up all the water and the fresh air and sputter out the filth for us to breathe in. There’s even epigenetic research on how stress, exacerbated by discrimination, has been passed down to and through us!
I say this all to say, a lot of what may be considered “Black” diseases, as well as the ability to treat them, often come with the presence of disparities. I don’t have worse asthma because I’m more likely to have it while Black, I have worse asthma because I was born in a place where the air was filthy, and that place is where many Black people in my city live! And that’s not an accident!
I LOVED Queen Charlotte- the show and the character. She reminds me of me, for real. And you want to know what I probably am? Autistic. Charlotte is an example of how this type of character might not have autism projected onto her despite having the traits associated (naive, strong sense of justice, blunt, witty, fixated on a certain style and way things should be, unable to understand rules that ‘don’t make sense’). You would think that people would go “oh! She’s like me!”
Instead, there seems to be this idea that autism, that neurodivergency as a whole, is white. White, awkward, and apparently unable to help being racist (I’ll never understand wanting to die on that hill, but it happens a lot more than y'all seem willing to believe). Well, just as everything else with Black people and characters, symptoms will not manifest differently than white people, but it’s going to be treated differently. Everything I’ve discussed up to this point in all my lessons is gonna apply. I hate to say this, but society doesn’t care if you’re Black and autistic (or have any other mental or developmental health issues) because it’s already judging you for your Blackness.
My Uncle (rip🙏🏾) was visibly autistic, from the stimming to the echolalia to the hyperfixation on country music, all the rest of his patterns, and people that didn’t know him still saw him as a 6’2 large fat scary threatening Black man. Hell, they barely consider women with autism, and they CERTAINLY don’t consider Black women and girls with autism. I’ve known a few of us, and we usually get the “mean uppity bitch” stigma because no one cares that you might be overstimulated or anxious, or that you are really devoted to a pattern that you see, or that you’re trying to express yourself with clear, assertive language, they just think you’re being aggressive and hurting their feelings (which is what they expect from Black women).
Very often when I’m on Tumblr, I wonder if I’m not autistic because when I see the behavior of white autistics… I don’t understand or relate to the… helplessness, the infantilization that I feel I’m seeing. But I’ve had to realize, that we are forced to mask ‘better’, because we already are used to having to wear the mask as it is. I already have to deal with not belonging, of having to figure out the game. Plus, I could go get diagnosed, but… What is that going to do for me? Why would I give the doctors more “valid” reason to ignore me and my concerns?
Point is, we don’t “look” autistic, and that’s why it doesn’t get treated the same, because what does it look like, then? 👀 The same behaviors indicative of autism in me might be the same as in you. Now, when it comes to being Black and autistic, I also think it’s important to recognize that a lot of us don’t get diagnosed, because of aforementioned reasons.
An excellent example of how to treat an autistic Black character is RJ Cyler’s Billy Cranston from Power Rangers. Now, I loved this movie, I was sick that it didn’t get a sequel. But the heart of the movie was by far Billy! Billy is a sweetheart, socially awkward and blunt, but well meaning. The other characters do not treat Billy as if he’s lesser because of his autism. They include him, they work with and modify for him, recognizing that they can still depend on him to come through (with a little bit of push outside of his comfort zone). You can tell that Billy matters to them, even if he’s different and doesn’t always understand as fast as they do. Now, he’s a little bit of the savant trope, which is unfortunate- so would I call him perfect autistic representation? Maybe not. But for me, who is reminded of her own autism and her family’s autism from seeing Billy on screen, it mattered to see him AT ALL.
“Health and the Black Fat”
There are two books I want to put y’all on for this conversation. One is Fearing The Black Body: The Racial Origins of Fatphobia by Sabrina Strings. Here’s an interview with her here. The other, which I’ve read recently, is Belly of the Beast by Da’Shaun L Harrison. I really enjoyed Belly of the Beast- it’s 109 pages, very concise, and ties together things that are often treated as separate entities. Da’Shaun is fat, Black, and nonbinary trans identifying.
I don’t have the space to quote as much as I’d love, but this book puts everything I’ve been discussing in further context. Chapter 2- Pretty Ugly- The Politics of Desire- discusses the manifestation of the Mammy in “little fast girls”. Chapter 4- Black, Fat, and Policed- explains how larger size manifests in fear of the Black male body.
But there’s a particular section I want to quote here from Chapter 2-
“As previously stated, the Black fat is misdiagnosed by medical professionals, are skipped over for jobs and housing, sit at the crux of harm committed by dieting and diet culture, experience heightened interactions with police, leading to state-sanctioned brutality, and are showcased as the evil that waits in children’s stories and beastly gluttons in religious texts. In various ways, the world has normalized the teachings that fat Black people are not Desirable and, thus, fat and Black bodies are deserving of the abuse they endure. Anti-fatness is coercive in that it teaches people to believe that the bodies of fat Black folks are only supposed to endure pain, never pleasure; that their very existence is always defined by Death, never Life; that their value, if any is assigned at all, is wrapped up in their ability to perform. They have to be the Mammy archetype or, for the fat, dark-skinned Black masc person, they must exist between what I refer to as the Fat Albert or Mark Henry tropes- purposed with the sole role of caring for everyone other than themselves, or positioned as animalistic and consistently tough.”
I want to clarify, I am not saying that fatness is a “bad” thing. What I am saying is that medically it’s already hard being Black or fat due to pre-existing biases, and so being fat AND Black will come with its own set of challenges. When I think of the conversation around fatness in the Black community, I think of diabetes, environmental factors, genetic factors, type 2 diabetes leading to holding on fat, likelihood of getting type 2 diabetes, blamed for not taking care of self. If you think that being fat is bad, and Black people’s (Women’s, in particular) are more often “fat”, then you make the connection that “well you’re more likely to be unhealthy”. It doesn’t matter that perhaps my weight is natural, perhaps I DO work out and take good care of myself! If I get sick, it’s because I’m fat, and I’m fat because I’m Black. Don’t even get me started on how in order to be seen as fat and attractive, you are expected to perform gender that much harder! Oh, please! We can’t even barely find clothes, and then they want you to put on a show too?! It’s a maelstrom of social pressures, that your existence is seen as the antithesis of.
“Black people don’t need therapy”
The history of using psychology against Black people is long and fraught.
You don’t have anxiety, you’re just high maintenance and extra. You don’t have depression, you’re just not praying for your blessings.
You don’t have CPTSD, you just happen to have a lot of ACEs (adverse childhood experiences) and are mad about getting whoopings. (from personal experience, I went to a doctor (a white trans lady, so she had intersecting experiences of her own!) and she said I didn’t have PTSD. She changed her mind a week later, but as I’ve gotten older and more cemented in believing myself, I’ve been like… that lady knew from my paperwork I had a gun pointed dead in my face as one of many experiences. What the hell else did she need to see?!)
You aren’t having mania or psychotic breakdown, you just “play too damn much” (Lil Nas X)
You aren’t exhausted from all that comes with being enslaved and decided to run away, you just have “drapetomania”.
You aren’t joyous at not being enslaved, you have “dysaesthesia aethiopica” (both of which could be ‘treated’ with 'washed open wounds, oiled bodies, beating with a leather strap and working in the sun' (Pg 34, Belly of the Beast))
You aren’t protesting your lack of human rights, you have “protest psychosis”.
You don’t have issues understanding what you’ve done wrong, you’re “disobedient” (Elijah McClain).
You don’t have ADHD, you have “Oppositional Defiant Disorder”
There’s a clip from The Crown, where a man named Michael Fagan manages to sneak into Queen Elizabeth’s chambers and have a private conversation with her about how the world she lives in is NOT the one the rest of them live in, under Margaret Thatcher. One line that struck me deep was when he said “They’ve diagnosed me with schizophrenia. But I’m not schizophrenic, I’m just poor.” And it was like… yeah, actually! Like yeah, I have depression, but it’s not (just) my brain, it’s… all of this! How can someone adequately address my mental health issues if they cannot recognize that what I’m going through is affected by the society I live in? That it’s not just some inherent dysfunction in me that makes me depressed, or angry, or willful, but the conditions of my life that aggravate my symptoms? I can take all the medicine I want, but the medicine isn’t gonna turn off the racism!
Writing Black Characters with Disabilities and Illnesses
I will also link my lesson on Violence, as not only does it have another list of questions that overlap, but medical malpractice is violence. Ableism, fatphobia, environmental racism, all of these things are a constant form of violence!
When people ask me about Black characters with disabilities it always baffles me a little, because… what do you expect me to say, really? The disability itself is likely no different than you with yours! It’s not like being Black makes it “Black autism”, “Black BPD”. It’s not some completely different disability- it’s just the experience while Black that is different, that affects how you are treated, medically and socially.
Blackness is often treated as a pre-existing condition rather than the conditions that we likely live in leading to or exacerbating and aggravating those illnesses or disabilities. I once looked up symptoms for HS, and it mentioned “Black ethnicity” 🙄 Let’s get rid of that mentality! Race, biologically, is not real. My body and brain are not so different, inhuman from yours, that it would require an entirely different understanding of function. We don’t get ‘Black people diseases’, we get diseases while Black. I know I’ve said this numerous times, but if it were so easy to understand, we wouldn’t still have this problem!
Let’s instead reframe our Black character design as ‘how will this character navigate the world with this disability, while Black’. ‘How will the world around this Black character treat them, while they have this disability’. You have control of the universe you write- if you want to say that everyone’s not racist and no one would treat this character differently, fine. But recognize what that will look like! Because you likely haven’t seen it in the world you currently live in! It might not be fundamentally different in how it presents, but it certainly exhausting in ways you might not have comprehended. And THAT'S what we need to remember when we're writing these characters!
I would love to see more Black characters with mental illnesses and disabilities- but only if we’re willing to do them respectfully, with the intent to understand our experience, and the follow through that shows you did your research. Medical malpractice especially is a tense topic within our community and we don’t deserve to have it, just like our pain, under-considered. Otherwise, leave it. Because it’s the thought that counts, but it’s the action that delivers!
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