Considering the dynamics and representations of oversexualized black women

In this blog entry, Trimiko Melancon, author of Unbought and Unbossed: Transgressive Black Women, Sexuality, and Representation, discusses contemporary dynamics regarding race, gender, and sexuality.

A week ago I served as an invited moderator for a college student forum, “Freakum: The Hypersexuality of Black Women.” What the event and the students organizing it sought to explore, in part, were representations of black women. More specifically, how today’s portrayals of black women are images of them as the event flyer and prompt indicated, “oversexualized to the point where a black woman cannot just be portrayed as a woman, but as a sexual being.”

Questions from students ranged from inquiries attempting to ascertain the history of such images and if black women and blacks generally are in control of media representations of their sexuality. There were also discussions of black female pop cultural icons, including mega superstar Beyoncé Knowles and leading televisual personas Olivia Pope (ABC’s Scandal) and Mary Jane (BET’s Being Mary Jane). While the forum was stimulating, and the students were very intellectually engaged, I was struck by how, even in the twenty-first century, their understandings of these dynamics and representations of black women were punctuated by, and articulated through, binaries. Either they expected black women to uphold respectable representations always, or to do the diametrical opposite: be both carefree and, indeed, free to not at all worry about or contend with how they carry themselves or are perceived and, ultimately, portrayed.

Unbought_smIn these very notions of black womanhood and representations—and the still, at times, limiting or narrow roles or characterizations confronting them—reverberates the precise motivation and premise behind my book, Unbought and Unbossed: Transgressive Black Women, Sexuality, and Representation. My book idea actually started during my very own matriculation as an undergraduate English major struck by and grappling with representations of black women in literature. These interests became the groundwork of my college senior honors thesis, doctoral dissertation, and now this first book—a reflection, of course, of the evolution and intellectual maturity of those formative ideas over the course of more than a decade of research, critical thinking, and writing.

In Unbought and Unbossed, I examine post-civil rights representations of black women in literary and cultural texts of the 1970s and 1980s, informed by and produced during consequential political movements: civil rights, feminism, black nationalism, gay liberation, and the sexual revolution. This is a particularly significant era precisely, in part, because of the ways in which black women’s texts of the era embody and embrace a shift in terms of representations. Unbought and Unbossed explores how these moments create a space, cultural and political, for “the transgressive:” representations of black women who transgress and challenge racial, gender, and sexual circumscriptions or mandates that impose particular roles and circumscriptions of female identity on black women. Ultimately, I argue for far greater complexity (and complex understandings) when it comes to black women, representation, and sexuality—especially in terms of what constitutes “woman” and “normativity.” But I also illuminate how certain behaviors/actions operate as strategies in these literary and cultural texts. Sexuality becomes representative of not simply intimacy but, more broadly, of a larger aspirational desire for more complex understandings, renderings, and notions of race, gender, and sexuality as it relates to black (female) bodies. These women exercise their rights to be full citizens, in the racial and sexual sense, reminding us not to falsely mark any, every, and all expressions of black sexuality as perverse, illicit, or pathological but, rather, to afford blacks the range both allowed their white counterparts and reflective of the human (sexual) condition.

Unbought and Unbossed explores various moments, literary and cultural, post-civil rights and contemporary—from Toni Morrison’s novel Sula and Nelly’s rap video Tip Drill and tons in between. It does so to illumine not only the racialization of sex and the ways race, gender, and sexuality intersect. But, it also enables us to better understand the black sexual revolution, representations in the age of First Lady Michelle Obama, and the complexities surrounding black sexuality. And so, just as I asked the students to consider what black sexuality might look like unencumbered by stereotypes and either/or binaries, so, too, does Unbought and Unbossed ask all of us to contemplate this notion, as well as transgress simplistic conclusions regarding black women and black sexuality. After all, it is the twenty-first century and time to allow blacks the full measure of their humanity, sexual and otherwise.

Trimiko Melancon is an Assistant Professor of English, African American Studies, and Women’s Studies at Loyola University New Orleans. Learn more about her work on her website www.trimikomelancon.com or connect with her on Facebook (Trimiko Melancon) or Twitter (@trimikomelancon).

So Yesterday

In this blog entry, Allan Johnson, author of The Gender Knot and The Forest and the Trees writes about how things have changed—or have not—since the last editions of his classic Temple University Press books.

Awhile back I received an email from a college teacher using one of my books, The Gender Knot, in her class. She mentioned a disagreement among her students about whether my account of male privilege still holds true. One of the students settled the argument by flipping to the front of the book where the copyright date is found and pointing out that, well, there it is, the thing is eight years old.

That was easy.

Gender Knot 3e_smApparently, there is a ‘believe until’ date on descriptions of reality, or at least ones we’d like to see go away. And social systems can change almost as fast as Apple puts out a new iPhone, except, unlike Apple, no one has to actually do anything to make it happen. I don’t know exactly how many years it takes for a book to lose its credibility, but for some readers it is shorter than the average length of time that people own a car.

Sometimes I hear from a student who wants me to know that however bad things may have been for my generation, things are different now. That was then and the new generation has left all that behind.

There is of course change, and there is good research showing that most of it happens between generations, but the idea that we can go from up-to-your-necks to past-all-that in the space of a few decades, not to mention years, is something else.

What might account for such sudden and dramatic change they do not say, as if it somehow explains itself. It’s not that I don’t get it. When I think back to being nineteen or so, I don’t think it occurred to me that my generation might have been a continuation of anything remotely connected to that of our parents. We didn’t have to do anything to be unlike them, to break from the past, to start all over, because something new is what we were in spite of all those years of going to school and reading books and watching tv and everything else that goes with being socialized to fit the world into which we are born.

And don’t adults give graduation speeches exhorting young people to go out and be the hope of the future by being different from them?

It speaks to the power of both individualism and wishful thinking that we can sustain what amounts to a myth of self-invention by which each generation starts out fresh and decides who they are without having to deal with any historical or emotional baggage that they didn’t pack themselves. If everything is all about my experience and I don’t experience the thing myself, then it must not be there. “I have never been discriminated against as a woman,” she says. “I don’t see color,” says he. “If I can do what I want then so can anyone else.”

The myth of self-invention is connected, in turn, to the idea that everyone is different from everyone else. I’ve never really known what that means, or, more precisely, why it matters so much. Why should we care that no one out there is an exact match for us when the thing that makes our lives possible is all the ways in which we are alike—presenting ourselves and behaving in ways that other people will understand and accept as familiar. So what if there are dead ringers for me somewhere in the world?

And if everyone is supposedly unique, then it follows that everyone must have their own opinions and perceptions. I suppose that’s true in the sense that everyone has their own underwear, but, again, what does that mean when those same opinions and perceptions (not to mention underwear) show up in millions of other people, there being only so many possibilities?

And yet, we persist in the idea that our experience and what we know are somehow both unique to us and independent of the world through which we come into being and exist. I think, therefore I am—not I belong, connect, relate, share, participate, or continue some form of what came before.

Which brings me back to expiration dates on reality and how easily unpleasant things get relegated to a ‘past’ where they no longer apply, as if we can give them up as we would a habit or a fashion. And if problems like race or gender or poverty persist, it must be because there are individuals who, for whatever reason, have decided to be different from the rest of ‘us.’

The thing is, though, that social systems, and systems of privilege in particular, do not continue from force of habit, inertia, or individual choice. They are more than a collection of self-conscious attitudes or beliefs or styles that come and go on their own or through individual self-improvement.

Systems continue because of powerful forces exerted across generations, including adaptations to new circumstances so as to preserve the underlying structure and effect while seeming to have changed. “Power does not yield except by demand,” wrote Frederick Douglass more than 100 years ago, and as far as I can tell, recent history records precious little of that.

Layout 1The illusion of change is on my mind because a new edition of The Gender Knot, along with another of my books, The Forest and the Trees, has just been published. I spent months digging into the latest data, reviewing what’s been published in books and journals. And has anything changed? Well, of course. We have a black president, for one, and same-sex marriage is gaining support, and words like ‘transgender’ have entered our vocabulary.

But the evidence is also overwhelming that the basic structures of male privilege and white privilege and class privilege and even heterosexual privilege remain solidly intact. The epidemic of rape everywhere from the military to college campuses, the almost complete lack of progress toward gender equity for more than 20 years, the devastation of people of color in the most recent economic collapse, racial segregation and discrimination in hiring and the criminal justice system, the dramatic surge of economic inequality, the almost complete dominance of state and national politics by corporations and the wealthy, the patriarchal capitalist juggernaut that continues its systematic destruction of the Earth . . . you get the idea.

This is not to say that we don’t have the potential to reinvent ourselves, both as individuals and as a society. After all, that is what my work, both public and private, is all about. But such invention comes only from our active engagement with the reality of what has been and how it continues into the present, however much it may shape-shift into forms that give the appearance of change. And however much we might wish it otherwise.

“The past,” wrote William Faulkner, “is never dead. It’s not even past.”

What we know about gender, race, and STEM – African American women

Sandra Hanson, author of Swimming Against the Tide explains that African American women are interested in Science, Technology, Engineering, and Math.

A recent publication (in Cultural Diversity and Ethnic Minority Psychology) by a group of psychologists found that race and gender intersect in understanding Science, Technology, Engineering and Math (STEM) attitudes and participation. The research team was headed by Laurie T. O’Brien and focused especially on African American women. The researchers and subsequent media reports on the findings (e.g. in Inside Higher Ed and The Chronicle of Higher Education) expressed surprise at the high interest and participation in STEM among African American women. Several decades ago I began doing research on African American women in STEM funded by the National Science Foundation (NSF). Although some researchers have not focused on the way that race/ethnicity and gender interact to affect STEM experiences we have known for some time that we can expect the unexpected when it comes to African American girls and women in STEM. Some have argued that because women do less well in STEM and minorities do less well in STEM, there will be a double disadvantage for African American women.

Layout 1The argument of double jeopardy sees race and gender as additive. My findings from a representative sample of young African American women (published in a number of journal articles and in my book, Swimming Against the Tide: African American Girls and Science Education) suggested otherwise. Quantitative data from my sample and larger NSF surveys as well as open-ended questions and responses to vignettes were critical in measuring the young women’s experiences. They loved science. The young African American women signed up for science classes, loved doing experiments, went to science camp, and had posters of scientists on their walls. One young woman said that “science was like opening up a present from your favorite aunt.” My findings provided considerable evidence for the African American family and community as key in understanding this love of science. African American families have always made considerable investment in and had high educational and occupational expectations for their daughters.

African American women have historically combined work and family roles. The answer to young African American women’s high level of interest and participation in STEM does not come from schools and teachers. In fact, the young women in my sample experienced considerable difficulty in the STEM classroom. One young girl reflected the opinion of many when she described the attitude of science teachers –“They looked at us like we weren’t supposed to be scientists.” The young women reported not being called on in the classroom and not being chosen as lab partners. Somehow, in spite of the chilly classroom climate, a disproportionate number of African American women manage to “swim against the tide” and persevere in STEM education and occupations.

Data from NSF show that African American women persist in many areas of STEM at a higher rate than do white women. My recent research on the male dominated area of engineering shows that even here African American women earn the largest share of doctorates relative to men (when looking within race/ethnic groups). In my testimony to the U.S Congress (Subcommittee on Girls in Science) I suggested that we need better teachers, science classrooms, and science textbooks. When young African American women look around them and see white teachers and white scientists in the science textbooks, they do not feel welcome. The considerable agency that African American women show in the context of a white, male STEM culture is encouraging. One can only imagine the increased number of talented African American women who would participate in STEM education and occupations in a more welcoming climate. The major science organization in the U.S. – the National Science Foundation – has recognized the problem and is funding a good number of programs to encourage minorities and minority women in STEM. After all, diversity in science makes for better science.

We’ve Got a Book on That!

This week in North Philly Notes, a rundown of recent news articles that relate to topics in Temple University Press books.

The Meaning of Emancipation Day in the Opinionator column of the August 4, 2014 issue of the New York Times

Korb writes about abolitionist writer and former slave Harriet Jacobs, who published Incidents in the Life of a Slave Girl.

Envisioning Emancipation_smJacobs was featured in Envisioning Emancipation: Black Americans and the End of Slavery by Deborah Willis and Barbara Krauthamer. The authors quote Jacobs about fleeing her North Carolina master in 1842, and making her way to Brooklyn:

“What a disgrace to a city calling itself free, that inhabitants, guiltless of offence, and seeking to perform their duties conscientiously, should be condemned to live in such incessant fear, and have nowhere to turn for protection. This state of things, of course, gave rise to many impromptu vigilance committees. Every colored person, and every friend of their persecuted race, kept their eyes wide open.”

Willis and Krauthamer write that activists like Jacobs, “portrayed themselves as intelligent, empowered, sensitive, and dignified women.”

Another New York Times piece, Bright Passages, Along the Northeast Corridor, published on July 24, celebrated the Philadelphia Mural Arts Program. The article showcased the five-mile stretch in Philadelphia that features, what the article described as  “Christo-esque installations of seven enormous works of art by the Berlin-based visual artist Katharina Grosse, entitled, ‘psychylustro'”

Phila Mural Arts 30_smJane Golden, Executive Director of the Philadelphia Mural Arts Program for 30 years, co-edited Philadelphia Mural Arts @ 30, with David Updike, an editor in the Philadelphia Museum of Art’s publishing department. Their book showcases the results of 21 projects completed since 2009 and features essays by policy makers, curators, scholars, and educators that offer valuable lessons for artists, activists, and communities to emulate. Philadelphia Mural Arts @ 30 traces the program’s history and evolution, acknowledging the challenges and rewards of growth and change while maintaining a core commitment to social, personal, and community transformation.

In other local news, Timothy Cwiek reported on SEPTA (Philadelphia’s transit agency) denying union workers same-sex marriage benefits in the Philadelphia Gay News on July 31.

Cwiek writes, “Due to an impasse with union representatives, SEPTA’s management only recognizes the same-sex marriages of its non-union workers for the purpose of workplace benefits.”

Out in the Union_smMiriam Frank’s recent publication, Out in the Union: A Labor History of Queer America, chronicles the evolution of labor politics with queer activism and identity formation, showing how unions began affirming the rights of lesbian, gay, bisexual, and transgender workers in the 1970s and 1980s.

Frank provides an inclusive history of the convergence of labor and LGBT interests. She carefully details how queer caucuses in local unions introduced domestic partner benefits and union-based AIDS education for health care workers-innovations that have been influential across the U.S. workforce. Out in the Union also examines organizing drives at queer workplaces, campaigns for marriage equality, and other gay civil rights issues to show the enduring power of LGBT workers.

 

 

 

 

 

 

 

 

 

Harvey Milk’s lasting influence in the labor history of queer America

In this blog entry, Miriam Frank, author of Out in the Union, explores Harvey Milk’s political vision of union involvement and LGBT progress.

article-stamp-0404Two months ago the United States Postal Service issued a new “Forever” postage stamp to honor Harvey Milk. I remember when Harvey Milk won his seat on San Francisco’s Board of Supervisors in 1977. He was California’s first openly gay elected official.

A year later Milk was still campaigning, but not for himself. A new amendment to California’s state constitution was on the ballot for the November election. If Proposition 6 passed, it would require local boards of education to fire school employees for public or private declarations of their queer identities, as well as any school worker, straight or gay, who affirmed or advocated gay existence.

In June 1978, Milk spoke out against the menace of Proposition 6 to hundreds of thousands of gay people at San Francisco’s Gay Freedom Day rally. He challenged supporters to defy the threat by making their gayness more open than ever. “Come out to your friends, if they indeed are your friends,” he said. “Come out to your neighbors, to your fellow workers, to the people who work where you eat and shop.”

Milk organized hard against the amendment. Throughout the summer, he was on TV for interviews, or for debates with state Senator John Briggs, Proposition 6’s author. Milk’s prominence and charisma kept the battle in the news, but central to the fight were California’s lesbian, gay, bisexual and transgender citizens: city dwellers, suburbanites, rural folks. Many so feared how the amendment would affect their lives that they did come out. Sons, daughters, friends and co-workers told the people in their lives the truth about what the amendment would mean for their futures. One by one they asked their families and neighbors to vote “no on 6.” And one by one, they broke through the secrecy and fear that had held them back from living open, authentic lives as equals in civil society.

The decision to come out had to be an individual one, but LGBT people who were fighting Proposition 6 were not alone. Harvey Milk was not only dedicated to the gay community of the Castro but had also supported the municipal workers’ unions and a successful Teamster-led boycott of Coors beer in the neighborhood’s gay bars. Unionists were familiar with Senator Briggs’ record of hostility to labor’s issues and opposed the amendment because it would undermine collective bargaining and legalize workplace discrimination. Three days after the Gay Freedom Day rally, the San Francisco’s Labor Council announced its unanimous opposition to Proposition 6.

Out in the Union_smUnion endorsements and donations enabled wide canvassing and publicity. By mid-summer, liberal religious groups and civil liberties organizations were also involved in the expanding grassroots campaign. Squads of queer activists knocked on doors in city and suburban neighborhoods and visited community meetings at union halls and country churches. In September, an endorsement of “No on 6” by former Governor Ronald Reagan, a right-wing rival of Senator Briggs, swung many more voters. Unions released the power of their political machine in late October with phone banks, a front- page editorial in the AFL-CIO newsletter and 2.3 million palm cards at the polls. On election day, Proposition 6 was rejected by 58 percent of California voters.

California’s successful defeat of Proposition 6 in 1978 was the first major political coalition to connect the fresh and angry power of gay liberation with labor’s long-haul commitment to fairness and equality. Many other great LGBT labor collaborations have flowed forth since then.

In my book, Out in the Union, I interviewed people who participated in those coalitions. My research began in 1995 and my search for stories continued for another several years. To explore the lives and achievements of primary activists, I conducted interviews in New York City, Boston, Detroit, Washington DC, Portland, Oregon, San Francisco, Seattle, Tacoma, Los Angeles, Salt Lake City and many places in between.

The lesbian, gay, bisexual and transgender union members who have told me their stories have been newspaper workers, nurses and health technicians, bus drivers, telephone installers, construction tradespeople, store clerks, hotel and restaurant employees, factory workers, social service workers and employees of AIDS clinics. Their queer lives have taken them through extraordinary adventures and long phases of everyday routine; and their everyday jobs are as various and their unions as diverse as the labor movement itself. Some have founded new union locals; others have negotiated innovative contracts; and still others have fought to save jobs when their plants were being closed. They are the people of Out in the Union.

Harvey Milk did not live to see the great changes that his activism started.  But  I like to think that he would have been proud of all that the labor and LGBT movements have accomplished.

 

Do you want an American nurse?

This week in North Philly Notes, an interview with  Catheters, Slurs, and Pickup Lines  author Lisa Ruchti  from Al-Jazeera America‘s July 3rd morning news program. [She appears at the 2:00 minute mark in the video link].

 

In addition, we repost Elijah Wolfson’s July 3 article from Al-Jazeera America‘s website that features Lisa Ruchti.

The doctor won’t see you now

Patients in American hospitals often get away with asking for caregivers based on race

Tonya Battle had been working as a nurse in the neonatal intensive care unit (NICU) of the Hurley Medical Center in Flint, Michigan, for 24 years. Her employment record was spotless — by all accounts she was one of the most knowledgeable and capable care providers on the NICU floor. Even so, it wasn’t so surprising when, in the fall of 2012, one infant’s father asked to speak to Battle’s supervisor: Health is extremely personal, and no matter how skilled a health care provider, there will be times when communication with a patient breaks down. It’s common for a patient to ask for another doctor or another nurse.

What was shocking, however, was the note posted on the department assignment clipboard the next day: “NO AFRICAN AMERICAN NURSE TO TAKE CARE OF BABY.”

Here’s how the incident unfolded, according to allegations made by Battle in a lawsuit that followed: After she had finished her shift the day before, the father had come to the charge nurse (Battle’s supervisor) demanding that no black nurses attend to his (very sick) infant girl. To punctuate his point, he rolled up his sleeve to show off a swastika tattoo. The charge nurse, Deborah Herholz, then called her boss, the nurse manager Mary Osika, to ask what she should do. Osika said to reassign the baby to another nurse.

A staff meeting followed, in which the NICU nurses were told that Hurley Medical Center had decided not to allow any African-American employees to take care of this particular baby. The note was posted on the assignment clipboard for everyone to see.

The next day, Osika called Battle at home to inform her that the father’s request would be granted. Later that day, Battle reported to work, where one of her co-workers showed her a photo of the offensive note (which had since been removed).

Battle would go on to sue Hurley Medical Center for employment discrimination, settling out of court for an undisclosed amount, and with Hurley agreeing to hire an “employee advocate” whose role would be to forestall similar misadventures in the future.

It’s unclear how common these types of experiences are; there have been no major studies on the issue, so advocates and policymakers have had to rely on anecdotal evidence, the few isolated stories that leak out of the hospital wing and into the press. But many believe Hurley represents the norm and not the exception — that discrimination of this kind is endemic to the health care system.

The ‘open secret’

“I think it happens a lot,” said Julie Gafkay, Battle’s attorney. “I have 20 plaintiffs in the last year who have been subjected to this type of discrimination.” According to Gafkay, after Battle’s case was made public, dozens of other health care workers (nurses, social workers, home health aides, etc.) reached out to her with similar complaints.

Some situations were even more outrageous than Battle’s. In one case, the plaintiff is a human resources employee who says she has direct knowledge that an African-American nurse was fired under false pretenses; the real reason for the firing, she alleges, is that a patient had made the request that no African-Americans care for him.

It’s an “open secret” that “patients routinely refuse or demand medical treatment based on the assigned physician’s racial identity, and hospitals typically yield to patients’ racial preferences,” wrote Kimani Paul-Emile, a professor of law and biomedical ethics at Fordham University, in a 2012 study published in the UCLA Law Review.

So why aren’t more people outraged? Racism in health care settings tends to be much more insidious than the type of racism that would, say, make it onto the nightly news. Patients aren’t screaming racial slurs in the ER or spray-painting derogatory signs on the sides of hospital buildings. They often won’t even say outright that they don’t want a black doctor.

“Patients know it’s not PC” to directly request a white doctor, said Paul-Emile. “They come up with different ways to do it. I talked to this one doctor who said there are these older ladies who will say, ‘You know, I want a Jewish doctor, I just think a Jewish doctor is better.’”

Lisa Ruchti, a professor of sociology at West Chester University and the author of the book “Catheters, Slurs, and Pick Up Lines,” agreed. “Patients who want to fire their nurses based on race say things like ‘I want an American nurse,’” she said.

And hospitals comply. Health care providers are trained to be so patient-focused that even when they feel a request is amiss, many ignore their qualms — whatever the patient wants, the patient gets. In another of Gafkay’s current cases, two plaintiffs allege that an elderly white woman was being treated in the rehabilitation facility of a nursing home when she began to express fears that an African-American man was coming into her bedroom at night to “touch” her. The facility decided that, for the good of the patient, no African-Americans — male or female — would be assigned to her care, and it issued a directive to its staff saying as much. One female African-American nurse was even questioned for coming into the patient’s room at night, and suspended during the questioning.

“[The organizations] are so patient-focused,” said Gafkay, “that they ignore the civil rights of their own employees.”

Not just nurses

At particular risk is the nurse-patient relationship, which Ruchti believes is regularly informed by racism. In providing what Ruchti called “professional intimate care,” nurses are already at risk of being seen more as hired help than as health care professionals. And racist beliefs can exacerbate that misconception. “There are lots of examples of nurses of color being mislabeled as housekeepers by patients even when they are obviously doing nurse work — symbolically demoting them, if you will.”

But it’s not just nurses. Dr. Meghan Lane-Fall treats cardiovascular patients in the surgical care unit at the Hospital of the University of Pennsylvania.

“All of the things that are taught in medicine about being a care provider are to really not think about yourself or your characteristics,” Lane-Fall said. “Your gender and ethnicity are, in theory, erased when you walk through the doors of the hospital.”

But in reality, as an African-American woman, Lane-Fall is often subjected to racially based judgments.

“I can be walking the hallway wearing a white coat,” she said, “and someone will think I’m the janitor, and I’ll think, ‘Is that because I’m black?’”

Lane-Fall recently wrote about an experience caring for a coma patient. On the third day during which the man was under her care, she happened to be in a room when the nurses were changing his gown. Spread across his chest was a tattoo: 3- to 4-inch-high lettering spelling out the words “White Power.”

At that moment, Lane-Fall recalled how she had felt nothing but coldness from the tattooed man’s family; until now, she had thought nothing of it. Now it seemed sinister.

She thought: “Oh, you’re not just this nameless, faceless person taking care of a patient; you’re a black woman who has all these other characteristics that affect the way patients see you.”

Race concordance

On the flip side, Ruchti said nurses of color she spoke with told her that patients of color sought them out on purpose. And in fact, research suggests that your health outcomes can improve if you and your physician have what’s called in the literature “race concordance.”

A Johns Hopkins study published in 2002, for example, found that, when given the choice, patients would choose doctors of their own race. And, when treated by same-race physicians, the patients reported higher satisfaction. The results cut across all races and ethnicities. The study, led by Thomas LaVeist, was one of the first of its kind.

But others soon followed. A 2005 study published in the Annals of Family Medicine found that many African-Americans and Latinos believed strongly that the health care system was racist — and that they preferred to have same-race doctors as a result.

And more recently, a 2010 study published in the Journal of the National Medical Association confirmed the previous findings: Black patients were more likely to feel that white doctors were giving them subpar care compared with black doctors and, therefore, preferred same-race health care providers.

Some will even argue that choosing a doctor of the same skin color is no different from choosing a doctor of the same gender. Many women don’t feel comfortable talking to a man about gynecological issues; is it that much of a stretch to imagine an African-American man feeling he can be more open and honest about his lifestyle and behavior with an African-American doctor?

All things being equal, if you offered me a black provider I’d probably choose that.

Dr. Meghan Lane-Fall

Preferences like these aren’t driven by ignorance. Lane-Fall got her undergraduate degree in molecular and cell biology from the University of California, Berkeley, her master’s in health policy from the University of Pennsylvania and her M.D. from Yale. She’s about as well educated as a human being could ever be. And yet, “all things being equal, if you offered me a black provider I’d probably choose that,” she said, adding that she’d assume someone from a similar background would know more about her.

Because of these complexities, the legal issues here are legion. The 1964 Civil Rights Act prohibits discrimination based on race, gender, national origin or religion in public accommodations and in any place that receives public funding. On the face of it, this would appear to mean that a patient could not make race-based requests for nurses and doctors. After all, pretty much every health care institution receives some federal funding, whether directly or in the form of public health insurance reimbursements.

But, as Paul-Emile argues, those provisions of the Civil Rights Act are actually meant to preclude institutions from “prohibiting individuals from enjoying the benefits that the institution provides” — and by accommodating a patient’s preference, “you are actually allowing that patient to enjoy the benefits” provided by a federally funded hospital.

And, in fact, that is what is happening in the real world. A 2010 study, for example, showed that patients across the board will often make race-based requests with regard to their health care provider — and that providers will often accede to these preferences. In that same study, Dr. Herbert Rakatansky, the former chair of the American Medical Association’s Council on Ethical and Judicial Affairs, is quoted as saying, “In a life-threatening situation, you would have to abide by a patient’s request.” In other words, there may be both a legal and an ethical imperative to accommodate racial preference in the hospital.

The positive preference

None of this, however, is meant to justify racism.

Paul-Emile has highlighted an important legal distinction between doctors, who can usually decide themselves whether to treat a given patient or not, and nurses and other health care support staff, who are assigned their charges. She argues that hospitals run afoul of the law when they reassign African-American nurses at a patient’s request, no matter the potential health benefits.

Gafkay, the attorney in Michigan, pointed out that all her cases involve an “organization validating the discriminatory request” — a much different situation, since it puts nurses in the precarious position of being unable to express themselves for fear of organization retribution.

Second, while it may be both legally and ethically acceptable for a patient of color to seek out a doctor of color, what about a white patient who seeks out a white doctor?

The legacy of years of racial discrimination has led to a disproportionately low number of African-American doctors. A 2009 Health System Change report, for example, found that the physician workforce was about 74 percent white and 4 percent black, while the U.S. population as a whole was 69 percent white and 12 percent black during the same year.

And one major study a few years back had patients go to doctors presenting with the exact same symptoms (which suggested cardiovascular disease), identical in every way except race and gender. Across the board, African-American women received substandard treatment and poor diagnoses.

Studies like this suggest that it’s entirely rational for an African-American patient to feel wary of the medical system. And that, Paul-Emile believes, is what should drive a physician’s decision whether or not to accommodate a racial preference.

In other words, though it may be difficult to discern a patient’s motivations, the goal of health care professionals should be to distinguish between a positive preference, in which patients are seeking better care, and discrimination, in which patients are just expressing racist beliefs.

And even then, Paul-Emile said, accommodating these positive preferences is far from ideal.

“I don’t think this is a solution,” she said. “I think it’s a stopgap measure until we get to the more fundamental issues that are driving this. The medical profession must instead increase diversity among providers to encourage tolerance and understanding of other cultures, and expand cultural awareness at all levels of practice and training to enable providers to interact more effectively with their diverse patient populations.”

Adia Harvey Wingfield, acknowledges receiving another award for No More Invisible Man

This week in North Philly Notes, Adia Harvey Wingfield, author of No More Invisible Man, offers her thoughts on winning the Distinguished Contribution to Scholarship Book Award from the American Sociological Association’s (ASA) section on Race, Gender and Class, 2014.

WingfieldFinal.inddI am so happy and proud to receive the Distinguished Contribution to Scholarship Book Award from the American Sociological Association’s (ASA) Race, Gender, and Class Section. This section of the ASA has long been at the forefront of focusing scholarly attention on how these fundamental issues of race, gender, and class are overlapping categories that mutually influence each other in different ways. It is a section that is replete with brilliant scholars doing cutting edge work, so it really means a lot to me to be honored in this way.

I particularly appreciate the recognition that black professional men’s work lives are significantly shaped by these issues of race, gender, and class in ways that render their experiences unique. As the title of this book indicates, for far too long these men have been ignored and overlooked by scholars and media alike. I am happy to be part of the effort to highlight how black professional men, too, live lives that are formed not just by race but also by their gender and class position, and am so pleased that the Race, Gender, and Class section saw fit to recognize these men as well.

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