āD.N.Aā- Blackness and Health/Medical Antiblackness
āYou know what DNA stands for? Dead N*gger Association.ā
āEnsconced 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. āItās 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!āā¦ 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 obviousā¦ Black Americans did not need me or anyone else to inculcate a fear of medicine. Medical history and practices had long since done so.ā - 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.
āNot painful enough to justify the risk [of better care]ā
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, didnāt 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. Weāre human enough to be experimented on, but not human enough to be treated! Letās talk about some reasons why that is.
āAbleism 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 āfixedā in one form or the other.ā
Now, letās consider this: if the Black body was never intended to be seen as human, as less thanā¦ 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 āphysically inhumanā, 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 āfeel less painā (and therefore can bear more) means that you donāt have to feel as bad because I ācan take it and need the guidanceā. It validates the conditions and the treatment of the enslaved, from overwork to forced starvation to cruel and unusual punishment. Slavery might be āoverā, but that mindset didnāt vanish from the world. To this day, ideas of Black āstrengthā persist.
How can I trust that Iām getting the right amount of medicine to treat me when they historically treat amounts on white bodies? If they think that Iām drug-seeking and not actually suffering because the amount of medication Iām receiving is in response to how much itās believed Iām 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 āif youāre scared, find a Black woman.ā Why? Why would it be any easier for me to handle what youāre 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 donāt deal with things because Iām inherently stronger, I deal with them because I donāt have a choice! I help because Iām a decent person, not because I feel like itās mandatory!
Innate? Or Socioeconomics?
Socioeconomic: ārelating to, or involving a combination of social and economic factorsā
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 āallowedā 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 donāt feel safe going outside) where am I supposed to exercise?
We are more likely put in spaces that arenāt 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. Thereās 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 āBlackā diseases, as well as the ability to treat them, often come with the presence of disparities. I donāt have worse asthma because Iām 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 thatās 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 ādonāt make senseā). You would think that people would go āoh! Sheās like me!ā
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 (Iāll 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 itās going to be treated differently. Everything Iāve discussed up to this point in all my lessons is gonna apply. I hate to say this, but society doesnāt care if youāre Black and autistic (or have any other mental or developmental health issues) because itās already judging you for your Blackness.
My Uncle (ripšš¾) was visibly autistic, from the stimming to the echolalia to the hyperfixation on country music, all the rest of his patterns, and people that didnāt know him still saw him as a 6ā2 large fat scary threatening Black man. Hell, they barely consider women with autism, and they CERTAINLY donāt consider Black women and girls with autism. Iāve known a few of us, and we usually get the āmean uppity bitchā 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 youāre trying to express yourself with clear, assertive language, they just think youāre being aggressive and hurting their feelings (which is what they expect from Black women).
Very often when Iām on Tumblr, I wonder if Iām not autistic because when I see the behavior of white autisticsā¦ I donāt understand or relate to theā¦ helplessness, the infantilization that I feel Iām seeing. But Iāve had to realize, that we are forced to mask ābetterā, 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, butā¦ What is that going to do for me? Why would I give the doctors more āvalidā reason to ignore me and my concerns?
Point is, we donāt ālookā autistic, and thatās why it doesnāt get treated the same, because what does it look like, then? š 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 itās important to recognize that a lot of us donāt get diagnosed, because of aforementioned reasons.
An excellent example of how to treat an autistic Black character is RJ Cylerās Billy Cranston from Power Rangers. Now, I loved this movie, I was sick that it didnāt 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 heās 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 heās different and doesnāt always understand as fast as they do. Now, heās 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 familyās autism from seeing Billy on screen, it mattered to see him AT ALL.
āHealth and the Black Fatā
There are two books I want to put yāall on for this conversation. One is Fearing The Black Body: The Racial Origins of Fatphobia by Sabrina Strings. Hereās an interview with her here. The other, which Iāve read recently, is Belly of the Beast by DaāShaun L Harrison. I really enjoyed Belly of the Beast- itās 109 pages, very concise, and ties together things that are often treated as separate entities. DaāShaun is fat, Black, and nonbinary trans identifying.
I donāt have the space to quote as much as Iād love, but this book puts everything Iāve been discussing in further context. Chapter 2- Pretty Ugly- The Politics of Desire- discusses the manifestation of the Mammy in ālittle fast girlsā. Chapter 4- Black, Fat, and Policed- explains how larger size manifests in fear of the Black male body.
But thereās a particular section I want to quote here from Chapter 2-
āAs 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 childrenās 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.ā
I want to clarify, I am not saying that fatness is a ābadā thing. What I am saying is that medically itās 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 peopleās (Womenās, in particular) are more often āfatā, then you make the connection that āwell youāre more likely to be unhealthyā. It doesnāt matter that perhaps my weight is natural, perhaps I DO work out and take good care of myself! If I get sick, itās because Iām fat, and Iām fat because Iām Black. Donāt 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 canāt even barely find clothes, and then they want you to put on a show too?! Itās a maelstrom of social pressures, that your existence is seen as the antithesis of.
āBlack people donāt need therapyā
The history of using psychology against Black people is long and fraught.
You donāt have anxiety, youāre just high maintenance and extra. You donāt have depression, youāre just not praying for your blessings.
You donāt 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 didnāt have PTSD. She changed her mind a week later, but as Iāve gotten older and more cemented in believing myself, Iāve been likeā¦ 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 arenāt having mania or psychotic breakdown, you just āplay too damn muchā (Lil Nas X)
You arenāt exhausted from all that comes with being enslaved and decided to run away, you just have ādrapetomaniaā.
You arenāt joyous at not being enslaved, you have ādysaesthesia aethiopicaā (both of which could be ātreatedā with 'washed open wounds, oiled bodies, beating with a leather strap and working in the sun' (Pg 34, Belly of the Beast))
You arenāt protesting your lack of human rights, you have āprotest psychosisā.
You donāt have issues understanding what youāve done wrong, youāre ādisobedientā (Elijah McClain).
You donāt have ADHD, you have āOppositional Defiant Disorderā
Thereās a clip from The Crown, where a man named Michael Fagan manages to sneak into Queen Elizabethās 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 āTheyāve diagnosed me with schizophrenia. But Iām not schizophrenic, Iām just poor.ā And it was likeā¦ yeah, actually! Like yeah, I have depression, but itās not (just) my brain, itāsā¦ all of this! How can someone adequately address my mental health issues if they cannot recognize that what Iām going through is affected by the society I live in? That itās 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 isnāt 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, becauseā¦ what do you expect me to say, really? The disability itself is likely no different than you with yours! Itās not like being Black makes it āBlack autismā, āBlack BPDā. Itās not some completely different disability- itās 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 āBlack ethnicityā š Letās 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 donāt get āBlack people diseasesā, we get diseases while Black. I know Iāve said this numerous times, but if it were so easy to understand, we wouldnāt still have this problem!
Letās instead reframe our Black character design as āhow will this character navigate the world with this disability, while Blackā. āHow will the world around this Black character treat them, while they have this disabilityā. You have control of the universe you write- if you want to say that everyoneās not racist and no one would treat this character differently, fine. But recognize what that will look like! Because you likely havenāt 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 weāre 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 donāt deserve to have it, just like our pain, under-considered. Otherwise, leave it. Because itās the thought that counts, but itās the action that delivers!
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