On Race, Medicine, and Reproduction: An Interview with Dorothy Roberts

dorothy_roberts copyDorothy Roberts is a scholar, professor, author and social justice advocate, and currently the 14th Penn Integrates Knowledge Professor at the University of Pennsylvania Law School. She has published a range of groundbreaking articles and books analyzing issues of law, race, gender, health and social inequality, including Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (1997), Shattered Bonds: The Color of Child Welfare (2002) and, most recently Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century (2012). When she visited Brown University to discuss her latest work on race and health inequities, Bluestockings Magazine had the privilege of interviewing Prof. Roberts beforehand.

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Sophia Seawell: To begin with, I was hoping that for those of us who aren’t able to come to your lecture if you could tell us what you’ll be speaking about and how it fits into what you’ve been working on lately.

Dorothy Roberts: I’m going to be talking about what I’m calling race medicine, which is the practice of treating diseases according to race both by using the notion that people of different races have different diseases and also that they experience common diseases differently. I argue that you can trace that practice in the United States from slavery, where the idea that Africans have different diseases was used to justify enslaving them, and also explained resistance to enslavement as a form of mental illness.

Race medicine has been used to treat social inequality as if it’s natural, and that’s a way to justify repression and to steer attention away from the need for social change. And so I show how those concepts and strategies that came out of slavery continue in contemporary medicine today, and how they’ve in fact been exacerbated by a new resurgence of the concept of biological races in genomic science, biomedical research, and medical practice.

So it’s a little bit of history, but I’m mostly looking at the way that treating disease as race-based and using that as a way to explain social inequality, especially racial inequality, has travelled across the centuries. We can’t believe that today, because we live in a liberal democracy and doctors say that they’re not racially biased, that we shouldn’t worry about it anymore.

SS: The first thing that comes to mind when you talk about race-based disease is high blood pressure in African Americans.

DR: I’ll use that example in my talk. I point out that it’s commonly thought among doctors and biomedical researchers that hypertension is higher in African Americans because of some innate difference—today it’s explained as a genetic difference—but actually these ideas originated before there was even knowledge of genetics, only now they’re cloaked in genetic terms.

I’ll mention a study conducted by a researcher named Richard Cooper who looked at a number of global studies, did a meta-analysis and discovered that in fact across theses studies people of African descent have a lower rate of hypertension than white people. It’s just in the United States that Blacks have a higher rates than whites; Nigerians have a lower rate than the average of people of European descent around the world. That’s pretty strong evidence, and there’s lots of other evidence as well that to the extent that African Americans have higher rates of blood pressure in the U.S., it’s nothing innate. There have been all sorts of biological theories—the salt hypothesis claimed that the Middle Passage weeded out certain genes and so those who survived it had a gene pool that predisposed them to hypertension. It doesn’t make sense! Because first of all, Jamaicans, whose ancestors also crossed the Atlantic, have a lower rate of hypertension than whites in the U.S.

SS: But we just won’t mention that!

DR: And I’ll talk about some other new fangled and ridiculous genetic explanations.

SS: I was also wondering, on a different note, about your experience in academia as a woman of color—specifically, since you do so much writing on race, medicine and science, if your work has ever been criticized because it’s “not objective” because it discusses race, or that you’re trying to “read race” into things.

DR: I’ve certainly gotten that response—pretty frequently in audiences when I talk about my most recent book, Fatal Invention, and especially if I’m talking to a group of physicians or people who are doing biomedical research. With genetic counselors I’ve also gotten a very defensive response. People feel you’re accusing them personally of racism and they want to defend their use of race in their practice and in their research. I’ve found that there’s this desire to hold on to biological racial concepts that is very disturbing to me. There’s a lot of resistance out there.

I’ve also spoken to very receptive audiences, and audiences that weren’t aware of this resurgence of concepts of biological concepts of race in science—what I call a new racial science—and many are very grateful to hear this information; they’re alarmed, but happy to hear about it.

Others believe that race is a political category if not a biological category, and that includes many scientists who understand that. So I’ve also been welcomed by some for my book, but there still is this resistance I’ve met and often the argument is “well, you just don’t understand the science.” But the thing is I’ve read many of these articles that claim to show that there are race-based genetic differences or that racial differences in health can be explained genetically and there’s so many flaws in them. Just simple flaws, like not defining what the scientist means by race.

SS: It’s just understood to be a natural category.

DR: They just use the term! They don’t explain how they decided who among their research subjects gets grouped in which race. Most of them use self-identification or come up with some made-up, invented way of determination… there are just so many flaws. They often control for just one socioeconomic variable and if they continue to see that race has an effect they leap to the conclusion that it must be genetic—which is also bad research, bad science. But the basic flaw is that they’re using a social category as if it was a biological category or a genetic category, and it isn’t. So the very basis of their hypothesis that genes cause health inequities, for example, is flawed. And then the methods of flawed on top of that.

SS: So I realize that you wrote Killing the Black Body in 1997, but the fact that reproductive rights, as they’re often called, is a mainstream issue but race is still often not a very explicit part of that conversation makes me want to ask you about race and reproductive justice—because I find that the arguments and history put forth in your book are still extremely relevant to the discourses that are circulating today. To start with, black women are the fastest growing prison population and I was wondering if you could speak to any reproductive justice concern in that context.

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DR: Oh, there are a lot of ways in which incarceration of black women violates their reproductive rights and is a barrier to true reproductive justice. One is just that when you’re incarcerated, you have very little control over your reproductive life. So for incarcerated women who want to have a baby, it’s hard to get pregnant in any truly voluntary way. That’s not to say that some women don’t become pregnant, but that is often because they’ve been assaulted by guards. If a woman becomes pregnant and wants to have an abortion, the reproductive health services are limited in prisons. And in addition, there’s evidence now in California prisons that women are being coercively sterilized. So the whole gamut of reproductive decisionmaking is very limited if not violated within prisons. And then there’s the continued practice of shackling pregnant women when they have babies in prison or in hospitals that they’re taken to from prison, which I think is a form of torture.

Another way in which prison intersects with reproductive justice—or injustice—is the termination of parental rights of incarcerated women. Most women who are incarcerated are mothers, and before they went to prison they were the primary caretakers of their children.

So those children are at risk of being put in foster care. It’s very difficult when you’re behind bars to keep in touch with your children and to fulfill the requirements that child protection agencies impose on women to be reunited with their children. In some states once a woman is incarcerated, if she’s going to be in prison for more than a year or so, she’s at risk of having her parental rights permanently terminated. And I call that an infringement of reproductive justice because part of reproductive justice is being able to have a relationship with your children.

SS: Which I think is something that gets lost in the way that people tend to frame it on larger and more mainstream platforms, as if reproductive justice only pertains to the right not to have children, but for black women historically that has not been the crux of their experience. And so reframing that way is extremely important and I’d like to see that happen more often: as motherhood, too.

DR: Right, if you only focus on the right to abortion, which is important and essential to reproductive justice, it leaves out the value that many women place on having children and having a relationship with their children. It also leaves out the form of state repression that uses reproductive regulation as a punishment of women for having children, which has been especially inflicted on black women. That was one of the focuses of Killing the Black Body—the way in which the devaluation of Black women’s childbearing, keeping Black women from having children and punishing them for having children has been part of racial and gender injustice in the United States for centuries.

SS: Another framing of reproductive justice I’ve been hearing about links it to environmental issues—what are your thoughts on that intersection?

DR: I haven’t really spent a lot of time investigating that, but I’ve read about it and engaged with people who are environmental justice advocates and there’s a couple aspects of that connection that come to mind. One is the way in which environmental toxins affect women’s reproductive health, and black women and other women of color, Native American women especially, are more vulnerable to exposure to environmental toxins because of toxins where they work, at low wage jobs, and also they tend to live in neighborhoods that are more likely to be near environmental hazards.

The other is the way in which a perverted view of the environment and protecting the environment promotes population control. So there is an aspect of environmental rights—a sort of mainstream, male-dominated, white-dominated view of environmental rights—that the Earth is in danger because of overpopulation. Historically, a mainstream concern with overpopulation has targeted the most marginalized people for population control to reduce their numbers: poor people, people of color, people with disabilities. There’s the view that it is protecting the environment to reduce those groups of people.

SS: And it’s often framed in a way that makes it seem like it’s not targeting specific groups. The other day I read something that said “I think that all men should be sterilized and then at a certain age if they can show financial and mental stability, it can be reversed” and I thought, ‘well, money!’

DR: And lack of disability.

SS: And poverty is, of course, racialized in a subtle way that allows these ideologies to be expressed in ways that might sound like they have nothing to do with race or disability, but they very much have to do with those things.

DR: And we can look at the eugenics era to see that there is a historic connection made between reducing populations and social inequality. Because people in power never target themselves. And this is a way—and this goes back to what I was saying about race medicine—of pointing to natural causes, in this case the overfertility of certain groups that are victims of social inequality, and blaming them for that social inequality; saying that the reason why they’re poor, they’re disadvantaged, they’re in poor health—whatever negative outcome of being at the bottom of a social ladder—is their fault and because of their risky behavior, which is often attributed to some innate problem that they have. This idea that social inequality has innate causes, including the overreproduction of certain groups, is a very powerful way of trying to justify an unjust power arrangement and to ignore the role of social hierarchies and the brutal way they’re implemented.

SS: Given the history of the construction of black women’s hyper-fertility and overproduction, something that I had to really do some mental work to think through was a billboard erected in SoHo, New York City by a group called Life Always that said “the most dangerous place for a black child is in the womb.” What do you make of this and the way that race is being mobilized by certain so-called pro-life groups?

DR: Well, I think that it’s wrong and harmful on a number of levels. And I think it operates very much the same way as these other programs and strategies I’ve been talking about, which is to blame black women for their reproductive decisions and attribute some harm to the community—in this case the Black community—to the bad decisions that Black women are making. They’re just a target, a scapegoat, for what is seen as a harm to Black society. And it also assumes, like eugenics, that people can be manipulated to achieve social ends. It treats black women as if they don’t have any right to make decisions for themselves, or that they’re not capable of doing so.

And of course, this is a way to promote an anti-abortion agenda. It’s really for the objective of promoting a pro-life or anti-abortion/anti-choice political agenda and they’re using Black women as just a convenient, inflammatory and powerful way to try to make an argument against the right to abortion.

For me, the most disturbing thing about those signs is when you say that the most dangerous place for an African American child is his mother’s womb, you’re really just restating a eugenicist proclamation: that there’s certain people whose very wombs are dangerous, and therefore they shouldn’t be having children. The conclusion to that isn’t that Black women shouldn’t be having abortions, it’s that they shouldn’t be having children at all—because the womb is dangerous! You could’ve seen that statement made in the 1920s or 1930s about people who were targeted for coercive sterilization, that their wombs were dangerous. It’s just, I think, an awful campaign at every level.

SS: And it’s such an interesting contradiction, as you just pointed out, because it’s a so-called pro-life campaign that is essentially framing Black women as bad mothers. So we don’t want you to have abortions, but we think you’re bad mothers. And in terms of saying the womb is the most dangerous place, it erases the very real dangers that Black people—especially men, but also women, in different ways—face in our society, while also erasing the history of institutions forcing or coercing Black women not to have children. It does so much work.

DR: It’s a very cynical twist of a history of regulating Black women’s decisions and devaluing their childbearing. It’s meant to conjure up eugenics and population control. They also use the word ‘genocide,’ as in abortion is the genocide of Black people, which conjures up this idea of the government trying to kill of black people. But now, instead of the government, it’s Black women themselves who are doing it. So they’re using a history of devaluation of Black women’s childbearing to target the very victims of that history.

SS: My last question for you, while recognizing the reasons for which some people do not identify with the term ‘feminist,’ is whether you see your work as part of a feminist project.

DR: Oh, definitely. I do consider myself a feminist. I believe that for one thing women have been subject to gender oppression and I believe that there is a system of patriarchy that harms people to uphold certain power arrangements between men and women. I also—just as importantly—believe that that system of patriarchy has always in the United States operated completely entangled with racism and so I don’t subscribe to a feminism that posits some universal woman who is oppressed by some universal man. I do think that gender affects power relationships in conjunction with class and ableism and racism and other forms of hierarchy and political inequality. I think it’s hard to hold every single system of oppression as your mind as you’re examining a problem but I do try in my work to look for how different systems of oppression are operating together. And also, just as importantly, how resisting those may require or does require recognition and understanding the way in which systems of power intersect. People of different movements that may be focusing on one or the other can collaborate and form coalitions to address these intersecting forms of hierarchy and subordination.

Interview with Dorothy Parker, conducted by Sophia Seawell, Co-Editor-in-Chief

All Images via Google Images

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