Across gynecology, primary care, and reproductive health, many Black women in the United States describe navigating the medical system as a harrowing nightmare, marked by dismissal, mistreatment, and a constant need for self-advocacy to ensure their survival and well-being.
The Personal Toll of Medical Dismissal
Christina Brown, a 30-year-old content creator based in New York City, experienced this firsthand when she discovered a lump in her breast at age 18. Despite a family history of breast cancer and her clear explanations, doctors repeatedly told her they could not feel anything, forcing her to physically guide their hands to the spot. It took four appointments over several months before a biopsy was scheduled, fundamentally altering her approach to healthcare.
Brown learned that knowing her body intimately is crucial, and she now actively seeks out Black doctors, believing they are more likely to listen from the outset. A 2023 survey supports this, showing that Black patients report more positive experiences with Black healthcare providers. Brown reflects, "To be a Black woman in America is to have an adverse experience at the doctor’s office, and with her health. It’s one where you are constantly feeling dismissed, misunderstood, gaslit, downplayed and straight up lied to."
Systemic Issues in Maternal and Reproductive Health
The challenges extend deeply into pregnancy and childbirth. Serena Williams famously nearly died after giving birth when doctors ignored her concerns about blood clots, highlighting a broader crisis. The recent death of Dr Janell Green Smith, a Black certified nurse-midwife from complications after childbirth, has reignited public discourse on these disparities.
In reproductive health, Christine Thomas, a 33-year-old strategy consultant in Washington DC, faced trauma during a pap smear in 2018 when her gynecologist made derogatory comments and used improper techniques, causing pain and bleeding. This led her to skip her next annual screening, illustrating how negative experiences can deter essential care.
The Role of Racial Concordance in Healthcare
Research indicates that patient-provider racial concordance can improve outcomes, such as lower emergency department use and reduced mortality rates for Black infants. Dr Kristamarie Collman, a primary care physician in Houston, notes that when patients feel heard, visits are more efficient and adherence to care improves. Dr Chiamaka Ilonzo-Ukwu, an obstetrician-gynecologist in Tampa, adds that trust issues often lead Black patients to hesitate in voicing symptoms, worsening health outcomes.
Brown describes appointments with non-Black doctors as performances: "I feel like I have to be my own doctor. I come in like a lawyer trying to make a case for my health." However, she cautions that racial concordance is not a cure-all, as bias can exist even among Black providers, but the difference in comfort and understanding is palpable.
Recent Encounters and Ongoing Struggles
Recently, Brown faced similar dismissal in an emergency room for respiratory issues, where doctors dismissed her concerns until a Black doctor acknowledged how race might relate to her condition. This highlights gaps in medical education, which often centers white patients, leaving Black women's symptoms, especially in autoimmune diseases, poorly recognized.
Ilonzo-Ukwu explains that Black physicians' lived experiences can make them more attuned to these patterns, enabling earlier intervention. Yet, access to Black doctors is limited, and the burden of navigating bias should not fall on patients. Collman emphasizes, "Black patients shouldn’t have to become hyper-vigilant and medical experts when being seen by a doctor."
Moving Towards Systemic Change
Ilonzo-Ukwu stresses that race-concordant care is additive, not exclusive, pointing to broader systemic failures in trust and communication. Healthcare systems must prioritize listening as a clinical skill and address implicit biases in training to improve outcomes for all patients, particularly Black women who endure these nightmares daily.
