First Do No Harm Part 1

Everyone has been saying that Black Americans will not take the vaccine because they distrust the system. So, for at least one blog a week, I will cover a story or two about the history of the medical atrocities that have affected Black Americans since the end of slavery. That is not to say that I believe, Black Americans will not take the vaccine. I think it’s too early to tell. This sentiment has been perpetuated almost daily since the announcement of the vaccine. Yet, the vaccine is not even widely available. Repetition of a thought, however, can become a reality if it convinces people that others are not taking the vaccine. But once again, it not widely available enough to know whether there is or is not a problem. 

The majority of the stories I will cover, on medical racism will be based on the research of Harriet A. Washingtion and her book, Medical Apartheid: The Dark History of Medical Experiementation on Black Americas from Colonial Times to the Present. Today’s blog will cover Eugenics and forced sterilization, but the book also covers radiation experiments, prisoner research, research on children, and other medical testing. The point is that everyone knows or has heard about Tuskegee, but there is so much more. However, for completion, Tuskegee will also be covered. 

The Tuskegee Experiments

The Tuskegee syphilis experiment, which is properly called the Public Health Service Study of Syphilis in Untreated Negro Males, is the most iconic symbol of abuse and racialized medical abuse in research. It ran between roughly 1932 and 1973.  In the late 1920s, Julius Rosenwald, who was the owner of Sears, Roebuck and Company, and Booker T. Washington decided to embark on a series of initiatives, in part to eradicate infectious diseases such as syphilis from Macon County, Alabama, where Tuskegee University is located. But, before much progress could be made, Rosenwald lost his money in the stock market crash. As a result, the Public Health Service took over, but with a very different focus. 

The Public Health Service wanted to study the progression of syphilis in black men. And they not only wanted to observe these men without treatment, but they were also hoping to validate their belief in a racial difference of the effects of  syphilis in blacks and whites. So what does that mean? The long held beliefs and tenets of scientific racism at the time held that black people were less intelligent with underdeveloped nervous systems, however, were very strong physically. The PHS physicians wanted to prove that syphilis did not attack the nervous systems of blacks because their nervous systems were so, “primitive.”

They accomplished this “experiment” by setting up clinics offering treatment, but of course not providing treatment. They watched these men suffer the ravages of late stage syphilis. They also waited for the men to die to autopsy their bodies to try to prove their theory. For 40 years, they watched the men, without a thought to their children, wives and loved ones, and waited for them to die. The “study” only ended because the nature of the experiments was leaked to the media. 


The idea of eugenics was developed by Francis Galton, an English scientist, who believed that scientists should control reproduction to encourage “healthy” children. There were two branches: positive and negative. Both promoted that people with “good” genes should be encouraged to procreate and those with “bad” genes should be stopped. They often used openly racist reasons, such as black and poor people have inferior genetic profiles compared to others. 

Margaret Sanger was the most famous American who popularized eugenics, but she was also a birth control pioneer. She wrote and spoke extensively on the topic of eugenics. She shaped American reproductive policy by stopping the “Comstock laws” against contraceptive distribution. Sanger, however, was subtle in her racism. In 1922, she wrote, The Pivot of Civilization, where she says “eugenics is chiefly valuable in its negative aspects . . .On its so called positive or constructive side, it fails to awaken any permanent interest.” She used many case histories in her book. One of which was of a dysgenic family case history she used to describe the eugenics problem in black families. She presented: “The parents of a feeble-minded girl, twenty years of age, who was committed to Kansas State Industrial Farm on a vagrancy charge, lived in a thickly populated Negro District which was reported by the police to be the headquarters for the criminal element of the surrounding State.”

Sanger went on to say the girl’s family died early and lead lives of hyper-fecundity (fecundity refers to the potential number of children that an average woman is able to give birth to), prostitution, violent crime, or all three. It was written in a way that, the readers should take this girl’s family as a representation of all black families in the Negro district. She later stopped using “good or bad breeding stock” and started using “class” and “income level” to choose whose birth rates should be curtailed. She began researching black births in 1932 and published her findings in the Birth Control Review, The Negro Number. She looked at birth patterns in Harlem where the majority of New York’s black population lived. She even recruited black leaders to contribute to her articles. W.E.B. Du Bois wrote and Sanger used often,” The mass of ignorant Negroes still breed carelessly and disastrously, so that the increase among Negroes, even more than the increase among whites, is from that portion of the population least intelligent and fit, and least able to rear their children properly.”  Charles S. Johnson, Fisk University’s first Black president wrote that eugenics discrimination was necessary for blacks. 

Sanger later in 1939 founded, The Negro Project,  which she stated was “established for the benefit of colored people.” This involved opening clinics in black neighborhoods to encourage birth control practices and reduce population growth. In the 1960s, Margaret Sanger helped to develop a birth-control pill. The US government actively encouraged black women to take the pill in order to prevent unwanted pregnancies and abortions. Many people in the Black community were suspicious of this because they believed that it was an act of genocide against them. However, many black women saw it as a way for them to have more freedom over their bodies. Thus, the pill and IUD methods used were quasi-voluntary and their effects were temporary. 

The most damaging threat, however, to Black reproductive freedom was surgical sterilization. When the infamous German eugenic sterilization initiation began in January 1934, seventeen U.S. states were already performing sterilizations routinely. At a rate of between two and four thousand Amercans sterilized that year. 

Forced sterilization started with the mentally ill. In the 1927, Buck v. Bell decision, Justice Oliver Wendell Holmes ordered the sterilization of an allegedly mentally ill poor white girl, Carrie Buck writing,” Three generations of imbeciles are enough.” In the 1930s and 1940s, compulsory sterilization was big business with 70,000 to 100,000 American women being sterilized, and a disproportionate number of them were Black women. By 1983, Black people made up 12% of the population but 43% of the women sterilized in federally funded family planning programs were Black. This was done by perpetuating the myth that the “welfare mother” was lazy and hyper-fertile. And saying “welfare mother” undoubtedly brings the image of an unemployed Black mother despite the fact that the majority of people on welfare were not black. And that is still true today

Forced sterilization and welfare were linked for half a century, but most sterilization of poor black women was done outside the law and without their consent. In June 1973, two sisters in Montgomery, Alabama exposed the abuse. Twelve year old Mary Alice Relf and her sister Minnie Lee, fourteen went with their mother to a Montgomery Community Action Agency for a federal funded contraceptive shot. Mom, who was illiterate denoted her consent to a shot with an “X.” It was until after the visit she learned her children were surgically sterilized (tubal ligation). The parents sought help from Atlanta’s Southern poverty law center and they filed a class-action lawsuit. The district court found an estimated 100,000 to 150,000 poor people were sterilized annually under federally-funded programs, half the women were black. Today, one-third of all adult Mississippi adult women and 57% of all Mississippi women 65 and older have undergone a hysterectomy. Physicians would coerce or trick women into unnecessary sterilization and some were done while they were unconscious. 

Fannie Lou Hamer, the famed civil rights leader,  was born in 1917 in Montgomery County, Mississippi. In 1961, she underwent surgery to remove what is believed to be a uterine tumor or fibroid, which she called a “knot in her stomach.” Without her permission she received a hysterectomy. The forced sterilization of Black women was so  commonplace it was called a “Mississippi appendectomy.” 

This however, was not just a southern problem. A 1973 study by Bernard Rosenfeld of Los Angeles County Hospital discovered that “doctors . . .are cavalierly subjecting women, most of them poor and black, to surgical sterilization without explaining either the potential hazards or alternate methods of birth control. In most of the major teaching hospitals of New York, it was the unwritten policy to do elective hysterectomies on poor Black and Puerto Rican women with minimal indications to train residents.”  In 1972, medical students at Boston City Hospital  (BCH) protested the policy of performing unnecessary hysterectomies on black women in order to allow residents to practice. Same thing happened at Columbia University. 

The reproductive freedom of many Black people, women especially was attacked with an aim of curtailing the growth of the Black population. Every means and method was used. This blog was just the tip of the iceberg when it comes to medical abuse. This is the beginning of a picture that shows why so many Black Americans are leery of doctors and the medical community. The unfortunate thing is that we still need the medical community, but history has fostered a distrust of an institution that can save your life. In a 2007, NPR interview, author Harriet Washington, mentioned at the beginning of this post stated:

We got the greatest health care system in the world in many aspects. And yet African-Americans have an understandable weariness, which is cheating us of years of life and health.