The Intersection of Slavery and Gynecology

Dear Asian Youth,


It was early morning in Central Park, New York, when the statue of James Marion Sims was hauled away in the back of the park department’s truck. Just months before, Black female activists from the organization Black Youth Project 100 were donned in hospital gowns, standing before his figure. During their demonstration, they splashed red liquid on themselves, emblematic of the blood shed under “the father of gynecology” during the nineteenth century.


Under slavery, Black people were seen as property. In 1807, Congress banned the importation of enslaved people, and as a result, enslaved women became even more important to plantation owners. Consequently, fertility was increasingly seen as an asset, capable of growing the labor force and bringing in more revenue. With the new legislation, a symbiotic relationship began between slave owners and gynecologists, the doctors who treat female ailments. Prior to this, physicians frequently accompanied plantation owners during auctions to ensure enslaved people were in peak condition. This relationship soon evolved, specializing in women’s health for slave owners who wanted the enslaved women to procreate successfully. Essentially, physicians exploited Black bodies to gain recognition within the medical community. These aspects of nineteenth century America furthered the gross dehumanization of Black women which is epitomized through the career of the “father of gynecology”—James Marion Sims.


Multiple works of medical literature during this time claimed Black women to be more pain-tolerant than white women. However, these sentiments were simply a way to justify the use of enslaved women as experimental subjects. For Sims, such long-held beliefs would lead him to conduct countless painful experiments on enslaved Black women without anesthesia. Physicians tested new protocols and forcibly explored Black bodies in the name of collective wellbeing for White women. One of Sims' set of experiments was focused on vesicovaginal fistula, a childbirth complication where the vagina is connected to another organ such as the bladder, resulting in chronic leakage of urine or stool. This uncomfortable condition can lead to many complications such as sepsis, organ damage, and even death—a danger to a slave owner’s coveted labor force. Consequently, Sims made it his focus to seek a surgery to reverse the effects of vesicovaginal fistula. However, no effort to rid young women of their pain could justify the additional pain and trauma he would subject them to within what he called “sick houses.” After making arrangements with slave owners to treat the enslaved women for free, Sims took them into sick houses set up in the backyard and began countless procedures on them.


Of the sixteen women Sims held captive, only three women are identified: Anarcha, Betsy, and Lucy. Anarcha was a seventeen-year-old enslaved girl with vesicovaginal fistula and Sims’ first experimental patient. Every day, he and his team of gynecologists and medical professionals routinely experimented on the women, seeing what procedures were fruitful and what weren’t—all without their consent and all without anesthesia, even after its use in surgery was established in 1846. After two years of futile experiments, the White medical apprentices who had initially assisted Sims stopped working at the sick houses. In lieu of their support, Sims demanded the other slave women assist him in the procedures. He taught those women how to use a scalpel to cut into each other’s uterus. Bound to beds and pinned down by other enslaved women, they received no rest from their procedures: Sims would experiment with C-sections and lacerate their vagina, while other women would be out working in his field. This rotational shift allowed him to maximally capitalize on the suffering of these Black women. It was after thirty procedures performed on Anarcha that Sims was able to successfully repair her fistula: it took thirty procedures done without anesthesia within five years for Anarcha’s suffering to finally end. Unfortunately, there were thirteen other enslaved women who Sims also experimented on, but their identities are lost to history. Soon after this successful procedure on Anarcha, the women returned to their former plantations to continue birthing more children for the slave owners. Years later, Sims would move to New York, where he’d established the Woman's Hospital of the State of New York. Because of the surgical procedure he created, as well as the speculum, an instrument he invented to examine the vagina and cervix, Sims ascended among elite medical men and was crowned the “ father of gynecology”.


Sims, like countless other physicians at the time, subscribed to racist ideologies hidden under the facade of science. Yet such notions resurface today. Just four years ago, “a provocative report… noted that medical students and residents at a leading institution held… deeply mistaken beliefs [that the] skin of Black patients being thicker than skin of white patients [resulted in] African Americans having lower sensitivity to pain” (Wailoo, Historical Aspects of Race and Medicine). Understanding the perspectives of Anarcha, Lucy, and Betsy allows us to see how racism can subtly and blatantly entangle itself within an objective field such as medicine, and even why within a socioeconomic stratification, the quality of medical service can diminish drastically. Physicians working in communities of color, especially those with Black people, may inadvertently invalidate their patients’ pain, believing pain tolerance differs by race, not by individuals. This and similar beliefs perpetuate the medical disparities our nation faces today.


Some Americans argue that Sims’ innovations should be highlighted, rather than the means by which he achieved them. After all, his innovations gave way to other life-saving gynecological advancements. However, to blatantly disregard the suffering he imposed on enslaved Black women is to ignore the comprehensive history of gynecology and the Black women— like Anarcha— who unknowingly advanced it. As such, it is not in spite of, but because of Sims’ significance to gynecology that makes it especially pertinent to remember women like Anarcha, Lucy, and Betsy.


For a long time, the history of America has been glorified and sugar-coated to cover up the unjust actions and events that have occurred within a nation seemingly founded on freedom. But by bringing to light dark histories that have been long hidden, we can begin identifying and combating the remnants of racism that continue to pervade in medicine today.


- Angela Huynh