“Don’t worry, it is common in Black women.”
This is the response I received when I was recently diagnosed with focal cemento-osseous dysplasia (FCOD), a benign condition that occurs when bone tissue in the posterior, tooth-bearing areas of the jaw is replaced by fibrous tissue. The oral pathologist assured me that there was nothing that needed to be done. She advised that we continue to monitor the lesion yearly to limit any future need for dental implants. Like the scholar that I am, I immediately turned to PubMed and Google Scholar. The results were scarce. However, two things caught my attention: (1) FCOD is most commonly found in middle-aged African-American women, and (2) although the cause of FCOD is unknown, it is likely a result of a hormone imbalance. I was relieved that the lesion was not cancerous, but my FCOD diagnosis still felt like a symptom of a silent, malignant condition: the weathering of a Black woman in philosophy, a Black woman in academia.
This fact struck me during my lecture on the utility of race in medicine and genetics. I was sharing Dorothy Roberts’ warning against medical stereotyping and race-based diagnoses and wondered if I, too, had been a victim. Healthcare professionals are taught to consider a patient’s race, given that certain diseases are disproportionately distributed along racial lines. The danger is in further assuming that race is biologically significant or that the disparity is caused by race-based biological differences. Even with a socially constructed conception of race, it is dangerous to assume the patient’s race is a “good enough” explanation. We can ask what role, if any, race plays in the causal chain of a particular condition. More specifically, we can also ask how an “‘it is common in Black women” diagnosis can potentially mask instances of systematic violence that are embodied by Black women such that our oppressive treatment can appear, in the words of Patricia Hill Collins, to be a “natural, normal, and inevitable part of everyday life.”
I was provided no further information as to why I, a woman in her twenties, suddenly developed FCOD. What were my risk factors? How would I know if the condition had worsened? Prior to my FCOD diagnosis, I experienced a kind of subtle bullying and chipping away at my integrity that I later learned is commonplace in academia. I was asked to prioritize service projects that addressed the lack of racial representation at my institution; I was explicitly told that I needed to prove that I was worth the investment. My work and work ethic were repeatedly questioned.
While navigating my own scrutiny as a Black woman in bioethics and philosophy, I saw newly appointed Harvard President Claudine Gay being publicly accused of plagiarism. I read about the suicide of Antoinette (Bonnie) Candia-Bailey, Lincoln University’s Vice President of Student Affairs, who alleged that the university’s president neglected her mental health concerns. I learned that a fellow young Black woman in philosophy, whose work I always admired, decided to step away from the profession. I didn’t have the heart to ask why, seeing as I was contemplating a self-preserving exodus from academia myself.
My first “it is common in Black women” diagnosis came during graduate school at the tail end of 2020. The pain started with microinvalidations, subtle reminders that I did not quite fit in the armchair profession. Classmates would say to me that my bubbly personality was the source of my success. Back pain. A mentor questioned my decision to pursue a PhD in philosophy, informing me that I would be of a better service to the world if I pursued an MD instead. (She asked if I was aware that Black women were greatly underrepresented in healthcare.) Back pain. And then George Floyd was killed. Excruciating. I did not have time to process my own feelings before my inbox was flooded with requests to share my perspective and advice on addressing anti-black racism on campus. One email even came from a math professor who wanted just a moment of my time to ask my perspective on the campus environment and also to share his insight, given his fifteen-year residence in the math department. I had not taken a math class since high school.
When the back pain finally landed me in the emergency room, a physician seemed shocked and annoyed by my ignorance of the source of my suffering. I had developed a fibroid, the size of a golf ball, in my uterus. Uterine fibroids are often benign growths and are three times more likely to be diagnosed in Black women compared to white women. Moreover, Black women are also more likely to develop fibroids early and have more severe symptoms. Nearly 25% of Black women between the ages of 18 and 30 will have fibroids compared to 8% of white women within that same age group. It is not clearly understood why fibroids disproportionately affect Black women, but risk factors that have been identified include a family history of fibroids, obesity, stress, low vitamin D levels—and hormonal imbalance.
An “it is common in Black women” diagnosis communicates and reproduces a non-knowledge, or what Matthias Gross defines as a knowledge about what is not known. It acknowledges that further research is needed while simultaneously discouraging the production of knowledge that would be more suitable in unmasking and addressing the disparate health outcomes that Black women face.
Hormonal imbalance is not innate to Black women. The reasons why Black women are disproportionately affected by hormonal imbalance are many, but each can be traced back to the fact that Black women are a gendered, racialized group and have been subjected to systematic violence as a result. Beauty products aimed at conforming Black women to Eurocentric beauty standards—i.e, relaxers, hot oil treatment, anti-frizz products, and leave-in conditioner—contain high levels of parabens and phthalates, chemicals that are known to disrupt our natural hormone production. Researchers have also noted that Black women’s health begins to deteriorate, or weather, in early adulthood and at a faster rate, and this is likely caused by repeated exposure to race-based fear and stressors that cause heightened levels of the hormone cortisol and epinephrine. Elevated cortisol levels can disrupt the normal production and function of other hormones, including estrogen, testosterone, and progesterone. Nearly 50% of Black women by age 45 had high levels of cortisol and epinephrine, and by age 64, more than 80% of Black women did.
Initially, the “weathering hypothesis” assumed that a shared, cumulative socioeconomic disadvantage was the source of the rapid deterioration observed in Black women. However, Black women are likely to face high levels of cortisol and epinephrine independent of socioeconomic status. The assumption is that upward social mobility and its accompanying education and economic resources afford health protections. Yet, researchers have found that, as socioeconomic status and educational levels increased, Black people experienced increased levels of racial discrimination and depression, causing a decline in health returns instead. With regards to Black women who work in higher education, one study found that many experienced polycystic ovary syndrome (PCOS) and other reproductive issues.
In 2013, there was a total of 55 Black women in philosophy in the United States, 31 of whom held tenured or tenure-tracked positions. In 2021, it was estimated that Black women only made up 4% of full-time faculty in the United States. While there are efforts to increase racial and gender representation in philosophy and in academia more broadly, these efforts alone will not address the covert and overt acts of violence against Black women that can be internalized and transformed into actual bodily disturbances or injuries. Of course, I cannot say definitively that chronic racial trauma led to my diagnoses, nor can I say how prominent of an issue this is for Black women in philosophy. However, as long as we continue to normalize the biological effects of being racialized as “common” or dismiss widespread hormonal imbalance in Black women as “just” stress, we may never know.
The Women in Philosophy series publishes posts on those excluded in the history of philosophy on the basis of gender injustice, issues of gender injustice in the field of philosophy, and issues of gender injustice in the wider world that philosophy can be useful in addressing. If you are interested in writing for the series, please contact the Series Editor Alida Liberman or the Associate Editor Elisabeth Paquette.
Jada Wiggleton- Little
Jada Wiggleton-Little is an Assistant Professor of Philosophy at The Ohio State University. She primarily works on issues of pain communication that lie at the intersection of philosophy of mind, social epistemology, bioethics, and race.
