The Dark History of Medical Racism

Most people assume medicine is neutral. Science, after all, is supposed to be objective. But the history of Western medicine is tangled up with racial ideology in ways that had real consequences for millions of people, and some of those consequences are still being felt today.

This isn't a story of a few bad actors. It's a story of institutions, governments, and respected scientists who built a medical system that treated Black, Indigenous, and other minority patients as less than human, often literally.

The Tuskegee Experiment

The most cited example of medical racism in American history is the Tuskegee Syphilis Study, which ran from 1932 to 1972. The U.S. Public Health Service recruited 399 Black men in Alabama who had syphilis and 201 without the disease. The men were told they were receiving treatment for "bad blood," a local term used for various ailments.

They were not receiving treatment. Researchers were studying the natural progression of untreated syphilis in Black men, based on a prevailing (and entirely false) assumption that the disease behaved differently in Black bodies than in white ones.

When penicillin became the standard cure for syphilis in 1947, the men in the study were not given it. The study continued for another 25 years. By the time a whistleblower ended it in 1972, 28 men had died directly from syphilis, 100 more had died from related complications, 40 wives had been infected, and 19 children had been born with congenital syphilis.

The fallout from Tuskegee extended far beyond those 399 men. Research has shown that Black Americans' distrust of the medical system increased sharply after the story broke, and that distrust persists in measurable ways today, including lower rates of participation in clinical trials and delayed care-seeking for serious conditions.

J. Marion Sims and the Origins of Gynecology

J. Marion Sims is often called the father of modern gynecology. His statue stood in New York's Central Park until 2018. What most celebrations of his work leave out is how he built his techniques.

In the 1840s, Sims performed experimental surgeries on enslaved Black women in Alabama to develop a surgical repair for vesicovaginal fistulas, a painful and debilitating condition. He operated on the same women multiple times, sometimes dozens of times. He operated without anesthesia, which was available at the time. His justification, in line with widespread medical belief of the era, was that Black people felt less pain than white people.

This belief was not fringe. It was published in medical literature, taught in medical schools, and used to justify different standards of care for Black patients well into the 20th century. A 2016 study published in the journal PNAS found that a significant percentage of medical students and residents still held false beliefs about biological differences in pain tolerance between Black and white patients, and that these beliefs affected their treatment recommendations.

Forced Sterilization and Native American Women

Between 1970 and 1976, the Indian Health Service sterilized somewhere between 25,000 and 50,000 Native American women. Government records obtained through Freedom of Information Act requests confirmed that many of these sterilizations were performed without proper informed consent, sometimes on women who were in labor, sometimes on minors, and sometimes under the threat of losing welfare benefits.

This was not an isolated program. Puerto Rican women were sterilized in large numbers as part of a deliberate population control policy backed by the U.S. government starting in the 1930s. By the 1960s, roughly one-third of Puerto Rican women of childbearing age had been sterilized, many without fully understanding that the procedure was permanent.

California sterilized more people under its eugenics law than any other state, a program that disproportionately targeted Latino, Black, and immigrant populations. More on the eugenics connection below, but the point here is that forced sterilization was systematic, it was medical, and it was targeted.

Medical Experimentation on Black Prisoners

Tuskegee gets the headlines, but it was not the only instance of non-consensual medical experimentation on Black Americans. Dr. Albert Kligman, a dermatologist at the University of Pennsylvania, conducted experiments on prisoners at Holmesburg Prison in Philadelphia from the 1950s through the 1970s. His subjects were overwhelmingly Black.

The experiments included testing dioxin (a toxic component of Agent Orange) on prisoners' skin, exposing them to radioactive isotopes, testing psychoactive drugs for the CIA, and applying experimental cosmetic compounds. Many prisoners were never told what was being done to them or what the substances were. Kligman later became famous for developing Retin-A, a widely used skin treatment. He received awards and honors throughout his career.

The Blood Bank Problem

During World War II, the American Red Cross segregated blood supplies by race, maintaining separate banks for "white blood" and "Black blood." This policy was supported by the U.S. military and persisted despite the fact that it was medically meaningless. Blood type determines compatibility, not race.

The cruel irony is that the system for collecting and storing blood plasma that made large-scale blood banking possible was developed largely by Dr. Charles Drew, a Black physician. Drew understood better than anyone that there was no scientific basis for separating blood by race. He was reportedly asked to resign as director of the Red Cross blood bank program partly over his objections to the segregation policy.

How These Ideas Were Built Into Medical Theory

Medical racism wasn't just individual bias. It was systematized through theory. Samuel Cartwright, a physician in antebellum Louisiana, invented a diagnosis called "drapetomania," which he described as a mental illness that caused enslaved people to flee captivity. He proposed that the cure was "whipping the devil out of them."

This is extreme, but it illustrates the function of racial medical theory: to use the authority of science to justify existing power arrangements. The idea that Black bodies were biologically different, that they could tolerate more pain, that they were more suited to physical labor, that their mental suffering was less significant, all of these claims appeared in respected medical publications.

Samuel Morton, a Philadelphia physician, spent decades collecting human skulls and measuring their cranial capacity in an attempt to prove a racial hierarchy of intelligence. His work was celebrated during his lifetime. Later analysis showed that his measurements were distorted to match his conclusions.

The Henrietta Lacks Case

In 1951, a Black woman named Henrietta Lacks went to Johns Hopkins Hospital with cervical cancer. Cells were taken from her tumor without her knowledge or consent. Those cells, now called HeLa cells, turned out to be remarkably durable in laboratory conditions. They became one of the most important tools in modern biomedical research, used in developing the polio vaccine, cancer research, HIV research, and thousands of other studies.

Henrietta Lacks died that year. Her family had no idea her cells were being used until more than 20 years later. They received no compensation. The cell line made enormous amounts of money for researchers and pharmaceutical companies. Her descendants still struggle to access healthcare.

The Lacks case became a landmark in bioethics debates about consent and tissue ownership. But it also reflects something specific about race: the assumption that Black bodies could be used without permission, that they were resources rather than persons.

The Long Tail

The effects of medical racism don't stop when the practices stop. Research shows that Black Americans have higher rates of maternal mortality, heart disease, and certain cancers than white Americans, and that these gaps are not explained by genetics. They are explained by stress, by reduced access to quality care, by implicit bias in diagnosis and treatment, and by the accumulated distrust that comes from a history like this one.

A 2020 study found that Black patients were significantly less likely to be prescribed adequate pain medication than white patients presenting with the same conditions. The false belief in differential pain tolerance, documented in medical literature for centuries, apparently never fully left.

Understanding this history doesn't mean every doctor is racist or that medicine is irredeemably broken. It means that institutions carry the weight of what they were built to do, and that correcting course requires knowing what the course has been.

The names in this story, Henrietta Lacks, the men of Tuskegee, the women at Holmesburg, the Native American women sterilized in Indian Health Service clinics, were not statistics. They were people who went to receive care and were treated as something else. That matters, and forgetting it has a cost.