Every International Women’s Day, we champion the progress of women. But as a therapist, I am reminded daily that “progress” is not felt equally. When we look at reproductive health – specifically conditions like fibroids and endometriosis – we see a landscape where Black women are not just underserved, but systemically neglected.
For Black women, reproductive health is not just a medical issue; it is an intersectional crisis of physical pain, racial trauma, and mental health erosion.
The Disproportionate Burden: More Than Just “Bad Luck”
The statistics are stark and demand our attention. Black women are three times more likely to develop uterine fibroids than white women. They tend to develop them at a younger age, experience more severe and debilitating symptoms, and are significantly more likely to be offered invasive surgeries like hysterectomies as a first or only option.
While endometriosis is often misdiagnosed as “pelvic inflammatory disease” in Black patients due to racial stereotyping, the reality is that the path to a correct diagnosis for a Black woman is often a marathon of being ignored.
The “Weathering” of Black Minds and Bodies
In the therapeutic space, we talk about “Weathering.” This concept, introduced by Dr. Arline Geronimus, describes how the cumulative impact of systemic racism and social adversity causes Black women’s bodies to age prematurely at a cellular level.
When a Black woman walks into a clinic with chronic reproductive pain, she isn’t just carrying the weight of her symptoms; she is carrying the physiological toll of a “high-effort coping” life. This chronic stress – a high allostatic load – makes the physical pain of fibroids or endometriosis more intense and the mental recovery more difficult.
The Anatomy of Medical Gaslighting: Misogyny Meets Racism
As a therapist, I see the “clinical scarring” left behind by medical interactions. For Black women, medical misogyny is weaponized by anti-Black bias.
- The Myth of the “Strong Black Woman”: Doctors often buy into the dangerous stereotype that Black women have a higher pain tolerance or are “naturally” resilient. This leads to the systematic under-treatment of pain and the dismissal of clear cries for help.
- The Legacy of Disposability: From the non-consensual experiments of J. Marion Sims to modern-day disparities in maternal mortality, there is a historical trauma that tells Black women their bodies are for labor or “practice,” not for care.
- The Mental Health Spiral: When you are told your pain isn’t real, or that it’s “just a part of being a woman,” it triggers a specific type of psychological distress. It fosters hyper-vigilance (anxiety) and a profound sense of institutional betrayal (depression).
The Psychological Cost of “Choosing” the Least Bad Option
Many Black women are offered few treatment options besides a hysterectomy – often decades before they are ready to lose their fertility. The mental health impact of being forced into “medical menopause” or losing reproductive autonomy in your 20s or 30s is catastrophic. It involves a unique form of grief – grieving the body you thought you had and the future you were told you could choose.
A Call for Reproductive Justice
This International Women’s Day, we must move beyond “awareness” and toward Reproductive Justice. This means:
- Validating the Intersectional Experience: As therapists and providers, we must acknowledge that a Black woman’s depression is often a rational response to a system that refuses to see her pain.
- Dismantling the “Resilience” Trap: We must stop asking Black women to be “strong” and start demanding they be heard.
- Culturally Competent Care: We need a healthcare model that understands “Weathering” and treats the patient with the radical empathy required to bridge the trust gap.
Your body is not a battlefield, and your pain is not a personal failure. You deserve more than “survival.” You deserve to be believed, to be cared for, and to be whole.