Invisible Black Women: Medical Bias and the Silencing of Enslaved Black Women in 18th- and 19th-Century British West Indian Medical Discourse.

Abstract

This article examines the historical roots of medical neglect experienced by Black women, focusing on the 18th- and 19th-century British West Indies. During this period, White male physicians constructed racialized and gendered frameworks of disease that excluded enslaved Black women from diagnosis, care, and medical legitimacy. Positioned not as patients but as reproducers and laborers, their suffering was either pathologized or dismissed. Drawing on medical treatises and plantation manuals, this article argues that enslaved Black women were relegated to a space of medical liminality: recognized as reproductive laborers but denied clinical legitimacy or voice. It advances three key arguments. First, it explores how physicians framed Black women as morally deficient and biologically inferior, blaming their behavior for illness. Second, it shows how reproductive outcomes like miscarriage and abortion were weaponized to portray Black women as lacking maternal instinct. Third, it examines how female-only diagnoses, such as Chlorosis, excluded Black enslaved women, even when they presented similar symptoms. Instead, they were assigned stigmatized conditions, like "dirt-eating," reinforcing assumptions of biological difference and unworthiness of care. By tracing this history, the article reveals the foundations of contemporary racial disparities in women's healthcare. It concludes by linking these colonial ideologies to current maternal health outcomes, where Black women in the United States still face disproportionate rates of medical dismissal and death. This legacy underscores the urgent need to confront the historical frameworks that continue to shape how Black women are treated in medicine today.